{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T10:05:34Z","timestamp":1793095534676,"version":"4.5.0"},"reference-count":26,"publisher":"Universa BV","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Carbon fibre reinforced polyetheretherketone (CFR-PEEK) implants have gained interest because of reported biomechanical advantages and radio-lucent properties. The aim of this study was to evaluate the role of CFR-PEEK nails in patients with metastatic bone disease (MBD). We performed a retrospective cohort study evaluating patients with MBD undergoing intramedullary (IM) nailing for prophylaxis or fixation of pathological fractures using CFR- PEEK or titanium implants. Patient survival, implant failure rates, ability to visualise disease progression on post- operative CT\/MRI, and post-operative radiotherapy dose were reported. Fifty patients underwent 56 IM nails (26 CFR-PEEK and 30 titanium). Median survival was 8 months for the entire cohort, 6 months for patients with CFR- PEEK nails and 8 months for those with conventional nails (p=0.691). No implant failures were recorded in either group. There was no correlation between implant type and post-operative radiotherapy dose given (\u03c7 2 = 0.139, p=0.710). Artefact on MRI was less evident with CFR-PEEK nails when hybrid imaging and metal artefact reduction techniques were used. The advantages of CFR-PEEK nails might not be realised in clinical practice for most patients with MBD requiring IM nailing except for in those likely to require prolonged disease surveillance.<\/jats:p>","DOI":"10.52628\/90.4.13032","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:37:10Z","timestamp":1737977830000},"page":"721-729","source":"Crossref","is-referenced-by-count":3,"title":["A comparative study of the role of carbon fibre reinforced polyetheretherketone and titanium intramedullary nails in patients with metastatic bone disease"],"prefix":"10.52628","volume":"90","author":[{"given":"M","family":"KAZZAM","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"AHLUWALIA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"VLES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"YOUNGMAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"RASHID","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"ROUSSOT","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27062","published-online":{"date-parts":[[2025,1]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Schulman KL, Kohles J. Economic burden of metastatic bone disease in the U.S. Cancer. 2007;109(11):2334-42.","DOI":"10.1002\/cncr.22678"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Angelini A, Trovarelli G, Berizzi A, Pala E, Breda A, Maraldi M, et al. Treatment of pathologic fractures of the proximal femur. Injury. 2018;49 Suppl 3:S77-S83.","DOI":"10.1016\/j.injury.2018.09.044"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Hoellwarth JS, Weiss K, Goodman M, Heyl A, Hankins ML, McGough R. Evaluating the reoperation rate and hardware durability of three stabilizing implants for 105 malignant pathologic humerus fractures. Injury. 2020;51(4):947-54.","DOI":"10.1016\/j.injury.2020.02.124"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Bickels J, Dadia S, Lidar Z. Surgical management of metastatic bone disease. J Bone Joint Surg Am. 2009;91(6):1503-16.","DOI":"10.2106\/jbjs.h.00175"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Hak DJ, Mauffrey C, Seligson D, Lindeque B. Use of carbon- fiber-reinforced composite implants in orthopedic surgery. Orthopedics. 2014;37(12):825-30.","DOI":"10.3928\/01477447-20141124-05"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Kojic N, Rangger C, Ozgun C, Lojpur J, Mueller J, Folman Y, et al. Carbon-Fibre-Reinforced PEEK radiolucent intramedullary nail for humeral shaft fracture fixation: technical features and a pilot clinical study. Injury. 2017;48 Suppl 5:S8-S11.","DOI":"10.1016\/s0020-1383(17)30731-3"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Ziran BH, O\u02bcPry EK, Harris RM. Carbon Fiber-Reinforced PEEK Versus Titanium Tibial Intramedullary Nailing: A Preliminary Analysis and Results. J Orthop Trauma. 2020;34(8):429-33.","DOI":"10.1097\/bot.0000000000001756"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Takashima K, Nakahara I, Uemura K, Hamada H, Ando W, Takao M, et al. Clinical outcomes of proximal femoral fractures treated with a novel carbon fiber-reinforced polyetheretherketone intramedullary nail. Injury. 2020;51(3):678-82.","DOI":"10.1016\/j.injury.2020.01.007"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Hillock R, Howard S. Utility of Carbon Fiber Implants in Orthopedic Surgery: Literature Review. Reconstructive Review. 2014;4(1):23-32.","DOI":"10.15438\/rr.v4i1.55"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Li CS, Vannabouathong C, Sprague S, Bhandari M. The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review. Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:33-45.","DOI":"10.4137\/cmamd.s20354"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Zimel MN, Hwang S, Riedel ER, Healey JH. Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging. Skeletal Radiol. 2015;44(9):1317-25.","DOI":"10.1007\/s00256-015-2158-9"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Piccioli A, Piana R, Lisanti M, Di Martino A, Rossi B, Camnasio F, et al. Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group. Injury. 2017;48 Suppl 3:S55-S9.","DOI":"10.1016\/s0020-1383(17)30659-9"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Vles GF, Brodermann MH, Roussot MA, Youngman J. Carbon- Fiber-Reinforced PEEK Intramedullary Nails Defining the Niche. Case Rep Orthop. 2019;2019:1538158.","DOI":"10.1155\/2019\/1538158"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Nevelsky A, Borzov E, Daniel S, Bar-Deroma R. Perturbation effects of the carbon fiber-PEEK screws on radiotherapy dose distribution. J Appl Clin Med Phys. 2017;18(2):62-8.","DOI":"10.1002\/acm2.12046"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Xin-ye N, Xiao-bin T, Chang-ran G, Da C. The prospect of carbon fiber implants in radiotherapy. J Appl Clin Med Phys. 2012;13(4):3821.","DOI":"10.1120\/jacmp.v13i4.3821"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Carter PR. Operational productivity and performance in English NHS acute hospitals: Unwarranted variations. An independent report for the Department of Health by Lord Carter of Coles An independent report for the Department of Health by Lord Carter of Coles2016 31 October 2021. Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/499229\/Operational_productivity_A.pdf.","DOI":"10.1080\/09548963.2021.1985936"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"S\u00f8rensen MS, Gerds TA, Hinds\u00f8 K, Petersen MM. Prediction of survival after surgery due to skeletal metastases in the extremities. The Bone & Joint Journal. 2016;98-B(2):271-7.","DOI":"10.1302\/0301-620x.98b2.36107"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Higuchi T, Yamamoto N, Hayashi K, Takeuchi A, Abe K, Taniguchi Y, et al. Long-term patient survival after the surgical treatment of bone and soft-tissue metastases from renal cell carcinoma. Bone Joint J. 2018;100-B(9):1241-8.","DOI":"10.1302\/0301-620x.100b9.bjj-2017-1163.r3"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Steinberg EL, Rath E, Shlaifer A, Chechik O, Maman E, Salai M. Carbon fiber reinforced PEEK Optima--a composite materialbiomechanical properties and wear\/debris characteristics of CF-PEEK composites for orthopedic trauma implants. J Mech Behav Biomed Mater. 2013;17:221-8.","DOI":"10.1016\/j.jmbbm.2012.09.013"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Shepherd KL, Cool P, Cribb G. Prognostic indicators of outcome for patients with skeletal metastases from carcinoma of the prostate. Bone Joint J. 2018;100-B(12):1647-54.","DOI":"10.1302\/0301-620x.100b12.bjj-2018-0697.r1"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Downie S, Lai FY, Joss J, Adamson D, Jariwala AC. The Metastatic Early Prognostic (MEP) score. Bone Joint J. 2020;102-B(1):72-81.","DOI":"10.1302\/0301-620x.102b1.bjj-2019-0794.r1"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Takashima K, Nakahara I, Hamada H, Ando W, Takao M, Uemura K, et al. A carbon fiber-reinforced polyetheretherketone intramedullary nail improves fracture site visibility on postoperative radiographic images. Injury. 2021.","DOI":"10.1016\/j.injury.2021.03.048"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Morone M, Bali MA, Tunariu N, Messiou C, Blackledge M, Grazioli L, et al. Whole-Body MRI: Current Applications in Oncology. American Journal of Roentgenology. 2017;209(6):W336-W49.","DOI":"10.2214\/ajr.17.17984"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"van der Vos CS, Arens AIJ, Hamill JJ, Hofmann C, Panin VY, Meeuwis APW, et al. Metal Artifact Reduction of CT Scans to Improve PET\/CT. J Nucl Med. 2017;58(11):1867-72.","DOI":"10.2967\/jnumed.117.191171"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Theivendran K, Arshad F, Hanif UK, Reito A, Griffin X, FooteCJ. Carbon fibre reinforced PEEK versus traditional metallic implants for orthopaedic trauma surgery: A systematic review. J Clin Orthop Trauma. 2021;23:101674.","DOI":"10.1016\/j.jcot.2022.101778"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Khan HA, Ber R, Neifert SN, Kurland DB, Laufer I, Kondziolka D, et al. Carbon fiber-reinforced PEEK spinal implants for primary and metastatic spine tumors: a systematic review on implant complications and radiotherapy benefits. J Neurosurg Spine. 2023;39(4):534-47.","DOI":"10.3171\/2023.5.spine23106"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T11:37:16Z","timestamp":1737977836000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actaorthopaedica.be\/archive\/volume-90\/issue-4\/original-studies\/a-comparative-study-of-the-role-of-carbon-fibre-reinforced-polyetheretherketone-and-titanium-intrame\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,1]]},"published-print":{"date-parts":[[2024,12]]}},"URL":"https:\/\/doi.org\/10.52628\/90.4.13032","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}