Treatment of nonunions with nonglycosylated recombinant human bone morphogenetic protein-2 delivered from a fibrin matrix

Hugo G. Schmökel, Franz E. Weber, Gabriela Seiler, Brigitte Von Rechenberg, Jason C. Schense, Peter Schawalder, Jeffrey Hubbell

Research output: Contribution to journalArticle

35 Scopus citations

Abstract

Objective - To report the results of the treatment of nonunions with nonglycosylated recombinant human bone morphogenetic protein-2 (nglBMP-2) delivered from a designed fibrin matrix. Study Design - Experimental trial in rodents and prospective clinical study in dogs and cats with nonunion fractures. Animals - Twenty adult female, albino, Sprague-Dawley rats; 8 client-owned cats and dogs. Methods - After development of a fibrin matrix and evaluation of nglBMP-2 in a rodent femoral defect model, 8 consecutive long bone nonunion fractures (no progression in healing in ≥ 3 months), were treated using 300 μg nglBMP-2 in a liquid fibrin precursor, injected into the defect gap after fracture revision and stabilization, or through a stab incision into the fracture site. The fibrin matrix was designed to clot in the wound after 60 seconds and to release the nglBMP-2 continuously over several days. Results - Using only fibrin gel, 7% of the rat femoral defect was filled with new formed bone compared with 79% defect filling using 2ng nglBMP-2 (P = .006). Five and 10 μg nglBMP in fibrin resulted in union of all femoral defects with complete filling of the gap with new bone. Bony bridging and clinical healing was achieved in 7 patients within 24 weeks of administration of nglBMP-2. Conclusions - Application of nglBMP-2 in a functional matrix can induce bone healing. Controlled release of nglBMP-2 from a fibrin matrix mimics the natural fracture hematoma. Clinical Relevance - nglBMP-2/fibrin can successfully replace a cancellous bone autograft in fracture treatment with an associated reduction in graft donor site morbidity and surgical time.

Original languageEnglish (US)
Pages (from-to)112-118
Number of pages7
JournalVeterinary Surgery
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2004

ASJC Scopus subject areas

  • veterinary(all)

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    Schmökel, H. G., Weber, F. E., Seiler, G., Von Rechenberg, B., Schense, J. C., Schawalder, P., & Hubbell, J. (2004). Treatment of nonunions with nonglycosylated recombinant human bone morphogenetic protein-2 delivered from a fibrin matrix. Veterinary Surgery, 33(2), 112-118. https://doi.org/10.1111/j.1532-950x.2004.04018.x