TITLE

Local Administration of Ibandronate and Bone Morphogenetic Protein-2 After Ischemic Osteonecrosis of the Immature Femoral Head

AUTHOR(S)
Vandermeer, Jacob S.; Kamiya, Nobuhiro; Aya-ay, James; Garces, Amanda; Browne, Richard; Kim, Harry K. W.
PUB. DATE
May 2011
SOURCE
Journal of Bone & Joint Surgery, American Volume;5/18/2011, Vol. 93-A Issue 10, p905
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Bisphosphonate therapy has been shown to preserve the osteonecrotic femoral head in experimental and short-term clinical studies. However, a lack of new bone formation within the preserved femoral head due to the inhibition of bone remodeling is a concern. The purpose of this investigation was to determine if combined therapy consisting of ibandronate and bone mprphogenetic protein-2 (BMP-2) can preserve the shape of the femoral head and stimulate new bone formation in an immature animal model of ischemic osteonecrosis. Methods: lschemic osteonecrosis was surgically induced in immature pigs. Four groups were studied: normal, treated with saline solution, treated with ibandronate, and treated with both ibandronate and BMP-2 (the ibandronate + BMP-2 group). The animals were killed eight weeks after surgery. Radiographic, histological, and histomorphometric assessments were performed. Results: Radiographic assessment showed better preservation of the femoral head shape-i.e., a 54% (Cl [95% confidence interval]: 22%, 86%) higher mean epiphyseal quotient-in the ibandronate + BMP-2 group than in the saline group. Histological assessment showed increased trabecular bone in the bandronate + BMP-2 group as compared with that in the saline group. The mean values for trabecular bone volume, thickness, and number and for osteoblast surface were an average of 400% (Cl: 242%; 558%), 212% (Cl: 166%, 259%), 71% (Cl: 6%, 137%), and 2402% (Cl: 2113%, 2693%) higher, respectively, in the ibandronate + BMP-2 group than in the saline group. The osteoclast number was significantly reduced in the ibandronate + BMP-2 group compared with that in the saline group (-59% [Cl: -75%, -42%]). The mean osteoblast surface value in the ibandronate + BMP-2 group was significantly higher (2567% [Cl: 2258%, 2877%]) than that in the ibandronate group. Heterotopic ossifications were present in the capsule of the hip joint in the ibandronate + BMP-2 group. Conclusions: A combination of ibandronate and BMP-2 decreased femoral head deformity while stimulating bone formation in an immature animal model of ischemic osteonecrosis. Clinical Relevance: The findings provide a proof of concept that a combination of antiresorptive and anabolic agents can significantly improve bone healing and decrease deformity following ischemic osteonecrosis in the immature femoral head of a pig. Additional studies are needed to investigate whether heterotopic ossification can be prevented.
ACCESSION #
60718924

 

Related Articles

  • Case Report: Fresh-Stored Osteochondral Allograft for Treatment of Osteochondritis Dissecans the Femoral Head. Evans, Korboi; Providence, Bertram // Clinical Orthopaedics & Related Research;Feb2010, Vol. 468 Issue 2, p613 

    Abstract  Osteochondral defects of the femoral head are exceedingly rare, with limited treatment options. Restoration procedures for similar defects involving the knee and ankle have been well described. In this report, we present a young patient who had a symptomatic osteochondral defect...

  • Osteochondral mosaicplasty of the femoral head. Girard, Julien; Roumazeille, Thibaut; Sakr, Mazen; Migaud, Henri // Hip International;2011, Vol. 21 Issue 5, p542 

    Abstract: Young adults with osteochondral lesions of the femoral head are at risk of rapid progression to symptomatic arthritis of the hip joint. Between January 2008 and July 2009, 10 patients were treated for femoral cartilage damage by a osteochondral mosaicplasty of the femoral head through...

