Dynamical Integration of Antimicrobial, Anti-Inflammatory, and Pro-Osteogenic Activities on Polyetheretherketone via a Porous N-Halamine Polymeric Coating

Polyetheretherketone (PEEK) has been widely used as orthopedic implants, but the poor antimicrobial and osseointegration properties hinder its advanced clinical applications. Most of the modification strategies are difficult to temporally fulfill initial broad-spectrum antimicrobial and later pro-osteogenic requirements for a long-term success of implantation. N-halamine is a kind of biofriendly antimicrobial agent, and its functional N & horbar;Cl groups could be converted into N & horbar;H groups, potentially resulting in new bioactivities. Therefore, it is supposed that N-halamine might provide a feasible design for the dynamical integration of antimicrobial and pro-osteogenic abilities. Herein, a new class of surface-porous PEEK implant with an N-halamine polymeric coating (sp-PEEK-NCl) is constructed by successive pore-making, polymer grafting, and chlorination. The as-prepared sp-PEEK-NCl exhibits broad-spectrum antibacterial, antifungal, anti-inflammatory, and pro-osteogenic effects. More importantly, with the consumption of oxidative chlorine, the N & horbar;Cl groups in sp-PEEK-NCl are transformed into N & horbar;H groups with enhanced pro-osteogenic ability, endowing sp-PEEK-NCl with dynamically compatible bioactivities for osseointegration in different periods after implantation. Rat implant-associated osteomyelitis model confirms that sp-PEEK-NCl obviously reduces infectious bone destruction and promotes osseointegration in vivo. This work may provide a promising strategy for intelligent integration of bioactivities and valuable insight into the design of orthopedic implants in bone tissue engineering.