title: Osteogenic protein-1 increases the fixation of implants grafted with morcellised bone allograft and ProOsteon bone substitute: an experimental study in dogs.
abstract: Impacted bone allograft is often used in revision joint replacement. Hydroxyapatite granules have been suggested as a substitute or to enhance morcellised bone allograft. We hypothesised that adding osteogenic protein-1 to a composite of bone allograft and non-resorbable hydroxyapatite granules (ProOsteon) would improve the incorporation of bone and implant fixation. We also compared the response to using ProOsteon alone against bone allograft used in isolation. We implanted two non-weight-bearing hydroxyapatite-coated implants into each proximal humerus of six dogs, with each implant surrounded by a concentric 3 mm gap. These gaps were randomly allocated to four different procedures in each dog: 1) bone allograft used on its own; 2) ProOsteon used on its own; 3) allograft and ProOsteon used together; or 4) allograft and ProOsteon with the addition of osteogenic protein-1. After three weeks osteogenic protein-1 increased bone formation and the energy absorption of implants grafted with allograft and ProOsteon. A composite of allograft, ProOsteon and osteogenic protein-1 was comparable, but not superior to, allograft used on its own. ProOsteon alone cannot be recommended as a substitute for allograft around non-cemented implants, but should be used to extend the volume of the graft, preferably with the addition of a growth factor.
authors.affiliation: Orthopaedic Research Group, Odense University Hospital, DK 5000 Odense C, Denmark. tbj@webspeed.dk
authors.forename: T B
authors.initials: TB
authors.lastname: Jensen
authors.forename: S
authors.initials: S
authors.lastname: Overgaard
authors.forename: M
authors.initials: M
authors.lastname: Lind
authors.forename: O
authors.initials: O
authors.lastname: Rahbek
authors.forename: C
authors.initials: C
authors.lastname: Bünger
authors.forename: K
authors.initials: K
authors.lastname: Søballe
mesh_terms: D000818:Animals; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D020099:Coated Materials, Biocompatible; D004285:Dogs; D004353:Drug Evaluation, Preclinical; D017886:Durapatite; D007595:Joint Prosthesis; D016348:Osseointegration / Q000187:drug effects*; D010012:Osteogenesis / Q000187:drug effects; D011897:Random Allocation; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D020099:Coated Materials, Biocompatible; D016212:Transforming Growth Factor beta; D017886:Durapatite