Bone regeneration using a naturally grown HA/TCP carrier loaded with rh BMP-2 is independent of barrier-membrane effects

The present study investigated whether bone regeneration and biomaterial replacement would be improved by loading of biogenous biphasic biomaterial scaffolds (HA/TCP ratio 30/70) with rhBMP-2, and whether the placement of three barrier membranes differing in structure and porosity (prototyped SLA Ti specimens, GORE RESOLUT Adapt specimens, and titanized TiMESH light specimens) would have a synergistic effect. A rabbit calvarial model was used for the implantation studies. Histological specimens were obtained after 12 weeks and evaluated quantitatively for differences between the various material combinations. Loading of the biomaterials with rhBMP-2 significantly enhanced the amount of regenerated bone and caused a pronounced biomaterial replacement. While BMP-induced bone had formed uniformly over the surgical defects, bone regeneration in the absence of BMP depends on bone promotion from the margins of the defects toward the center. No positive effect on bone regeneration was seen for any of the placed barrier membranes. While the present study had shown that rhBMP-2 loading significantly increases bone regeneration using the investigated biomaterial, barrier-membrane placement may be useful in predetermining the final shape of the regenerative site but provides no additional beneficial impact on the amount and quality of the bone regeneration induced by rhBMP-2.     

A novel hydroxyapatite ceramic bone substitute transformed by ostrich cancellous bone: characterization and evaluations of bone regeneration activity

Various biomaterials have been used for bone repair and reconstruction of bone defects. Inorganic xenogenic bone substitutes have been intensively studied because they possesses favorable regenerative properties. The purpose of this study was to evaluate the properties of a novel inorganic xenogenic bone substitute, sintered ostrich cancellous bone (SOCB). Bone regeneration capability was also comparing to that of other bone substitutes in rabbit calvarial defects. Biochemical and biomechanical properties of the SOCB ceramic closely resembled those of human bone. Bone regeneration was evaluated by radiograph, histology, and histomorphometry. Bone regeneration was significantly enhanced in defects treated with SOCB when compared with other bone substitutes. The biochemical and biomechanical properties of SOCB are favorable for bone regeneration. SOCB might be a promising biomaterial for the repair of bone defects.     

The inhibitory effect of zoledronate on early-stage osteoinduction by recombinant human bone morphogenetic protein 2 in an osteoporosis model

Abstract

This study evaluated the effect of the combined treatment of intravenous zoledronic acid (ZA, 0.08?mg/kg) and rhBMP-2 (5?µg) on osteogenesis in a calvarial defect model of ovariectomized SD rats. New bone formation was evaluated 4 or 8 weeks after calvarial defect implantation using micro-CT and histology. Micro-CT results revealed that the rhBMP-2 group showed significantly higher calvarial defect coverage ratio compared with the ZA?+?rhBMP-2 group at 4 weeks. In addition, bone formation indices were significantly lower in ZA?+?rhBMP-2 group when compared with the rhBMP-2 group after 4 weeks, which indicates a negative effect of ZA on the initial bone formation and the bone quality. At 8 weeks, the negative effect induced by ZA treatment was alleviated as time passed. Histological examination showed similar results to the micro-CT measurements. In conclusion, although ZA treatment lowered the new bone formation induced by rhBMP-2 initially, as time passed, the negative effect was decreased.     

Repairing defect and preventing collapse of canine femoral head using titanium implant enhanced by autogenous bone graft and rhBMP-2

There is a direct relationship between mechanical stress and the progressive collapse of the necrotic region in osteonecrosis of the femoral head. The titanium implant combined with autogenous bone graft and recombinant human bone morphogenetic protein (rhBMP)-2 to repair the defect and prevent collapse of the femoral head was investigated. The femoral head defects were made by the trapdoor procedure and then the defects were filled, respectively, with the titanium implant combined with autogenous bone graft and rhBMP-2, with autogenous bone graft and rhBMP-2, and with autogenous bone graft alone. Roentgenographic and histological examinations were performed at various times postoperatively. The defects were repaired completely and the titanium implant was integrated with the surrounding bone tissues. The defects healed faster than did without rhBMP-2. No trapdoor cartilage collapsed and joint space narrowed. The titanium implant combined with autogenous bone graft and rhBMP-2 can enhance the repairing procedure and prevent the collapse of the femoral head.     

Long-term stability of bone tissues induced by an osteoinductive biomaterial, recombinant human bone morphogenetic protein-2 and a biodegradable carrier

The long-term stability of bone tissues induced by recombinant human bone morphogenetic protein-2 (rhBMP-2) and poly[L-lactide-co-glycolide] copolymer-coated gelatin sponge (PGS) was examined. In 16 dogs, 2.5 cm unilateral bone defects were created in the left tibial diaphyses. Tibia was fixed with metal plate, and PGS impregnated with (0.4 mg/cm(3)) or without rhBMP-2 was implanted into 15 or one defects, respectively. The metal plates of rhBMP-2-treated limbs were removed 16 weeks after the implantation. The bilateral tibiae of five animals each of the rhBMP-2-treated group were harvested at 32, 52 or 104 weeks, and served for biomechanical testing and histology. Although the defect that received PGS alone resulted in nonunion at 16 weeks, all defects treated with rhBMP-2 achieved radiographic bony union by 8 weeks. Biomechanical properties of the regenerated bones restored to the levels of intact tibiae at 32 weeks, but torsional stiffness was significantly higher. No statistical significances were detected in all parameters between regenerated and intact tibiae at 104 weeks. No radiographic and histological findings suggesting enhanced resorption to the regenerated bones were observed. These results suggest the long-term stability of the bone tissues induced by rhBMP-2, and the usefulness of rhBMP-2-impregnated PGS as a biomaterial for long bone defect filling.     

Repairing Defect and Preventing Collapse of Canine Femoral Head Using Titanium Implant Enhanced by Autogenous Bone Graft and rhBMP-2

There is a direct relationship between mechanical stress and the progressive collapse of the necrotic region in osteonecrosis of the femoral head. The titanium implant combined with autogenous bone graft and recombinant human bone morphogenetic protein (rhBMP)-2 to repair the defect and prevent collapse of the femoral head was investigated. The femoral head defects were made by the trapdoor procedure and then the defects were filled, respectively, with the titanium implant combined with autogenous bone graft and rhBMP-2, with autogenous bone graft and rhBMP-2, and with autogenous bone graft alone. Roentgenographic and histological examinations were performed at various times postoperatively. The defects were repaired completely and the titanium implant was integrated with the surrounding bone tissues. The defects healed faster than did without rhBMP-2. No trapdoor cartilage collapsed and joint space narrowed. The titanium implant combined with autogenous bone graft and rhBMP-2 can enhance the repairing procedure and prevent the collapse of the femoral head.     

Functionalization of scaffolds with chimeric anti-BMP-2 monoclonal antibodies for osseous regeneration

Recent studies have demonstrated the ability of murine anti-BMP-2 monoclonal antibodies (mAb) immobilized on an absorbable collagen sponge (ACS) to mediate de novo bone formation, a process termed antibody-mediated osseous regeneration (AMOR). The objectives of this study were to assess the efficacy of a newly generated chimeric anti-BMP-2 mAb in mediating AMOR, as well as to evaluate the suitability of different biomaterials as scaffolds to participate in AMOR. Chimeric anti-BMP-2 mAb was immobilized on 4 biomaterials, namely, titanium microbeads (Ti), alginate hydrogel, macroporous biphasic calcium phosphate (MBCP) and ACS, followed by surgical implantation into rat critical-size calvarial defects. Animals were sacrificed after 8 weeks and the degree of bone fill was assessed using micro-CT and histomorphometry. Results demonstrated local persistence of chimeric anti-BMP-2 mAb up to 8 weeks, as well as significant de novo bone regeneration in sites implanted with chimeric anti-BMP-2 antibody immobilized on each of the 4 scaffolds. Ti and MBCP showed the highest volume of bone regeneration, presumably due to their resistance to compression. Alginate and ACS also mediated de novo bone formation, though significant volumetric shrinkage was noted. In vitro assays demonstrated cross-reactivity of chimeric anti-BMP-2 mAb with BMP-4 and BMP-7. Immune complex of anti-BMP-2 mAb with BMP-2 induced osteogenic differentiation of C2C12 cells in vitro, involving expression of RUNX2 and phosphorylation of Smad1. The present data demonstrated the ability of chimeric anti-BMP-2 mAb to functionalize different biomaterial with varying characteristics to mediate osteogenesis.     

The effect of a fibrin-fibronectin/beta-tricalcium phosphate/recombinant human bone morphogenetic protein-2 system on bone formation in rat calvarial defects

In spite of good prospects for bone morphogenetic proteins (BMP) applications, an ideal carrier system for BMPs has not yet been identified. The purpose of this study was to evaluate the osteogenic effect of a fibrin-fibronectin sealing system (FFSS) combined with beta-tricalcium phosphate (beta-TCP) as a carrier system for recombinant human bone morphogenetic proteins (rhBMP-2) in the rat calvarial defect model. Eight-millimeter critical-size calvarial defects were created in 100 male Sprague-Dawley rats. The animals were divided into five groups of 20 animals each. The defects were treated with rhBMP-2/FFSS, rhBMP-2/FFSS/beta-TCP, FFSS and FFSS/beta-TCP carrier control or were left untreated as a sham-surgery control. Defects were evaluated by histologic and histometric parameters following a 2- and 8-week healing interval (10 animals/group/healing intervals). The FFSS/beta-TCP carrier group was significantly greater in new bone area at 2 weeks (p<0.05) and new tissue area at 2 and 8 weeks (p<0.01) relative to the FFSS carrier group. New bone and new tissue area in the rhBMP-2/FFSS/beta-TCP group were significantly greater than in the rhBMP-2/FFSS group at 8 weeks (p<0.01). On histologic observation, FFSS remnants were observed at 2 weeks, but by 8 weeks, the FFSS appeared to be completely resorbed. rhBMP-2 combined with FFSS/beta-TCP produced significantly more new bone and new tissue formation in this calvarial defect model. In conclusion, FFSS/beta-TCP may be considered as an available carrier for rhBMP-2.     

The stimulation of healing within a rat calvarial defect by mPCL–TCP/collagen scaffolds loaded with rhBMP-2

Bone morphogenetic proteins (BMPs) have been widely investigated for their clinical use in bone repair and it is known that a suitable carrier matrix to deliver them is essential for optimal bone regeneration within a specific defect site. Fused deposited modeling (FDM) allows for the fabrication of medical grade poly ?-caprolactone/tricalcium phosphate (mPCL–TCP) scaffolds with high reproducibility and tailor designed dimensions. Here we loaded FDM fabricated mPCL–TCP/collagen scaffolds with 5 μg recombinant human (rh)BMP-2 and evaluated bone healing within a rat calvarial critical-sized defect. Using a comprehensive approach, this study assessed the newly regenerated bone employing micro-computed tomography (μCT), histology/histomorphometry, and mechanical assessments. By 15 weeks, mPCL–TCP/collagen/rhBMP-2 defects exhibited complete healing of the calvarium whereas the non-BMP-2-loaded scaffolds showed significant less bone ingrowth, as confirmed by μCT. Histomorphometry revealed significantly increased bone healing amongst the rhBMP-2 groups compared to non-treated scaffolds at 4 and 15 weeks, although the % BV/TV did not indicate complete mineralisation of the entire defect site. Hence, our study confirms that it is important to combine microCt and histomorphometry to be able to study bone regeneration comprehensively in 3D. A significant up-regulation of the osteogenic proteins, type I collagen and osteocalcin, was evident at both time points in rhBMP-2 groups. Although mineral apposition rates at 15 weeks were statistically equivalent amongst treatment groups, micro-compression and push-out strengths indicated superior bone quality at 15 weeks for defects treated with mPCL–TCP/collagen/rhBMP-2. Consistently over all modalities, the progression of healing was from empty defect < mPCL–TCP/collagen < mPCL–TCP/collagen/rhBMP-2, providing substantiating data to support the hypothesis that the release of rhBMP-2 from FDM-created mPCL–TCP/collagen scaffolds is a clinically relevant approach to repair and regenerate critically-sized craniofacial bone defects.     

Evaluation of BMP-2 tethered polyelectrolyte coatings on hydroxyapatite scaffolds in vivo

The goal of this in vivo study was to evaluate the osteoinductive and angio-inductive properties of a porous hydroxyapatite (HAp) scaffold with immobilized recombinant bone morphogenetic protein-2 (rhBMP-2) on the surface. It was hypothesized in this study that the use of a rhBMP-2 incorporated polyelectrolyte coating on the HAp scaffold would allow for controlled exposure of rhBMP-2 into the tissue and would provide a sound platform for tissue growth. The scaffolds were characterized for porosity and interconnectivity using pycnometry, scanning electron microscopy and micro-ct. These scaffolds were then divided into the following four groups: (a) HAp scaffold (n-HAp group), (b) rhBMP-2 physically adsorbed on HAp scaffold (HAp-BMP-2 Group), (c) polyelectrolyte coating on HAp scaffold without rhBMP-2 (HAp-PEI Scaffold Group), and (d) polyelectrolyte coating tethered with rhBMP-2 on HAp scaffold (HAp-PEI-BMP-2 Scaffold Group). Using 18 skeletally matured New Zealand white rabbits, these scaffolds were evaluated in a nonload bearing femoral condyle plug model. The negative controls for this study have defects that were left untreated and the positive controls have defects that were filled with autologous bone graft harvested from epsilateral iliac crest. Bone induction, vessel growth, and scaffold-bone contact were analyzed after 8-week implantation using micro-CT and histomorphometry. It was concluded from this study that the use of scaffold with an attached rhBMP-2 increased the vascularization around the implant when compared with the uncoated n-HAp scaffold, a necessary step of bone regeneration. The open-pore HAp scaffold was also concluded to provide a platform for tissue growth, drug loading, and tissue interaction. ? 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2012.     

Synchrotron X-ray microtomography (on a micron scale) provides three-dimensional imaging representation of bone ingrowth in calcium phosphate biomaterials

This study used synchrotron X-ray microtomography on a micron scale to compare three-dimensional (3D) bone ingrowth after implantation of various calcium phosphate bone substitutes in a rabbit model. The advantage of using this new method for the study of biomaterials was then compared with histomorphometry for analysis of interconnection and bone ingrowth. The study focused on the newly formed bone-biomaterial interface. Macroporous Biphasic Calcium Phosphate (MBCP) ceramic blocks and two different injectable calcium phosphate biomaterials [an injectable bone substitute (IBS) consisting of a biphasic calcium phosphate granule suspension in hydrosoluble polymer and a calcium phosphate cement material (CPC)] were studied after in vivo implantation.Absorption or phase-contrast microtomography was performed with the dedicated set-up at beamline ID22. Experimental spatial resolution was between 1 and 1.4 microm, depending on experimental radiation. All calcium phosphates tested showed osteoconduction. IBS observations after 3D reconstruction showed interconnected bioactive biomaterial with total open macroporosity and complete bone ingrowth as early as 3 weeks after implantation. This experimentation was consistent with two-dimensional histomorphometric analysis, which confirmed its suitability for biomaterials. This 3D study relates the different types of bone substitution to biomaterial architecture. As porosity and interconnection increase, bone ingrowth becomes greater at the expense of the bone substitute: IBS>MBCP>CPC.     

