Poly(
ether ether ketone) (
PEEK) has emerged as an alternative endosseous material to
metal implants mainly because of its lack of allergic sensitivity and radiolucency, while maintaining similar mechanical properties with bone. However, a disadvantage of
PEEK is its weak osseointegration ability compared with
metal implants. To overcome this, we prepared a
phosphate group-modified
PEEK by plasma treatment and subsequent phosphorylation reaction. Plasma treatment and
phosphate modification of
PEEK changed its hydrophobic surface to a hydrophilic surface while maintaining the original surface topography and roughness.
Phosphate modification increased the bioactivity of rat bone marrow stromal cells (BMSCs), including proliferation,
alkaline phosphatase activity, and bone-like nodule formation; however, this effect was negligible in plasma-treated
PEEK. In addition,
phosphate modification attenuated the phenotypic polarization of
lipopolysaccharide-primed RAW264.7 macrophages to an inflammatory phenotype, based on the finding that macrophages on
phosphate-modified
PEEK produced decreased levels of the inflammatory
cytokine and increased levels of the anti-inflammatory
cytokine. Finally, in an animal study,
phosphate-modified
PEEK exhibited a doubled pullout force from the femur bone cavity compared with bare
PEEK. Thus, we conclude that
phosphate modification can significantly improves the implant-bone bonding strength of
PEEK by enhancing BMSCs activity and reducing excessive
inflammation.