Review of 3D Printing of Polyaryletherketone/Apatite Composites for Lattice Structures for Orthopedic Implants

Abstract

Neck and lower back pain, often caused by spinal disorders such as scoliosis and degenerative disc disease, affects over 80% of the global population, with an estimated from 250,000 to 500,000 spinal cord injuries occurring annually according to the WHO. As the demand for spinal procedures continues to rise, advancements in implant materials have become essential. Orthopedic implants play a vital role in restoring mobility and improving the quality of life of patients with musculoskeletal disorders. Metallic implants, such as stainless steel, titanium, and its alloys, are commonly used to make fixation devices for spinal fusion surgery due to their excellent mechanical properties. However, complications such as stress shielding have been recorded. Polymeric materials offer new prospects as an alternative to metal-based materials such as those based on Polyaryletherketone (PEAK). Among the advanced materials used in these implants, PAEK has emerged as the preferred choice due to its exceptional mechanical strength, thermal stability, and chemical resistance. Polyetheretherketone (PEEK) and Polyetherketoneketone (PEKK) offer notable advantages, such as radiolucency and mechanical properties resembling those of natural bone, reducing stress shielding and facilitating postoperative imaging. Although PEEK and PEKK are considered as bioinert, it has been demonstrated that adding bioactive agents such as hydroxyapatite (HA) into the matrix to make composites solves this problem and can help with aiding direct bone apposition. Furthermore, PAEK’s compatibility with 3DP enables the creation of patient-specific implants with intricate geometries, enhancing the surgical outcomes. In addition, the lattice structures of orthopedic implants can alleviate stress shielding, provide an enhanced surface area for the release of bioactive agents (or antimicrobial materials), and eliminate more imaging artifacts compared to that of simple, solid metal implants. PAEK/HA composite implants represent a transformative solution, addressing the psychological, social, and economic burdens of spinal disorders, while enhancing the surgical outcomes. With continuous technological evolution, PAEK/HA composites are poised to play a pivotal role in modern spinal care.