Osteogenic devices and methods of use thereof for repair of endochondral bone and osteochondral defects
View Patent ↗Disclosed herein are improved osteogenic devices and methods of use thereof for repair of bone and cartilage defects. The devices and methods promote accelerated formation of repair tissue with enhanced stability using less osteogenic protein than devices in the art. Defects susceptible to repair with the instant invention include, but are not limited to: critical size defects, non-critical size defects, non-union fractures, fractures, osteochondral defects, subchondral defects, and defects resulting from degenerative diseases such as osteochondritis dessicans.
1. A method for inducing local bone or cartilage formation, comprising the step of providing to a defect site a device comprising:
(a) a bone morphogenetic protein selected from the group consisting of OP1, OP2, OP3, BMP2, BMP3, BMP4, BMP5, BMP6, BMP9, BMP10, BMP11, BMP12, BMP15, BMP16, DPP, Vgl, 60A protein, GDF-1, GDF3, GDF5, GDF6, GDF7, GDF8, GDF9, GDF10 and GDF11;
(b) a matrix selected from the group consisting of collagen, apatites, hydroxyapatites, tricalcium phosphate, and admixtures thereof; and
(c) a binding agent selected from the group consisting of cellulosic agents and salts thereof wherein said binding agent has a degree of substitution of 0.65-0.90 and a viscosity of about 10-200 cP at a 4% (w/v) concentration of said binding agent.
2. The method of claim 1 , wherein said bone morphogenetic protein is selected from the group consisting of OP1, OP2, BMP2, BMP4, BMP5, and BMP6.
3. The method of claim 1 , wherein said bone morphogenetic protein is OP-1.
4. The method of claim 1 , wherein said device comprises at least two different bone morphogenetic proteins.
5. The method of claim 1 , wherein said matrix is collagen.
6. The method of claim 1 , wherein said device comprises at least two different matrix materials.
7. The method of claim 1 , wherein said binding agent is an alkylcellulose.
8. The method of claim 1 , wherein said binding agent is selected from the group consisting of methylcellulose, methylhydroxyethylcellulose, hydroxyethylcellulose, hydroxypropylmethylcellulose, carboxymethylcellulose, sodium carboxymethylcellulose, hydroxyalkylcelluloses, and admixtures thereof.
9. The method of claim 1 , wherein said binding agent is carboxymethylcellulose or a sodium salt thereof.
10. The method of claim 1 , wherein said device comprises at least two different binding agents.
11. The method of claim 1 , wherein said device further comprises a wetting agent.
12. The method of claim 1 , wherein the binding agent to matrix ratio is one part by weight binding agent to 1-10 parts by weight matrix.
13. The method of claim 1 , wherein the binding agent to matrix ratio is 1-10 parts by weight binding agent to 1 part by weight matrix.
14. The method of claim 3 , wherein the amount of the OP-1 ranges from approximately 0.125 mg to 10.0 mg.
15. The method of claim 14 , wherein the amount of the OP-1 is approximately 3.5 mg.
16. The method of claim 11 , wherein said wetting agent is saline.
17. The method of claim 12 , wherein the binding agent to matrix ratio is one part by weight binding agent to 1-5 parts by weight matrix.
18. The method of claim 12 , wherein the binding agent to matrix ratio is one part by weight binding agent to 5 parts by weight matrix.
19. The method of claim 13 , wherein the binding agent to matrix ratio is fewer than 10 parts by weight binding agent to one part by weight matrix.
20. The method of claim 1 , wherein bone formation is endochondral bone formation.
21. The method of claim 1 , wherein cartilage formation is articular cartilage formation.
22. The method of claim 1 , wherein said defect site is selected from the group consisting of: critical size defect, non-critical size defect, segmental nonunion defect, nonunion fracture, fracture, osteochondral defect and subchondral defect.
23. The method of claim 1 , wherein the volume of said device provided to the defect site is sufficient to fill the defect site.
24. A method for inducing local bone and cartilage formation, comprising the step of providing to a defect site a device comprising:
(a) a bone morphogenetic protein comprising an amino acid sequence having at least 70% homology with the C-terminal 102-106 amino acids, including the conserved seven cysteine domain, of human OP 1;
(b) a matrix selected from the group consisting of collagen, apatites, hydroxyapatites, tricalcium phosphate, and admixtures thereof; and
(c) a binding agent selected from the group consisting of cellulosic agents and salts thereof; wherein said binding agent has a degree of substitution of 0.65-0.90 and a viscosity of about 10-200 cP at a 4% (w/v) concentration of said binding agent; and
wherein said bone morphogenetic protein is capable of inducing repair of endochondral bone when implanted together with a matrix in a mammal.
25. The method of claim 24 , wherein said defect site is selected from the group consisting of: critical size defect, non-critical size defect, segmental nonunion defect, nonunion fracture, fracture, osteochondral defect and subchondral defect.
26. The method of claim 24 , wherein the volume of said device provided to the defect site is sufficient to fill the defect site.
27. A method for inducing local bone or cartilage formation, comprising the step of providing to a defect site a device comprising:
(a) at least approximately 1.25 mg of OP-1; and
(b) at least approximately 180 mg of carboxymethylcellulose per 1000 mg of collagen matrix; wherein said carboxymethylcellulose has a degree of substitution of 0.65-0.90 and a viscosity of about 10-200 cP at a 4% (w/v) concentration of said carboxymethylcellulose.
28. The method of claim 27 , wherein said device comprises at least approximately 2.5 mg of OP-1 per 1000 mg of collagen matrix.
29. The method of claim 27 or 28 , wherein said device comprises at least approximately 200 mg of carboxymethylcellulose per 1000 mg of collagen matrix.
30. The method of claim 27 or 28 , wherein said device further comprises saline.
31. The method of claim 29 , wherein said device further comprises saline.
32. The method of claim 27 , wherein said defect site is selected from the group consisting of: critical size defect, non-critical size defect, segmental nonunion defect, nonunion fracture, fracture, osteochondral defect and subchondral defect.
33. The method of claim 27 , wherein the volume of said device provided to the defect site is sufficient to fill the defect site.
34. A method for inducing local bone or cartilage formation, comprising the step of providing to a defect site a device comprising:
(a) OP-1;
(b) collagen matrix; and
(c) carboxymethylcellulose having a degree of substitution of 0.65-0.90 and a viscosity of about 10-200 cP at a 4% (w/v) concentration of said carboxymethylcellulose.