title: The use of bone morphogenic protein-7 (OP-1) in the management of resistant non-unions in the upper and lower limb.
abstract: The aim of the present study was to investigate the safety and efficacy of local implantation of BMP-7 for the treatment of resistant non-unions in the upper and lower limb. Fifty-two patients (30 males, mean age 52.8 years; range 20-81) were treated with local BMP-7 implantation in a bovine bone-derived collagen paste with or without revision of fixation. Thirty-six patients had closed injuries, ten had open injuries and six had infected non-unions. Patients had undergone a mean of 2 (1-5) operations prior to implantation of BMP-7. Clinical and radiological union was achieved in 94% at a mean time of 5.6 months (3-19). Two patients with subtrochanteric femoral fractures failed to achieve union secondary to inadequate fracture stabilisation, persistent unfavourable biological environment and systemic co-morbidities. One patient developed synostosis attributed to the BMP-7 application. This study demonstrates BMP-7 implanted in a bovine-derived collagen paste is an effective adjunctive treatment for resistant non-unions in the upper and lower limb.
authors.affiliation: Dept of Orthopaedics and Limb Reconstruction, Salford Royal Hospital, Salford, UK; Doncaster Royal Infirmary, Doncaster DN2 5LT, UK. drmadhavan@hotmail.com
authors.forename: M C
authors.initials: MC
authors.lastname: Papanna
authors.forename: N
authors.initials: N
authors.lastname: Al-Hadithy
authors.forename: B V
authors.initials: BV
authors.lastname: Somanchi
authors.forename: M D
authors.initials: MD
authors.lastname: Sewell
authors.forename: P M
authors.initials: PM
authors.lastname: Robinson
authors.forename: S A
authors.initials: SA
authors.lastname: Khan
authors.forename: R A
authors.initials: RA
authors.lastname: Wilkes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055419:Bone Morphogenetic Protein 7 / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005264:Femoral Fractures / Q000188:drug therapy; D005500:Follow-Up Studies; D017102:Fracture Healing / Q000187:drug effects*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006810:Humeral Fractures / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012784:Shoulder Fractures / Q000188:drug therapy; D013978:Tibial Fractures / Q000188:drug therapy; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000188:drug therapy
chemical_list: D055419:Bone Morphogenetic Protein 7