A versatile and injectable poly(methyl methacrylate) cement functionalized with quaternized chitosan-glycerophosphate/nanosized hydroxyapatite hydrogels

Injectable polymethylmethacrylate (PMMA) bone cement is alluring because it allows a minimally invasive surgical approach, reducing both the cost of treatment and patient discomfort. However, several documented drawbacks have necessitated the design of a more versatile version with adorable properties for future application. In this study, to amend the bulk behavior of PMMA cement, we synthesized a modified version by combining PMMA with quaternized chitosan (N-(2-hydroxy)propyl-3-trimethylammonium chitosan chloride, HTCC)-based hydrogels loaded with nanosized hydroxyapatite (Nano-HA). Then, the physicochemical properties, antimicrobial properties, remineralization capacity and mechanical performance changes under imitated physiological conditions were tested for these cements using a type K thermocouple, scanning electron microscope (SEM), microcomputed tomography (μ-CT), calcium ion test kit and mechanical compression tests. The results demonstrated that the HTCC-GP thermosensitive hydrogel generated interconnected pores, lower the T max value, lengthened the working time, developed appropriate mechanical properties and imparted excellent antibacterial activity to the cement. The Nano-HA particles engendered improved biomineralization ability of the cements without adversely influencing the mechanical performance. Hence, these results indicated that the injectable and multifunctional cement resulting from the p-PMMA/HTCC-GP/Nano-HA combination grips rosy prospect for future applications in bone reconstruction.