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

Bone & Joint Research

article

Rasmus Cleemann¹  Mette Sorensen²  Andreas West³  Kjeld Soballe²  Joan E. Bechtold⁴  Jorgen Baas² 

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

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

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsWe 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.MethodsAn 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.ResultsNo 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).ConclusionLocal 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】

CC BY-NC