Purpose: Bone morphogenetic proteins (BMPs) strongly induce osteogenesis. However, BMPs also directly or indirectly stimulate catabolic osteoclast activity, leading to strong bone resorption, especially in the bone marrow. The aim of this study was to investigate whether the combination of a local recombinant human BMP-2 (rh-BMP-2)/beta-tricalcium phosphate ([Formula: see text]-TCP) composite with systemically administrated bisphosphonate, zoledronate (ZOL) could promote osteogenesis in a rabbit model. Methods: [Formula: see text]-TCP columns, with or without rh-BMP-2 (30 [Formula: see text]g/column), were implanted into the left femur canal of 20 rabbits. The animals were injected with 0.4[Formula: see text]mg of ZOL or saline 1 week after implantation. The implants were evaluated by micro-computed tomography ([Formula: see text]-CT) and histology 6 weeks after implantation. Results: [Formula: see text]-CT data revealed that the bone volume/tissue volume ratio of bone nodules inside [Formula: see text]-TCP columns in combination with rh-BMP-2 and ZOL was significantly higher than that of [Formula: see text]-TCP columns treated with rh-BMP-2, ZOL, or neither. Histological evaluation also revealed that significantly more new bone formed inside [Formula: see text]-TCP columns treated with rh-BMP-2 and ZOL than inside [Formula: see text]-TCP columns treated with rh-BMP-2, ZOL, or neither. Conclusion: This combination therapy contributed to the maintenance of the newly formed BMP-2-induced bone structure in the bone marrow.
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