Outcome in patient-specific PEEK cranioplasty: A two-center cohort study of 40 implants

J Craniomaxillofac Surg. 2016 Sep;44(9):1266-72. doi: 10.1016/j.jcms.2016.07.005. Epub 2016 Jul 9.


Objective: The best material choice for cranioplasty following craniectomy remains a subject to discussion. Complication rates after cranioplasty tend to be high. Computer-assisted 3-dimensional modelling of polyetheretherketone (PEEK) was recently introduced for cranial reconstruction. The aim of this study was to evaluate patient- and surgery-related characteristics and risk factors that predispose patients to cranioplasty complications.

Material and methods: This retrospective study included a total of 40 cranial PEEK implants in 38 patients, performed at two reference centers in the Netherlands from 2011 to 2014. Complications were registered and patient- and surgery-related data were carefully analysed.

Results: The overall complication rate of PEEK cranioplasty was 28%. Complications included infection (13 %), postoperative haematoma (10 %), cerebrospinal fluid leak (2.5 %) and wound-related problems (2.5 %). All postoperative infections required removal of the implant. Nonetheless removed implants could be successfully re-used after re-sterilization.

Conclusion: Although overall complication rates after PEEK cranioplasty remain high, outcomes are satisfactory, as our results compare favourably to recent literature reports on cranial vault reconstruction.

Keywords: Computer aided-design and modelling; Cranial vault reconstruction; Craniectomy; Cranioplasty; PEEK; Patient specific implant.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biocompatible Materials / therapeutic use
  • Child
  • Female
  • Humans
  • Ketones / therapeutic use*
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Polyethylene Glycols / therapeutic use*
  • Postoperative Complications / epidemiology
  • Prostheses and Implants*
  • Reconstructive Surgical Procedures / instrumentation
  • Reconstructive Surgical Procedures / methods*
  • Retrospective Studies
  • Skull / surgery*
  • Treatment Outcome


  • Biocompatible Materials
  • Ketones
  • polyetheretherketone
  • Polyethylene Glycols