Abstract

Autologous bone graft substitute (ABGS) containing rhBMP6 in autologous blood coagulum (ABC) with synthetic ceramics is a novel therapeutic solution for bone repair. The aim of this study was to investigate whether the application of Zoledronate (ZOL) with ABGS might enhance the properties of newly formed bone. The effect of ZOL on bone induction was tested in a rat subcutaneous implant model. ZOL bound to synthetic ceramics was added into ABGS implants, and the quantity, quality, and longevity of the induced bone were assessed by micro-CT, histomorphometry, and histology over a period of 365 days. Local use of ZOL in the ABGS implants with ceramics had no influence on the bone volume (BV) on day 14 but subsequently significantly increased BV on days 35, 50, 105, 140, and 365 compared to the control implants. Locally applied ZOL had a similar effect in all of the applied doses (2–20 µg), while its systemic use on stimulating the BV of newly induced bone by ABGS depended on the time of application. BV was increased when ZOL was applied systemically on day 14 but had no effect when applied on day 35. The administration of ZOL bound to ceramics in ABGS increased and maintained the BV over a period of one year, offering a novel bone tissue engineering strategy for treating bone defects and spinal fusions.

Highlights

  • Bone morphogenetic proteins (BMPs) are growth and differentiation factors known for their ability to induce cartilage and bone and have a morphogenic role in the development and maintenance of tissue structure throughout the body [1,2]

  • We have demonstrated that our novel autologous bone graft substitute (ABGS) containing rhBMP6 within autologous blood coagulum (ABC) with or without compression resistant matrix (CRM) restores large bone defects and achieves successful lumbar fusion

  • ABC further allows a sustained release of rhBMP6 and suppresses foreign body responses elicited by the mineral-rich ceramics used as CRM [2,13,14]

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Summary

Introduction

Bone morphogenetic proteins (BMPs) are growth and differentiation factors known for their ability to induce cartilage and bone and have a morphogenic role in the development and maintenance of tissue structure throughout the body [1,2]. The osteoinductive device containing rhBMP2 and bovine collagen carrier has been approved for use in anterior lumbar interbody fusion (ALIF) [7] and acute tibial fractures [8,9]. We have demonstrated that our novel autologous bone graft substitute (ABGS) containing rhBMP6 within autologous blood coagulum (ABC) with or without compression resistant matrix (CRM) restores large bone defects and achieves successful lumbar fusion. The biology of BMP-induced bone formation has been studied at various time points in a rat subcutaneous bone formation assay [12,13,14,17], rabbit segmental bone defects, and in a rabbit and sheep posterolateral and anterior lumbar spinal fusion models [13,14,15,16]. ABGS has been proven to be safe and efficacious in patients with distal radial fractures

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