  • Which Functional Assessments Predict Long-term Wear After Total Hip Arthroplasty? Takenaga, Ryan; Callaghan, John; Bedard, Nicholas; Liu, Steve; Gao, Yubo // Clinical Orthopaedics & Related Research;Aug2013, Vol. 471 Issue 8, p2586 

    Background: There is a paucity of literature concerning functional assessment at long-term followup of THAs in general and in young patients specifically. Functional data may be useful in determining differences in the performance of various implants and surgical techniques in THA....

  • Bone Apposition of the Acetabular Rim in Deep Hips: A Distinct Finding of Global Pincer Impingement. Corten, Kristoff; Ganz, Reinhold; Chosa, Etsuo; Leunig, Michael // Journal of Bone & Joint Surgery, American Volume;5/4/2011 Supplement, Vol. 93-A, p10 

    Background: Hips with coxa profunda can develop a pincer-type impingement with linear impact between the proximal part of the femur and the acetabulum, leading to bone apposition on the acetabular rim. Methods: Twenty hips with radiographic features of rim ossification were isolated from a pilot...

  • Increased post-operative ischemia in the femoral head found by microdialysis by the posterior surgical approach: a randomized clinical trial comparing surgical approaches in hip resurfacing arthroplasty. Lorenzen, Nina Dyrberg; Stilling, Maiken; Ulrich-Vinther, Michael; Trolle-Andersen, Niels; Prynø, Thomas; Søballe, Kjeld; Birke-Sørensen, Hanne // Archives of Orthopaedic & Trauma Surgery;Dec2013, Vol. 133 Issue 12, p1735 

    Background: Hip resurfacing arthroplasty (HRA) is associated with osteonecrosis of the femoral head and femoral neck fracture, which may be caused by a decrease in the perfusion of the bone initiated at surgery. Several studies have demonstrated a decreased blood flow during surgery depending on...

  • Osteochondritis dissecans of the femoral head ...includes discussion. Siebenrock, Klaus A.; Powell, James N.; Ganz, Reinhold // Hip International;Oct-Dec2010, Vol. 20 Issue 4, p489 

    Seven patients with symptomatic osteochondritic lesions of the femoral head are presented. All were male with a mean age of 26 years (16 - 33 years). Two distinct morphologic appearances of the hip joint could be identified. Five patients presented with a coxa valga deformity, four of whom had...

  • The effect of femoral head size on functional outcome in primary total hip arthroplasty: a single-blinded randomised controlled trial. Hanna, Sammy A.; Sewell, Mathew D.; Sri-Ram, Kesavan; Miles, Jonathan; S. Aston, William J.; Pollock, Robin C.; J. Carrington, Richard W.; R. Briggs, Timothy W. // Hip International;Dec2012, Vol. 22 Issue 6, p592 

    We conducted a prospective single-blinded randomised controlled trial to compare the functional and quality of life outcomes in two groups of patients between 60 and 80 years of age undergoing THR; the first receiving a small head (28-32 mm) metal on polyethylene (MoP) articulation, and the...

  • Improved Healing of Large Segmental Defects in the Rat Femur by Reverse Dynamization in the Presence of Bone Morphogenetic Protein-2. Glatt, Vaida; Miller, Micah; Ivkovic, Alan; Fangjun Liu; Parry, Nicola; Griffin, Damian; Vrahas, Mark; Evans, Christopher // Journal of Bone & Joint Surgery, American Volume;11/21/2012, Vol. 94-A Issue 22, p2063 

    Background: Large segmental defects in bone do not heal well and present clinical challenges. This study investigated modulation of the mechanical environment as a means of improving bone healing in the presence of bone morphogenetic protein (BMP)-2. Although the influence of mechanical forces...

  • Sliding of Two Lag Screw Designs in a Highly Comminuted Fracture Model. Kummer, Frederick J.; Schwarzkopf, Ran; Takemoto, Richelle C.; Egol, Kenneth A. // Bulletin of the NYU Hospital for Joint Diseases;2011, Vol. 69 Issue 4, p289 

    A fracture construct, representing a worst-case model of a comminuted intertrochanteric fracture, was created in order to compare the fixation stability of two different cephalomedullary nails: one where the lag screw can telescope within itself to achieve displacement of the head-neck fragment,...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics