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Published in: Archives of Orthopaedic and Trauma Surgery 1/2010

01-01-2010 | Trauma Surgery

Clinical application of BMP 7 in long bone non-unions

Authors: Arash Moghaddam, Charlotte Elleser, Bahram Biglari, Andreas Wentzensen, Gerald Zimmermann

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2010

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Abstract

Background

Non-unions of long bone fractures are a therapeutic and economic problem of increasing frequency. Aside from conservative treatment options such as ultrasound, impulse waves, and casts, the basic surgical options are autogenous cancellous bone grafting, rod dynamization, reamed nailing, plate fixation, and bone transport techniques. If these methods fail to work, there is a need for alternative treatment options.

Methods

Since May 2001, treatment with recombinant human bone morphogenic protein 7 (BMP 7 or osteogenic protein 1) in combination with a type-one collagen carrier has been the subject of increasing interest. BMP 7 induces the formation of new bone by stem cell differentiation, thereby initiating the reaction cascade of osteogenesis. Non-unions over 9 months and unsuccessful bone grafting constitute the indication for this treatment.

Results

We report our experience with 54 patients who had atrophic non-union of long bone fractures. Between May 2002 and May 2006, 57 units of BMP 7 were used. The localization of the non-unions included 21 in the femur, 26 in the tibia, 3 in the humerus and 7 in the forearm. In 36 cases, BMP 7 was used in combination with osteosynthesis revision and bone grafting; in 9 additional patients, BMP 7 was used with bone grafting alone. In 12 patients, BMP 7 was applied as a single procedure without any bone grafting or any change in osteosynthesis.

Conclusions

There were no perioperative or postoperative complications. Follow-up was obtained for a minimum of 6 months. 47 of the 57 (82%) implantations were successful, with bony healing confirmed by clinical and radiological evaluation. In summary, our results support BMP 7 as an additional innovative therapy for long bone non-unions.
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Metadata
Title
Clinical application of BMP 7 in long bone non-unions
Authors
Arash Moghaddam
Charlotte Elleser
Bahram Biglari
Andreas Wentzensen
Gerald Zimmermann
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 1/2010
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-009-0982-x

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