title: Enhancement of tendon-bone healing with the use of bone morphogenetic protein-2 inserted into the suture anchor hole in a rabbit patellar tendon model.
abstract: OBJECTIVE
  Suture anchor fixation failure has been reported as a result of anchor loosening and migration during the tendon-bone repair. The aim of this study was to evaluate the effects of bone morphogenetic protein-2 (BMP-2) inserted into the suture anchor hole on bone formation and the tendon-bone healing.
  
  
  METHODS
  Both back legs of 24 New Zealand White rabbits (n = 48) were used in this study. A metal suture anchor was then placed 5 mm below the cortex. In the control group, the space over the eyelet of the anchor (suture anchor hole) was not filled. In the experimental group, the suture anchor hole was filled with 0.1 mL of fibrin glue (group 2) or collagen gel (group 3) with 1 μg BMP-2. Histologic analysis, real-time-polymerase chain reaction, bone density and failure load measurement were performed, and differences were analyzed at 4 and 8 weeks.
  
  
  RESULTS
  Histologic analysis revealed more abundant new bone, mature bone and organized fibrocartilage at the tendon-bone interface at 4 and 8 weeks in groups in which BMP-2 was applied. At 8 weeks, the failure load of groups 1, 2 and 3 was significantly different among the three groups (P = 0.01). After post hoc Tukey test, the failure load of group 2 was significantly higher than that of group 1 (P = 0.01).
  
  
  CONCLUSIONS
  BMP-2, administrated as described in this study, improved tendon-bone healing and bone formation, resulting in improved biomechanical strength of the tendon-bone junction.
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Ansan, Gyeonggi-do, South Korea.
authors.forename: Jae Gyoon
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Guro Hospital, Seoul, South Korea.
authors.forename: Hak Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Rare Disease Institute, Guro Hospital, Seoul, South Korea.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Ansan, Gyeonggi-do, South Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Bae
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Ansan, Gyeonggi-do, South Korea.
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Ko
authors.affiliation: Department of Orthopedic Surgery, Korea University College of Medicine, Ansan Hospital, Ansan, Gyeonggi-do, South Korea. Electronic address: canall@korea.ac.kr.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
mesh_terms: D000818:Animals; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D003094:Collagen / Q000378:metabolism; D006801:Humans; D010012:Osteogenesis / Q000235:genetics*; D017847:Patellar Ligament / Q000293:injuries / Q000601:surgery*; D011817:Rabbits; D019651:Plastic Surgery Procedures; D053441:Suture Anchors; D014945:Wound Healing / Q000187:drug effects
chemical_list: D055396:Bone Morphogenetic Protein 2; D003094:Collagen
keywords: bone morphogenetic protein-2; collagen gel; fibrin glue; patellar tendon; suture anchor