Comparing ectopic bone growth induced by rhBMP‐2 on an absorbable collagen sponge in rat and rabbit models

Recombinant human Bone Morphogenetic Protein‐2 (rhBMP‐2) is currently employed as an autograft replacement for spinal fusion. The morphogen is incorporated onto its carrier, an absorbable collagen sponge (ACS), in the operating room. Although the effectiveness of the rhBMP‐2/ACS implant in stimulating bone formation in human subjects has now been well established, further investigations of its use are necessary to deepen our understanding of its performance. The objective of the present study was to determine whether fluid released from the rhBMP‐2/ACS implant could induce bone growth in tissue sites away from the implant site. We first measured the amount of protein in the fluid released from the rhBMP‐2‐soaked ACS during intraoperative handling. Variables included soak time and degree of compression. In the compression group that most closely approximated intraoperative conditions, more than 95% of the rhBMP‐2 protein was retained by the ACS following a 15‐min. soak time. This in vitro study was followed by an in vivo ectopic implant experiment using rat and rabbit models. The animal investigation compared the amount of bone induced by rhBMP‐2 solution alone versus the de novo bone formation induced by rhBMP‐2/ACS implants with varying concentrations of rhBMP‐2. No ossicles were found at the sites where rhBMP‐2 solution was injected in either animal species. Twenty‐two of the 24 subcutaneous sites in the rats implanted with the rhBMP‐2/ACS constructs displayed the presence of the typical 4‐ and 12‐week ossicle. There were no noticeable differences in the size and shape of the ossicles after 4 and 12 weeks. There was a greater percentage of implant sites without ossicles in the rabbits, compared to the rats. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1660–1669, 2006

[1]  J. Burkus,et al.  Radiographic Assessment of Interbody Fusion Using Recombinant Human Bone Morphogenetic Protein Type 2 , 2003, Spine.

[2]  H. Uludaǧ,et al.  Characterization of absorbable collagen sponges as recombinant human bone morphogenetic protein-2 carriers. , 1999, International journal of pharmaceutics.

[3]  T. Lanman,et al.  Lumbar interbody fusion after treatment with recombinant human bone morphogenetic protein-2 added to poly(L-lactide-co-D,L-lactide) bioresorbable implants. , 2004, Neurosurgical focus.

[4]  C. Kirker-Head,et al.  Potential applications and delivery strategies for bone morphogenetic proteins. , 2000, Advanced drug delivery reviews.

[5]  Y. Tabata,et al.  Enhanced osteoinduction by controlled release of bone morphogenetic protein-2 from biodegradable sponge composed of gelatin and beta-tricalcium phosphate. , 2005, Biomaterials.

[6]  J. Wozney,et al.  Delivering on the promise of bone morphogenetic proteins. , 2001, Trends in biotechnology.

[7]  H. Sandhu Bone Morphogenetic Proteins and Spinal Surgery , 2003, Spine.

[8]  M. Marone,et al.  Posterolateral intertransverse process spinal arthrodesis with rhBMP-2 in a nonhuman primate: important lessons learned regarding dose, carrier, and safety. , 1999, Journal of spinal disorders.

[9]  S. Santavirta,et al.  Recombinant Human Bone Morphogenetic Protein-2 for Treatment of Open Tibial Fractures: A Prospective, Controlled, Randomized Study of Four Hundred and Fifty Patients , 2002, The Journal of bone and joint surgery. American volume.

[10]  Safdar N. Khan,et al.  The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in orthopaedic applications , 2004, Expert opinion on biological therapy.

[11]  J. Burkus Bone morphogenetic proteins in anterior lumbar interbody fusion: old techniques and new technologies. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. , 2004, Journal of neurosurgery. Spine.

[12]  S. Boden,et al.  Use of Recombinant Human Bone Morphogenetic Protein-2 to Achieve Posterolateral Lumbar Spine Fusion in Humans: A Prospective, Randomized Clinical Pilot Trial 2002 Volvo Award in Clinical Studies , 2002, Spine.

[13]  Hollinger,et al.  Sustained release emphasizing recombinant human bone morphogenetic protein-2. , 1998, Advanced drug delivery reviews.

[14]  K. Kusumoto,et al.  Experimental studies on bone inducing activity of composites of atelopeptide type I collagen as a carrier for ectopic osteoinduction by rhBMP-2. , 1995, Biochemical and biophysical research communications.

[15]  T. Zdeblick,et al.  Is INFUSE Bone Graft Superior to Autograft Bone? An Integrated Analysis of Clinical Trials Using the LT-CAGE Lumbar Tapered Fusion Device , 2003, Journal of spinal disorders & techniques.

[16]  David S Baskin,et al.  A Prospective, Randomized, Controlled Cervical Fusion Study Using Recombinant Human Bone Morphogenetic Protein-2 With the CORNERSTONE-SR™ Allograft Ring and the ATLANTIS™ Anterior Cervical Plate , 2003, Spine.

[17]  Hak-Sun Kim,et al.  Simple Carrier Matrix Modifications Can Enhance Delivery of Recombinant Human Bone Morphogenetic Protein-2 for Posterolateral Spine Fusion , 2003, Spine.

[18]  J. Wozney,et al.  Delivery Systems for BMPs: Factors Contributing to Protein Retention at an Application Site , 2001, The Journal of bone and joint surgery. American volume.

[19]  S. Boden,et al.  Demineralized bone matrix, bone morphogenetic proteins, and animal models of spine fusion: an overview , 2001, European Spine Journal.

[20]  W. Hutton,et al.  Experimental Spinal Fusion With Recombinant Human Bone Morphogenetic Protein‐2 , 1995, Spine.

[21]  W. Friess,et al.  Collagen sponges for bone regeneration with rhBMP-2. , 2003, Advanced drug delivery reviews.

[22]  J. Ong,et al.  Experimental studies on bone induction using low-molecular-weight poly (DL-lactide-co-glycolide) as a carrier for recombinant human bone morphogenetic protein-2. , 2002, Journal of biomedical materials research.

[23]  K E Healy,et al.  Ectopic bone formation via rhBMP-2 delivery from porous bioabsorbable polymer scaffolds. , 1998, Journal of biomedical materials research.

[24]  W. Hutton,et al.  Delivery of Recombinant Human Bone Morphogenetic Protein-2 Using a Compression-Resistant Matrix in Posterolateral Spine Fusion in the Rabbit and in the Non-Human Primate , 2002, Spine.

[25]  C. Branch,et al.  Posterior lumbar interbody fusion using recombinant human bone morphogenetic protein type 2 with cylindrical interbody cages. , 2004, The spine journal : official journal of the North American Spine Society.