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Lee, Lee, Lee, and Ahn: Influence of Recombinant Human Bone Morphogenetic Protein-2 on the Remodeling of Subchondral Bone and Cartilage Healing in the Articular Cartilage Defect of the Rabbit
Original Article

Journal of the Korean Orthopaedic Association 2015; 50(3): 241-248.

Published online: 30 June 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.3.241

Influence of Recombinant Human Bone Morphogenetic Protein-2 on the Remodeling of Subchondral Bone and Cartilage Healing in the Articular Cartilage Defect of the Rabbit

Suk Ha Lee, M.D., Ph.D., Seoung-Joon Lee, M.D., Ph.D., Jong Soo Lee, M.D., Jaesung Ahn, M.D.*

Department of Orthopedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

*Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.

Correspondence to: Seoung-Joon Lee, M.D., Ph.D. Department of Orthopedic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea. TEL: +82-2-2030-7616, FAX: +82-2-2030-7369, lsjmd@kuh.ac.kr

Received 2 October 2014       Revised 6 February 2015       Accepted 7 March 2015

Copyright © 2015 by The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to evaluate the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) after microfracture on the remodeling of subchondral bone and cartilage healing in a model of full-thickness articular cartilage injury in a rabbit.

Materials and Methods

A full thickness articular cartilage defect of 6×3-mm-size was created in the trochlear groove of the right femur in 24 rabbits. The defect was left empty in six rabbits, and microfracture was done in 18 rabbits. After microfracture, no treatment was done in six rabbits, defect was filled with fibrin glue in six rabbits, and with fibrin glue and rhBMP-2 in six rabbits. The effect of rhBMP-2 after microfracture was evaluated based on histological analysis and real-time polymerase chain reaction (PCR) for analysis of collagen type at 8 weeks after surgery.

Results

The score of histological grade scale of six rabbits in which the defect was filled with fibrin glue and rhBMP-2 was better than that of others and real-time PCR also showed a higher amount of collage type 1 and collage type 2 in these six rabbits.

Conclusion

We consider that fibrin glue and rhBMP-2 after microfracture may accelerate cartilage healing in an articular cartilage defect and maybe helpful in healing the articular cartilage defect into more closely native hyaline cartilage.

Keywords: articular cartilage defect, microfracture, bone morphogenetic protein-2

Figures and Tables

Figure 1

Experiment photographs. (A) A 3×6 mm defect is made at the intercondylar notch of rabbit's femur with a 3 mm diameter drill hole (1-2 mm thickness) without subchondral bone damage. (B) Microfracture (arrows) is made with a fine K-wire. (C) The defect (dashed arrow) is filled with fibrin glue and recombinant human morphogenetic protein-2.

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Figure 2

Photographs of H&E stain (×40). (A) Cartilage defect only. (B) Treatment with microfracture. (C) Treatment with microfracture and fibrin glue. (D) Treatment with microfracture, fibrin glue, and recombinant human bone morphogenetic protein-2 (rhBMP-2). The defect filled with fibrin glue and rhBMP-2 demonstrated more cartilagenous tissue and replacement of subchondral bone. The arrows indicate the boundary between the preexisting articular cartilage and the repair tissues. RC, repair cartilage; NC, normal cartilage.

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Figure 3

Photographs of Alcian blue stain (×40). (A) Cartilage defect only. (B) Treatment with microfracture. (C) Treatment with microfracture and fibrin glue. (D) Treatment with microfracture, fibrin glue, and recombinant human bone morphogenetic protein-2 (rhBMP-2). These findings demonstrated the presence of greater amounts of hyaline cartilage in the group treated with microfracture, fibrin glue and rhBMP-2. The arrows indicate the boundary between the preexisting articular cartilage and the repair tissues. RC, repair cartilage; NC, normal cartilage.

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Figure 4

Results of real-time polymerase chain reaction in each group. Group filled with fibrin glue and recombinant human morphogenetic protein-2 after microfracture demonstrated a higher amount of collagen type 1 and collagen type 2.

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Table 1

Summary of Real-Time Polymerase Chain Reaction

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Table 2

Histological Scores of Articular Cartilage Defect

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Values are presented as mean±standard deviation. The score for defects treated with rhBMP-2 was significantly different (p<0.05) from that for the other defects. CD, cartilage defect; MF, microfracture; FG, fibrin glue; rhBMP, recombinant human morphogenetic protein-2.

Notes

This paper was supported by Konkuk University in 2009.

CONFLICTS OF INTEREST The authors have nothing to disclose.

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