Synergistic Akermanite/PMMA/Zirconia Composites with Nature Inspired Structure via 3D Printing for orthopaedics

The development of orthopedic implants requires bone cements that combine bioactivity with mechanical stability. In this study, 25% Akermanite/PMMA/25% Zirconia composites were fabricated using a bio plotter additive manufacturing process in three structural configurations, solid, 5-channel, and 6-channel--mimicking the lotus root's porous structure. Structural and biological characterizations were conducted using SEM, micro-CT, mechanical testing, antibacterial assays, and hemocompatibility and cytocompatibility analyses. SEM confirmed uniform phase dispersion and strong interfacial bonding, while micro-CT revealed porosities of 53±1% (5-channel) and 67±3% (6-channel). The 6-channel design exhibited superior antibacterial activity against E. coli (16 mm) and S. aureus (21 mm), higher cell viability, and the lowest hemolytic effect. Compressive strengths were 145.6 MPa (solid), 132.8 MPa (5-channel), and 120.5 MPa (6-channel), demonstrating a balance between porosity and strength. Overall, the 6-channel structure achieved an optimal trade-off between mechanical performance and biological functionality, suggesting its potential for next-generation orthopedic applications. • This research work evaluates the potential performance of Akermanite and zirconia as reinforcement materials in PMMA bone cements, which could contribute to advancements in 3Dprinting process used in orthopedic applications. • Particularly in enhancing the mechanical properties and bioactivity of nature inspired structure scaffold, it provides new insights into scaffold design for large bone defect repair and clinical translation. • The study addresses the preparation and properties of the lotus root-like biomimetic materials in tissue engineering in comparison with traditional 3D scaffolds for cell delivery and tissue regeneration. • By combining the biocompatibility of polymers with the mechanical strength and osteoconductivity of ceramics, this composite approach enables the creation of bioactive scaffolds that closely resemble the hierarchical architecture of natural cortical bone.