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Novel 3D printable PEEK-HA-Mg2SiO4 composite material for spine implants: biocompatibility and imaging compatibility assessments

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Abstract

Purpose

To develop a novel 3D printable polyether ether ketone (PEEK)-hydroxyapatite (HA)-magnesium orthosilicate (Mg2SiO4) composite material with enhanced properties for potential use in tumour, osteoporosis and other spinal conditions. We aim to evaluate biocompatibility and imaging compatibility of the material.

Methods

Materials were prepared in three different compositions, namely composite A: 75 weight % PEEK, 20 weight % HA, 5 weight % Mg2SiO4; composite B: 70 weight% PEEK, 25 weight % HA, 5 weight % Mg2SiO4; and composite C: 65 weight % PEEK, 30 weight % HA, 5 weight % Mg2SiO4. The materials were processed to obtain 3D printable filament. Biomechanical properties were analysed as per ASTM standards and biocompatibility of the novel material was evaluated using indirect and direct cell cytotoxicity tests. Cell viability of the novel material was compared to PEEK and PEEK-HA materials. The novel material was used to 3D print a standard spine cage. Furthermore, the CT and MR imaging compatibility of the novel material cage vs PEEK and PEEK-HA cages were evaluated using a phantom setup.

Results

Composite A resulted in optimal material processing to obtain a 3D printable filament, while composite B and C resulted in non-optimal processing. Composite A enhanced cell viability up to ~ 20% compared to PEEK and PEEK-HA materials. Composite A cage generated minimal/no artefacts on CT and MR imaging and the images were comparable to that of PEEK and PEEK-HA cages.

Conclusion

Composite A demonstrated superior bioactivity vs PEEK and PEEK-HA materials and comparable imaging compatibility vs PEEK and PEEK-HA. Therefore, our material displays an excellent potential to manufacture spine implants with enhanced mechanical and bioactive property.

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Acknowledgements

The authors would like to thank—the Centre for Translational MR Research (NUS–TMR) for MR imaging service and the Clinical Imaging Research Centre (NUS–CIRC) for CT imaging service. The authors would like to thank the National University of Singapore Center for Additive Manufacturing (AM.NUS) for their technical support. The authors would also like to thank Mr. Ramruttun Amit Kumarsing for his assistance with biomechanical testing and Dr. Deepika Kandilya for her assistance with cell cytotoxicity testing. We would also like to thank Dr. Karthigesh Palanichami, Dr. Veluru Jagadeesh Babu, Dr. Pradnya Mohite & Laranya Kumar for their help in editing the manuscript.

Funding

This research/project (Grant No: 2019024) is supported by NAMIC Singapore, NUS Centre for Additive Manufacturing (AM.NUS) and funded by the National Research Foundation Singapore under its Innovation Cluster Programme.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, National University Health System, Level 11 Tower Block, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore

    Naresh Kumar, Sridharan Alathur Ramakrishnan & Keith Gerard Lopez

  2. Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore, 117575, Singapore

    Niyou Wang

  3. Department of Radiation Oncology, National University Health System, Level 7, Tower Block, 1E, Lower Kent Ridge Road, Singapore, 119228, Singapore

    Balamurugan A. Vellayappan

  4. Department of Diagnostic Imaging, National University Hospital, National University Hospital Main Building, Level 2, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore

    James Thomas Patrick Decourcy Hallinan

  5. Department of Mechanical Engineering, National University of Singapore, #04-18 Block EA, 9 Engineering Drive 1, Singapore, 117575, Singapore

    Jerry Ying Hsi Fuh

  6. Department of Mechanical Engineering, National University of Singapore, #05-26 Block EA, 9 Engineering Drive 1, Singapore, 117575, Singapore

    A. Senthil Kumar

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  1. Naresh Kumar
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Correspondence to Naresh Kumar.

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Kumar, N., Alathur Ramakrishnan, S., Lopez, K.G. et al. Novel 3D printable PEEK-HA-Mg2SiO4 composite material for spine implants: biocompatibility and imaging compatibility assessments. Eur Spine J 32, 2255–2265 (2023). https://doi.org/10.1007/s00586-023-07734-0

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