PMMA-based cements are the most used
bone cements in vertebroplasty
and total hip arthroplasty. However, they present several drawbacks,
including susceptibility to bacterial infection, monomer leakage toxicity,
and high polymerization temperature, which can all lead to damage
to the surrounding tissues and their failure. In the present study,
silver nanowires (AgNWs) have been introduced to bestow antibacterial
properties; chitosan (CS) to promote porosity and to reduce the polymerization
temperature, without negatively affecting the mechanical performance;
and methacryloyl chitosan (CSMCC) to promote cross-linking with methyl
methacrylate (MMA) and reduce the quantity of monomer required for
polymerization. Novel PMMA cements were formulated containing AgNWs
(0 and 1% w/w) and CS or CSMCC at various concentrations (0, 10, 20,
and 30% w/w), testing two different ratios of powder and MMA (P/L).
Mechanical, thermal, antibacterial, and cytotoxic properties of the
resulting composite cements were tested. Cements with concentrations
of CS > 10% presented a significantly reduced polymerization temperature.
The mechanical performances were affected for concentrations >
20%
with a P/L concentration equal to 2:1. Concentrations of AgNWs as
low as 1% w/w conferred antimicrobial activity against S. aureus, whereas biofilm formation on the surface
of the cements was increased when CS was included in the preparation.
The combination of CS and AgNWs allowed a higher concentration of
Ag+ to be released over time with enhanced antimicrobial
activity. Inclusion of AgNWs did not affect cell viability on the
scaffolds. In conclusion, a combination of CS and AgNWs may be beneficial
for reducing both polymerization temperature and biofilm formation,
without significantly affecting mesenchymal stem cell proliferation
on the scaffolds. No advantages have been noticed as a result of the
reducing P/L ratio or using CSMCC instead of CS.