Purpose
Our purpose was to determine whether a bioresorbable interference screw coated with
a hydroxyapatite-based mineral layer designed to release an engineered peptide growth
factor (linkBMP-2 [where “BMP-2” indicates bone morphogenetic protein 2]) improved
tendon-bone healing compared with a screw without coating.
Methods
Tagged linkBMP-2 peptides were used to quantify binding efficiency and release kinetics
on 9 mineral-coated BIORCI screws (Smith & Nephew, Andover, MA). Fourteen mature female
sheep were used in this study. In each of the 14 sheep, each stifle was randomized
to either receive a linkBMP-2–coated or uncoated interference screw (n = 14 per treatment).
The sheep were euthanized at 6 weeks after surgery. Eight sheep were subjected to
biomechanical testing for peak load at failure and stiffness, and six sheep were used
for histologic analysis according to a semiquantitative scoring scale.
Results
The linkBMP-2 molecule bound efficiently to the surface of mineral-coated interference
screws. Over 80% of the initially bound linkBMP-2 was released during a 6-week time
frame in vitro. Peak load at failure in the linkBMP-2–coated interference screw group
(mean ± SD, 449.3 ± 84.7 N) was not significantly different from that in the uncoated
group (421.0 ± 61.8 N) (P = .22). Stiffness in the linkBMP-2–coated interference screw group (157.3 ± 39.6
N/mm) was not significantly different from that in the uncoated group (140.6 ± 20.3
N/mm) (P = .12). Histologic analysis showed that the tendons in the linkBMP-2–coated interference
screw group had higher scores (better) than the uncoated group. In the linkBMP-2–coated
interference screw group, mesenchymal cells were present at the interface between
screw and tendon, whereas these cells were not present in the uncoated group.
Conclusions
We found that linkBMP-2 can be bound onto a mineral-coated BIORCI interference screw
surface and subsequently released from the screw surface in a sustained manner. The
histologic result of this study showed that the linkBMP-2–coated interference screw
significantly improved the histologic scores of early tendon-bone healing in this
sheep model.
Clinical Relevance
This linkBMP-2 coating material may improve early tendon/ligament fixation.
Key Words
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Article Info
Publication History
Published online: November 09, 2009
Accepted:
June 10,
2009
Received:
November 13,
2008
Footnotes
Supported by the Wallace H. Coulter Foundation (Translational Research Partnership Grant) and the National Institutes of Health (R03AR052893). The authors report no conflict of interest.
Note: To access the supplementary tables accompanying this report, visit the December issue of Arthroscopy at www.arthroscopyjournal.org.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
