Treatment of osteonecrosis of the femoral head with hBMP-2-gene-modified tissue-engineered bone in goats

Abstract

The efficacy of beta-tricalcium phosphate (beta-TCP) loaded with bone morphogenetic protein-2 (BMP-2)-gene-modified bone-marrow mesenchymal stem cells (BMSCs) was evaluated for the repair of experimentally-induced osteonecrosis of the femoral head in goats. Bilateral early-stage osteonecrosis was induced in adult goats three weeks after ligation of the lateral and medial circumflex arteries and delivery of liquid nitrogen into the femoral head. After core decompression, porous beta-TCP loaded with BMP-2 gene- or beta-galactosidase (gal)-gene-transduced BMSCs was implanted into the left and right femoral heads, respectively. At 16 weeks after implantation, there was collapse of the femoral head in the untreated group but not in the BMP-2 or beta-gal groups. The femoral heads in the BMP-2 group had a normal density and surface, while those in the beta-gal group presented with a low density and an irregular surface. Histologically, new bone and fibrous tissue were formed in the macropores of the beta-TCP. Sixteen weeks after implantation, lamellar bone had formed in the BMP-2 group, but there were some empty cavities and residual fibrous tissue in the beta-gal group. The new bone volume in the BMP-2 group was significantly higher than that in the beta-gal group. The maximum compressive strength and Young's modulus of the repaired tissue in the BMP-2 group were similar to those of normal bone and significantly higher than those in the beta-gal group. Our findings indicate that porous beta-TCP loaded with BMP-2-gene-transduced BMSCs are capable of repairing early-stage, experimentally-induced osteonecrosis of the femoral head and of restoring its mechanical function.

Osteonecrosis of the femoral head: treatment with ancillary growth factors

“…The authors noted new bone formation in the pores of the β-TCP scaffold, with no collapse of the femoral head. Furthermore, the resultant compressive strength approached that of a normal femoral head in the goats treated with scaffold [22].…”

“…In a goat model for ON, Tang and colleagues were able to show the formation of lamellar bone using a β-tricalcium phosphate (β-TCP) scaffold loaded with BMP-2 gene-modified MSCs [22]. The authors noted new bone formation in the pores of the β-TCP scaffold, with no collapse of the femoral head.…”

“…This would provide a scaffold allowing for ingrowth of bone and also blood vessels, while recruiting MSCs to the area to form bone [24]. Various scaffolds composed of PLGA, collagen hydroxyapatite, and β-TCP have been used to Bcarry^BMP-2 and release it over a sustained period of time [22,24,31,32,38,39]. In a study by Wang and colleagues, an improvement in healing of necrotic segments of bone with controlled release of BMP was noted [24].…”

Legg-Calvé-Perthes hastalığında medikal tedavi

“…Hayvanlarda femur başı osteonekrozu tedavisinde, BMP-2, kor dekompresyon ve greftleme sonrası kemik yapımını uyarması amacıyla kullanılmış ve iyileşmede etkili olduğu gös-terilmiştir. [39][40][41] İnsanlarda yapılan bir araştırmada ise, 17 kalçaya kor dekompresyon sonrası BMP-2 uygulanmış, ortalama 53 aylık takipte 14 kalçada iyi sonuçlar elde edilmiştir. Papaganitou, çökme önce-si evredeki yedi kalçada, otojen vaskülarize olmayan fibula greftlemesi ile beraber BMP-7 uygulamış [42] , Ortalama dört yıl takipte, beş kalçada çökmenin engellendiğini belirtmiştir.…”

A Animal Study of Immunohistochemical Analysis of Sympathetic Nerve Fibers in Osteonecrosis of Femoral Head in Comparison with Osteoarthritis

“…Osteonecrosis of the femoral head (ONFH) is a progressive nonbacterial localized bone disease in adulthood, and accompanied with a complete destruction of the femoral head and a severe secondary osteoarthritis [1][2][3]. The disease is often asymptomatic at first, so it is difficult to diagnose ONFH early.…”