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Clinical Orthopaedics and Related Research®

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01-12-2009 | Symposium: Tribute to Dr. Marshall Urist: Musculoskeletal Growth Factors

Complications of Recombinant Human BMP-2 for Treating Complex Tibial Plateau Fractures: A Preliminary Report

Authors: Sreevathsa Boraiah, MD, Omesh Paul, MD, David Hawkes, MBChB, Matthew Wickham, MBChB, Dean G. Lorich, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2009

Abstract

Bone morphogenic proteins (BMPs) are potent osteoinductive agents. Their use in fracture surgery is still being studied and the clinical indications are evolving. Heterotopic bone after BMP use in spine surgery is a known complication. While some literature describes the ability of BMP to enhance fracture healing, few articles describe complications of BMP. In tibial plateau fractures, after elevating the cartilage en mass, a subchondral void may be created in these fractures. Structural support provided by bone void-filling agents can be augmented with osteoinduction achieved by BMP. We asked whether heterotopic bone formation would occur more frequently with BMP-2 when used in tibial plateau fractures and whether BMP-2 enhanced the ability to maintain surgically restored subchondral bone integrity. Heterotopic bone developed more frequently in patients receiving BMP (10 of 17) than in patients not receiving BMP (one of 23). Four patients receiving BMP and no patients not receiving BMP underwent removal of heterotopic bone. Maintenance of subchondral bone integrity was similar without and with the use of BMP. BMP is a potent osteoinductive agent; however, when used for an off-label indication in periarticular situations, complications such as heterotopic bone are common and increase reoperation rates.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Title: Complications of Recombinant Human BMP-2 for Treating Complex Tibial Plateau Fractures: A Preliminary Report
Authors: Sreevathsa Boraiah, MD
Omesh Paul, MD
David Hawkes, MBChB
Matthew Wickham, MBChB
Dean G. Lorich, MD
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 12/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-009-1039-8

At a glance: The STEP trials

Springer Medicine

Complications of Recombinant Human BMP-2 for Treating Complex Tibial Plateau Fractures: A Preliminary Report

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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