Abstract
Orthopedic surgeons sometimes combine recombinant, human BMP-2 with autograft bone when dealing with problematic osseous fractures. Although some case reports indicate success with this off-label strategy, there have been no randomized controlled trials. Moreover, a literature search revealed only one pre-clinical study and this was in a cranial defect model. The present project examined the consequences of combining BMP-2 with particles of living bone in a rat femoral defect model. Human bone particles were recovered with a reamer-irrigator-aspirator (RIA). To allow acceptance of the xenograft as surrogate autograft, rats were administered an immunosuppressive cocktail that does not interfere with bone healing. Implantation of 200μg living bone particles generated a small amount of new bone and defects did not heal. Graded amounts of BMP-2 that alone provoked no healing (1.1μg), borderline healing (5.5μg), or full healing (11μg) were added to this amount of bone particles. Addition of BMP-2 (1.1μg) increased osteogenesis, and produced bridging in 2 of 7 defects. The combination of BMP-2 (5.5μg) and bone particles made healing more reliable and advanced the maturation of the regenerate. Bone formation with BMP-2 (11μg) and bone particles showed improved maturation. Thus, the combination of autograft and BMP-2 may be helpful clinically under conditions where the healing response is suboptimal.
| Original language | English (US) |
|---|---|
| Journal | Journal of Orthopaedic Research |
| DOIs | |
| State | Accepted/In press - 2016 |
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Keywords
- Autograft
- Immunosuppression
- INFUSE
- RIA
- Xenograft
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
Interaction between living bone particles and rhBMP-2 in large segmental defect healing in the rat femur. / Liu, Fangjun; Wells, James W.; Porter, Ryan M.; Glatt, Vaida; Shen, Zhenxin; Schinhan, Martina; Ivkovic, Alan; Vrahas, Mark S.; Evans, Christopher H; Ferreira, Elisabeth.
In: Journal of Orthopaedic Research, 2016.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Interaction between living bone particles and rhBMP-2 in large segmental defect healing in the rat femur
AU - Liu, Fangjun
AU - Wells, James W.
AU - Porter, Ryan M.
AU - Glatt, Vaida
AU - Shen, Zhenxin
AU - Schinhan, Martina
AU - Ivkovic, Alan
AU - Vrahas, Mark S.
AU - Evans, Christopher H
AU - Ferreira, Elisabeth
PY - 2016
Y1 - 2016
N2 - Orthopedic surgeons sometimes combine recombinant, human BMP-2 with autograft bone when dealing with problematic osseous fractures. Although some case reports indicate success with this off-label strategy, there have been no randomized controlled trials. Moreover, a literature search revealed only one pre-clinical study and this was in a cranial defect model. The present project examined the consequences of combining BMP-2 with particles of living bone in a rat femoral defect model. Human bone particles were recovered with a reamer-irrigator-aspirator (RIA). To allow acceptance of the xenograft as surrogate autograft, rats were administered an immunosuppressive cocktail that does not interfere with bone healing. Implantation of 200μg living bone particles generated a small amount of new bone and defects did not heal. Graded amounts of BMP-2 that alone provoked no healing (1.1μg), borderline healing (5.5μg), or full healing (11μg) were added to this amount of bone particles. Addition of BMP-2 (1.1μg) increased osteogenesis, and produced bridging in 2 of 7 defects. The combination of BMP-2 (5.5μg) and bone particles made healing more reliable and advanced the maturation of the regenerate. Bone formation with BMP-2 (11μg) and bone particles showed improved maturation. Thus, the combination of autograft and BMP-2 may be helpful clinically under conditions where the healing response is suboptimal.
AB - Orthopedic surgeons sometimes combine recombinant, human BMP-2 with autograft bone when dealing with problematic osseous fractures. Although some case reports indicate success with this off-label strategy, there have been no randomized controlled trials. Moreover, a literature search revealed only one pre-clinical study and this was in a cranial defect model. The present project examined the consequences of combining BMP-2 with particles of living bone in a rat femoral defect model. Human bone particles were recovered with a reamer-irrigator-aspirator (RIA). To allow acceptance of the xenograft as surrogate autograft, rats were administered an immunosuppressive cocktail that does not interfere with bone healing. Implantation of 200μg living bone particles generated a small amount of new bone and defects did not heal. Graded amounts of BMP-2 that alone provoked no healing (1.1μg), borderline healing (5.5μg), or full healing (11μg) were added to this amount of bone particles. Addition of BMP-2 (1.1μg) increased osteogenesis, and produced bridging in 2 of 7 defects. The combination of BMP-2 (5.5μg) and bone particles made healing more reliable and advanced the maturation of the regenerate. Bone formation with BMP-2 (11μg) and bone particles showed improved maturation. Thus, the combination of autograft and BMP-2 may be helpful clinically under conditions where the healing response is suboptimal.
KW - Autograft
KW - Immunosuppression
KW - INFUSE
KW - RIA
KW - Xenograft
UR - http://www.scopus.com/inward/record.url?scp=84964344022&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964344022&partnerID=8YFLogxK
U2 - 10.1002/jor.23255
DO - 10.1002/jor.23255
M3 - Article
C2 - 27037517
AN - SCOPUS:84964344022
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
SN - 0736-0266
ER -