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PEEK is sulfonated by concentrated sulfuric acid to fabricate a 3D network on the surface and a hydrothermal treatment is conducted to remove the remaining sulfure residues.

The samples with the smallest sulfur content, SPW120, exhibit enhanced proliferation and osteogenic differentiation of rBMSCs in vitro. All the sulfonated samples show antibacterial properties against S. aureus and E. coli, especially an excellent antibacterial properties against S. aureus. In the cortico-cancellous rat femur implantation model, not only the premeditated injected bacteria cells are sterilized, but also bone remodeling occurs around SPW120.

The in vivo results agree well with the in vitro results, revealing that the sample with the optimized sulfur concentration enhances both osseointegration and antibacterial resistance. PEEK after sulfonation and hydrothermal treatment has large potential in orthopedic and dental applications.

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