The use of a coral composite implant containing bone morphogenetic protein to repair a segmental tibial defect in sheep

A composite implant consisting of a coral cylinder, moose bone morphogenetic protein and type IV collagen was used to repair a segmental tibial defect in sheep. Healing, related variance in mechanical strength and immune responses were evaluated. In comparison with a coral control, a larger amount of newly formed external callus was observed in the composite group at 6 weeks. The maximal torque capacity, maximal angular deformation at failure and bone stiffness of a healed osteotomised tibia recovered 113%, 117% and 120% in the coral controls and 67%, 92% and 79% in the composite implants against the corresponding contralateral tibia at 16 weeks respectively. A significantly elevated anti-BMP antibody was detectable in the composite group at 3 and 6 weeks. Augmented bone formation at an early stage and weakened torsional performance at a later stage in the composite implants may indicate the phase-specific osteoinduction and the immune response of xenogenic BMP with time.