Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Shoulder Elbow Surg. 2018 May;27(5):894-902. doi: 10.1016/j.jse.2017.11.025. Epub 2018 Feb 12.
Bone morphogenetic protein 2 (BMP-2) plays an important role in the tendon-to-bone repair process. However, there is no previous literature on acceleration of the tendon-to-bone repair process by BMP-2 delivered by β-tricalcium phosphate (β-TCP). The aim of this study was to investigate the accelerated effect of recombinant human BMP-2 (rhBMP-2) delivered by β-TCP on the tendon-to-bone repair process.
The infraspinatus tendon of elderly female Japanese white rabbits was detached from its insertion site on the humerus. A bone tunnel (4.2 mm) was created at the original insertion site of the tendon, which was repaired using the McLaughlin procedure after filling in β-TCP (porosity 75%) without BMP-2 (control group) or with 10 µg rhBMP-2 (BMP group). The rabbits were sacrificed at the second, fourth, and eighth weeks after surgery for histologic analysis and biomechanical testing. We also evaluated the maturity of the tendon-to-bone junction using the tendon-to-bone maturity score.
Histologic analysis revealed no significant difference between the groups at 2 and 8 weeks but a more abundant organized fibrocartilage at the tendon-to-bone junction in the BMP group at 4 weeks. The tendon-to-bone maturity score improved sequentially. The interface of the BMP group at 4 weeks had significantly improved biomechanical properties than that of the control group.
The tendon-to-bone repair process was facilitated by the use of rhBMP-2 delivered by β-TCP at 4 weeks.
骨形态发生蛋白 2(BMP-2)在腱骨修复过程中起着重要作用。然而,以前没有文献报道过β-磷酸三钙(β-TCP)递送的 BMP-2 加速腱骨修复过程。本研究旨在探讨 rhBMP-2 经β-TCP 递送至腱骨修复过程的加速作用。
老年雌性日本白兔冈上肌腱从肱骨附着处分离。在肌腱的原始附着部位创建一个骨隧道(4.2mm),在没有 BMP-2(对照组)或填充 10μg rhBMP-2(BMP 组)的情况下,用 McLaughlin 手术修复β-TCP(孔隙率 75%)。术后第 2、4 和 8 周处死兔子进行组织学分析和生物力学测试。我们还使用腱骨成熟评分评估腱骨交界处的成熟度。
组织学分析显示两组在 2 周和 8 周时没有明显差异,但在 4 周时 BMP 组腱骨交界处有更多丰富的有组织纤维软骨。腱骨成熟评分依次提高。4 周时 BMP 组的界面具有比对照组更好的生物力学性能。
rhBMP-2 经β-TCP 在 4 周时促进了腱骨修复过程。