title: Plasma-sprayed titanium coating to polyetheretherketone improves the bone-implant interface.
abstract: BACKGROUND
  Rapid and stable fixation at the bone-implant interface would be regarded as one of the primary goals to achieve clinical efficacy, regardless of the surgical site. Although mechanical and physical properties of polyetheretherketone (PEEK) provide advantages for implant devices, the hydrophobic nature and the lack of direct bone contact remains a limitation.
  
  
  OBJECTIVE
  To examine the effects of a plasma-sprayed titanium coated PEEK on the mechanical and histologic properties at the bone-implant interface.
  
  
  METHODS
  A preclinical laboratory study.
  
  
  METHODS
  Polyetheretherketone and plasma-sprayed titanium coated PEEK implants (Ti-bond; Spinal Elements, Carlsbad, CA, USA) were placed in a line-to-line manner in cortical bone and in a press-fit manner in cancellous bone of adult sheep using an established ovine model. Shear strength was assessed in the cortical sites at 4 and 12 weeks, whereas histology was performed in cortical and cancellous sites at both time points.
  
  
  RESULTS
  The titanium coating dramatically improved the shear strength at the bone-implant interface at 4 weeks and continued to improve with time compared with PEEK. Direct bone ongrowth in cancellous and cortical sites can be achieved using a plasma-sprayed titanium coating on PEEK.
  
  
  CONCLUSIONS
  Direct bone to implant bonding can be achieved on PEEK in spite of its hydrophobic nature using a plasma-sprayed titanium coating. The plasma-sprayed titanium coating improved mechanical properties in the cortical sites and the histology in cortical and cancellous sites.
authors.affiliation: Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, The University of New South Wales, Prince of Wales Hospital, Level 1 Clinical Science Building, Avoca Street, Randwick, Sydney, Australia, 2031. Electronic address: W.Walsh@unsw.edu.au.
authors.forename: William R
authors.initials: WR
authors.lastname: Walsh
authors.affiliation: Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, The University of New South Wales, Prince of Wales Hospital, Level 1 Clinical Science Building, Avoca Street, Randwick, Sydney, Australia, 2031.
authors.forename: Nicky
authors.initials: N
authors.lastname: Bertollo
authors.affiliation: Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, The University of New South Wales, Prince of Wales Hospital, Level 1 Clinical Science Building, Avoca Street, Randwick, Sydney, Australia, 2031.
authors.forename: Chrisopher
authors.initials: C
authors.lastname: Christou
authors.affiliation: Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, The University of New South Wales, Prince of Wales Hospital, Level 1 Clinical Science Building, Avoca Street, Randwick, Sydney, Australia, 2031.
authors.forename: Dominik
authors.initials: D
authors.lastname: Schaffner
authors.affiliation: Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, The University of New South Wales, Prince of Wales Hospital, Level 1 Clinical Science Building, Avoca Street, Randwick, Sydney, Australia, 2031.
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Mobbs
mesh_terms: D000818:Animals; D001577:Benzophenones; D001842:Bone and Bones / Q000187:drug effects; D020099:Coated Materials, Biocompatible / Q000009:adverse effects / Q000737:chemistry*; D016268:Internal Fixators / Q000009:adverse effects*; D007595:Joint Prosthesis / Q000009:adverse effects*; D007659:Ketones / Q000009:adverse effects / Q000737:chemistry; D008297:Male; D058626:Plasma Gases / Q000737:chemistry; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000737:chemistry; D011108:Polymers; D012756:Sheep; D014025:Titanium / Q000009:adverse effects / Q000737:chemistry
chemical_list: D001577:Benzophenones; D020099:Coated Materials, Biocompatible; D007659:Ketones; D058626:Plasma Gases; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols; D014025:Titanium
keywords: Animal model; Bone ongrowth; Implant fixation; PEEK; Shear strength; Titanium coating