Enhancing bone healing through concurrent anabolic- and anti-catabolic pharmacological treatment
Author
Summary, in English
In study 1, autograft was compared with autograft+BMP-7 and autograft+BMP-7+ZOL with the hypothesis that the latter treatment would lead to superior healing compared with the others. All three treatments increased the healing rate from 60 % to 100 %. The autograft group reached half the strength compared with the non-operated controls, while the autograft+BMP-7 and the autograft+BMP-7+ZOL equaled and doubled the strength of the controls respectively.
In study 2, we investigated if allograft+BMP can replace autograft. Allograft and different combinations of allograft, BMP-7 and ZOL were compared with; no treatment, autograft and autograft+ZOL with the hypothesis that allograft+BMP-7+ZOL would lead to superior union compared with autograft. Allograft+BMP-7+ZOL-treatment yielded a substantially higher peak force than all other groups.
In study 3, we investigated if the testing method influenced the results of the mechanical tests. BMP-7 and BMP-7+ZOL were compared with controls and each other. Calluses were tested both in three-point bending and twisting. All femurs healed. BMP-7+ZOL-treatment led to higher ultimate force and greater stiffness than BMP-7 alone. This difference was most evident in the three-point bending test
In study 4, the Masquelet induced membrane technique, was used to study the healing of a 6 mm rat femoral critical size defect. A synthetic scaffold was compared with BMP-7, BMP-7+scaffold and BMP-7+scaffold+ZOL. We found the combination of BMP-7+scaffold+ZOL to be superior to the other treatments.
In conclusion we could show a synergistic effect by concurrent treatment with BMP-7 and zoledronate in all four studies. This supports the use of the combination, either alone or as a supplement to autograft, allograft or synthetic scaffold in both nonunions and bone defects.
Department/s
Publishing year
2014
Language
English
Publication/Series
Lund University Faculty of Medicine Doctoral Dissertation Series
Volume
2014:104
Full text
Document type
Dissertation
Publisher
Department of Orthopaedics, Lund University
Topic
- Orthopedics
Keywords
- autograft
- BMP
- bisphosphonate
- nonunion
- Masquelet
Status
Published
Supervisor
ISBN/ISSN/Other
- ISSN: 1652-8220
- ISBN: 978-91-7619-033-3
Defence date
26 September 2014
Defence time
09:00
Defence place
Strålbehandlingshuset, Föreläsningssalen, Klinikgatan 5, Skånes Universitetssjukhus, Lund
Opponent
- Sune Larsson (Prof)