Abstract
BackgroundNonunion in cases of open fracture is common. Both bone morphogenetic protein 2 (BMP-2) and parathyroid hormone (PTH) have been used to enhance bone healing. We investigated the combination of BMP-2 and PTH and examined the effects on a rat model of open femoral fractures.MethodsGroup I (n = 11) was implanted with control carrier. Group II (n = 12) was implanted with carrier containing 1 μg of recombinant human BMP-2 (rhBMP-2). Group III (n = 12) was implanted with carrier alone, followed by injections of PTH 1-34. Group IV (n = 11) was implanted with carrier containing 1 μg of rhBMP-2, followed by injections of PTH 1-34. Group V (n = 11) was implanted with carrier containing 10 μg of rhBMP-2. Group VI (n = 11) was implanted with carrier containing 10 μg of rhBMP-2, followed by injections of PTH 1-34. Rats were euthanized after 8 weeks, and their fractured femurs were explanted and assessed by manual palpation, radiographs, micro-computerized tomography, and histological analysis.ResultsManual palpation tests showed that the fusion rates of groups III (66.7%), IV (63.6%), V (81.8%), and VI (81.8%) were considerably higher than those of group I. Groups V and VI had higher radiographic scores compared to group I. Micro-CT analysis revealed enhanced bone marrow density expressed as bone volume/tissue volume in groups V (61.88 ± 3.16%) and VI (71.14 ± 3.89%) versus group I (58.26 ± 1.86%). A histological analysis indicated that group VI had enhanced remodeling.ConclusionThe combination of abundant rhBMP-2 and PTH enhanced bone healing and remodeling of newly formed bone in a rat femoral open fracture model.
Highlights
Nonunion in cases of open fracture is common
We investigated the effects of a combination of locally applied recombinant human BMPs (rhBMPs)-2 and intermittent administration of parathyroid hormone (PTH) after surgical intervention to enhance fracture repair in a well-accepted rodent model of open femoral fractures
The results were comparable with our previous findings [11, 12] indicating that the application of 1 μg of recombinant human BMP-2 (rhBMP-2) with carrier effectively enhanced bone healing in a rat model of femoral fractures, it was not enough to achieve complete bone union; 10 μg of rhBMP2 was necessary for complete bone union
Summary
Nonunion in cases of open fracture is common Both bone morphogenetic protein 2 (BMP-2) and parathyroid hormone (PTH) have been used to enhance bone healing. The osteoinductive effects of recombinant human BMPs (rhBMPs) have been documented for fracture repair, the healing of critical bone defects, and spinal fusion in animal models and clinical trials [5,6,7]. Based on this evidence, rhBMP-2 and rhBMP-7 are approved for clinical use.
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