大鼠股骨缺损模型中BBP增强BMP-2的骨诱导作用*

目的验证在大鼠节段性骨缺损模型中骨形态发生蛋白结合肽（BMP Binding Peptide,BBP）对于重组人骨形态发生蛋白-2（recombinent human bone morphogenetic protein-2,rhBMP-2）骨诱导作用的影响。方法 70只缺损大鼠分别分成7组,每组不同剂量的rhBMP-2＋/-1000 gBBP,4w和8w后分别摄片,动物8w后处死,股骨样本分别手工评估,采用uCT测量骨容积,随后分别采用组织学和生物力学分析。结果高剂量（10 g）rhBMP-2组术后8w可见骨愈合,骨缺损处骨完全覆盖和桥接,但低剂量（5 g和2 g）rhBMP-2组术后8w骨愈合欠佳。与单独应用rhBMP-2相比,使用低剂量的rhBMP-2复合一定量的BBP可以取得更满意的骨形成量。BBP增强rhBMP-2的骨形成活性发生于4~8w时,而在术后早期并无明显作用。单纯应用BBP仅可见骨缺损处局部的钙化,未见骨愈合。结论 BBP能显著增强rhBMP-2的骨形成活性,这种增强作用需要一定时间来产生效果;其活性发生于术后4~8w时,在术后早期并无明显作用。而且BBP本身并没有骨诱导潜力,仅仅能增强rhBMP-2的骨形成活性。BBP起到缓释作用,与rhBMP-2紧密结合后,让rhBMP-2缓慢而持久的释放。     

BMP-2 incorporated in a tricalcium phosphate bone substitute enhances bone remodeling in sheep

Bone morphogenetic protein-2 (BMP-2) is a well-known osteoinductive protein, which requires a carrier for local application. As an alternative to the previously described carriers, an in situ hardening, resorbable, and osteoconductive beta-tricalcium phosphate cement (TCP) is tested. Trepanation defects in the bovine distal femoral epiphysis are filled with a composite consisting of TCP and 200 microg rhBMP-2 per cm3 TCP, autologous bone graft, pure TCP, or left empty. A radiological follow-up is performed after 7 weeks and 3 months. The sheep are euthanized and bone samples are analyzed by microradiography, histology, and histomorphometry. Microradiography and histology show similar results for pure TCP and the composite. The defects are filled with trabecular bone and newly formed bone is in close contact with the remaining TCP-particles. The majority of the cement is resorbed, in the composite group the amount of remaining cement particles is reduced. Defects treated with autologous bone graft are filled completely, while untreated defects shows only a small amount of bone originating from the rim of the defect. Histomorphometry of the defects treated with pure TCP shows a significantly increased bone content in comparison to defects treated with the composite or autologous bone graft. Analysis of the remaining cement particles shows significantly less cement in the TCP/rhBMP-2 group in comparison to pure TCP. The sum of bone and cement content in the rhBMP-2 group shows amounts comparable to the calcified structures found following autologous bone grafting. The addition of rhBMP-2 to the TCP leads to faster remodeling of the defect comparable to autologous bone graft, while defects treated with pure TCP are not completely remodeled.     

Characterization of rhBMP-2 pharmacokinetics implanted with biomaterial carriers in the rat ectopic model.

Recombinant human bone morphogenetic protein-2 (rhBMP-2) is a member of the bone morphogenetic protein family involved in de novo bone induction. Successful use of rhBMP-2 requires implantation with a biomaterial which can act as a scaffold for cell invasion for osteoinduction and retains rhBMP-2 at a site of implantation. This study was carried out to characterize rhBMP-2 pharmacokinetics from a variety of biomaterial carriers in a rat ectopic model. Retention of rhBMP-2 within carriers after 3 h was variable among the carriers (range, 75-10%), with collagenous sponges retaining the highest fraction of implanted dose. A gradual loss of rhBMP-2 was subsequently observed, the kinetics of which was strongly dependent on the implanted carrier. Collagenous carriers were observed to lose rhBMP-2 gradually from the implant site, whereas some of the mineral-based carriers retained a fraction of implanted rhBMP-2 within the implants. These differences in protein pharmacokinetics among carriers, in addition to their physicochemical nature, are expected to affect the biological activity of implanted rhBMP-2.     

