Nanocomposite therapy as a more efficacious and less inflammatory alternative to bone morphogenetic protein-2 in a rodent arthrodesis model

J Orthop Res. 2011 Dec;29(12):1812-9. doi: 10.1002/jor.21454. Epub 2011 May 16.


The use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in spine fusion has led to concerns regarding a potential accompanying inflammatory response. This study evaluates a combination therapy (TrioMatrix®; Pioneer Surgical, Inc., Marquette, MI) comprised of a demineralized bone matrix (DBM), hydroxyapatite, and a nanofiber-based collagen scaffold in a rodent spine fusion model. Thirty-six athymic rats that underwent a posterolateral intertransverse spinal fusion were randomly assigned to 1 of 5 treatment groups: absorbable collagen sponge alone (ACS, negative control), 10 µg rhBMP-2 on ACS (positive control), TrioMatrix®, Grafton® (Osteotech, Inc., Eatontown, NJ), and DBX® (Synthes, Inc., West Chester, PA). Both TrioMatrix® and rhBMP-2-treated animals demonstrated 100% fusion rates as graded by manual palpation scores 8 weeks after implantation. This rate was significantly greater than those of the ACS, Grafton®, and DBX® groups. Notably, the use of TrioMatrix® as evaluated by microCT quantification led to a greater fusion mass volume when compared to all other groups, including the rhBMP-2 group. T2-weighted axial MRI images of the fusion bed demonstrated a significant host response associated with a large fluid collection with the use of rhBMP-2; this response was significantly reduced with the use of TrioMatrix®. Our results therefore demonstrate that a nanocomposite therapy represents a promising, cost-effective bone graft substitute that could be useful in spine fusions where BMP-2 is contraindicated.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bone Morphogenetic Protein 2 / pharmacology*
  • Bone Substitutes / pharmacology*
  • Collagen / pharmacology*
  • Disease Models, Animal
  • Durapatite / pharmacology*
  • Fracture Healing / drug effects
  • Fracture Healing / immunology
  • Glycerol / pharmacology
  • Humans
  • Lumbar Vertebrae / drug effects
  • Lumbar Vertebrae / surgery
  • Nanocomposites*
  • Osteitis / diagnostic imaging
  • Osteitis / immunology
  • Osteitis / prevention & control
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / immunology
  • Postoperative Complications / prevention & control*
  • Pseudarthrosis / diagnostic imaging
  • Pseudarthrosis / immunology
  • Pseudarthrosis / prevention & control
  • Rats
  • Rats, Nude
  • Recombinant Proteins / pharmacology
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / surgery*
  • Spinal Fusion / methods*
  • Transforming Growth Factor beta / pharmacology*
  • X-Ray Microtomography


  • Bone Morphogenetic Protein 2
  • Bone Substitutes
  • Grafton demineralized bone matrix gel
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • TrioMatrix
  • recombinant human bone morphogenetic protein-2
  • Collagen
  • Durapatite
  • Glycerol