Repair of bone allograft fracture using bone morphogenetic protein-2.
Long-term clinical data have shown that reconstruction using bone allografts provide adequate function after extensive tumor surgery. Complications such as nonunion of allograft-host interface, infection, and allograft fracture often require major revision surgeries. Allograft fractures usually do not induce the same repair process that is seen in normal fracture healing. The authors did an experimental study to test whether bone morphogenetic protein-2 can induce and achieve osseous repair in an allograft osteotomy model. Recombinant human bone morphogenetic protein-2 was applied at femoral intercalary allograft osteotomy sites in 20 rats. Forty additional rats served as controls (carrier alone and sham). Specimens in all groups were examined histologically and radiographically at 4 and 8 weeks. Specimens in the control groups showed only fibrosis by 8 weeks. In contrast, none of 10 specimens in the experimental group showed radiographic union at 8 weeks. New bone formation and integration with underlying allografts were seen in the experimental group as early as 4 weeks. These data suggest that fracture repair in the allograft bone can be triggered by a biologic regulator that is expressed during normal fracture healing.
Lee
Francis Young-In
FY
Orthopaedic Oncology Unit and Orthopaedic Research Laboratory, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Storer
Stephen
S
Hazan
Eric J
EJ
Gebhardt
Mark C
MC
Mankin
Henry J
HJ
D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000096:biosynthesis / Q000494:pharmacology* / Q000627:therapeutic use; D002146:Bony Callus; D005264:Femoral Fractures / Q000503:physiopathology / Q000601:surgery*; D017102:Fracture Healing / Q000187:drug effects* / Q000502:physiology; D023421:Models, Animal; D010027:Osteotomy; D051381:Rats; D011917:Rats, Inbred Lew; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D016212:Transforming Growth Factor beta / Q000494:pharmacology* / Q000627:therapeutic use
C525718:BMP2 protein, human; C525720:Bmp2 protein, rat; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta