Raleigh Matthew, Gagnon Stephane, Felice Hilary, Godbout Charles A, Halai Mansur M, Atrey Amit, Khoshbin Amir, Hall Jeremy, Schemitsch Emil, Nauth Aaron
Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
Bone Joint J. 2025 Jul 1;107-B(7):744-751. doi: 10.1302/0301-620X.107B7.BJJ-2024-1127.R1.
The management of nonunions continues to challenge orthopaedic surgeons. The application of growth factors represents a potential strategy to promote healing in such patients. The aim of this study was to compare two commercially available growth factors, bone morphogenetic protein-2 (BMP-2) and platelet-derived growth factor (PDGF), to assess their individual and relative efficacy in a small animal model of nonunion.
A total of 50 male Fischer 344 rats received one of five forms of treatment for a femoral diaphyseal defect: 1) control; 2) PDGF carrier; 3) PDGF treatment; 4) BMP-2 carrier; and 5) BMP-2 treatment. After ten weeks, radiographs were assessed for bone formation and union, with the femora being subjected to micro-CT analysis and biomechanical testing.
BMP-2 treatment resulted in a 100% rate of radiological union. This was significantly different from all other groups (p < 0.05), with a correspondingly significantly higher mean radiological score than the PDGF treatment group (p =0.004). Similarly, micro-CT analysis demonstrated a significantly increased mean bone volume and bone volume fraction with BMP-2 treatment compared with PDGF (p < 0.01). Under mechanical testing, the BMP-2 treatment group also demonstrated significantly increased maximum stiffness compared with all other groups (p < 0.05), with significantly increased ultimate torque and yield point compared with the PDGF treatment group (p < 0.001).
BMP-2 treatment resulted in significantly improved healing compared with PDGF treatment in a small animal model of nonunion, using clinically relevant carriers. BMP-2 may thus be superior to PDGF in the treatment of nonunions and segmental bony defects.
骨不连的治疗一直是骨科医生面临的挑战。生长因子的应用是促进此类患者愈合的一种潜在策略。本研究的目的是比较两种市售生长因子，骨形态发生蛋白-2（BMP-2）和血小板衍生生长因子（PDGF），以评估它们在骨不连小动物模型中的个体疗效和相对疗效。
总共50只雄性Fischer 344大鼠接受了五种股骨骨干缺损治疗方式中的一种：1）对照组；2）PDGF载体；3）PDGF治疗；4）BMP-2载体；5）BMP-2治疗。十周后，评估X线片上的骨形成和骨愈合情况，并对股骨进行显微CT分析和生物力学测试。
BMP-2治疗组的放射学骨愈合率为100%。这与所有其他组有显著差异（p<0.05），其平均放射学评分相应地显著高于PDGF治疗组（p =0.004）。同样，显微CT分析表明，与PDGF治疗相比，BMP-2治疗的平均骨体积和骨体积分数显著增加（p<0.01）。在力学测试中，BMP-2治疗组与所有其他组相比，最大刚度也显著增加（p<0.05），与PDGF治疗组相比，极限扭矩和屈服点显著增加（p<0.001）。
在使用临床相关载体的骨不连小动物模型中，与PDGF治疗相比，BMP-2治疗能显著改善愈合情况。因此，在骨不连和节段性骨缺损的治疗中，BMP-2可能优于PDGF。
