Biodegradable Implants in Fracture Fixation: Early Results of Treatment of Fractures of the Ankle

Rokkanen, P; Böstman, O; Vainionpää, S.; Vihtonen, Kimmo; Törmälä, P.; Laiho, Juha; Kilpikari, J.; Tamminmäki, M.

doi:10.1016/s0140-6736(85)91847-1

Cited by 266 publications

(84 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Polymers used as carriers of BMP comprise the various forms of (poly) alfa-hydroxyl acid (Phydroxyapatite) such as (poly) L-lactic acid (PLLA), (poly) glycolic acid (PGA) and their copolymers, (poly) D,L-lactic acid-co-glycolic acid (PLGA) (132). Polymers have been applied in clinical practice in fracture fixation for 15 years (133) and are interesting as BMP carriers because of the possibility of controlled drug release.…”

Section: Role Of Bmp Carriers In Bone Inductionmentioning

confidence: 99%

Bone morphogenetic proteins in human bone regeneration

Groeneveld

Burgér

2000

European Journal of Endocrinology

358

217

View full text Add to dashboard Cite

Recently, the first clinical reports on bone regeneration by two recombinant human bone morphogenetic proteins (rhBMPs), BMP-2 and BMP-7 (also named osteogenic protein-1, OP-1) have been published (1-4) . Although both BMPs were able to support bone regeneration, a significant variation in individual response was observed with both proteins. Animal studies and laboratory experiments reveal a number of conditions that influence the osteoinductivity of BMP, such as BMP concentration, carrier properties and influence of local and systemic growth factors and hormones. In this paper, these studies and the clinical reports are reviewed, and the conditions that modulate the BMP-dependent osteoinduction are discussed. The information may provide clues as to how the performance of recombinant human BMP as bone-graft substitute in humans can be improved. European Journal of Endocrinology 142 9-21 BMP and demineralized bone matrixThe history of bone morphogenetic proteins (BMPs) began with the observation that demineralized bone matrix (DBM) is able to induce ectopic bone formation in subcutaneous and intramuscular pockets in rodents (5, 6). This bone induction process has been studied extensively (7-13). Histological and biochemical analyses showed that cartilage appears 5-10 days after implantation of active DBM (8). This cartilage mineralizes by day 7-14 and is subsequently replaced by bone (7-9). After 21 days, haematopoietic bone marrow formation can be observed (12). These cellular events observed after DBM implantation mimic embryonic bone development and normal fracture repair (11). As DBM-related bone formation was observed to occur at ectopic sites, it was assumed that pluripotent mesenchymal cells are attracted to the site of implantation. Isolation of the bone-inducing substance revealed that certain proteins were responsible, which were termed bone morphogenetic proteins (BMPs) or osteogenetic proteins (OPs).The use of DBM in treating bone defects has proven beneficial for bone regeneration both in animals and in humans (14-17). DBM has become widely accepted as a bone-graft substitute in clinical practice (18-22), but its bone inductive capacity has been questioned (23, 24). In several studies, including our own, histology revealed that new bone was generated by osteoconduction rather than osteoinduction (25-27) -that is, bone regeneration occurred by growth of existing host bone on the DBM granules, which acted as a scaffold, rather than by de novo differentiation of bone, independent of pre-existing bone. Lack of inductive properties of DBM may be related to the procedures of production of commercially available DBM, as preservation of osteoinductive activity can be affected by the processing (28-30) or sterilization procedures (31). It is also possible that DBM of human origin, which is preferred for use in clinical practice, is less osteoinductive than DBM derived from animals, which is commonly used in animal studies. Several studies show that DBM from long-lived species such as baboon and human...

show abstract

Section: Role Of Bmp Carriers In Bone Inductionmentioning

confidence: 99%

Bone morphogenetic proteins in human bone regeneration

Groeneveld

Burgér

2000

European Journal of Endocrinology

358

217

View full text Add to dashboard Cite

show abstract

“…Totally absorbable internal fixation devices have been in clinical use at our department since 1984 (Rokkanen et al 1985) and more than 2800 patients have been operated on. In this study we have examined the postoperative infections observed in all 3 1 11 ankle fracture patients treated with metallic or absorbable fracture fixation devices during an 8-year period.…”

Section: Metallic or Absorbable Implants For Ankle Fracturesmentioning

confidence: 99%

Metallic or absorbable implants for ankle fractures:A comparative study of infections in 3,111 cases

Sinisaari¹,

Pätiälä²,

Böstman³

et al. 1996

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

“…The results of biodegradable fixation were better for fracture of cancellous bone as compared with cortical bone. Rokkanen et al (1985) reported successful early results of biodegradable fixation of fractures of the ankle. We studied fixation of experimental osteotomies with carbon fibre reinforced and gold overlaid implants.…”

Section: Acta Orthop Sand 57 237-2391986mentioning

confidence: 99%