Osseointegration of long-term implants is still a problem in orthopaedic surgery. In recent years, several techniques to modify the implant surface to increase bone formation around implants have been described by many authors. Most endoprostheses used in orthopaedic surgery are manufactured from titanium. To understand the process of osseointegration, one has to take into account, that the adhesion of plasma proteins on the surface of titanium implants plays an essential role in the process of implant integration. In the last years, several modifications of implant surfaces (structure, chemistry, surface charge, wettability) have been investigated to improve osseointegration of titanium implants. Furthermore, several cytokines and growth factors have also been suggested to stimulate an implant ingrowth. In this respect, functionalized titanium implant surfaces with bone morphogenetic proteins-2 (BMP-2) as one particular member of the superfamily of transforming growth factor β (TGF-β), have proven a potential to stimulate bone formation around implants in different species. In this review the authors provide an overview of surface coatings with BMP-2 and their use in laboratory and experimental settings.
F. Thorey et al. / Enhancement of endoprosthesis anchoring using BMP-277]. In the last years, several modifications of implant surfaces (structure, chemistry, surface charge, wettability) have been investigated to improve osseointegration of titanium implants [4]. Furthermore, several cytokines and growth factors have also been suggested to stimulate an implant ingrowth [73,83]. The functionalization of implant surfaces with bone morphogenetic proteins (BMP), as one particular growth factor, has proven a potential to stimulate bone formation both in extraskeletal sites [86,88] and in defect models in different species [69,89].As multi-functional growth factors, BMP's belong to the superfamily of transforming growth factor β (TGFβ). Urist et al. first identified the activity of BMPs in the 1960s [72], but the proteins responsible for bone induction remained unknown. Further investigations were made in the late 1980s by Wozney et al., who purified and sequenced bovine BMP-3 (osteogenin) and cloned human 82]. So far, about 20 BMP family members have been identified and characterized. BMPs signal through serine/threonine kinase receptors, type I and type II. Several type I and type II receptors have been described to bind BMP ligands: three type I receptors (BMPR-IA or ALK-3, BMPR-IB or ALK-6, and type IA activin receptor ActR-IA or ALK-2) [37,47,70] and three type II receptors (type II BMP receptor (BMPR-II) and type II and IIB activin receptors (ActR-II and ActR-IIB) [36,58,85]). Whereas BMPR-IA, IB and II are specific to BMPs ActR-IA, II and IIB are also signaling receptors for activins. All these receptors are expressed differentially in diverse tissues. Type I and II BMP receptors are both indispensable for signal transduction. A heterotetrameric-activated receptor complex is formed after ligand binding. This c...