Sustained-release rhBMP-2 increased bone mass and bone strength in an ovine model of postmenopausal osteoporosis

Objective: The purpose of this study was to analyze the local treatment effects of rhBMP-2 combined with fibrin sealant (FS) on bone mineral density, microarchitectural and mechanical properties in osteoporotic ovine spine. Materials and methods: Postmenopausal osteoporosis was induced in eight sheep through ovariectomy (OVX) and a low-calcium diet for a period of 12 months. According to the Latin square design, L3-L6 vertebrae were randomly assigned to four treatment groups: A (rhBMP-2/FS), B (rhBMP-2), C (FS) and D (blank control). All materials were injected into the assigned vertebra transpedicularly. All animals were euthanized 3 months after treatment. Bone mineral density (BMD), microarchitectural and mechanical properties were assessed. ANOVA analysis of variance was used to determine effects of rhBMP-2/FS (α = 0.05). Results: The BMD in group A (rhBMP-2/FS) was 18.8, 30.4 and 27.9% higher than that in group B, C and D, respectively. Analysis of bone structure by micro-CT revealed higher trabecular bone volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N) in the rhBMP-2/FS group (P < 0.01). In addition, vertebrae treated with rhBMP-2/FS exhibited higher yield stress, ultimate stress, energy absorption and bone modulus compared to the control groups. Conclusions: Local administration of rhBMP-2/FS showed a positive trend in improving BMD, microarchitectural parameters and mechanical strength of osteoporotic vertebra. Slow release of rhBMP-2 using FS appeared to be an effective method of protein delivery. The local treatment of osteoporosis in the spine can increase bone strength and reduce fracture risk quickly.