Augmentation of implant surfaces with BMP-2 in a revision setting: effects of local and systemic bisphosphonate. Issue 8 (10th August 2021)

• Record Type: Journal Article
• Authors: Cleemann, Rasmus; Sorensen, Mette; West, Andreas; Soballe, Kjeld; Bechtold, Joan E.; Baas, Jorgen
• Is Part Of: Bone & joint research. Volume 10:Issue 8(2021)
• Page Start: 488
• Page End: 497
• Publication Date: 2021-08-10
• Subjects: Bone anabolic -- Anti-catabolic -- Revision -- Bone morphogenetic protein 2 (BMP-2) -- allografted -- revision surgery -- implant fixation -- Stiffness -- bone graft -- Augmentation -- anabolic agent -- rhBMP-2 -- bisphosphonates; Musculoskeletal system -- Periodicals; 573.705
• DOI: 10.1302/2046-3758.108.BJR-2020-0280.R1
• Languages: English
• ISSNs: 2046-3758

Abstract

Abstract : Aims: We wanted to evaluate the effects of a bone anabolic agent (bone morphogenetic protein 2 (BMP-2)) on an anti-catabolic background (systemic or local zoledronate) on fixation of allografted revision implants. Methods: An established allografted revision protocol was implemented bilaterally into the stifle joints of 24 canines. At revision surgery, each animal received one BMP-2 (5 µg) functionalized implant, and one raw implant. One group (12 animals) received bone graft impregnated with zoledronate (0.005 mg/ml) before impaction. The other group (12 animals) received untreated bone graft and systemic zoledronate (0.1 mg/kg) ten and 20 days after revision surgery. Animals were observed for an additional four weeks before euthanasia. Results: No difference was detected on mechanical implant fixation (load to failure, stiffness, energy) between local or systemic zoledronate. Addition of BMP-2 had no effect on implant fixation. In the histomorphometric evaluation, implants with local zoledronate had more area of new bone on the implant surface (53%, p = 0.025) and higher volume of allograft (65%, p = 0.007), whereas implants in animals with systemic zoledronate had the highest volume of new bone (34%, p = 0.003). Systemic zoledronate with BMP-2 decreased volume of allograft by 47% (p = 0.017). Conclusion: Local and systemic zoledronate treatment protects bone at different stages of maturity; local zoledronate protects the allograft from resorption and systemic zoledronate protects newly formed bone from resorption. BMP-2 in the dose evaluated with experimental revision implants was not beneficial, since it significantly increased allograft resorption without a significant compensating anabolic effect. Cite this article: Bone Joint Res 2021;10(8):488–497.