A major problem associated with distraction osteogenesis is the long time required for consolidation.
OBJECTIVE:
The goal of this study was to determine whether a percutaneous injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a Gelfoam carrier would enhance bone consolidation following distraction.
METHODS:
A unilateral tibial osteotomy combined with external stabilization was performed in 14 adult sheep. After a latency of four days, distraction was performed at 1.25 millimetres per day for 20 days. On days 23 and 30, the sheep received an injection of rhBMP-2/Gelfoam or buffer/Gelfoam. During the following 50 days, radiographs and in vivo torsional stiffness measurements were obtained weekly. The effect of rhBMP-2 treatment post-mortem was assessed using destructive biomechanical testing, quantitative CT and DXA analysis.
RESULTS:
The in vivo stiffness measurements of the sheep treated with rhBMP-2 were significantly higher than those of the carrier control group ( 0.05). These in vivo data were verified by post-mortem biomechanical testing and quantitative CT analysis. The maximum torsional moment observed was 55% greater in the sheep treated with rhBMP-2.
CONCLUSIONS:
These data support the potential use of rhBMP-2 in an injectable carrier for enhancing consolidation, as it may ultimately lead to shorter treatment times for patients undergoing distraction procedures.
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