physical characterization and osteogenic activity of the quaternized chitosan-loaded pmma bone cement

gentamicin-loaded polymethylmethacrylate (pmma), widely used for primary cemented arthroplasty and revision surgery for preventing or treating infections, may lead to the evolution of antibiotic-resistant bacteria and dysfunction of osteogenic cells, which further influence the osteointegration of bone cement. in a previous study, we reported that a new quaternized chitosan derivative (hydroxypropyltrimethyl ammonium chloride chitosan, hacc) that was loaded into pmma significantly inhibited the formation of biofilms caused by methicillin-resistant staphylococcus strains. in the present study, we further investigated the surface morphology, hydrophilicity, apatite formation ability and osteogenic activity of hacc-loaded pmma. chitosan-loaded pmma, gentamicin-loaded pmma and pmma without antibiotic were also investigated and compared. the results showed that, compared to other pmma-based cements, hacc-loaded pmma had improved properties such as a lower polymerization temperature, prolonged setting time, porous structures after immersion in phosphate-buffered saline, higher hydrophilicity, more apatite formation on the surface after immersion in simulated body fluid, and better attachment and spreading of the human-marrow-derived mesenchymal stem cells. we also found better stem cell proliferation, osteogenic differentiation, and osteogenesis-associated genes expression on the surface of the hacc-loaded pmma compared to the gentamicin-loaded pmma. therefore, this new anti-infective bone cement had improved physical properties and osteogenic activity, which may lead to better osteointegration of the bone cement in cemented arthroplasty.