title: Outcomes following polyetheretherketone (PEEK) cranioplasty: Systematic review and meta-analysis.
abstract: Polyetheretherketone (PEEK) has been used in cranioplasty since the early 2000s. However, there remains limited data that compares its long-term complication rate to autologous grafts and titanium mesh implants. To compare complication and implant failure rates after PEEK, autologous and titanium mesh cranioplasties, the authors of this study conducted a systematic review using the PubMed database. Studies that contained outcome data on complication rates of PEEK cranioplasty patients and studies that compared outcomes of patients who underwent PEEK cranioplasties versus other materials were included in the meta-analysis. Pooled odds ratios using the Mantel-Haenszel method were used for analysis. Fifteen articles, comprised of 183 PEEK cranioplasty patients were included. Of these patients, 15.3% developed post-operative complications and 8.7% experienced implant failure requiring reoperation. Patients who underwent cranioplasties with PEEK implants had 0.130 times the odds of developing post-operative complications (P=0.065) and 0.574 times the odds of implant failure compared to patients with autologous bone graft cranioplasties (P=0.629). Patients who had undergone PEEK cranioplasties had 0.127 times the odds of developing post-op complications (P=0.360) and 0.170 times the odds of implant failure compared to individuals who had undergone titanium mesh cranioplasties (P=0.168). The analysis was severely limited by the paucity in literature. However, there was a trend toward lower post-operative complication rates following PEEK cranioplasty versus autologous grafts, and lower implant failure rates with PEEK versus titanium mesh implants.
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Punchak
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Lawrance K
authors.initials: LK
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Carlito
authors.initials: C
authors.lastname: Lagman
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Bui
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Lazareff
authors.affiliation: Department of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Kameron
authors.initials: K
authors.lastname: Rezzadeh
authors.affiliation: Department of Plastic Surgery, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Jarrahy
authors.affiliation: Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA. Electronic address: iyang@mednet.ucla.edu.
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
mesh_terms: D000328:Adult; D064592:Autografts; D001577:Benzophenones; D005260:Female; D006801:Humans; D007659:Ketones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011108:Polymers; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012886:Skull / Q000601:surgery*
chemical_list: D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols
keywords: Cranioplasty; Meta-analysis; Outcomes