Mechanical performance and bioactivation of 3D-printed PEEK for high-performance implant manufacture: a review.

Polyetheretherketone (PEEK) has stood out as the leading high-performance thermoplastic for the replacement of metals in orthopaedic, trauma and spinal implant applications due to its high biocompatibility and mechanical properties. Despite its potential for custom-made medical devices, 3D-printed PEEK's mechanical performance depends on processing parameters and its bioinertness may hinder bone opposition to the implant. Concerning these challenges, this review focuses on the available literature addressing the improvement of the mechanical performance of PEEK processed through "fused filament fabrication" (FFF) along with literature on bioactivation of PEEK for improved osseointegration. The reviewed research suggests that improvements can be achieved in mechanical performance of 3D-printed PEEK with adequate FFF parametrization while different bioactivation techniques can be used to improve the bioperformance of 3D-printed PEEK. The adequate approaches towards these procedures can increase PEEK's potential for the manufacture of high-performance custom-made implantable devices that display improved bone-implant integration and prevent stress shielding of the treated bone.

High-Cycle Fatigue Behaviour of Polyetheretherketone (PEEK) Produced by Additive Manufacturing.

Polyetheretherketone (PEEK) is the leading high-performance thermoplastic biomaterial that can be processed through material extrusion (ME) additive manufacturing (AM), also known as three-dimensional (3D) printing, for patient-specific load-bearing implant manufacture. Considering the importance of cyclic loading for load-bearing implant design, this work addresses the high-cycle fatigue behaviour of 3D-printed PEEK. In this work, printed PEEK specimens are cyclically loaded under stress-controlled tension-tension using different stress levels between 75% and 95% of printed PEEK's tensile strength. The experimental results are used to document 3D-printed PEEK's fatigue behaviour using Basquin's power law, which was compared with previous fatigue research on bulk PEEK and other 3D-printing materials. As a pioneering study on its fatigue behaviour, the results from this work show that 3D-printed PEEK exhibits an above-average fatigue strength of 65 MPa, corresponding to about 75% of its tensile strength. Fracture surface analysis suggests that a transition can occur from ductile to brittle fracture with maximum stresses between 85% and 95% of the tensile strength. Evidence of crack propagation features on fracture surfaces under scanning electron microscope (SEM) observation suggests crack initiation in void defects created by printing deposition that propagates longitudinally through line bonding interfaces along layers. Considering this, 3D-printed PEEK's fatigue behaviour can be strongly related to printing conditions. Further research on the fatigue behaviour of 3D-printed PEEK is necessary to support its use in load-bearing implant applications.