Polymethyl methacrylate (PMMA) bone cement is a commonly used bone adhesive and filling material in percutaneous vertebroplasty and percutaneous kyphoplasty surgeries. However, PMMA bone cements have been reported to cause some severe complications, such as secondary fracture of adjacent vertebral bodies, and loosening or even dislodgement of the set PMMA bone cement, due to the over-high elastic modulus and poor osteointegration ability of the PMMA. In this study, mineralized collagen (MC) with biomimetic microstructure and good osteogenic activity was added to commercially available PMMA bone cement products, in order to improve both the mechanical properties and the cytocompatibility. As the compressive strength of the modified bone cements remained well, the compressive elastic modulus could be significantly down-regulated by the MC, so as to reduce the pressure on the adjacent vertebral bodies. Meanwhile, the adhesion and proliferation of pre-osteoblasts on the modified bone cements were improved compared with cells on those unmodified, such result is beneficial for a good osteointegration formation between the bone cement and the host bone tissue in clinical applications. Moreover, the modification of the PMMA bone cements by adding MC did not significantly influence the injectability and processing times of the cement.
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