Objective To extend its application in the field of bone repair by adding oxygen-carboxymethylated chitosan (O-CMC) and gentamicin for modification of the calcium sulfate cement (CSC). Methods The O-CMC/CSC was prepared by adding O-CMC with different concentrations (0.1wt%, 0.3wt%, 0.5wt%, 0.7wt%, and 1.0wt%) in the CSC liquid phase. The effect of O-CMC on the CSC was evaluated by testing the injectability, compressive strength, degradation rate, pH value, cytotoxicity and osteogenesis. After the optimal concentration of O-CMC was determined, gentamicin with different concentrations (0.5wt%, 1.5wt%, and 2.5wt%) was added in the O-CMC/CSC, and then the compressive strength and antibacterial properties were investigated. Results After adding O-CMC in the CSC liquid phase, the injection time of O-CMC/CSC was increased to more than 5 minutes; it significantly prolonged with increased concentration of O-CMC (P<0.05). The compressive strength of the modified bone cement was in the range of 11-18 MPa and it was the highest when the concentration of O-CMC was 0.5wt% (P<0.05). The degradation rate of O-CMC/CSC was not influenced obviously by O-CMC (P>0.05). The pH value was in the range of 7.2-7.4 and Ca2+ concentration was in the range of 6-8 mmol/L.In vitro mineralization experiment indicated that the induced mineralization ability of O-CMC/CSC was much higher than that of pure CSC. The 0.5wt% O-CMC/CSC had the best performance; the compressive strength of the composite bone cement was above 5 MPa after gentamicin was added, which had antibacterial effect. Conclusion O-CMC is able to effectively improve the injection, compressive strength, and osteogenic activity of CSC; in addition, antibacterial properties is obtained in the CSC after adding gentamicin.
