Effects of orthopedic implants with a polycaprolactone polymer coating containing bone morphogenetic protein-2 on osseointegration in bones of sheep

Andrew J. Niehaus Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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David E. Anderson Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Valerie F. Samii Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Steven E. Weisbrode Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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Jed K. Johnson Department of Materials Science Engineering, College of Engineering, The Ohio State University, Columbus, OH 43210.

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Mike S. Noon Department of Materials Science Engineering, College of Engineering, The Ohio State University, Columbus, OH 43210.

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David L. Tomasko Department of Materials Science Engineering, College of Engineering, The Ohio State University, Columbus, OH 43210.

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John J. Lannutti Department of Materials Science Engineering, College of Engineering, The Ohio State University, Columbus, OH 43210.

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Abstract

Objective—To determine elution characteristics of bone morphogenetic protein (BMP)-2 from a polycaprolactone coating applied to orthopedic implants and determine effects of this coating on osseointegration.

Animals—6 sheep.

Procedures—An in vitro study was conducted to determine BMP-2 elution from polycaprolactone-coated implants. An in vivo study was conducted to determine the effects on osseointegration when the polycaprolactone with BMP-2 coating was applied to bone screws. Osseointegration was assessed via radiography, measurement of peak removal torque and bone mineral density, and histomorphometric analysis. Physiologic response was assessed by measuring serum bone-specific alkaline phosphatase activity and uptake of bone markers.

Results—Mean ± SD elution on day 1 of the in vitro study was 263 ± 152 pg/d, which then maintained a plateau at 59.8 ± 29.1 pg/d. Mean peak removal torque for screws coated with polycalprolactone and BMP-2 (0.91 ± 0.65 dN·m) and screws coated with polycaprolactone alone (0.97 ± 1.30 dN·m) did not differ significantly from that for the control screws (2.34 ± 1.62 dN·m). Mean bone mineral densities were 0.535 ± 0.060 g/cm2, 0.596 ± 0.093 g/cm2, and 0.524 ± 0.142 g/cm2 for the polycaprolactone–BMP-2–coated, polycaprolactone-coated, and control screws, respectively, and did not differ significantly among groups. Histologically, bone was in closer apposition to the implant with the control screws than with either of the coated screws.

Conclusions and Clinical Relevance—BMP-2 within the polycaprolactone coating did not stimulate osteogenesis. The polycaprolactone coating appeared to cause a barrier effect that prevented formation of new bone. A longer period or use of another carrier polymer may result in increased osseointegration.

Abstract

Objective—To determine elution characteristics of bone morphogenetic protein (BMP)-2 from a polycaprolactone coating applied to orthopedic implants and determine effects of this coating on osseointegration.

Animals—6 sheep.

Procedures—An in vitro study was conducted to determine BMP-2 elution from polycaprolactone-coated implants. An in vivo study was conducted to determine the effects on osseointegration when the polycaprolactone with BMP-2 coating was applied to bone screws. Osseointegration was assessed via radiography, measurement of peak removal torque and bone mineral density, and histomorphometric analysis. Physiologic response was assessed by measuring serum bone-specific alkaline phosphatase activity and uptake of bone markers.

Results—Mean ± SD elution on day 1 of the in vitro study was 263 ± 152 pg/d, which then maintained a plateau at 59.8 ± 29.1 pg/d. Mean peak removal torque for screws coated with polycalprolactone and BMP-2 (0.91 ± 0.65 dN·m) and screws coated with polycaprolactone alone (0.97 ± 1.30 dN·m) did not differ significantly from that for the control screws (2.34 ± 1.62 dN·m). Mean bone mineral densities were 0.535 ± 0.060 g/cm2, 0.596 ± 0.093 g/cm2, and 0.524 ± 0.142 g/cm2 for the polycaprolactone–BMP-2–coated, polycaprolactone-coated, and control screws, respectively, and did not differ significantly among groups. Histologically, bone was in closer apposition to the implant with the control screws than with either of the coated screws.

Conclusions and Clinical Relevance—BMP-2 within the polycaprolactone coating did not stimulate osteogenesis. The polycaprolactone coating appeared to cause a barrier effect that prevented formation of new bone. A longer period or use of another carrier polymer may result in increased osseointegration.

Contributor Notes

Dr. Anderson's present address is Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

The authors thank Dr. Paivi Rajala-Schultz for assistance with statistical analysis, Dr. Jeff Lakritz for assistance with fluorescent microscopy, and Walter Hoffmann for assistance with the bone-specific alkaline phosphatase assay.

Address correspondence to Dr. Niehaus (niehaus.25@osu.edu).
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