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.
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.
Murakami
Narumichi
N
Department of Orthopaedic Surgery, Shinshu University School of Medicine 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
Saito
Naoto
N
Takahashi
Jun
J
Ota
Hiroshi
H
Horiuchi
Hiroshi
H
Nawata
Masashi
M
Okada
Takao
T
Nozaki
Kazutoshi
K
Takaoka
Kunio
K
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
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