An ovine model to evaluate the biologic properties of impacted morselized bone graft substitutes

The objectives of this study were to develop and evaluate a bone-defect model to study the biologic behavior of biomaterials being considered for impaction grafting in revision hip arthroplasty. A miniature impactor was designed to produce pellets of aggregates at a standard compactive effort. In Phase 1, 22 sheep underwent implantation of pellets into six metaphyseal defects in both rear limbs. In Phase 2, eight sheep underwent surgical implantation of four pellets in metaphyseal defects. Defects were sealed with polymethylmethacrylate in both phases. Healing of the defects was evaluated at 7 weeks (Phase 1, n = 11) and 14 weeks (n =19) with computed tomography, histology, and histomorphometry. Complications in Phase 1 included four femoral fractures and migration of cement seals (18/102 defects). No complications occurred in Phase 2. Whereas no difference was found between left and right limbs, osteogenesis and incorporation of biomaterials varied among implantation sites. For comparison of grafting materials, treatment site allocations were randomized according to a Latin square design. This model allows evaluation of several impacted aggregates (including large particles) in the same animal. It is particularly suitable for analyzing the biologic properties of grafting materials prior to evaluation under loading conditions.     

Repair of long intercalated rib defects using porous beta-tricalcium phosphate cylinders containing recombinant human bone morphogenetic protein-2 in dogs

A new method to repair rib defects with biomaterials containing recombinant human bone morphogenetic protein-2 (rhBMP-2) is presented in this report. We had reported previously the successful regeneration of bony rib defects by placing a short chain of small beta-tricalcium phosphate (beta-TCP) cylinders on the intact periosteum. The multi-cylinder implants were ineffective in promoting rib repair when the periosteum was absent. By adding rhBMP-2 to the beta-TCP cylinders, we were able to promote rib bone regeneration in the presence or absence of the periosteum. The osteogenic capacity of the rhBMP-2/beta-TCP composite implant and the time required to complete regeneration were evaluated in a canine model. An 8cm long section of rib bone, including the periosteum, was removed and replaced with a chain of the rhBMP-2/beta-TCP cylinders. At 6 weeks after implantation, the ribs were restored to their original configuration and mechanical strength. The multi-cylinder beta-TCP implants were degraded and replaced by new bone in 12 weeks. This new degradable bone-inducing implant material has significant clinical potential for rib repair.     

缓释型重组人骨形态发生蛋白2/壳聚糖生物骨修复材料诱导骨形成

背景：重组人骨形态发生蛋白2在体内半衰期短、易降解代谢,达不到理想的骨再生效果。 目的：制备缓释型重组人骨形态发生蛋白2/壳聚糖生物骨修复材料,并观察其缓释性能、骨诱导活性。 方法：将重组人骨形态发生蛋白2与壳聚糖混合制备壳聚糖膜,涂覆于生物骨修复材料表面,ELISA方法检测其体外释药性能。茜素红染色检测缓释型人骨形态发生蛋白2/壳聚糖生物骨材料、重组人骨形态发生蛋白2生物骨材料、单纯骨填充材料诱导C2C12细胞骨钙蛋白的形成,观察其诱导成骨细胞能力。同时将3种骨修复材料植入清洁级KM小鼠股部肌袋内,2周后检测新生骨Ca2+离子含量,评价其异位骨诱导能力。 结果与结论：材料表面的壳聚糖膜分布均匀,负载的重组人骨形态发生蛋白2呈团簇状。重组人骨形态发生蛋白2/壳聚糖生物骨修复材料体外释药存在突释,前4 d释放量达总药量的50%,持续至12 d,释药量达到90%,第18天时释放完全。与单纯骨填充材料、重组人骨形态发生蛋白2生物骨材料相比,缓释型人骨形态发生蛋白2/壳聚糖生物骨修复材料诱导C2C12细胞向成骨晚期分化能力与异位骨形成能力显著增强(P < 0.05)。结果提示缓释型人骨形态发生蛋白2/壳聚糖生物骨修复材料缓释性能好,促进骨形成能力强。     

Transplantation of chondrocytes seeded on a hyaluronan derivative (hyaff-11) into cartilage defects in rabbits

