Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Strategies in Trauma and Limb Reconstruction
Published in: Strategies in Trauma and Limb Reconstruction 1/2016

Open Access 01-04-2016 | Original Article

The use of recombinant morphogenic protein-2(rhBMP-2) in children undergoing revision surgery for persistent non-union

Authors: Madhavan C. Papanna, K. A. Saldanha, Binu Kurian, James A. Fernandes, Stan Jones

Published in: Strategies in Trauma and Limb Reconstruction | Issue 1/2016

Login to get access

Abstract

The purpose of the study was to evaluate the safety and efficacy with the use of BMP-2 for treating persistent non-unions in children with underlying complex conditions. Between October 2006 and November 2010 in our unit, 15 patients were treated with rhBMP-2 to enhance bone union. There were nine females and six males with a mean age of 9.5 years (range 4–15) at time of surgery. Seventy-five per cent of the patients required revision of internal fixation with insertion of rhBMP-2 to the non-union site, and the reminder had freshening of the non-union site with rhBMP-2 application. Patients had undergone a mean of 2 (1–5) operations prior to implantation of rhBMP-2. All the patients in the study group were available for review with mean follow-up of 44 months (range 21–70). The mean time to union was 16 weeks (range 10–28 weeks). No adverse events related to BMP-2 application were noted in our study group. Healing occurred clinically and radiographically in 16 of the 17 sites. Our study demonstrates that BMP-2 enhances healing of the persistent non-unions without any adverse events
Literature
1.
Megas P (2005) Classification of non-union. Injury 36(Supp 4):S30–S37PubMed
2.
Phieffer LS, Goulet JA (2006) Delayed unions of the tibia. JBJS [Am] 88(1):206–216
3.
Goulet JA, Senunas LE, DeSilva GL, Greenfield ML (1997) Autogenous iliac crest bone graft. Complications and functional assessment. CORR 339:76–81CrossRef
4.
Schnee CL, Freese A, Weil RJ (1997) Analysis of harvest morbidity and radiographic outcome using autograft for anterior cervical fusion. Spine 22:222–227CrossRef
5.
6.
Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R (2002) BMP-2 Evaluation in Surgery for Tibial Trauma (BESTT) Study Group. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am 84:2123–2134CrossRefPubMed
7.
Boden SD, Kang J, Sandhu H, Heller JG (2002) Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial: 2002 Volvo Award in clinical studies. Spine 27:2662–2673CrossRefPubMed
8.
Burkus JK, Transfeldt EE, Kitchel SH, Watkins RG, Balderston RA (2002) Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2. Spine 27:2396–2408CrossRefPubMed
9.
Jones AL, Bucholz RW, Bosse MJ, Mirza SK, Lyon TR, Webb LX (2006) Recombinant humanBMP-2 and allograft compared with autogenous bone graft for reconstruction of diaphyseal tibial fractures with cortical defects. A randomized, controlled trial. J Bone Joint Surg Am 88:1431–1441CrossRefPubMed
10.
Krause F, Younger A, Weber M (2008) Recombinant human BMP-2 and allograft compared with autogenous bone graft for reconstruction of diaphyseal tibial fractures with cortical defects. J Bone Joint Surg Am 90:1168PubMed
11.
Abd-El-Barr MM, Cox JB, Antonucci MU, Bennett J, Murad GJ, Pincus DW (2011) Recombinant human bone morphogenetic protein-2 as an adjunct for spine fusion in a pediatric population. Pediatr Neurosurg 47(4):266–271CrossRefPubMed
12.
Oetgen ME, Richards BS (2010) Complications associated with the use of bone morphogenetic protein in pediatric patients. J Pediatr Orthop 30:192–198CrossRefPubMed
13.
Ritting AW, Weber EW, Lee MC (2012) Exaggerated inflammatory response and bony resorption from BMP-2 use in a pediatric forearm non-union. J Hand Surg Am 37(2):316–321CrossRefPubMed
14.
Dohin B, Dahan-Oliel N, Fassier F, Hamdy R (2009) Enhancement of difficult nonunion in children with osteogenic protein-1 (OP-1): early experience. Clin Orthop Relat Res 467(12):3230–3238CrossRefPubMedPubMedCentral
15.
Lee FY, Sinicropi SM, Lee FS, Vitale MG, Roye DP Jr, Choi IH (2006) Treatment of congenital pseudarthrosis of the tibia with recombinant human bone morphogenetic protein-7 (rhBMP-7). A report of five cases. J Bone Joint Surg Am 88(3):627–633CrossRefPubMed
16.
Birke O, Schindeler A, Ramachandran M, Cowell CT, Munns CF, Bellemore M (2010) Preliminary experience with the combined use of recombinant bone morphogenetic protein and bisphosphonates in the treatment of congenital pseudarthrosis of the tibia. J Child Orthop 4(6):507–517CrossRefPubMedPubMedCentral
17.
Fabeck L, Ghafil D, Gerroudj M, Baillon R, Delincé P (2006) Bone morphogenetic protein-7 in the treatment of congenital pseudarthrosis of the tibia. J BoneJoint Surg Br 88:116–118CrossRef
18.
Spiro AS, Babin K, Lipovac S, Stenger P, Mladenov K, Rupprecht M (2011) Combined treatment of congenital pseudarthrosis of the tibia, including recombinant human bone morphogenetic protein-2: a case series. J Bone Joint Surg Br 93(5):695–699CrossRefPubMed
19.
Richards BS, Oetgen ME, Johnston CE (2010) The use of rhBMP-2 for the treatment of congenital pseudarthrosis of the tibia: a case series. J Bone Joint Surg [Am] 92-A:177–185CrossRef
20.
Friedlaender GE, Perry CR, Cole JD, Cook SD, Cierny G, Muschler GF (2001) Osteogenic protein-1 (Bone morphogenetic protein-7) in the treatment of tibial nonunions. J Bone Joint Surg Am 83-A(suppl 1):S151–S158PubMed
21.
Geesink RG, Hoefnagels NH, Bulstra SK (1999) Osteogenic activity of OP-1 bone morphogenetic protein (BMP-7) in a human fibular defect. J Bone Joint Surg Br 81(4):710–718CrossRefPubMed
22.
Dobbs MB, Rich MM, Gordon JE, Szymanski DA, Schoenecker PL (2005) Use of an intramedullary rod for the treatment of congenital pseudarthrosis of the tibia. Surg Tech Suppl 1(Pt 1):33–40
Metadata
Title
The use of recombinant morphogenic protein-2(rhBMP-2) in children undergoing revision surgery for persistent non-union
Authors
Madhavan C. Papanna
K. A. Saldanha
Binu Kurian
James A. Fernandes
Stan Jones
Publication date
01-04-2016
Publisher
Springer Milan
Published in
Strategies in Trauma and Limb Reconstruction / Issue 1/2016
Print ISSN: 1828-8936
Electronic ISSN: 1828-8928
DOI
https://doi.org/10.1007/s11751-016-0251-9

Other articles of this Issue 1/2016

Strategies in Trauma and Limb Reconstruction 1/2016 Go to the issue

Case Report

Brodie’s abscess following percutaneous fixation of distal radius fracture in a child

Erratum

Erratum to: External fixation reconstruction of the residual problems of benign bone tumours

Original Article

Intramedullary nailing versus external fixation in Gustilo type III open tibial shaft fractures: a meta-analysis of randomised controlled trials

Original Article

Patterns of healing: a comparison of two proximal tibial osteotomy techniques

Original Article

The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube

Original Article

External fixation reconstruction of the residual problems of benign bone tumours