Use of three-dimensionally printed β-tricalcium phosphate synthetic bone graft combined with recombinant human bone morphogenic protein-2 to treat a severe radial atrophic nonunion in a Yorkshire terrier.
Animals
Bone Morphogenetic Protein 2
/ metabolism
Bone Transplantation
/ instrumentation
Calcium Phosphates
/ chemistry
Dogs
/ injuries
Fractures, Malunited
/ surgery
Male
Printing, Three-Dimensional
Radius Fractures
/ surgery
Recombinant Proteins
/ metabolism
Transforming Growth Factor beta
/ metabolism
Journal
Veterinary surgery : VS
ISSN: 1532-950X
Titre abrégé: Vet Surg
Pays: United States
ID NLM: 8113214
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
29
11
2019
revised:
10
04
2020
accepted:
14
05
2020
pubmed:
9
7
2020
medline:
15
1
2021
entrez:
9
7
2020
Statut:
ppublish
Résumé
To describe a novel surgical approach to treat a critical-sized bone defect due to severe, radial atrophic nonunion in a miniature dog. Case report ANIMAL: A 1-year-old Yorkshire terrier with a critical-sized left radial defect after failed internal fixation of a transverse radial fracture. Computed tomographic (CT) images of the radius were imported for three-dimensional (3D) printing of a custom-designed synthetic 3D-printed β-tricalcium phosphate (β-TCP) scaffold. The radius was exposed, and the β-TCP scaffold was press-fitted in the bone gap underneath the plate. Recombinant human bone morphogenic protein-2 (RhBMP-2) collagen sponges were squeezed to soak the scaffold with growth factor and then placed on both sides of the synthetic graft. Two additional cortical screws were also placed prior to routine closure of the surgical site. Radiographic examination was consistent with complete healing of the radius defect 4 months after surgery. The bone plate was removed 10 months after surgery. According to CT examination 18 months after surgery, there was no evidence of the synthetic graft; instead, complete corticalization of the affected area was noted. Complete functional recovery was observed until the last clinical follow-up 36 months postoperatively. Screw fixation and use of a 3D-printed ceramic scaffold augmented with rhBMP-2 resulted in excellent bone regeneration of the nonunion and full recovery of a miniature breed dog. The therapeutic approach used in this dog could be considered as an option for treatment of large-bone defects in veterinary orthopedics, especially for defects affecting the distal radius of miniature dogs.
Substances chimiques
Bone Morphogenetic Protein 2
0
Calcium Phosphates
0
Recombinant Proteins
0
Transforming Growth Factor beta
0
beta-tricalcium phosphate
0
recombinant human bone morphogenetic protein-2
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
1626-1631Informations de copyright
© 2020 The American College of Veterinary Surgeons.
Références
Piras L, Cappellari F, Peirone B, Ferretti A. Treatment of fractures of the distal radius and ulna in toy breed dogs with circular external skeletal fixation: a retrospective study. Vet Comp Orthop Traumatol. 2011;24:228-235.
Welch JA, Boudrieau RJ, DeJardin LM, Spodnick GJ. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg. 1997;26:57-61.
Dimitriou R, Jones E, McGonagle D, Giannoudis PV. Bone regeneration: current concepts and future directions. BMC Med. 2011;9:66.
Ginebra MP, Espanol M, Montufar EB, Perez RA, Mestres G. New processing approaches in calcium phosphate cements and their applications in regenerative medicine. Acta Biomater. 2010;6:2863-2873.
Franch J, Díaz-Bertrana C, Lafuente P, Fontecha P, Durall I. Beta-tricalcium phosphate as a synthetic cancellous bone graft in veterinary orthopaedics: a retrospective study of 13 clinical cases. Vet Comp Orthop Traumatol. 2006;19:196-204.
Maazouz Y, Montufar EB, Guillem-Marti J, et al. Robocasting of biomimetic hydroxyapatite scaffolds using self-setting inks. J Mater Chem B. 2014;2:5378-5386.
Trombetta R, Inzana JA, Schwarz EM, Kates SL, Awad HA. 3D printing of calcium phosphate ceramics for bone tissue engineering and drug delivery. Ann Biomed Eng. 2017;45:23-44.
Barba A, Maazouz Y, Diez-Escudero A, et al. Osteogenesis by foamed and 3D-printed nanostructured calcium phosphate scaffolds: effect of pore architecture. Acta Biomater. 2018;79:135-147.
Lissenberg-Thunnissen SN, de Gorter DJJ, Sier CFM, Schipper IB. Use and efficacy of bone morphogenetic proteins in fracture healing. Int Orthop. 2011;35:1271-1280.
Pinel CB, Pluhar GE. Clinical application of recombinant human bone morphogenetic protein in cats and dogs: a review of 13 cases. Can Vet J. 2012;53:767-774.
Boudrieau RJ. Initial experience with rhBMP-2 delivered in a compressive resistant matrix for mandibular reconstruction in 5 dogs. Vet Surg. 2015;44:443-458.
O'Brien CM, Holmes B, Faucett S, Zhang LG. Three-dimensional printing of nanomaterial scaffolds for complex tissue regeneration. Tissue Eng Part B Rev. 2015;21:103-114.
Bialy IE, Jiskoot W, Nejadnik MR. Formulation, delivery and stability of bone morphogenetic proteins for effective bone regeneration. Pharm Res. 2017;34:1152-1170.
Ishack S, Mediero A, Wilder T, Ricci JL, Cronstein BN. Bone regeneration in critical bone defects using three-dimensionally printed β-tricalcium phosphate/hydroxyapatite scaffolds is enhanced by coating scaffolds with either dipyridamole or BMP-2. J Biomed Mater Res B Appl Biomater. 2017;105:366-375.
Minier K, Touré A, Fusellier M, et al. BMP-2 delivered from a self-crosslinkable CaP/hydrogel construct promotes bone regeneration in a critical-size segmental defect model of non-union in dogs. Vet Comp Orthop Traumatol. 2014;27:411-421.
Wang J, Chen Y, Zhu X, et al. Effect of phase composition on protein adsorption and osteoinduction of porous calcium phosphate ceramics in mice. J Biomed Mater Res A. 2014;102:4234-4243.