title: Application of recombinant BMP-7 on persistent upper and lower limb non-unions.
abstract: The purpose of this study was to evaluate the efficacy and safety of recombinant bone morphogenetic protein 7 (rhBMP-7 or OP-1) as a bone-stimulating agent in the treatment of persistent fracture non-unions. Twenty-five consecutive patients [19 males, mean age 39.4 years (range: 18-79)] with 26 fracture non-unions were treated with rhBMP-7. There were 10 tibial non-unions, eight femoral, three humeral, three ulnar, one patellar, and one clavicular non-union. The mean follow-up was 15.3 months. The mean number of operations performed prior to rhBMP-7 application was 3.2, with autologous bone graft and bone marrow injection being used in 10 cases (38.5%). Both clinical and radiological union occurred in 24 (92.3%) cases, within a mean time of 4.2 months and 5.6 months, respectively. Of the remaining two cases, one patient ultimately underwent a below knee amputation, secondary to recurrence of deep sepsis. The other patient with recalcitrant ulnar non-union although the radiological union was incomplete, declined further intervention, as he was asymptomatic. No complications or adverse effects from the use of rhBMP-7 were encountered. This study supports the view that the application of rhBMP-7 as a bone-stimulating agent is safe and a power adjunct to be considered in the surgeon's armamentarium for the treatment of these challenging clinical conditions.
authors.affiliation: St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
authors.forename: R
authors.initials: R
authors.lastname: Dimitriou
authors.forename: Z
authors.initials: Z
authors.lastname: Dahabreh
authors.forename: E
authors.initials: E
authors.lastname: Katsoulis
authors.forename: S J
authors.initials: SJ
authors.lastname: Matthews
authors.forename: T
authors.initials: T
authors.lastname: Branfoot
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000008:administration & dosage*; D016025:Bone Transplantation; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery; D007718:Knee Injuries / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010329:Patella / Q000293:injuries / Q000601:surgery; D011859:Radiography; D011994:Recombinant Proteins / Q000008:administration & dosage; D012784:Shoulder Fractures / Q000188:drug therapy / Q000601:surgery; D013978:Tibial Fractures / Q000188:drug therapy / Q000601:surgery; D016212:Transforming Growth Factor beta / Q000008:administration & dosage*; D014458:Ulna Fractures / Q000188:drug therapy / Q000601:surgery
chemical_list: C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta