Calcium phosphate‐based composite cement: Impact of starch type and starch pregelatinization on its physicochemical properties and performance in the vertebral fracture surgical models in vitro

Abstract

Calcium phosphate cement (CPC) modified with native and pregelatinized normal corn and waxy maize starches was studied. Effects of starch pregelatinization and starch type on the physicochemical properties of CPC were investigated. CPC modified with pregelatinized normal corn starch (CPB-PNC) or pregelatinized waxy maize starch (CPB-PW) was evaluated by two vertebral fracture surgical models in vitro.Both granular and pregelatinized starches significantly improved the setting times and injectability of CPC, but only the pregelatinized starches improved the anticollapsibility and compressive strength of CPC significantly. CPB-PW, whose microstructure was compact and uniform, showed the best physicochemical properties. Addition of starch did not inhibit the hydro-reaction of CPC. Unmodified CPC had very poor dispersibility and could not apply in the tests of the surgical models.Pregelatinized starch especially waxy maize starch improved the dispersibility of CPC and showed good dispersion area, volume, improved pull-out force and maximum torque in the Sawbones sponge model. Similarly, in the minimally invasive kyphoplasty model, CPB-PNC and CPB-PW could disperse in the osteoporotic sheep vertebrae and improve the compressive strength of the sheep vertebral body. In conclusion, starch pregelatinization and starch botanical source affect the physicochemical properties of CPC significantly. Bone cements modified by different starches also Abbreviations: CICPS, cement-injectable cannulated pedicle screw; CPB, CPC and the radiopaque agent BaSO4; CPB-NC, CPB modified with native normal corn starch; CPB-PNC, CPB modified with pregelatinized normal corn starch; CPB-PW, CPB modified with pregelatinized waxy maize starch; CPB-W, CPB modified with native waxy maize starch; CPC, calcium phosphate cement; DCPD, dicalcium phosphate dihydrate (CaHPO 4 •2H 2 O); OP, osteoporosis; OVCF, osteoporotic vertebral compression fracture; PMMA, polymethyl methacrylate; RVA, rapid visco analyzer; α-TCP, alpha-tricalcium phosphate (α-Ca 3 (PO 4 ) 2 ).Yixing Tian and Huiling Liu contributed equally to this study.

Modification and evaluation of diatrizoate sodium containing polymethyl methacrylate bone cement

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Advances in materials used for minimally invasive treatment of vertebral compression fractures

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