Wear mechanism and debris analysis of PEEK as an alternative to CoCrMo in the femoral component of total knee replacement

The polyetheretherketone (PEEK)-highly cross-linked polyethylene (XLPE), all-polymer knee prosthesis has excellent prospects for replacing the traditional metal/ceramic-polyethylene joint prosthesis, improving the service life of the joint prosthesis and the quality of patients’ life. The long-term wear mechanism of PEEK-XLPE knee joint prosthesis is comprehensively evaluated from wear amount, wear morphology, and wear debris compared to that of CoCrMo-XLPE joint prosthesis. After 5 million cycles of in vitro wear, the wear loss of XLPE in PEEK-XLPE (30.9±3.2 mg) is lower than that of XLPE in CoCrMo-XLPE (32.1±3.1 mg). Compared to the XLPE in CoCrMo-XLPE, the plastic deformation of XLPE in PEEK-XLPE is more severe in the early stage, and the adhesive peeling and adhesion are lighter in the later stage. The size distribution of XLPE wear debris in PEEK-XLPE is relatively dispersed, which in CoCrMo-XLPE is relatively concentrated. Wear debris is mainly flake and block debris, and the wear mechanism of XLPE was abrasive wear. The wear volume per unit area of PEEK femoral condyle (10.45×10⁵ μm³/mm²) is higher than that of CoCrMo (8.32×10⁵ μm³/mm²). The PEEK surface is mainly furrows and adhesions, while the CoCrMo surface is mainly furrows and corrosion spots. The PEEK wear debris is mainly in flakes and blocks, and the CoCrMo wear debris is mainly in the shape of rods and blocks. The wear mechanism of PEEK is abrasive wear and adhesion, and that of CoCrMo is abrasive wear and corrosion.