Bioabsorbable vs PEEK Interference Screws: Which Option Should You Choose?

Interference screws are among the most important fixation devices used in modern arthroscopic ligament reconstruction procedures. Whether performing an ACL reconstruction, PCL reconstruction, or other tendon fixation procedures, the choice of interference screw can significantly influence surgical handling, fixation stability, imaging characteristics, and future revision options.

Today, two of the most commonly used materials are bioabsorbable polymers and PEEK (Polyether Ether Ketone). Each offers distinct advantages and potential limitations. Understanding these differences helps surgeons select the most appropriate solution for each clinical situation.

What Is an Interference Screw?

An interference screw is designed to secure a tendon graft within a bone tunnel. During ACL or PCL reconstruction, the graft is positioned inside tunnels drilled into the femur and tibia. The interference screw compresses the graft against the tunnel wall, creating immediate fixation and allowing biological incorporation during healing.

Interference screws are widely used in:

  • ACL reconstruction
  • PCL reconstruction
  • Revision ligament surgery
  • Tendon fixation procedures
  • Sports medicine applications

What Are Bioabsorbable Interference Screws?

Bioabsorbable interference screws are manufactured from biodegradable polymers such as PLDLLA or bio-composite materials containing β-TCP.

These implants provide mechanical fixation during the critical healing period and gradually degrade over time.

The degradation process allows the implant to be replaced by biological tissue, eliminating the presence of permanent hardware.

Advantages of Bioabsorbable Screws

No Permanent Implant

The screw gradually resorbs after fulfilling its fixation function.

Reduced Long-Term Hardware Presence

Many surgeons prefer avoiding permanent implants, particularly in younger patients.

Excellent Imaging Compatibility

Bioabsorbable materials generally create minimal interference during MRI evaluation.

Potential Biological Remodeling

Certain bio-composite materials may support bone remodeling during degradation.

Potential Limitations of Bioabsorbable Screws

Although highly successful, bioabsorbable implants may present certain considerations:

  • Variable degradation rates
  • Potential inflammatory reactions in rare cases
  • Tunnel enlargement during degradation in some patients
  • Reduced implant visibility in future revision procedures

What Are PEEK Interference Screws?

PEEK (Polyether Ether Ketone) is a high-performance medical-grade polymer widely used in orthopedic implants.

Unlike bioabsorbable screws, PEEK implants do not degrade. They remain permanently within the bone unless surgically removed.

PEEK has gained popularity because it combines excellent mechanical strength with favorable imaging properties.

Advantages of PEEK Screws

High Mechanical Stability

PEEK provides consistent fixation strength throughout the healing process.

Excellent Biocompatibility

The material is biologically inert and well tolerated by surrounding tissues.

Radiolucent Properties

PEEK does not create significant imaging artifacts and allows postoperative evaluation of graft position and tunnel healing.

Long-Term Structural Integrity

Because the material does not degrade, it maintains its original strength and dimensions indefinitely.

Potential Limitations of PEEK Screws

Possible considerations include:

  • Permanent implant retention
  • Potential need for removal during revision surgery
  • Lack of biological resorption

However, many surgeons consider these characteristics advantages due to predictable long-term stability.

Bioabsorbable vs PEEK: Direct Comparison

FeatureBioabsorbablePEEK
Material DegradationYesNo
Permanent ImplantNoYes
Mechanical StabilityHighHigh
MRI CompatibilityExcellentExcellent
Revision VisibilityLowerHigher
Biological ResorptionYesNo
Long-Term Hardware PresenceNonePermanent

Which Option Is Better?

There is no universally superior choice.

The ideal implant depends on:

  • Surgeon preference
  • Patient age
  • Activity level
  • Revision risk
  • Graft selection
  • Clinical objectives

Many surgeons prefer bioabsorbable screws for younger patients and primary reconstructions, while others favor PEEK due to its predictable mechanical stability and long-term performance.

Both materials have demonstrated excellent clinical outcomes when used appropriately.

Orthosyn Medikal Interference Screw Solutions

Orthosyn Medikal offers a complete range of interference screw solutions for arthroscopic ligament reconstruction procedures.

Available options include:

  • PEEK Interference Screws
  • PLDLLA Bioabsorbable Interference Screws
  • PLDLLA + β-TCP Bio Composite Interference Screws

These systems are designed to support reliable graft fixation in ACL and PCL reconstruction procedures while meeting the demands of modern sports medicine surgery.

Conclusion

Both bioabsorbable and PEEK interference screws remain excellent options for ligament reconstruction procedures.

Bioabsorbable screws offer temporary fixation with gradual resorption, while PEEK screws provide permanent structural stability and long-term predictability.

The optimal choice depends on patient-specific factors, surgical objectives, and surgeon preference. Understanding the characteristics of each material allows for informed decision-making and successful surgical outcomes.

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