Different methods have been used to improve chondrocyte transplantation for the repair of articular cartilage defects. Several groups of biomaterials have been proposed as support for in vitro cell growth and for in vivo implantation. Here. we describe a new approach investigating the healing of rabbit cartilage by means of autologous chondrocytes seeded on a hyaluronan derivative referred to as Hyaff-11. Full thickness defects were created bilaterally in the weight-bearing surface of the medial femoral condyle of both femora of New Zealand male rabbits. The wounds were then repaired using both chondrocytes seeded on the biomaterial and biomaterial alone. Controls were similarly treated but received either no treatment or implants of the delivery substance. Histologic samples from in and around the defect sites were examined 1, 3 and 6 months after surgery and were scored from 0 to 16. Statistically significant differences in the quality of the regenerated tissue were found between the grafts carried out with biomaterial carrying chondrocyte cells compared to the biomaterial alone or controls. This study demonstrates the efficacy of this hyaluronan-based scaffold for autologous chondrocytes transplantation.     

Repair of long intercalated rib defects in dogs using recombinant human bone morphogenetic protein-2 delivered by a synthetic polymer and beta-tricalcium phosphate

Long intercalated defects in canine ribs can be repaired successfully using porous beta-tricalcium phosphate (beta-TCP) cylinders, infused with a biodegradable polymer (poly D,L-lactic acid-polyethylene block copolymer) containing recombinant human bone morphogenetic protein-2 (rhBMP-2). We previously reported the successful regeneration of bony rib and periosteum defects using beta-TCP cylinders containing 400 microg of rhBMP-2. To reduce the amount of rhBMP-2 and decrease the time required for defect repair, we utilized a biodegradable polymer carrier, in combination with rhBMP-2 and the porous beta-TCP cylinders. An 8 cm long section of rib bone was removed and replaced with an implant comprised of the porous beta-TCP cylinders and the polymer containing 80 microg of rhBMP-2. Six weeks after surgical placement of the beta-TCP cylinder/polymer/BMP-2 implants, new rib bone with an anatomical configuration and mechanical strength similar to the original bone was regenerated at the defect site. The stiffness of the regenerated ribs at 3, 6, and 12 weeks after implantation of the composite implant was significantly higher than that of ribs regenerated by implantation of rhBMP-2/beta-TCP implants. Thus, addition of the synthetic polymer to the drug delivery system for BMP potentiated the bone-regenerating ability of the implant and enabled the formation of mechanically competent rib bone. This new method appears to be applicable to the repair of intercalated long bone defects often encountered in clinical practice.     

Bone inductive properties of rhBMP-2 loaded porous calcium phosphate cement implants in cranial defects in rabbits

In this study, the osteoinductive properties of porous calcium phosphate (Ca-P) cement loaded with bone morphogenetic protein 2 (rhBMP-2) were evaluated and compared with rhBMP-2 loaded absorbable collagen sponge (ACS). Discs with a diameter of 8mm were loaded with a buffer solution with or without 10 microg rhBMP-2 and inserted in 8mm full thickness cranial defects in rabbits for 2 and 10 weeks of implantation. Histological analysis revealed excellent osteoconductive properties of the Ca-P material. It maintained its shape and stability during the implantation time better than the ACS but showed no degradation like the ACS. Quantification of the Ca-P cement implants showed that bone formation was increased significantly by administration of rhBMP-2 (10 weeks pore fill: 53.0+/-5.4%), and also reached a reasonable amount without rhBMP-2 (43.1+/-10.4%). Remarkably, callus-like bone formation outside the implant was observed frequently in the 2 weeks rhBMP-2 loaded Ca-P cement implants, suggesting a correlation with the presence of growth factor in the surrounding tissue. However, an additional in vitro assay revealed an accumulative release of no more than 9.7+/-0.9% after 4 weeks. We conclude that: (1). Porous Ca-P cement is an appropriate candidate scaffold material for bone engineering. (2). Bone formation can be enhanced by lyophilization of rhBMP-2 on the cement. (3). Degradation of porous Ca-P cement is species-, implantation site- and implant dimension-specific.