title: Successful treatment of a humeral capitulum osteonecrosis with bone morphogenetic protein-7 combined with autologous bone grafting.
abstract: We present the case of a 27-year-old female with subcortical osteonecrosis of the humeral capitulum. Percutaneous retrograde drilling of the lesion and application of recombinant human bone morphogenetic protein (BMP)-7 were combined with autologous bone grafting. At follow-up the patient was almost pain-free, had normalized her range of motion, and radiography showed consolidation of the lesion without any heterotopic bone formation. By timing surgery prior to subchondral collapse, biomechanical stability of the subchondral bone was maintained. To our knowledge, this is the first report on the treatment of an osteonecrosis in this location with a BMP, and this strategy could potentially be applied in other locations with juxta-articular osteonecrosis.
authors.affiliation: Department of Orthopaedics, Institute of Surgical Sciences, Uppsala University Hospital , SE-751 85 Uppsala , Sweden.
authors.forename: Richard
authors.initials: R
authors.lastname: Marsell
authors.forename: Nils P
authors.initials: NP
authors.lastname: Hailer
mesh_terms: D000328:Adult; D055419:Bone Morphogenetic Protein 7 / Q000627:therapeutic use*; D016025:Bone Transplantation; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006811:Humerus / Q000473:pathology*; D010020:Osteonecrosis / Q000188:drug therapy* / Q000601:surgery*
chemical_list: C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7
keywords: Bone graft; bone morphogenetic protein; elbow; osteochondritis dissecans; osteonecrosis