Repairing Defect and Preventing Collapse of Canine Femoral Head Using Titanium Implant Enhanced by Autogenous Bone Graft and rhBMP-2

Abstract

There is a direct relationship between mechanical stress and the progressive collapse of the necrotic region in osteonecrosis of the femoral head. The titanium implant combined with autogenous bone graft and recombinant human bone morphogenetic protein (rhBMP)-2 to repair the defect and prevent collapse of the femoral head was investigated. The femoral head defects were made by the trapdoor procedure and then the defects were filled, respectively, with the titanium implant combined with autogenous bone graft and rhBMP-2, with autogenous bone graft and rhBMP-2, and with autogenous bone graft alone. Roentgenographic and histological examinations were performed at various times postoperatively. The defects were repaired completely and the titanium implant was integrated with the surrounding bone tissues. The defects healed faster than did without rhBMP-2. No trapdoor cartilage collapsed and joint space narrowed. The titanium implant combined with autogenous bone graft and rhBMP-2 can enhance the repairing procedure and prevent the collapse of the femoral head.

The efficacy and safety of core decompression for the treatment of femoral head necrosis: a systematic review and meta-analysis

“…Three studies [27, 33, 36] added additional bone morphogenetic proteins (BMP) during treatment, which caught our interest in this substance. Exogenous BMP has a positive effect on the treatment of femoral head necrosis [48]. BMP is widely present in the bone matrix, which induces osteogenic cells in normal bone tissue and generates bone and cartilage tissue in bone and surrounding soft tissues [49].…”

Mid- to long-term results of modified non-vascularized allogeneic fibula grafting combined with core decompression and bone grafting for early femoral head necrosis

“…The first one, the biological factor, which included removing the dead bone adequately and promote bone regeneration and blood flow recovery. The other is biomechanics factor that is to implant the scaffold, including implantation bioactive materials or not, to function as mechanical supporting and osteoconduction to the defect area so that it can delay or prevent the femoral head from collapse [18,19]. Though several studies have revealed that tantalum rod insertion can effectively delay or prevent the progression of osteonecrosis of the femoral head, whose overall survival rates were 68.1 to 72.49% at 48 to 60 months postoperatively [20,21].…”

Icariin: A promising osteoinductive compound for repairing bone defect and osteonecrosis

“…Therefore, these findings raised interest for a pathophysiological approach of the ON treatment by removing the necrotic bone and implanting autogenous bone, or biomaterials. 3,4,6,7,33,37 The implanted materials could offer mechanical strength immediately after the necrotic lesion was excuretted through core decompression, and enhance angiogenesis and osteogenesis to repair the bone defects. With the nutritional supply by the new micro-vessel, bone tissue will regenerate into the implanted materials and the implanted materials will subsequently be replaced by NB.…”

“…4,5 The collapse of the femoral head is probably the effect of a combination of biomechanical and biological factors. 6,7 When preserving surgical procedure is performed, the necrotic bone is removed and replaced by autogenous bone or biomaterials, which could stimulate bone formation (biological factors) and support the subchondral bone and articular cartilage of the femoral head (biomechanical factors) for the precollapsed ONFH treatment.…”