Dual-purpose bone grafts improve healing and reduce infection

Scott A. Guelcher, Kate V. Brown, Bing Li, Teja Guda, Baek Hee Lee, Joseph C. Wenke

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Objective: To determine if a dual-purpose bone graft can regenerate bone and reduce infection in highly contaminated bone critical size defects in rats. Methods: Biodegradable polyurethane (PUR) scaffolds were loaded with recombinant human bone morphogenetic protein-2 (BMP-2) and vancomycin (Vanc). The release kinetics of the BMP-2 were tuned to take advantage of its mechanism of action (ie, an initial burst to recruit cells and sustained release to induce differentiation of the migrating cells). The Vanc release kinetics were designed to protect the graft from contamination until it is vascularized by having a burst for a week and remaining well over the minimum inhibitory concentration for Staphylococcus aureus for 2 months. The bone regeneration and infection reduction capability of these dual-purpose grafts (PUR+2) were compared with collagen sponges loaded with BMP-2 (collagen+2) and PUR+2 in infected critical size rat femoral segmental defects. Results: The dual-delivery approach resulted in substantially more new bone formation and a modest improvement in infection than PUR+2 and collagen+2 treatments. Conclusions: The PUR bone graft is injectable, provides a more sustained release of BMP-2 than the collagen sponge, and can release antibiotics for more than 8 weeks. Thus, the dual-delivery approach may improve patient outcomes of open fractures by protecting the osteoinductive graft from colonization until vascularization occurs. In addition, the more optimal release kinetics of BMP-2 may reduce nonunions and the amount of growth factor required.

Original languageEnglish (US)
Pages (from-to)477-482
Number of pages6
JournalJournal of orthopaedic trauma
Volume25
Issue number8
DOIs
StatePublished - Aug 2011
Externally publishedYes

Keywords

  • antibiotic
  • contamination
  • controlled release
  • critical size defect
  • dual delivery
  • infection
  • PUR scaffold
  • rhBMP-2

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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