eCM (Eur Cell Mater / e Cells & Materials) Not-for-Profit Open Access
Created by Scientists, for Scientists
 ISSN:1473-2262         NLM:100973416 (link)         DOI:10.22203/eCM

2015   Volume No 29 – pages 141-154

Title: Full regeneration of segmental bone defects using porous titanium implants loaded with BMP-2 containing fibrin gels

Author: J van der Stok, MKE Koolen, MPM de Maat, S Amin Yavari, J Alblas, P Patka, JAN Verhaar, EMM van Lieshout, AA Zadpoor, H Weinans, H Jahr

Address: Room Ee1614, PO Box 2040, 3000CA Rotterdam, The Netherlands

E-mail: j.vanderstok at

Key Words: BMP, bone graft, bone regeneration, fibrin, metal surface treatment, scaffold, titanium.

Publication date: March 4th 2015

Abstract: Regeneration of load-bearing segmental bone defects is a major challenge in trauma and orthopaedic surgery. The ideal bone graft substitute is a biomaterial that provides immediate mechanical stability, while stimulating bone regeneration to completely bridge defects over a short period. Therefore, selective laser melted porous titanium, designed and fine-tuned to tolerate full load-bearing, was filled with a physiologically concentrated fibrin gel loaded with bone morphogenetic protein-2 (BMP-2). This biomaterial was used to graft critical-sized segmental femoral bone defects in rats. As a control, porous titanium implants were either left empty or filled with a fibrin gels without BMP-2. We evaluated bone regeneration, bone quality and mechanical strength of grafted femora using in vivo and ex vivo µCT scanning, histology, and torsion testing. This biomaterial completely regenerated and bridged the critical-sized bone defects within eight weeks. After twelve weeks, femora were anatomically re-shaped and revealed open medullary cavities. More importantly, new bone was formed throughout the entire porous titanium implants and grafted femora regained more than their innate mechanical stability: torsional strength exceeded twice their original strength. In conclusion, combining porous titanium implants with a physiologically concentrated fibrin gels loaded with BMP-2 improved bone regeneration in load-bearing segmental defects. This material combination now awaits its evaluation in larger animal models to show its suitability for grafting load-bearing defects in trauma and orthopaedic surgery.

Article download: Pages 141-154 (PDF file)
DOI: 10.22203/eCM.v029a11