Abstract
BackgroundHydrogen gas formed by magnesium (Mg) screw corrosion can accumulate around the implant and create bone cysts, long-term osteolysis lesions, and bone healing delay. Thus, several authors currently do not recommend Mg implants for clinical use. In contrast, bone morphogenetic proteins (BMP)-2 have a very strong osteoinductive activity. The purpose of this study was to evaluate the effect of rhBMP-2/hydroxyapatite (HA) inside specially designed Mg cannulated screws in a rabbit femur model for hydrogen gas formation avoidance.MethodsFifteen rabbits underwent randomly different cannulated Mg screw implantation in both distal femora; 30 femora were divided into three groups depending on the materials fill in the cannulated Mg screw: control group (Mg screw with no treatment), HA group (Mg screw with HA), and BMP-2/HA group (Mg screw with a composite BMP-2/HA). Plain radiography, micro-CT, and histological analysis were accomplished, and the ability to release BMP-2 of the screws was evaluated by immersion of both the screw with no treatment and screw with a composite BMP-2/HA into the SBF for up to 7 days.ResultsX-ray assessment found the gas shadow around the implant was slightly smaller in the BMP-2/HA group than the HA and control groups at 8 weeks. Micro-CT analysis demonstrated statistically significant higher new bone formation in the BMP-2/HA group than the other groups, respectively, which also correlated with a decreased gas volume. Histological analysis showed higher osteointegration between implants and host femurs in the BMP-2/HA group than the HA and control groups at 12 weeks.ConclusionsThis study indicates that the combination of BMP-2/HA within Mg screws enhances new bone formation and therefore has the potential to decrease the complications of hydrogen gas formation around these implants.
Highlights
Hydrogen gas formed by magnesium (Mg) screw corrosion can accumulate around the implant and create bone cysts, long-term osteolysis lesions, and bone healing delay
Fifteen male New Zealand white rabbits were used, and the 30 distal femora were divided into three groups of 10 which had different Mg screw preparations randomly implanted into both distal femora: control group (Mg screw with no treatment), HA group (Mg screw with HA), and bone morphogenetic proteins (BMP)-2/HA group (Mg screw with a composite BMP-2/HA)
At 8 weeks, the radiopacity areas around the implant were slightly more in the BMP-2/HA group than the HA and control groups
Summary
Hydrogen gas formed by magnesium (Mg) screw corrosion can accumulate around the implant and create bone cysts, long-term osteolysis lesions, and bone healing delay. The main disadvantage of Mg is a high corrosion rate with resultant hydrogen gas formation on contact with fluids [5] This gas can induce complications such as superficial skin necrosis, and the gas bubbles can accumulate around the implant creating complications of bone cysts and long-term osteolysis lesions. These lesions can seriously delay the bone healing so that several authors are currently not recommending their clinical use [6,7,8]. It is necessary to attempt different solutions to overcome these complications relative to hydrogen gas formation
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