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The Journal of Bone and Joint Surgery, Vol 77, Issue 8 1135-1147, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Enhancement of bone ingrowth by transforming growth factor-beta
DR Sumner, TM Turner, AF Purchio, WR Gombotz, RM Urban and JO Galante
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Enhancement of bone ingrowth with transforming growth factor-beta was
evaluated in a canine model. Ten dogs had bilateral implantation of a
titanium-fiber-metal-coated rod in the proximal part of the humerus. A
three-millimeter gap between the outer surface of the porous coating and
the surrounding cancellous bone was created to impair bone ingrowth. All of
the implants were plasma-flame-sprayed with hydroxyapatite and tricalcium
phosphate. In each animal, one implant was also treated with recombinant
transforming growth factor-beta 1 while the other implant, which was not so
treated, served as a paired control. Two doses of transforming growth
factor-beta 1 were used: 335 micrograms in five animals and 120 micrograms
in the other five. At four weeks, the amount of bone ingrowth in the
implants that had been treated with 120 micrograms of transforming growth
factor-beta 1 was threefold higher than that in the paired controls (p =
0.009), but with the numbers available there was no significant increase in
bone ingrowth with the higher dose. The amount of new-bone formation in the
three-millimeter gaps adjacent to the treated implants was twice that in
the gaps of the paired controls, regardless of the dose. The differences
between the treated and control implants with regard to the architecture of
the new bone in the gap indicate that the mechanism of action of
transforming growth factor-beta 1 may include both proliferation of
osteoprogenitor cells and production of matrix by committed osteoblasts.
Compared with the findings in a previous study in which this canine model
was used, the data from the present investigation indicate that enhancement
of bone ingrowth in implants that have been treated with a combination of a
hydroxyapatite-tricalcium phosphate coating and transforming growth
factor-beta 1 may exceed that obtainable with grafting of the gap with
autogenous cancellous bone.
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