Bone Healing in Porcine Segmental Defects with rhBMP-2 loaded grafts
Updated: Jan 23, 2019
Immediate healing, tracking bone volume and looking out for inflammation
At least 26% of recent battlefield injuries are to the craniomaxillofacial (CMF) region. Recombinant human bone morphogenetic protein 2 (rhBMP‐2) is used to treat CMF open fractures, but several complications have been associated with its use.
This study tested the efficacy and safety of a lower (30%
recommended) dose of rhBMP‐2 to treat mandibular fractures. rhBMP‐2 delivered via a polyurethane (PUR) and hydroxyapatite/β‐tricalcium phosphate (Mastergraft®) scaffold was evaluated in a 2 cm segmental mandibular defect in minipigs. Bone regeneration was analyzed at 4, 8, and 12 weeks postsurgery using clinical computed tomography (CT) and rhBMP‐2, and inflammatory marker concentrations were analyzed in serum and surgery‐site drain effluent.
CT scans revealed that pigs treated with PUR‐Mastergraft® + rhBMP‐2 had complete bone bridging, while the negative control group showed incomplete bone‐bridging (n = 6). Volumetric analysis of regenerated bone showed that the PUR‐Mastergraft® + rhBMP‐2 treatment generated significantly more bone than control by 4 weeks, a trend that continued through 12 weeks. Variations in inflammatory analytes were detected in drain effluent samples and saliva but not in serum, suggesting a localized healing response. Importantly, the rhBMP‐2 group did not exhibit an excessive increase in inflammatory analytes compared to control.
Treatment with low‐dose rhBMP‐2 increases bone regeneration capacity in pigs with mandibular continuity defects and restores bone quality.
Negative complications from rhBMP‐2, such as excessive inflammatory analyte levels, were not observed. Together, these results suggest that treatment with low‐dose rhBMP‐2 is efficacious and may improve safety when treating CMF open fractures.
© 2018 Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2018.