Rapid construction of polyetheretherketone (PEEK) biological implants incorporated with brushite (CaHPO4·2H2O) and antibiotics for anti-infection and enhanced osseointegration

Xue, Zhiqiang; Wang, Zhenzhen; Sun, An’an; Huang, Jiyue; Wu, Wen; Chen, Min; Hao, Xiaoli; Huang, Zhengjun; Lin, Xinhua; Weng, Shaohuang

doi:10.1016/j.msec.2020.110782

Cited by 52 publications

(53 citation statements)

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“…Brushite (dicalcium phosphate dehydrate; DCPD; CaHPO 4 .2H 2 O) is one of the best known CaPs (Alkhraisat et al , 2011; Alshaaer et al , 2011). Brushite is formed by chemical reactions in slightly acidic solutions (Xue et al , 2020). This mineral is stable in weakly acidic environments (pH 4.0–6.0) and at low temperatures (<80°C) (Kim et al , 2015; Xue et al , 2020).…”

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confidence: 99%

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Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system

et al. 2020

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Brushite (CaHPO4.2H2O) is an important calcium phosphate encountered in bone tissue engineering and bone cement formulation. There are many studies on the synthesis and characterization of brushite, but full-scale substitution and replacement of Ca by Sr in brushite as a key element in medical and environmental applications has not yet been explored systematically. Therefore, this study aims to evaluate the effects of substitution of Ca by Sr on the microstructural and thermal properties of brushite, including the chemical phases present, crystallization, structural water and phase stability. The chemical phases were determined by means of powder X-ray diffraction. The thermal properties were studied by thermogravimetric analysis. Crystallization and surface morphology were analysed using scanning electron microscopy. Various properties were dependent on the incorporated Sr ions. The replacement percentage of Sr may be divided into two major stages: the first from 0% to 50%; and the second from 50% up to 100%. The (Ca x Sr1–x)HPO4.nH2O shows that micro-scale crystals of platy brushite formed in the first stage of Sr replacement, from 0% up to 50%. As Sr might inhibit the formation of crystals, crystal nucleation rates were reduced as the Sr percentage increased. An amorphous product formed as a result of 50% Sr replacement. The second stage of Sr replacement with Sr contents >50% yielded a new crystal morphology corresponding mainly to SrHPO4.nH2O. The complete replacement of Ca by Sr transforms the brushite with platy microcrystals into SrHPO4 nanosheets.

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confidence: 99%

“…Brushite is formed by chemical reactions in slightly acidic solutions (Xue et al , 2020). This mineral is stable in weakly acidic environments (pH 4.0–6.0) and at low temperatures (<80°C) (Kim et al , 2015; Xue et al , 2020). Therefore, it is usually metastable at neutral conditions ( i.e.…”

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confidence: 99%

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system

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“…Several strategies (e.g., surface modification with physical, chemical and biological ways) have been applied to increase the surface bioactivity of PAEK (e.g., PEEK) to facilitate new bone regeneration and osteointegration, such as plasma treatment, NaOH-etched/boron-doped nanohydroxyapatite coating or a bone morphogenetic protein-2 immobilized collagen coating on PEEK [ [9] , [10] , [11] ]. However, these surface modification strategies may not be sufficient to produce biomedical implants with excellent osteogenic bioactivity and stability for clinical applications [ 12 , 13 ]. Furthermore, peri-implantitis caused by pathogenic bacteria invasion is the most common complication leading to implantation failure [ 14 ].…”

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A microporous surface containing Si3N4/Ta microparticles of PEKK exhibits both antibacterial and osteogenic activity for inducing cellular response and improving osseointegration

Mei

Wang

et al. 2021

Bioactive Materials

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As an implantable biomaterial, polyetherketoneketone (PEKK) exhibits good mechanical strength but it is biologically inert while tantalum (Ta) possesses outstanding osteogenic bioactivity but has a high density and elastic modulus. Also, silicon nitride (SN) has osteogenic and antibacterial activity. In this study, a microporous surface containing both SN and Ta microparticles on PEKK (STP) exhibiting excellent osteogenic and antibacterial activity was created by sulfonation. Compared with sulfonated PEKK (SPK) without microparticles, the surface properties (roughness, surface energy, hydrophilicity and protein adsorption) of STP significantly increased due to the SN and Ta particles presence on the microporous surface. In addition, STP also exhibited outstanding antibacterial activity, which inhibited bacterial growth in vitro and prevented bacterial infection in vivo because of the presence of SN particles. Moreover, the microporous surface of STP containing both SN and Ta particles remarkably induced response (e.g., proliferation and differentiation) of rat bone mesenchymal stem (rBMS) cells in vitro . Furthermore, STP significantly improved new bone regeneration and osseointegration in vivo . Regarding the induction of cellular response in vitro and improvement of osseointegration in vivo , the microporous surface containing Ta was better than the surface with SN particles. In conclusion, STP with optimized surface properties activated cellular responses in vitro , enhanced osseointegration and prevented infection in vivo . Therefore, STP possessed the dual biofunctions of excellent osteogenic and antibacterial activity, showing great potential as a bone substitute.

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“…Porous PEEK can induce macrophages to the anti-inflammatory M2 phenotype (Liu et al., 2019 ; Wei et al., 2019 ), and this immunomodulation facilitates the osteogenic differentiation for the enhancement of bone healing (Bai et al., 2020 ; Gao et al., 2020 ). Moreover, bacterial infections can cause the serious consequences of implant loosening and even detachment (Busscher et al., 2012 ; Campoccia et al., 2013 ; Braem et al., 2014 ; Yan et al., 2018 ; Xue et al., 2020 ). Therefore, aside from immunomodulation, the PEEK implant also needs improved antibacterial ability to combat potential infection and reduce the risk of implant loosening especially in surgical areas trapped by bacterial infections.…”

Section: Introductionmentioning

confidence: 99%

Facile surface functional polyetheretherketone with antibacterial and immunoregulatory activities for enhanced regeneration toward bacterium-infected bone destruction

et al. 2021

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Existing biologically inert or unmodified implants to treat infectious bone defects or osteomyelitis still cannot effectively solve bacterial infection and osseointegration. In this work, a simple co-deposition strategy was developed to modify porous polyetheretherketone (PEEK) with improved antibacterial activity and controllable immunoregulatory ability. After PEEK was treated by H 2 SO 4 to obtain porous PEEK (SPEEK), the self-polymerization of dopamine was operated on SPEEK in the solution of dopamine and gentamicin sulfate (GS) to prepare polydopamine (pDA) and GS layer-modified SPEEK (labeled as SPEEK–pDA–GS). The morphology, surface property, and molecular structure of SPEEK–pDA–GS were investigated. Besides the antibacterial property of SPEEK–pDA–GS ascribed to the successful immobilization of GS, SPEEK–pDA–GS exhibited promoted osseointegration through the results of mineralization, alkaline phosphatase (ALP) levels and osteogenic gene expression. Furthermore, the evaluation of the cell proliferation suggested that SPEEK–pDA–GS possessed the biocompatibility and the immunoregulatory ability that induced macrophages to anti-inflammatory M2 phenotype. Using rat as model, in vivo results containing X-ray, μ-CT, immunohistochemistry, and pathological analysis showed the excellent healing effect of SPEEK–pDA–GS on bone defect with infection with biological safety. This work illustrates a new insight into the simple and effective modification of PEEK and other implants with antibacterial, immunoregulatory, and osseointegration abilities for clinical requirement.

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Rapid construction of polyetheretherketone (PEEK) biological implants incorporated with brushite (CaHPO4·2H2O) and antibiotics for anti-infection and enhanced osseointegration

Cited by 52 publications

References 60 publications

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system

A microporous surface containing Si3N4/Ta microparticles of PEKK exhibits both antibacterial and osteogenic activity for inducing cellular response and improving osseointegration

Facile surface functional polyetheretherketone with antibacterial and immunoregulatory activities for enhanced regeneration toward bacterium-infected bone destruction

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Rapid construction of polyetheretherketone (PEEK) biological implants incorporated with brushite (CaHPO4·2H2O) and antibiotics for anti-infection and enhanced osseointegration

Cited by 52 publications

References 60 publications

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (CaxSr1–x)HPO4.nH2O system

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (CaxSr1–x)HPO4.nH2O system

A microporous surface containing Si3N4/Ta microparticles of PEKK exhibits both antibacterial and osteogenic activity for inducing cellular response and improving osseointegration

Facile surface functional polyetheretherketone with antibacterial and immunoregulatory activities for enhanced regeneration toward bacterium-infected bone destruction

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Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system

Effects of the full-scale substitution of strontium for calcium on the microstructure of brushite: (Ca_xSr_1–x)HPO₄.nH₂O system