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Fine grained osseointegrative coating improves biocompatibility of PEEK in heterotopic sheep model

Caroline M.F. Meers, DVM, PhD,1 Gino B.M. Verleye, PhD,2 Dirk Smeets, PhD,3 Hadewych Y.R. Van Hauwermeiren, DVM, MLAS,1 Dirk Loeckx, PhD,3 Karel Willems, MD,4 Vincent G.M.G.G.B. Siau, MSc,5 Philippe J.M.E. Lauweryns, MD, PhD6

1Medanex Clinic, Diest, Belgium, 2Social Sciences Department, Ghent University, Ghent, Belgium, 3IcoMetrix, Leuven, Belgium, 4Department of Orthopaedic Surgery, AZ Delta, Roeselare, Belgium, 5Orthobion GmbH Konstanz, Germany, 6Department of Morphology, Hasselt University, Diepenbeek, Belgium


Background and aim

Polyetheretherketone (PEEK) materials already have been used successfully in orthopedic and especially spine surgery. PEEK is radiolucent and comparable with bone regarding elasticity. However, PEEK is inert and the adhesion of PEEK implants to bone tissue proceeds slowly because of their relatively low biocompatibility. The aim of the study is to evaluate the effect of titanium and CaP coating on the adhesion of bone tissue.

Material and Methods

Six adult sheep (body weight 57.6 ± 3.9 kg) were included in this study. Three different types of cylindrical dowels (12 mm length x 8 mm diameter) were implanted in long bones (tibia and femur): PEEK dowels without coating (the control group), and PEEK dowels with a nanocoating of calcium phosphate (CaP group) or titanium (titanium group). Animals were sacrificed after 6, 12 and 26 weeks. Dowels were explanted for micro CT and histology.


Bone implant contact (BIC) ratio was significantly higher in the titanium versus control groups in the 6 to 12 weeks period (p = 0.03). The ratio between bone volume and tissue volume (BV/TV) was significantly higher in titanium versus control in the 6 to 12 weeks period (p = 0.02). A significant correlation between BIC and BV/TV was seen (r = 0.85, p < 0.05).


Coating of PEEK dowels with a nanocoating of titanium has beneficial effects on adhesion of bone tissue.

titanium, Bone ingrowth, Polyetheretherketone, spinal surgery, Nanotopography, In vivo test
Volume 9 Article 35 - Biomechanics Special Issue