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Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

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The role of the bone morphogenetic proteins 2 and 7 in the repair of circumscribed cartilage lesions

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  • H. Schmal - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany
  • P. Niemeyer - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany
  • J. Zwingmann - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany
  • F. Stoffel - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany
  • A. Mehlhorn - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany
  • N.P. Südkamp - Universitätsklinikum Freiburg, Deparmtent für Orthopädie und Traumatologie, Freiburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN23-210

doi: 10.3205/10dkou147, urn:nbn:de:0183-10dkou1471

Published: October 21, 2010

© 2010 Schmal et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Bone morphogenetic proteins are candidate growth factors with good potential in cartilage tissue engineering as well as cartilage repair. Although there is much known about the in vitro role of BMPs in cartilage metabolism reliable data about in vivo regulation in natural and surgically induced cartilage repair are still missing.

Methods: Lavage fluids of knee joints of 47 patients were prospectively collected between August 2006 and September 2007 during surgical therapy (UKF001822). 5 patients had no cartilage lesion and served as a control group, in case of the other 42 patients the cartilage defects were treated by microfracturing (19 patients) or by an Autologous Chondrocyte Implantation (23 patients). The average age of the patients with cartilage lesions was 42±10 years, the gender distribution was equal. The concentrations of BMP-2, and BMP-7 were determined by ELISA. Clinical status was evaluated using the IKDC and the Lysholm Score prior to and 1 year following cartilage regenerating surgery.

Results and conclusions: High level expression in the controls was found for BMP-2, concentrations of BMP-7 in the control group remained below detection levels. The concentrations of neither BMP-2 nor BMP-7 in the lavage fluids of knees with cartilage lesions were significantly different from the control group. Levels of BMP-7 did not change after surgical cartilage repair, whereas concentrations of BMP-2 (p<0.001) significantly increased after the intervention. The clinical outcome following cartilage regenerating surgery measured by the IKDC score increased after 1 year by 29% (p<0.001), and by 21% when evaluated by the Lysholm Score (p<0.01). The difference of both scores prior to the operation and after 1 year was used to quantitate the degree of improvement following surgery. This difference significantly correlated with initial BMP-2 (R=0.554, p<0.001) but not BMP-7 (R=0.031, n.s.) levels in the knee joints.

BMP-2 but seems to play an important role in surgically induced cartilage repair and might be suitable as a prognostic indicator for clinical outcome.