Journal
ACTA ORTHOPAEDICA
Volume 77, Issue 5, Pages 799-805Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/17453670610013024
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Background Osteogenic growth factors have been suggested to enhance the fixation of implants used in joint replacement. We examined the effect of locally delivered transforming growth factor-beta 1 and insulin-like growth factor-1 in a biodegradable poly (D, L-lactide) coating. Material and methods In a paired study using 9 dogs, unloaded titanium implants surrounded by a 1-mm gap were inserted into the proximal humerus. The growth factors were incorporated in a poly (D, L-lactide) coating at a 1% (w/w) ratio of TGF-beta 1 and a 5% (w/w) ratio of IGF-1. Control implants were uncoated. After 4 weeks, the implants were evaluated by mechanical push-out test and by histomorphometry. Results A twofold increase was seen in mechanical fixation (strength, stiffness, energy absorption) for the growth factor-treated implants (p = 0.04). Similar results were seen in histomorphometry, as bone ongrowth was 2.5 times higher (p = 0.02), and gap healing was 30-110% higher (p = 0.04) for the growth factor-treated implants than for the control implants. Ongrowth of fibrous tissue was eliminated by the treatment. Interpretation TGF-beta-1 and IGF-1, locally delivered in a biodegradable poly (D, L-lactide) coating, enhance the mechanical fixation and osseointegration of titanium implants in cancellous bone, and no fibrous tissue is produced in the growth factor treated implants.
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