OP-1 application in bone allograft integration: preliminary results in sheep experimental surgery

• Published in: Injury Vol. 39; pp. S65 - S72
• Main Authors: Donati, D, Bella, C. Di, Lucarelli, E, Dozza, B, Frisoni, T, Aldini, N. Nicoli, Giardino, R
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.09.2008; Elsevier
• Subjects: Allograft incorporation; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; BMP-7; Bone Morphogenetic Protein 7 - administration & dosage; Bone Morphogenetic Protein 7 - pharmacology; Bone regeneration; Bone Remodeling - drug effects; Bone Transplantation - methods; Bony Callus - drug effects; Disease Models, Animal; Diseases of the osteoarticular system; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Medical sciences; Metatarsal Bones - diagnostic imaging; Metatarsal Bones - drug effects; Metatarsal Bones - injuries; Metatarsal Bones - pathology; Metatarsal Bones - surgery; OP-1; Orthopedics; Osteotomy; Radiography; Recombinant Proteins - administration & dosage; Recombinant Proteins - pharmacology; Sheep; Sheep model; OP-1; BMP-7; Allograft incorporation; Bone regeneration; Sheep model; Incorporation; Transforming growth factor β; Homograft; Regeneration; Vertebrata; Mammalia; Meat animals; Bone morphogenetic protein; Treatment; Graft; Anesthesia; Sheep; Models; Artiodactyla; Bone; Experimental surgery; Ungulata; Bone morphogenetic protein 7
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/S0020-1383(08)70017-2

Summary Massive bone allografts are frequently used in orthopaedic reconstructive surgery. However the failure rate at long term follow-up is around 25%. Aim Stimulation of allograft incorporation. Materials and Methods In order to stimulate bone remodeling of an allograft we applied recombinant human osteogenic protein-1 (rh-OP-1, also know as bone morphogenetic protein-7, BMP-7) to a long bone critical size defect sheep model. In nine sheep we created a 3 cm osteoperiosteal metatarsal defect replaced with a structural allograft alone (control group, 4 animals), or an allograft added with rh-BMP-7 (BMP group, 5 animals). Radiographic, mechanical, histological and histomorphometric analysis were performed. Results X-rays in the BMP group showed a better and faster callus formation, compared to the control group within the first 8 weeks after surgery. After 16 weeks there was a higher evidence of bone remodeling in the BMP group. Radiographic healing at junction sites was more evident in the BMP group at 4, 8 and 16 weeks. Mechanical testing on screw extraction showed no statistical differences between the two groups and histomorphometry showed no difference in terms of newly formed bone inside the allograft as well. The resorption rate of the graft was higher in the BMP group in comparison to the control group. The penetration of newly formed vessels was significantly higher in the BMP group. Conclusions These findings indicate that BMP-7 added to a structural bone allograft inducing early remodeling of the graft through stimulation of neo-angiogenesis and osteoclastic activity, without negative effects in mechanical strength and clinical outcome.