Evidence map›Paper›PMID 41410757›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Anatomical implant region - a critical determinant for the osteogenic potency of small extracellular vesicles and rhBMP-2.

Christian Deininger, Andrea Wagner, Florian Wichlas, Eva Rohde, Thomas Freude, Amelie Deluca, Johann Fierlbeck, Martin Holzleitner, Sascha Senck, Herbert Tempfer and 2 more

Abstract read
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Christian DeiningerInstitute of Tendon and Bone Regeneration, Paracelsus Medical University, Salzburg, Austria. JohannesChristianMaximilian.Deininger@uniklinikum.kages.at.
Andrea WagnerInstitute of Tendon and Bone Regeneration, Paracelsus Medical University, Salzburg, Austria.
Florian WichlasDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria.
Eva RohdeDepartment of Transfusion Medicine, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria.
Thomas FreudeDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, Salzburg, Austria.
Amelie DelucaInstitute of Tendon and Bone Regeneration, Paracelsus Medical University, Salzburg, Austria.
Johann FierlbeckDepartment of Technology Transfer, Paracelsus Medical University Salzburg, Salzburg, Austria.
Martin HolzleitnerComputed Tomography Research Group, University of Applied Sciences Upper Austria, Wels, Austria.
Sascha SenckComputed Tomography Research Group, University of Applied Sciences Upper Austria, Wels, Austria.
Herbert TempferInstitute of Tendon and Bone Regeneration, Paracelsus Medical University, Salzburg, Austria.
Mario GimonaGMP Unit, Paracelsus Medical University, Salzburg, Austria.
Andreas TrawegerInstitute of Tendon and Bone Regeneration, Paracelsus Medical University, Salzburg, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMechanical stabilization is crucial for bone healing, yet complex fractures, particularly osteoporotic or comminuted, remain challenging due to impaired implant osseointegration, resulting in implant loosening or non-unions. This study investigated whether co-application of small extracellular vesicles (sEVs) derived from human umbilical cord mesenchymal stromal cells (hUC-MSC-sEVs) with a low dose of recombinant human bone morphogenetic protein 2 (rhBMP-2) could enhance screw implant osseointegration.

methodsA novel small animal model was established to evaluate the effect of anatomical femur regions on screw integration. Six weeks postoperatively, bone formation and bone-implant contact were assessed by micro-computed tomography and descriptive histology. Biomechanical stability was determined using pull-out tests.

resultsOutcomes differed significantly between the proximal and distal implant locations, with no improvements in osseointegration observed in the distal region. In the proximal region, application of hUC-MSC-sEVs alone did not significantly improve osseointegration, whereas local application of 1.5 µg rhBMP-2 resulted in measurable biomechanical improvements. No additive or synergistic effects were observed when sEVs were co-administered with rhBMP-2. Descriptive histology supported these findings, demonstrating the most pronounced bone formation at the proximal site following rhBMP-2 treatment.

conclusionhUC-MSC-sEVs did not enhance screw implant osseointegration and slightly reduced new bone formation. In contrast, a low dose of rhBMP-2 (1.5 µg) promoted implant integration, with no additive effect when combined with sEVs. Notably, the osteogenic effect of rhBMP-2 was observed only at the proximal femoral site, indicating that anatomical location critically influences implant osseointegration. These findings highlight the importance of considering anatomical region when evaluating osteoinductive treatments and implant materials in small animal models.

Indexed as

Bone Morphogenetic Protein 2Bone ScrewsExtracellular VesiclesFemoral FracturesFemurOsseointegrationOsteogenesisTransforming Growth Factor betaAnimalsBiomechanical PhenomenaFracture HealingHumansMaleMesenchymal Stem CellsRecombinant ProteinsX-Ray MicrotomographyBone Morphogenetic Protein 2recombinant human bone morphogenetic protein-2Recombinant ProteinsTransforming Growth Factor betaBMP-2ExosomesExtracellular vesiclesOsseointegration

Identifiers

PMID41410757
PMCPMC12715041

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.