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REVIEW
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Surface modification of polyetheretherketone for boosted osseointegration: a review

Yu Chen1 ,  Zhiyong Chen1 ,  Kewen Lei2 ,  Jiandong Ding1 ,  Lin Yu1*
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1 State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
2 Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
BMT 2025 , 6(2), 181–201; https://doi.org/10.12336/bmt.24.00052
Submitted: 20 August 2024 | Revised: 18 October 2024 | Accepted: 15 December 2024 | Published: 25 June 2025
Copyright © 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution–NonCommercial–ShareAlike 4.0 License.
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Abstract

The field of orthopaedic implants has experienced rapid growth in recent decades, evolving from a few obscure examples to become one of the most vibrant domains within regenerative medicine. Polyetheretherketone (PEEK) stands out as a formidable competitor in this field due to its exceptional biocompatibility and appropriate mechanical strength. However, the clinical application of PEEK is limited by its inherent biological inertness. Therefore, numerous studies have focused on overcoming the bio-inert issue of PEEK using surface activation techniques. It is necessary to delve into the intricate effects of these modifications and their corresponding methods. In this review, we provide a comprehensive summary of contemporary research on surface modification for enhancing osseointegration of PEEK implants, categorising them into four parts based on their modification methods and techniques used: (1) physical treatment, (2) wet chemical methods, (3) combination of physical and chemical treatments, and (4) bioactive coating. Finally, we outline the challenges and unmet needs that must be addressed by future designs of PEEK surfaces. Overall, altering the surface morphology and/or surface group of PEEK to obtain a rough, porous, hydrophilic, and bioactive surface, or incorporating bioactive agents/coatings with bone-forming abilities onto the surface of PEEK has shown great potential for promoting osseointegration, which can serve as a solid foundation for subsequent clinical translation.

Keywords
Coating
Orthopaedic implants
Osseointegration
PEEK
Surface modification
Funding
This work was supported by the Special Project for Emerging Interdisciplinary Research in the Health Industry of the Shanghai Municipal Health Commission (No. 2022JC030) and National Key R&D Program of China (No. 2020YFC1107102).
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Conflict of interest
The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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