title: Repair of a proximal femoral bone defect in dogs using a porous surfaced prosthesis in combination with recombinant BMP-2 and a synthetic polymer carrier.
abstract: Total hip arthroplasty (THA) has become an almost standard procedure for the treatment of various hip lesions. However, one of the limitations has been the mechanical loosening of the prosthesis, a condition termed peri-prosthetic osteolysis. Consequently, at revision surgery, various grades of bone defect are often noted. Alternative approaches aimed at overcoming this problem have included a special design of the revision prosthesis and allo- or autogeneic bone grafting in combination with or without biomaterials. In a further attempt to address the loosening of the prosthesis, we have combined human bone morphogenetic protein-2, produced by DNA recombination (rhBMP-2) with a new synthetic biodegradable polymer (poly-D,L-lactic-acid-para-dioxanone-polyethyleneglycol block co-polymer; PLA-DX-PEG). We present data on the efficacy of the rhBMP-2 laden prosthesis to reconstruct a bone defect in a canine model. In this model, medial half of the proximal femur was surgically resected to create a bone defect that was repaired with the rhBMP-2/PLA-DX-PEG composite. Twelve weeks after implantation, the original bone defects in the rhBMP-2 treatment groups had been repaired. Thus, this type of 'hybrid' prosthesis may provide a new modality to repair bone defects or restore lost bone mass encountered in revision arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University School of Medicine 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
authors.forename: Narumichi
authors.initials: N
authors.lastname: Murakami
authors.forename: Naoto
authors.initials: N
authors.lastname: Saito
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Horiuchi
authors.forename: Masashi
authors.initials: M
authors.lastname: Nawata
authors.forename: Takao
authors.initials: T
authors.lastname: Okada
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nozaki
authors.forename: Kunio
authors.initials: K
authors.lastname: Takaoka
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D020099:Coated Materials, Biocompatible / Q000138:chemical synthesis*; D003131:Combined Modality Therapy / Q000379:methods; D004285:Dogs; D019544:Equipment Failure Analysis; D005264:Femoral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control; D007773:Lactates; D008297:Male; D011092:Polyethylene Glycols; D016062:Porosity; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013499:Surface Properties; D016212:Transforming Growth Factor beta
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D020099:Coated Materials, Biocompatible; D007773:Lactates; D016212:Transforming Growth Factor beta; C432470:polylactic acid-dioxanone-polyethylene glycol block copolymer; D011092:Polyethylene Glycols