Table 6.
Study outcomes of all included studies.
| Study | Design | Surgical use | Sample | Outcomes | CFR PEEK | Metal | P value | ||
|---|---|---|---|---|---|---|---|---|---|
| Ziegler et al.10 |
Randomised controlled trial | Proximal humeral fractures (plate fixation) | 63 32 CFR PEEK 31 Metal |
Complete bony consolidation | 12 weeks | 32/32 | 31/31 | NR | |
| Significant loss of reduction | 0/32 | 0/32 | NR | ||||||
| Head shaft angle | Post op | 142.46 ± 6.39° | 139.97 ± 7.70° | NR | |||||
| 6 weeks | 142.13 ± 6.38° | 139.82 ± 7.70° | NR | ||||||
| 12 weeks | 142.53 ± 6.45° | 138.81 ± 8.21° | NR | ||||||
| Disabilities of the arm, shoulder and hand (DASH) Score | 6 weeks | 56.5 ± 19.3 | 59.8 ± 15.6 | NR | |||||
| 12 weeks | 38.4 ± 21.4 | 37.7 ± 16.2 | NR | ||||||
| 6 months | 27.5 ± 20.5 | 28.5 ± 17.9 | 0.82 | ||||||
| Simple Shoulder Test | 6 weeks | 30.0 ± 20.8 | 29.4 ± 18.9 | NR | |||||
| 12 weeks | 54.9 ± 24.8 | 51.5 ± 16.5 | NR | ||||||
| 6 months | 62.5 ± 22.3 | 65.0 ± 20.1 | NR | ||||||
| Oxford Shoulder Score | 6 weeks | 20.3 ± 9.8 | 20.4 ± 8.5 | NR | |||||
| 12 weeks | 33.8 ± 10.0 | 33.3 ± 6.5 | NR | ||||||
| 6 months | 37.7 ± 8.8 | 38.6 ± 6.8 | NR | ||||||
| Padolino et al.11 | Retrospective observational study | Proximal humeral fractures (plate fixation) | 42 21 CFR PEEK 21 Metal |
Inadequate fracture reduction | 3/21 | 4/21 | >0.05 | ||
| Cortical thinning (mm); change from pre-op values in brackets | 4.7 (1.3) | 3.9 (0.13) | 0.002 | ||||||
| Adequate calcar reduction | 11/21 | 13/21 | 0.548 | ||||||
| >50% tuberosity resorption | 3/21 | 9/21 | 0.040 | ||||||
| Varus/valgus malalignment | 2/21 | 2/21 | >0.05 | ||||||
| Humeral head collapse/necrosis | 1/21 | 1/21 | >0.05 | ||||||
| Simple Shoulder Test | Final follow up | 7 ± 2.25 | 7 ± 2.16 | >0.05 | |||||
| Constant Murley Score | Final follow up | 66.3 ± 20.5 | 63.3 ± 19.6 | >0.05 | |||||
| Active anterior elevation | Final follow up | 142.8 ± 38° | 127.6 ± 33° | 0.075 | |||||
| Active lateral elevation | Final follow up | 134.1 ± 40° | 113.8 ± 38° | 0.099 | |||||
| External rotation (points) | Final follow up | 32.6 ± 12 | 36.6 ± 26 | 0.737 | |||||
| Internal rotation (points) | Final follow up | 2.8 ± 2 | 2.4 ± 2 | 0.664 | |||||
| Katthagen et al.12 | Retrospective observational study | Proximal humeral fractures (plate fixation) | 42 21 CFR PEEK 21 metal (matched from literature) |
Constant Murley Score | 3 months | 57.5 ± 16.2 | 52.4 ± 15.5 | 0.31 | |
| 12 months | 73.8 ± 15.4 | 69.4 ± 18.5 | 0.43 | ||||||
| One or more screw perforation | NR | 5/21 | NR | ||||||
| Revision surgery due to screw perforations | Less | More | 0.048 | ||||||
| Schliemann et al.13 | Prospective observational study | Proximal humeral fractures (plate fixation) | 58 29 CFR PEEK 29 Metal |
Simple Shoulder Test | 24 months | 59 | 48 | NR | |
| Oxford Shoulder Score | 24 months | 27.4 (8–45) | 21.6 (9–43) | 0.029 | |||||
| Constant Murley Score | 24 months | 71.3 (44–97) | 59.2 (28–86) | 0.038 | |||||
| Perugia et al.14 | Randomised Controlled Trial | Distal radius fractures (plate fixation) | 30 15 CFR PEEK 15 Metal |
Mean follow-up for outcomes (months) | 15.7 (12–19) | 16.1 (13–21) | |||
| DASH Score | 15.3 (2.5–58.9) | 12.2 (10.6–54.8) | >0.05 | ||||||
| Visual Analogue Scale (VAS) pain score | 3.6 (0–7) | 2.9 (0–6) | NR | ||||||
| Complete recovery of range of movement | 10/15 | 12/15 | NR | ||||||
| Wrist extension | 64° (44°–76°) | 61° (42°–75°) | >0.05 | ||||||
| Wrist flexion | 78° (59°–80°) | 80° (62°–80°) | >0.05 | ||||||
| Radial deviation | 18° (7°–20°) | 15° (5°–20°) | >0.05 | ||||||
| Ulnar deviation | 39° (23°–45°) | 42° (26°–45°) | >0.05 | ||||||
| Supination | 87° (72°–90°) | 88° (70°–90°) | >0.05 | ||||||
| Pronation | 80° | 77° (70°–80°) | >0.05 | ||||||
