Augmentation of implant surfaces with BMP-2 in a revision setting: effects of local and systemic bisphosphonate

Bone & Joint Research

Joan E. Bechtold¹  Mette Sorensen²  Kjeld Soballe²  Jorgen Baas²  Andreas West³  Rasmus Cleemann⁴ 

[1] Department of Orthopedic Surgery, Hennepin Healthcare Research Institute, Minneapolis Medical Research Foundation, Orthopedic Biomechanics Laboratory, University of Minnesota, Minneapolis, Minnesota, USA;Orthopedic Research Laboratory, Aarhus University Hospital, Aarhus, Denmark;Orthopedics, Regionshospitalet Horsens, Horsens, Denmark;Orthopedics, Zealand University Hospital Koge, Køge, Denmark;

关键词: bone anabolic;    anti-catabolic;    revision;    bone morphogenetic protein 2 (bmp-2);    allografted;    revision surgery;    implant fixation;    stiffness;    bone graft;    augmentation;    anabolic agent;    rhbmp-2;    bisphosphonates;   

DOI  :  10.1302/2046-3758.108.BJR-2020-0280.R1

来源: DOAJ

【 摘 要 】

Aims: We wanted to evaluate the effects of a bone anabolic agent (bone morphogenetic protein 2 (BMP-2)) on an anti-catabolic background (systemic or local zoledronate) on fixation of allografted revision implants. Methods: An established allografted revision protocol was implemented bilaterally into the stifle joints of 24 canines. At revision surgery, each animal received one BMP-2 (5 µg) functionalized implant, and one raw implant. One group (12 animals) received bone graft impregnated with zoledronate (0.005 mg/ml) before impaction. The other group (12 animals) received untreated bone graft and systemic zoledronate (0.1 mg/kg) ten and 20 days after revision surgery. Animals were observed for an additional four weeks before euthanasia. Results: No difference was detected on mechanical implant fixation (load to failure, stiffness, energy) between local or systemic zoledronate. Addition of BMP-2 had no effect on implant fixation. In the histomorphometric evaluation, implants with local zoledronate had more area of new bone on the implant surface (53%, p = 0.025) and higher volume of allograft (65%, p = 0.007), whereas implants in animals with systemic zoledronate had the highest volume of new bone (34%, p = 0.003). Systemic zoledronate with BMP-2 decreased volume of allograft by 47% (p = 0.017). Conclusion: Local and systemic zoledronate treatment protects bone at different stages of maturity; local zoledronate protects the allograft from resorption and systemic zoledronate protects newly formed bone from resorption. BMP-2 in the dose evaluated with experimental revision implants was not beneficial, since it significantly increased allograft resorption without a significant compensating anabolic effect.

【 授权许可】

Unknown