Antibiotic-free antimicrobial functionalization of PEEK via UV-induced self-initiation and N-halamine grafting.

Background: Implant-associated infection remains a major challenge in orthopedic surgery. Although polyether ether ketone (PEEK) is widely used owing to its favorable mechanical properties and radiolucency, its intrinsic bioinertness renders it highly susceptible to bacterial colonization. Developing a durable, antibiotic-free antibacterial surface modification for PEEK with translational relevance remains clinically desirable. Methods: In this study, a covalently grafted N-halamine-functionalized PEEK surface (PEEK- Results: PEEK- Conclusion: This study demonstrates that covalent N-halamine functionalization endows PEEK with sustained, antibiotic-free antibacterial activity while preserving biocompatibility performance. PEEK- The translational potential of this article: This study presents an antibiotic-free antibacterial surface modification strategy for PEEK implants based on UV-induced covalent grafting of N-halamine polymers. The robust antibacterial efficacy, preserved cytocompatibility, and supportive bone-related biological responses suggest potential applicability in preventing implant-associated infections in orthopedic settings. This work provides a feasible surface engineering approach that may be further optimized and translated toward clinically relevant load-bearing implants.