Effects of adding resorbable chitosan microspheres to calcium phosphate cements for bone regeneration

• We synthesized an injectable, bioactive chitosan microsphere/CPC for the first time.
• 100–400 μm chitosan microspheres were incorporated into the cement solid phase.
• XRD showed the construct contained diffraction peaks of hydroxyapatite and chitosan.
• Compressive strength of the composite was about 15 MPa comparable to cancellous bone.
• The new construct shows better bone formation and degradation than control group.

Calcium phosphate cements (CPCs) have been widely used as bone graft substitutes. However, the undesirable osteoinductivity and slow degradability of CPCs greatly hamper their clinical application. The aim of this study was to synthesize a type of injectable, bioactive cement. This was accomplished by incorporating chitosan microspheres into CPC. CPC containing chitosan microspheres was analyzed by X-ray diffraction (XRD) and scanning electron microscope (SEM). XRD showed that the hardened chitosan microsphere/CPC with different proportions of microspheres contained diffraction peaks of hydroxyapatite and chitosan. Compressive strength and dissolution in simulated body fluid were measured. The chitosan microsphere/CPC containing 10% (w/w) chitosan microspheres had a compressive strength of 14.78 ± 0.67 MPa. Cavity defects were created in both femoral condylar regions of New Zealand White rabbits. Chitosan microsphere/CPC (composite group) and α-TCP/CPC (control group) were implanted separately into the bone defects of both femurs. X-ray analysis was performed to observe the filling of these bone defects 3 days after surgery. The extent of bone substitute degradation and new bone formation were evaluated by SEM and histological examination at 8, 16, and 24 weeks after implantation. These results showed far more new bone formation and degradation of the chitosan microsphere/CPC composite in the bone defects. These data indicate that a chitosan microsphere/CPC composite might be considered as a promising injectable material for the generation of new bone tissue.