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Effects of starch pregelatinization and starch type on the physicochemical properties of CPC were investigated. CPC modified with pregelatinized normal corn starch (CPB\u2010PNC) or pregelatinized waxy maize starch (CPB\u2010PW) was evaluated by two vertebral fracture surgical models <jats:italic>in vitro<\/jats:italic>. Both granular and pregelatinized starches significantly improved the setting times and injectability of CPC, but only the pregelatinized starches improved the anti\u2010collapsibility and compressive strength of CPC significantly. CPB\u2010PW, whose micro\u2010structure was compact and uniform, showed the best physicochemical properties. Addition of starch did not inhibit the hydro\u2010reaction of CPC. Unmodified CPC had very poor dispersibility and could not apply in the tests of the surgical models. Pregelatinized starch especially waxy maize starch improved the dispersibility of CPC and showed good dispersion area, volume, improved pull\u2010out force and maximum torque in the Sawbones sponge model. Similarly, in the minimally invasive kyphoplasty model, CPB\u2010PNC and CPB\u2010PW could disperse in the osteoporotic sheep vertebrae and improve the compressive strength of the sheep vertebral body. In conclusion, starch pregelatinization and starch botanical source affect the physicochemical properties of CPC significantly. Bone cements modified by different starches also performed differently in surgical models for osteoporotic vertebral fracture. Pregelatinized waxy maize starch may be a better candidate for CPC modification comparing to the pregelatinized normal corn starch.<\/jats:p>","DOI":"10.1002\/jbm.b.34855","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T12:22:55Z","timestamp":1621858975000},"page":"2068-2078","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Calcium phosphate\u2010based composite cement: Impact of starch type and starch pregelatinization on its physicochemical properties and performance in the vertebral fracture surgical models <i>in vitro<\/i>"],"prefix":"10.1002","volume":"109","author":[{"given":"Yixing","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Orthopedic Institute The First Affiliated Hospital, Soochow University  Suzhou 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