By using a non-aqueous solution as the mixing liquid, the washout resistance of the calcium deficient apatite biocement (cd-AB) was significantly improved, over that of the conventional method of using cd-AB with water as the liquid phase. In this study, premixed and injectable cd-AB was prepared, which had the advantage of being stable in the syringe and hardens only after being delivered to the defect area. The cd-AB powder with a Ca/P ratio of 1.5 consists of a mixture of tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA). A solution of polylactide (PLA) in N-methyl-2-pyrrolidone (NMP) was used as the liquid phase of the premixed cd-AB. The premixed cd-AB paste injected into an aqueous environment exhibited excellent washout resistance. The premixed cd-AB had longer setting time and lower compressive strength than conventional cd-AB. The hydration products of premixed cd-AB were a mixture of calcium deficient hydroxyapatite (cd-HA) and PLA. In vitro Tris-HCl immersion tests demonstrated that the premixed cd-AB could be degradable. The results revealed that the premixed cd-AB was cytocompatible and had no adverse effects on the attachment and proliferation of MG-63 osteoblast-like cells in vitro. The most distinct advantages of premixed and injectable PLA-modified cd-AB were its excellent washout resistance and in vitro degradability, suggesting that it may be a promising candidate for bone repair.
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