Bone defect healing with an osteogenic protein‐1 device combined with carboxymethylcellulose

Abstract

One consideration for the practical use and application of osteogenic proteins is an effective method of delivery. This study evaluated a putty-type collagen carrier with recombinant human osteogenic protein-1 (rhOP-1) ability to heal canine critical sized (2.5 cm) ulna segmental defects compared to rhOP-1 with a particulate collagen carrier (OP device). The addition of carboxymethylcellulose (CMC) to the particulate collagen carrier (OPCMC device) to form the putty consistency was evaluated in two doses (3.5 and 1.75 mg rhOP-1/g carrier). The CMC greatly improved the intraoperative handling and site containment of the device. For the one-half dose and full-dose sites there were no statistically significant differences in the radiographic grading of defect healing when treated with the particulate OP-1 device and the device with CMC added. However, there was a dose effect with greater and earlier new bone formation observed with increased rhOP-1. Mechanically, there were no differences between particulate and putty formulations, although again, a significant effect was observed for treatment dose with the full-dose OPCMC device restoring 94% of the strength of the intact ulna compared to only 65% for the identical one-half dose implant. Regardless of rhOP-1 dose, the quality of union grading and total histologic score appearance were improved with the addition of CMC, although differences in histologic scoring were not statistically significant. Overall, the radiographic, mechanical, and histologic bone-healing characteristics with the one-half dose OPCMC device were similar to sites treated with the full-dose OP device. The observed improvement in healing may allow for lesser amounts of the device or a device with less rhOP-1 to be used.

Radiological assessment of bioengineered bone in a muscle flap for reconstruction of a critical-size mandibular defect

“…Cook's scoring system [18] combined with the quantitative scoring system gQS provided a comprehensive measurement of the quantity of bone formation at the surgical bone defect, which was consistent with the morphometeric analysis of the micro-CT images. In this experimental model the application of a radio-dense material, the ceramic cement, which had a similar radio-opacity to that of bone, added to the complexity of studying the pattern of bone regeneration.…”

“…On the other hand the objective evaluation of radiographs and the application of a comprehensive scoring system are mandatory for the assessment of the quality and magnitude of the bioengineered bone. Radiographic assessment of bone regeneration should be comprehensive enough to record the dynamics of bone formation and the rate of degradation of bioscaffold [16][17][18][19]. It has been recognized that cone beam computerized tomography (CBCT) is a reliable imaging modality for the 3D assessment of bioengineered bone [20].…”

Enhancement of recombinant human BMP‐7 bone formation with bmp binding peptide in a rodent femoral defect model

“…The addition of a carrier that would enhance the effect of BMP could potentially decrease the amount of BMP needed. 7 In 1965, Urist 17 described the ectopic bone formation induced by demineralized bone matrix. He used the term bone morphogenetic protein/non-collagen protein (BMP/ NCP), a partial purified extract from demineralized bone matrix, to characterize the properties of the protein to induce bone formation.…”

“…Therefore, several strategies were developed to lower the dose of BMPs, which may decrease the dose-related complications, but achieve similar or more efficacious healing. These strategies include the use of delivery devices that allow better application of rhBMP-7 and obtain better retention at the surgery site, 7 the use of carriers that control the release of rhBMP-7, 8 and the use of a specific binding peptide that enhances the effect of rhBMP-2 in bone healing. 9 BMP binding peptide (BBP) was developed by Behnam et al 10 They isolated an 18.5 kDa fragment of the human bone matrix protein that has the chemical and physical properties of Urist's ''BMP.''…”

Lumbar body fusion with a bioresorbable cage in a goat model is delayed by the use of a carboxymethylcellulose‐stabilized collagenous rhOP‐1 device

“…It has been shown previously that rhOP-1 delivered via such a carrier biomaterial (OPCMC device) improved bone healing of critical-sized bone defects. 22 In this study we address the question if the OPCMC device is a suitable alternative grafting material in spinal fusion, using resorbable interbody fusion cages. A well-established goat lumbar spinal fusion model was used.…”