The role of bone morphogenetic protein-7 (Osteogenic Protein-1) in the treatment of tibial fracture non-unions. An overview of the use in Belgium.
The evolution of a fracture non-union is complex; treatment strategies are therefore challenging. The use of BMP-7 could be an interesting adjunct. We present an overview of the monitored use of this product in tibial non-unions in Belgium. Our retrospective data covers 53% (62 patients) of the cases in which it was used between 2001 and 2006. Questionnaires were sent to surgeons who had been using BMP-7 (OP-1) in tibial non-unions in Belgium. Of 55 surgeons contacted, 27 who had been treating 62 patients with a non-union of a tibial fracture responded. These fractures were most commonly treated with an external fixator and 50% of them had already received some form of graft material. Non-union was diagnosed after a median of 365 days (range, 123-1212). Treatment with OP-1 resulted in a clinical healing rate of 79.6% and a radiographic healing rate of 84.9%. Union was reported after a median of 230 (32-872) days clinically and 232 (32-739) days radiographically. We documented a large number of cases of use of BMP-7 in tibial non-union in Belgium. The healing rates of around 80% are comparable to other reports on success rates with BMP-7. Many cases presented originally with open fractures, infected wounds or fractures with bone loss. This makes the reported results even more promising. Further studies are needed to analyse the socio-economical value of this relatively expensive treatment.
Desmyter
Stefan
S
Department of Orthopaedic Surgery and Traumatology, University Hospital Ghent, Belgium. stefandesmyter@yahoo.com
Goubau
Yannick
Y
Benahmed
Nadia
N
de Wever
Alain
A
Verdonk
René
R
D000328:Adult; D001530:Belgium; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D005260:Female; D005599:Fractures, Ununited / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000188:drug therapy*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D016212:Transforming Growth Factor beta