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Review
. 2021 Oct 28:23:101674.
doi: 10.1016/j.jcot.2021.101674. eCollection 2021 Dec.

Carbon fibre reinforced PEEK versus traditional metallic implants for orthopaedic trauma surgery: A systematic review

Kanthan Theivendran  1   2 , Faizan Arshad  1 , Umar-Khetaab Hanif  1 , Aleksi Reito  3 , Xavier Griffin  4 , Clary J Foote  5
Affiliations
Review

Carbon fibre reinforced PEEK versus traditional metallic implants for orthopaedic trauma surgery: A systematic review

Kanthan Theivendran et al. J Clin Orthop Trauma. .

Abstract

Introduction: There is no literature review comparing outcomes of fixation using carbon-fibre-reinforced polyetheretherketone (CFR PEEK) compared to metal implants used in orthopaedic extremity trauma surgery. A systematic review was performed to compare CFR PEEK to metal implants for clinically-important fracture outcomes.

Methods: A search of the online databases of PubMed/Medline, EMBASE and Cochrane Database was conducted. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A meta-analyses was performed for functional outcomes in proximal humerus fractures converting the score differences to standard mean difference units. GRADE approach was used to determine the level of certainty of the estimates.

Results: Two prospective randomised controlled trials and seven comparative observational studies with a total of 431 patients were included. Of the nine studies included, four compared the use of CFR PEEK against metal plates in proximal humerus fractures. Aggregated functional scores across the proximal humerus studies, there was a small signal of better improvement with CFR PEEK (SMD 0.22, 95% CI -0.03 to 0.47, p = 0.08, low certainty). Greater odds of adverse events occurred in the metal group (OR 2.34, 95% CI 0.73 to 7.55, p = 0.15, low certainty).

Conclusions: Low to very low certainty evidence suggests a small improvement in functional recovery with CFR PEEK in proximal humerus fractures. This may be mediated through a small reduction in major adverse events related to fracture healing and stability. There is currently insufficient evidence to support the widespread use of CFR PEEK implants in fracture fixation.

Level of evidence: Level IV.

Keywords: Biomaterials; CFR PEEK; Carbon-fibre-reinforced polyetheretherketone; Evidence-based orthopedics; Fixation; Fracture; Meta-analysis; Systematic review; Trauma outcomes.

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Conflict of interest statement

All authors have no conflicts of interests.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) flow diagram of the identification and selection process for the studies included in the review.
See this image and copyright information in PMC

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