Application of rhBMP-7 and platelet-rich plasma in the treatment of long bone non-unions: a prospective randomised clinical study on 120 patients.
The purpose of this prospective randomised clinical study was to compare the efficacy of recombinant bone morphogenetic protein 7 (rhBMP-7) and platelet-rich plasma (PRP) as bone-stimulating agents in the treatment of persistent fracture non-unions. One hundred and twenty patients were randomised into two treatment groups (group rhBMP-7 vs. group PRP). Sixty patients with sixty fracture non-unions were assigned to each group (median age: 44 years, range 19-65, for the rhBMP-7 group and 41 years, range 21-62, for the PRP group, respectively). In the rhBMP-7 group, there were 15 tibial non-unions, 10 femoral, 15 humeral, 12 ulnar, and 8 radial non-unions. In the PRP group, there were 19 tibial non-unions, 8 femoral, 16 humeral, 8 ulnar, and 9 radial non-unions. The median number of operations performed prior to our intervention was 2 (range 1-5) and 2 (range 1-5) with autologous bone graft being used in 23 and 21 cases for the rhBMP-7 and PRP groups, respectively. Both clinical and radiological union occurred in 52 (86.7%) cases of the rhBMP-7 group compared to 41 (68.3%) cases of the PRP group, with a lower median clinical and radiographic healing time observed in the rhBMP-7 group (3.5 months vs. 4 months and 8 months vs. 9 months, respectively). This study supports the view that in the treatment of persistent long bone non-unions, the application of rhBMP-7 as a bone-stimulating agent is superior compared to that of PRP with regard to their clinical and radiological efficacy.
Calori
G M
GM
Orthopaedic Institute, G. Pini University of Milan, Milan, Italy. gmc@studiocalori.it
Tagliabue
L
L
Gala
L
L
d'Imporzano
M
M
Peretti
G
G
Albisetti
W
W
D000328:Adult; D000368:Aged; D055419:Bone Morphogenetic Protein 7 / Q000627:therapeutic use*; D005260:Female; D005264:Femoral Fractures / Q000188:drug therapy / Q000601:surgery; D017102:Fracture Healing / Q000187:drug effects; D005599:Fractures, Ununited / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D006810:Humeral Fractures / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000187:drug effects*; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D013978:Tibial Fractures / Q000188:drug therapy / Q000601:surgery; D014458:Ulna Fractures / Q000188:drug therapy / Q000601:surgery; D055815:Young Adult
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D011994:Recombinant Proteins