The evolution of rhPDGF-BB in musculoskeletal repair and its role in foot and ankle fusion surgery.
Platelet-derived growth factor (PDGF) is one of the most thoroughly studied proteins in the body. Research has progressively highlighted the role of PDGF during wound healing and in the bone repair cascade. This research has resulted in FDA approval of 2 products containing a recombinant version of the protein, rhPDGF-BB, for treating chronic diabetic foot ulcers and periodontal bone defects. This article reviews the applicable basic science and mechanisms of action of PDGF, with attention to the increasingly defined role of rhPDGF-BB in initiating bone regeneration. The most recent data from prospective clinical trials evaluating the use of rhPDGF-BB in combination with beta tricalcium phosphate as a substitute for autogenous bone graft in hindfoot and ankle arthrodesis are also summarized.
Division of Foot and Ankle Surgery, Department of Orthopaedic Surgery, The Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02904, USA. christopher_digiovanni@brown.edu
Christopher W
CW
DiGiovanni
James M
JM
Petricek
D000818:Animals; D000842:Ankle / Q000601:surgery*; D001174:Arthrodesis; D000077214:Becaplermin; D001672:Biocompatible Materials / Q000627:therapeutic use; D001861:Bone Regeneration / Q000502:physiology; D002130:Calcium Phosphates / Q000627:therapeutic use; D002633:Chemotaxis; D005528:Foot / Q000601:surgery*; D006801:Humans; D059630:Mesenchymal Stem Cells / Q000502:physiology; D018919:Neovascularization, Physiologic; D019637:Orthopedic Procedures / Q000379:methods*; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D001672:Biocompatible Materials; D002130:Calcium Phosphates; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; C485817:beta-tricalcium phosphate; D000077214:Becaplermin