An experimental and related research of segmental bone defects repaired with calcium phosphate cement as carrier to bone morphogenetic protein / 中华骨科杂志

ABSTRACT

Objective A new type of bone graft material was constructed by combining calcium phosphate cement(CPC) with bone morphogenetic protein(BMP). In order to evaluate the feasibility to use this material to repair the segmental bone defect in clinic, the ability of CPC was compared with CPC/BMP in bone defects reconstruction by animal experiments. Methods The model of 15 mm bone defect was established in the middle shaft of the radius in 60 rabbits, of which 30 defects were implanted with CPC/BMP composites, 22 implanted with CPC, and the other 8 rabbits served as control group. The specimens were harvested separately at the end of 2, 4, 8, 16 and 24 weeks after operation. In order to observe the formation of new bone and the degradation process of the material, a series of examinations were carried out including of radiography, histomorphology, serum detection, energy dispersion analysis X-ray(EDAX), scanning electron microscope(SEM),bone density detection, mechanical measurement and inorganic substance detection. The results of CPC group and CPC/BMP group were compared on the same condition. Results All the animals survived after operation, and no reactions of toxicity were found. New bone formation was observed to be increasing significantly in CPC/BMP group with the time of implantation. Only little new bone formed in CPC group and no healing was found in the control group. By the end of 24 weeks, new bone had bridged the gap between the proximal and distal fragments in CPC/BMP group. In histomorphological detection, chondrocytes were found at the 2nd week, and woven bone at 4th week in CPC/BMP group. Remodeling of new lamellar bone and absorption of the composite material were observed at the 16th week, and the mechanical strength of the composite material reached almost to normal level at the 24th week. Calcification was significantly higher in CPC/BMP group than that in CPC group examined by EDAX, new bone density detection and measurement of inorganic substance in specimens. During the repairing process of bone defect, the material degraded while new bone formed, the speed of degradation of CPC/BMP was evidently higher than that of CPC group. Moreover, in the process of CPC degradation, the concentration of calcium in serum increased, and the concentration of phosphate in serum kept unchanged. Conclusion The CPC/BMP composite has great potential in bone defects repairing and could be used as a material for bone graft substitute in clinical patients.