Layered Double Hydroxide Modified Bone Cement Promoting Osseointegration <i>via</i> Multiple Osteogenic Signal Pathways

Poly(methyl methacrylate) (PMMA) bone cement has been widely used in orthopedic surgeries including total hip/knee replacement, vertebral compression fracture treatment, and defect filling. However, aseptic loosening of the interface between PMMA often leads to failure. Hence, development modified that facilitates growth into is key reducing incidence loosening. In this study, MgAl-layered double hydroxide (LDH) microsheets (PMMA&LDH) with superior osseointegration performance synthesized. The maximum polymerization reaction temperature PMMA&LDH decreased by 7.0 11.8 °C, respectively, compared PMMA&COL-I (mineralized collagen I PMMA). mechanical slightly comparison PMMA, which beneficial alleviate stress-shielding osteolysis, indirectly promote osseointegration. osteogenic ability demonstrated vivo, boosts 2.17- 18.34-fold increments groups at 2 months, postoperatively. Moreover, transcriptome sequencing revealed four pathways: p38 MAPK, ERK/MAPK, FGF, TGF-β, were further confirmed IPA, qPCR, Western blot assays. LDH-modified a promising biomaterial enhance potential applications relevant surgeries.