Modulation of bone homeostasis by dual drug-loaded premixed magnesium tri-magnesium phosphate bone cement for the treatment of osteoporotic vertebral compression fractures

Osteoporotic vertebral compression fractures (OVCF) have emerged as a significant public health concern. Traditionally, poly(methyl methacrylate) (PMMA) has been utilized in clinical to treat OVCF. Nevertheless, its poor degradability, uncontrollable setting time, high curing temperatures, and the potential for cement leakage have limited their application. In addition, these bone cements required clinical handling, bringing inconvenience to surgery.This study developed a premixed magnesium phosphate bone cement loaded with strontium ranelate and bioglass microspheres grafted with alendronate sodium (pTMPC-SMA), to achieve regulation between osteogenesis and osteoclastogenesis on osteoporosis. The premixed cement offered storage stability, easy of use, anti-washout behavior, and sustained drug release properties. The in vivo osteoporotic rabbit vertebroplasty model demonstrated that pTMPC-SMA exhibited excellent cavity-filling adaptability, significantly enhanced new bone formation, and achieved superior osseointegration compared to the PMMA group. These findings demonstrate that pTMPC-SMA provides both excellent handling properties and osteogenic therapeutic advantages for treating osteoporosis-related bone defects.