Short-term osteoclastic activity induced by locally high concentrations of recombinant human bone morphogenetic protein-2 in a cancellous bone environment
An experimental study investigating osteoclastic activity induced by rhBMP-2 in sheep. To examine the effects of increasing local rhBMP-2 concentration on osteoclastic response and peri-implant bone resorption. Level I clinical studies have established the safe and effective volume and concentration...
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Published in | Spine (Philadelphia, Pa. 1976) Vol. 34; no. 6; p. 539 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
15.03.2009
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Subjects | |
Online Access | Get more information |
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Summary: | An experimental study investigating osteoclastic activity induced by rhBMP-2 in sheep.
To examine the effects of increasing local rhBMP-2 concentration on osteoclastic response and peri-implant bone resorption.
Level I clinical studies have established the safe and effective volume and concentration of rhBMP-2 delivered on an absorbable collagen sponge. However, peri-implant bone resorption appearing as decreased mineral density has been observed radiographically in rare instances after implantation of rhBMP-2 on an absorbable collagen sponge (rhBMP-2/ACS).
Bilateral corticocancellous defects were created in the distal femora of 30 adult sheep. Combinations of rhBMP-2/ACS implant volume (V) (1V = normal fill or 2V = overfilled) and rhBMP-2 solution concentration (x) (1x = normal concentration or 3.5x = hyperconcentrated) resulted in local rhBMP-2 concentrations of 0x, 1x, 2x, 3.5x, and 7x the estimated effective concentration for this model. Faxitron radiography, quantitative CT, histology, and quantitative histomorphometry were conducted in a blinded fashion to analyze the effect of the treatments.
At 1 week, the normal fill-normal concentration implants (1x) produced the least transient osteoclastic activity resulting in limited peri-implant resorption. Overfilled-hyperconcentrated implants (2x, 3.5x) demonstrated moderate resorption zones. Overfilled-hyperconcentrated implants (7x) demonstrated extensive osteoclastic activity and marked resorption. Results at 4 and 8 weeks revealed dense osteoid and bone in the voids with progressive bony healing. Control defects showed no osteoclastic activity with little to no bony healing.
Increasing the local rhBMP-2 concentration by overfilling the defect with rhBMP-2/ACS or hyperconcentrating the rhBMP-2 solution on the absorbable collagen sponge led to a concentration-dependent osteoclastic resorption of peri-implant bone. The osteoclastic effect was transient, and progressive healing took place over the 8-week survival period. |
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ISSN: | 1528-1159 |
DOI: | 10.1097/brs.0b013e3181952695 |