The Role of Surface Chemistry in the Osseointegration of PEEK Implants

Emily Buck, Seunghwan Lee, Qiman Gao, Simon D. Tran, Faleh Tamimi, Laura S. Stone, Marta Cerruti

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Poly(etheretherketone) (PEEK) implants suffer from poor osseointegration because of chronic inflammation. In this study, we hypothesized that adding NH2and COOH groups to the surface of PEEK could modulate macrophage responses by altering protein adsorption and improve its osseointegration. NH2and COOH-functionalized PEEK surfaces induced pro- and anti-inflammatory macrophage responses, respectively, and differences in protein adsorption patterns on these surfaces were related to the varied inflammatory responses. The macrophage responses to NH2surfaces significantly reduced the osteogenic differentiation of mesenchymal stem cells (MSCs). MSCs cultured on NH2surfaces differentiated less than those on COOH surfaces even though NH2surfaces promoted the most mineralization in simulated body fluid solutions. After 14 days in rat tibia unicortical defects, the bone around NH2surfaces had thinner trabeculae and higher specific bone surface than the bone around unmodified implants; surprisingly, the NH2implants significantly increased bone-binding over the unmodified implants, while COOH implants only showed a trend for increasing bone-binding. Taken together, these results suggest that both mineral-binding and immune responses play a role in osseointegration, and PEEK implant integration may be improved with mixtures of these two functional groups to harness the ability to reduce inflammation and bind bone strongly.

Original languageEnglish (US)
Pages (from-to)1506-1521
Number of pages16
JournalACS Biomaterials Science and Engineering
Issue number4
StatePublished - Apr 11 2022

Bibliographical note

Funding Information:
This study was funded by the Canada Research Chair program, an FRQNT grant, a Vanier Canada Graduate Scholarship, RSBO Fellowship and MEDA Scholarship, a CIHR operating grant (MOP-126046), and a postdoctoral fellowship from the Louise and Alan Edwards Research Grants Program.

Publisher Copyright:
© 2022 American Chemical Society. All rights reserved.


  • bone-binding
  • diazonium
  • immune response
  • macrophages
  • proteomics


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