| Hand grip strength as percentage of unaffected limb at final follow up | 92.30% | 94.40% | NR | ||||||
| Key pinch strength as percentage of unaffected limb at final follow up | 90.40% | 90.70% | NR | ||||||
| Radiological restoration of normal radial inclination (21°–25°) | 74.5% (15°–27.5°) | 73% (14°–29°) | >0.05 | ||||||
| Radiological restoration of normal Radial height (10–13 mm) | 66.6% (6.8–17.3 mm) | 70% (6.3–18.2 mm) | >0.05 | ||||||
| Radiological restoration of normal volar tilt (7°–15°) | 90.2% (3°–187°) | 91.3% (5°–185°). | >0.05 | ||||||
| Radiological restoration of normal ulnar variance (0.7–1.5 mm) | 86.3% (0.7–4.1 mm) | 85.8% (0.5–4.8 mm) | >0.05 | ||||||
| Mitchell et al.15 | Retrospective observational study | Distal femur fractures (plate fixation) | 22 11 CFR PEEK 11 Metal (stainless steel) |
Non-union | 1/11 (9.1%) | 4/11 (36.4%) | 0.12 | ||
| Hardware failure | 0/11 (0%) | 2/11 (18.2%) | 0.14 | ||||||
| Re-operation | 1/11 (9.1%) | 4/11 (36.4%) | 0.12 | ||||||
| Mean time to Radiographic Union | 18.7 weeks | 12.4 weeks | 0.26 | ||||||
| Mean time to Full Weight-bearing | 9.9 weeks | 12.4 weeks | 0.23 | ||||||
| Byun et al.16 | Retrospective observational study | Distal femur fractures (plate fixation) | 31 10 CFR PEEK 21 Metal (stainless steel) |
Modified Radiographic Union Score for Tibia (mRUST) score | 3 months | 9.0 ± 1.9 (6.3–12.3) | 6.9 ± 2.0 (4.3–11.7) | 0.015 | |
| 6 months | 11.4 ± 2.6 (7.7–16.0) | 10.5 ± 2.5 (6.0–15.7) | 0.374 | ||||||
| Loss of alignment | 1/10 (10%) | 1/21 (5%) | 0.548 | ||||||
| Unplanned surgeries (nonunion repairs) | 0/10 (0%) | 3/21 (15%) | 0.296 | ||||||
| Guzzini et al.17 | Prospective observational study | Ankle fractures (plate fixation) | 87 46 CFR PEEK 41 Metal (stainless steel) |
OMAS (Olerud-Molander Ankle Score) | 6 months | 79.25 ± 10 (69.25–89.25) | 78.8 ± 15 (63.8–93.8) | >0.05 | |
| 12 months | 85.1 ± 5 (80.1–90.1) | 84.1 ± 6.7 (77.4–90.8) | >0.05 | ||||||
| 24 months | 91.1 ± 4.16 (86–95.26) | 88.7 ± 4.7 (84–93.4) | >0.05 | ||||||
| American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale | 6 months | 77.25 ± 9 (68.25–86.25) | 75.8 ± 15 (60.8–90.8) | >0.05 | |||||
| 12 months | 86.4 ± 7 (79.4–93.4) | 83.1 ± 6.7 (76.4–89.8) | >0.05 | ||||||
| 24 months | 92.1 ± 4.16 (87.94–96.26) | 90.1 ± 4.7 (85.4–94.7) | >0.05 | ||||||
| Visual Analogue Scale (VAS) pain score | 6 months | 2.8 ± 2.1 (0.7–4.9) | 3.1 ± 1.5 (1.6–4.6) | >0.05 | |||||
| 12 months | 2.4 ± 1.1 (1.3–3.5) | 2.1 ± 1.7 (0.4–3.8) | >0.05 | ||||||
| 24 months | 1.4 ± 1.1 (0.3–2.5) | 1.5 ± 0.7 (0.8–2.2) | >0.05 | ||||||
| Talo-crural angle | 24 months | 9.3° ± 0.9 (8.4°–10.2°) | 10.4° ± 0.8 (9.6°–11.2°) | NR | |||||
| Restoration of joint line | 98% (45/46) | 95% (39/41) | NR | ||||||
| Satisfactory rotation of the peroneal malleolus on its axis | 100% (46/46) | 100% (41/41) | NR | ||||||
| Removal of hardware for local infection | 6% (3/46) | 9% (4/41) | NR | ||||||
| Ziran et al.18 | Retrospective observational study | Diaphyseal Tibial fractures (Intramedullary nailing) | 56 26 CFR PEEK 30 metal (titanium) |
RUST (Radiographic Union Scale in Tibia) | 8 weeks | 19% (5/26) | 0% (0/30) | <0.0001 | |
| 12 weeks | 69% (18/26) | 17% (5/30) | <0.0001 | ||||||
| 16 weeks | 92% (24/26) | 57% (17/30) | <0.0001 | ||||||
| 20 weeks | 96% (25/26) | 87% (26/30) | <0.0001 | ||||||
| 24 weeks | 96% (25/26) | 97% (29/30) | >0.05 | ||||||
| Nonunion | 0 | 0 | >0.05 | ||||||
| Infection | 0 | 0 | >0.05 | ||||||
| Nonunion/infection | 1/26 | 1/30 | >0.05 | ||||||
| Barometric pain | 8% (2/26) | 23% (7/30 | 0.065 | ||||||
| Ankle/knee pain | 8% (2/26) | 20% (6/30) | 0.109 | ||||||
| Removal of implant | 8% (2/26) | 3% (1/30) | 0.269 | ||||||
| Associated injuries | 35% (9/26) | 13% (4/30) | >0.05 | ||||||
KEY.
+/- Standard Deviation.
(range).
NR: not recorded in literature.