Simvastatin locally applied from a biodegradable coating of osteosynthetic implants improves fracture healing comparable to BMP-2 application.

Abstract:

:Many clinical and experimental investigations address the influence of statins on bone formation and fracture healing. Simvastatin was shown to increase the expression of Bone morphogenetic protein (BMP-2), which is one of the most potent growth factors targeting bone formation. In this study, the effect of simvastatin locally applied from a bioactive polymer coating of implants on fracture healing was investigated. A closed fracture of the right tibia of 5-month-old Sprague-Dawley rats was performed. Intramedullary stabilization was achieved with uncoated vs. polymer-only coated vs. polymer plus drug coated titanium Kirschner wires. Test substances (either simvastatin low- or high dosed or BMP-2) were incorporated into a biodegradable layer of poly(d,l-lactide). Tibiae were harvested after 28 or 42 days, respectively and underwent biomechanical testing (torsional stiffness and maximum load) and histomorphometric analysis. Radiographic results demonstrated progressed callus consolidation in the BMP-2- and simvastatin-treated groups compared to the uncoated group at both timepoints. The simvastatin-high-dosed group revealed an increased torsional stiffness and significantly elevated maximum load (d 28) compared to control group as well as a significant increase in both parameters at d 42. BMP-2-treated animals showed significantly elevated maximum load and stiffness at the early timepoint and elevated torsional stiffness after d 42. The histomorphometric analysis revealed a significantly decreased cartilage area for BMP-2 treated animals at d 28. Even though an increase of mineralized areas among periosteal callus was found at d 42 for simvastatin-high as well as BMP-2 treated animals, no significant difference could be detected at both timepoints compared to the uncoated group. However, simvastatin-high treated animals revealed significantly reduced cartilage areas within the periosteal callus at d 42. The present study revealed a dose-dependent effect and improved fracture healing under local application of simvastatin. Biomechanical, radiographic and histomorphometric properties showed comparable results to BMP-2- treated animals in this study.

journal_name

Bone

journal_title

Bone

authors

Pauly S,Luttosch F,Morawski M,Haas NP,Schmidmaier G,Wildemann B

doi

10.1016/j.bone.2009.05.010

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

505-11

issue

3

eissn

8756-3282

issn

1873-2763

pii

S8756-3282(09)01605-6

journal_volume

45

pub_type

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