Enhanced biological activity of ACPs/cc/cs/PVA composite bone cement: a study on degradation, mineralization, and bone repair properties

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The application of calcium phosphate cement in bone repair is often limited by its restricted degradation and mineralization capabilities. Here, we developed a novel composite material integrating amorphous calcium phosphates (ACPs) and calcium citrate (CC) to enhance biological activity. The composite was combined with powdered chitosan (CS) and liquid polyvinyl alcohol (PVA) to formulate the ACPs/CC/CS/PVA bone cement. We investigated the influence of varying PVA concentrations (0.3%, 0.6%, 1.0%, and 1.5%) on the cement’s setting time, hydrophilicity, compressive strength, pH, calcium release rate, and degradation rate. We find the ACPs/CC/CS/PVA bone cement demonstrates favorable injectability and anti-washout characteristics within the PVA concentration range of 0.3–1.5%. An elevated PVA concentration is correlated with enhanced anti-washout properties and improved compressive strength, reaching 42.8 MPa, which is essential for maintaining mechanical stability at the defect site. Additionally, the 1.5% PVA cement formulation ensures an adequate calcium ion concentration (6.5–9.5 mg/L) for the beginning of bone repair. Furthermore, in vivo animal studies have confirmed the biocompatibility of the ACPs/CC/CS/PVA bone cement. Controlled release of Ca2+ and PO4 3− ions from ACPs is suggested to facilitate osteoconduction and osteogenesis, highlighting the material’s prospect in bone repair applications.