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Brian K. Howard, MD; Karla R. Brown, MD; Joseph L. Leach, MD; Cheng-Hui Chang, PhD; David I. Rosenthal, MD

Arch Otolaryngol Head Neck Surg. 1998;124:985-988.

Objective  To prove the efficacy of bone morphogenic protein as an osteoinductive agent in irradiated tissue.

Design  Prospective randomized controlled trial designed to test the effectiveness of recombinant bone morphogenic protein 2 (rBMP-2) combined with solid hydroxyapatite disks in an irradiated tissue bed.

Subjects  Eighteen adult, male, white New Zealand rabbits weighing 3.0 to 3.5 kg.

Intervention  The rabbits were randomly divided, with 9 receiving radiation treatment and 9 receiving no radiation treatment. Each animal underwent implantation of 2 hydroxyapatite disks onto the snout at 9 weeks following radiation treatment. One disk was impregnated with rBMP-2 and the other with buffer only. The animals were killed at 3, 6, or 20 weeks after implantation for analysis.

Results  Histological analysis demonstrated that rBMP-2 was equally effective as an osteoinductive agent in the irradiated and nonirradiated tissue. We also found significantly increased new bone formation in the rBMP-2 group vs the buffer group.

Conclusions  This study supports the potential clinical utility of rBMP-2 and solid hydroxyapatite in irradiated tissue beds. These findings have interesting implications for patients with head and neck cancer who have undergone radiation therapy and need bony reconstruction.

From the Departments of Otorhinolaryngology (Drs Howard, Brown, and Leach) and Radiation Oncology (Drs Chang and Rosenthal), University of Texas Southwestern Medical Center, Dallas. Dr Howard is now with the Department of Plastic Surgery, University of Texas Southwestern Medical Center; Dr Brown is now with the Department of Otolaryngology, Children's Hospital, Boston, Mass; and Dr Rosenthal is now with the Department of Radiation Oncology, University of Pennsylvania Medical School, Philadelphia.

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