Canine investigation of rhBMP-2, autogenous bone graft, and rhBMP-2 with autogenous bone graft for the healing of a large segmental tibial defect.
OBJECTIVE
The purpose of this study was to compare the effects of bone morphogenetic protein, bone morphogenetic protein with autogenous bone graft (ABG), and ABG alone on the healing of a large bone defect in the canine tibia.


METHODS
Fifteen 45- to 55-lb canines were randomly assigned to 1 of 5 treatment groups, 3 per group. The groups included (1) recombinant human bone morphogenetic protein (rhBMP-2, 0.43 mg/mL)/absorbable collagen sponge (ACS) + collagen/ceramic matrix (CCM), (2) rhBMP-2 (0.22 mg/mL) ACS + CCM, (3) rhBMP-2 (0.43 mg/mL) ACS + ABG, (4) rhBMP-2 (0.22 mg/mL) ACS + ABG, and (5) ABG alone. A 5-mL defect was created in the right tibia and fixed with a 4.5 mm locking plate and 1 of the grafts described above implanted. X-rays were taken biweekly for 12 weeks and evaluated for radiographic union. Representative histology was also examined.


RESULTS
All defects treated with rhBMP-2 (any combination) healed at 6.0 +/- 0.9 weeks. None of the ABG alone-treated defects were healed at 12 weeks. Dogs receiving rhBMP-2/ACS + CCM healed at 5.7 +/- 0.8 weeks, whereas rhBMP-2/ACS + ABG defects healed at 6.3 +/- 0.8 weeks. Histology showed healing consistent with 12-week radiologic results.


CONCLUSIONS
Large segmental defects in canine tibiae can be effectively healed with stable fixation and rhBMP-2/ACS + ABG or CCM. These conclusions may offer insight into the clinical treatment of segmental defect nonunions in the human.
Boyce
Andrew S
AS
OrthoIndy, Indianapolis, IN; and daggerAlegius Consulting, LLC, Avon, IN 46123, USA.
Reveal
Greg
G
Scheid
D Kevin
DK
Kaehr
David M
DM
Maar
Dean
D
Watts
Melanie
M
Stone
Marcus B
MB
D000818:Animals; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy; D004285:Dogs; D017102:Fracture Healing / Q000187:drug effects*; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013978:Tibial Fractures / Q000175:diagnosis / Q000628:therapy*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*; D016896:Treatment Outcome
D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2