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Orthopaedic Applications   |    
A Review of Preclinical Program Development for Evaluating Injectable Carriers for Osteogenic Factors
Howard Seeherman, PhD, VMD; Rebecca Li, PhD; John Wozney, PhD
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Corresponding author: Howard Seeherman, PhD, VMDWyeth Research, 87 Cambridge Park Drive, Cambridge, MA 02140. E-mail address: hseeherman@wyeth.com

The research for this paper was sponsored by Wyeth. All three authors are employees of Wyeth. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2003 Aug 01;85(suppl 3):96-108
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Extract

Recombinant human bone morphogenetic protein-2 (rhBMP-2) delivered with an absorbable collagen sponge (ACS) has been used to both accelerate and ensure healing of open tibial fractures in human patients 1,2 . Recombinant human osteogenic protein-1 (rhOP-1, rhBMP-7) delivered with type-1 bovine bone-derived collagen has also been used to treat tibial nonunions in patients 3 . A major limitation of both of these biomaterials is the requirement for open surgical placement, which prevents treatment of patients with a closed fracture managed by closed reduction. This represents a substantial patient population, since closed fractures constitute the vast majority of the 6.3 million fractures seen annually in the United States 4 . Development of an injectable carrier for osteogenic factors would allow treatment of closed fractures and would also overcome several other limitations of current implantable carriers. Placement of implantable products during the repair of open long-bone fractures is generally limited to areas of exposed bone caused by the injury, which often are not ideal environments for healing. For example, the anteromedial surface of the bone is typically exposed in open tibial fractures, and there is minimal soft tissue for interaction with osteogenic factors placed in this location. Elevation of normal muscle attachments to create a space for more optimal placement of implantable osteogenic factors is often not done because of the risk of further compromising the already damaged blood supply to the fractured bone. In contrast, injectable formulations could be delivered to these more advantageous sites with no additional soft-tissue exposure.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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