Tungsten carbide-enhanced radiopaque and biocompatible PMMA bone cement and its application in vertebroplasty

Abstract

Polymethyl methacrylate (PMMA) cement is widely used in bone surgery for its good plasticity, chemical inertness, and excellent mechanical properties. Because of the high transparency of pure PMMA bone cement under X-ray imaging, it is necessary to add radiopacifiers such as barium sulfate. However, the interface compatibility between barium sulfate and PMMA is poor, leading to poor mechanical properties of the cement. In addition, the leaching of toxic barium ions significantly reduced the biocompatibility of the cement. In this study, a corrosion-resistant, insoluble ceramic, tungsten carbide (WC), is used as a radiopacifier. When the WC content is 10 wt%, the compressive strength is approximately 90 MPa without affecting the continuity of PMMA. The modified bone cement with 10 wt% WC showed superior radiopacity to that of commercial PMMA bone cement containing 30 wt% BaSO4. Moreover, the addition of WC greatly decreased the cytotoxicity of conventional PMMA. Our study proposed a novel PMMA cement with enhanced radiopacity and biocompatibility, showing great potential to be applied in the orthopedic field.