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Augmentation of autologous bone graft by a combination of bone morphogenic protein and bisphosphonate increased both callus volume and strength

Bosemark, Per LU ; Isaksson, Hanna LU ; McDonald, Michelle M.; Little, David G. and Tägil, Magnus LU (2013) In Acta Orthopaedica 84(1). p.106-111
Abstract
Background and purpose Bone morphogenic proteins (BMPs) can be used in non-unions to replace autograft. BMPs induce osteoblasts and (less well known) also osteoclasts, which can in turn be controlled by a bisphosphonate. In the present study, our aim was to improve the biological effect of autologous bone graft by adding an anabolic BMP, with or without bisphosphonates, in an open-fracture model prone to non-union. Methods Rat femurs were osteotomized and fixed with an intramedullary K-wire. Autograft was placed at the osteotomy, mixed with either saline or BMP-7. After 2 weeks, the rats had a single injection of saline or of a bisphosphonate (zoledronate). The rats were killed after 6 weeks and the femurs were evaluated by radiography,... (More)
Background and purpose Bone morphogenic proteins (BMPs) can be used in non-unions to replace autograft. BMPs induce osteoblasts and (less well known) also osteoclasts, which can in turn be controlled by a bisphosphonate. In the present study, our aim was to improve the biological effect of autologous bone graft by adding an anabolic BMP, with or without bisphosphonates, in an open-fracture model prone to non-union. Methods Rat femurs were osteotomized and fixed with an intramedullary K-wire. Autograft was placed at the osteotomy, mixed with either saline or BMP-7. After 2 weeks, the rats had a single injection of saline or of a bisphosphonate (zoledronate). The rats were killed after 6 weeks and the femurs were evaluated by radiography, micro-CT, histology, and 3-point bending test. Results All fractures healed. The callus volume was doubled in the BMP-treated femurs (p < 0.01) and increased almost 4-fold in the femurs treated with both BMP and systemic zoledronate (p < 0.01) compared to autograft. In mechanical testing, the autograft group reached approximately half the strength of the contralateral, non-osteotomized femur (p < 0.001). By adding BMP to the autograft, the strength was doubled (p < 0.001) and with both BMP and systemic zoledronate, the strength was increased 4-fold (p < 0.001) compared to autograft alone. Interpretation The combination of BMP and bisphosphonate as an adjunct to autograft is superior to autograft alone or combined with BMP. The combination may prove valuable in the treatment of non-unions. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
84
issue
1
pages
106 - 111
publisher
Taylor & Francis
external identifiers
  • wos:000314897500019
  • scopus:84873897043
ISSN
1745-3682
DOI
10.3109/17453674.2013.773123
language
English
LU publication?
yes
id
f2564d0f-d5e3-4d7e-a6a7-f7a15077f8b8 (old id 3580840)
date added to LUP
2013-04-02 07:44:25
date last changed
2019-08-14 02:14:41
@article{f2564d0f-d5e3-4d7e-a6a7-f7a15077f8b8,
  abstract     = {Background and purpose Bone morphogenic proteins (BMPs) can be used in non-unions to replace autograft. BMPs induce osteoblasts and (less well known) also osteoclasts, which can in turn be controlled by a bisphosphonate. In the present study, our aim was to improve the biological effect of autologous bone graft by adding an anabolic BMP, with or without bisphosphonates, in an open-fracture model prone to non-union. Methods Rat femurs were osteotomized and fixed with an intramedullary K-wire. Autograft was placed at the osteotomy, mixed with either saline or BMP-7. After 2 weeks, the rats had a single injection of saline or of a bisphosphonate (zoledronate). The rats were killed after 6 weeks and the femurs were evaluated by radiography, micro-CT, histology, and 3-point bending test. Results All fractures healed. The callus volume was doubled in the BMP-treated femurs (p &lt; 0.01) and increased almost 4-fold in the femurs treated with both BMP and systemic zoledronate (p &lt; 0.01) compared to autograft. In mechanical testing, the autograft group reached approximately half the strength of the contralateral, non-osteotomized femur (p &lt; 0.001). By adding BMP to the autograft, the strength was doubled (p &lt; 0.001) and with both BMP and systemic zoledronate, the strength was increased 4-fold (p &lt; 0.001) compared to autograft alone. Interpretation The combination of BMP and bisphosphonate as an adjunct to autograft is superior to autograft alone or combined with BMP. The combination may prove valuable in the treatment of non-unions.},
  author       = {Bosemark, Per and Isaksson, Hanna and McDonald, Michelle M. and Little, David G. and Tägil, Magnus},
  issn         = {1745-3682},
  language     = {eng},
  number       = {1},
  pages        = {106--111},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {Augmentation of autologous bone graft by a combination of bone morphogenic protein and bisphosphonate increased both callus volume and strength},
  url          = {http://dx.doi.org/10.3109/17453674.2013.773123},
  volume       = {84},
  year         = {2013},
}