Background This study aimed to prepare the polymethylmethacrylate (PMMA) bone cement release system with different concentrations of enoxaparin sodium (ES) and to investigate the release characteristics of ES after loading into the PMMA bone cement. Methods In the experimental group, 40 g Palacos®R PMMA bone cement was loaded with various amount of ES 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, respectively. The control group was not loaded with ES. Scanning electron microscopy (SEM) was used to observe the surface microstructure of the bone cement in the two groups. In the experiment group, the mold was extracted continuously with pH7.4 Tris-HCL buffer for 10 days. The extract solution was collected every day and the anti-FXa potency was measured. The experiment design and statistical analysis were conducted using a quantitative response parallel line method. Results Under the SEM, it was observed that ES was filled in the pores of PMMA bone cement polymer structure and released from the pores after extraction. There was a burst effect of the release. The release amount of ES on the first day was 0.415, 0.858, 1.110, 1.564, 1.952, and 2.513, respectively, from the six groups with various ES loading amount of 4000, 8000, 12,000, 16,000, 20,000, and 24,000 AXaIU, all reaching the peak of release on the first day. The release decreased rapidly on the next day and entered the plateau phase on the fourth day. Conclusion The prepared ES-PMMA bone cement has high application potential in orthopedic surgery. ES-PMMA bone cement shows good drug release characteristics. The released enoxaparin sodium has a local anti-coagulant effect within 24 h after application, but it will not be released for a long time, which is complementary to postoperative anti-coagulation therapy.

Silk fibroin (SF) is a kind of natural protein, which is widely used in biomedical materials because of its biodegradability, easy modification, biocompatibility and good mechanical properties. In this exploration, it was used as bone cement materials and compared with conventional bone cement materials to obtain the efficacy of different bone cement materials in the treatment of osteoporotic vertebral compression fractures. First, the effect of degumming time of silk in boiling on SF was analyzed. Then, hydroxyapatite silk fibroin (HA-SF) was added to calcium phosphate cement (Cap) by coprecipitation method. The properties of the composite bone cement were analyzed by morphology analysis and mechanical properties testing. Finally, 40 patients who underwent percutaneous kyphoplasty (PKP) from May 2019 to June 2020 were selected and divided into two groups. Among them, one group used the composite bone cement material proposed in this exploration, and the other group used the conventional bone cement material. Patients in different groups were evaluated for postoperative treatment. In the experiment, the sericin could be removed by boiling, and the SF short fiber could be peeled by boiling for a long time; the compressive strength of Cap material could be improved by adding HA-SF. At the same time, the introduction of SF could shorten the coagulation time under the premise of injectability, so as to improve the anti-collapse ability of Cap; the patients using different bone cement materials were compared, and the cobb angle, anterior height of vertebral body and VAS score of different groups were analyzed 3 days and 3 months after operation. The results show that the bone cement material proposed in this exploration can effectively treat osteoporotic vertebral compression fractures.