Poly(methyl methacrylate) (PMMA) is the most commonly used material for the treatment of osteoporosis-induced vertebral compression fractures. However, its high stiffness may introduce an increased risk of adjacent vertebral fractures post-surgery. One alternative in overcoming this concern is the use of additives. This presents its own challenge in maintaining an adequate biocompatibility when modifying the base cement. The aim of this study was to evaluate the in vivo biocompatibility of linoleic acid (LA)-modified acrylic bone cement using a large animal model for the first time, in order to further advance towards clinical use. A worst-case approach was used, choosing a slow-setting base cement. The in vitro monomer release from the cements was also assessed. Additional material characterization, including mechanical tests, are summarized in Appendix A. Unmodified and LA-modified cements were injected into a total of 56 bone defects created in the femur and humerus of sheep. Histopathologic and histomorphometric analysis indicated that LA-modified cement showed a harmless tissue response similar to that of the unmodified cement. Adjacent bone remodeling was observed microscopically 4 weeks after implantation, suggesting a normal healing process of the bone tissues surrounding the implant. LA-modified cement exhibited lower mechanical properties, with a reduction in the elastic modulus of up to 65%. The handling properties were slightly modified without negatively affecting the injectability of the base cement. LA-modified bone cement showed good biocompatibility as well as bone compliant mechanical properties and may therefore be a promising material for the treatment of osteoporotic vertebral fractures.

聚甲基丙烯酸甲酯（PMMA）是用于治疗骨质疏松症引起的椎体压缩性骨折的最常用材料。但是，其高刚度可能会增加手术后邻近椎骨骨折的风险。解决这一问题的一种替代方法是使用添加剂。在改性基础水泥时，这在维持足够的生物相容性方面提出了自己的挑战。这项研究的目的是首次使用大型动物模型评估亚油酸（LA）改性的丙烯酸骨水泥的体内生物相容性，以进一步推进临床应用。使用了最坏情况的方法，选择了一种慢速凝固的基础水泥。在体外还评估了单体从水泥中的释放。附录A中概述了其他材料特性，包括机械测试。未改性和LA改性的水泥被注入到绵羊股骨和肱骨中产生的总共56个骨缺损中。组织病理学和组织形态计量学分析表明，LA改性的水泥显示出与未改性的水泥相似的无害组织反应。植入后4周，在显微镜下观察到相邻的骨重塑，表明植入物周围的骨组织正常愈合过程。LA改性的水泥表现出较低的机械性能，其弹性模量降低了65％。在不对基础水泥的可注入性产生负面影响的情况下，对处理性能进行了轻微的修改。