title: Growth factors in orthopaedic surgery: demineralized bone matrix versus recombinant bone morphogenetic proteins.
abstract: During recent decades the utilisation of growth factors, especially BMPs, has received an increasing interest in orthopaedic surgery. For clinical implantation the two main options are demineralised bone matrix (DBM) and recombinant bone morphogenetic proteins (rhBMP). Many clinical studies agree on an equivalent osteoinductive effect between DBM, BMPs and autologous bone graft; however, the different origins and processing of DBM and rhBMP may introduce some fluctuations. Their respective characteristics are reviewed and possible interactions with their effectiveness are analysed. The main difference concerns the concentration of BMPs, which varies to an order of magnitude of 10(6) between DBM and rhBMPs. This may explain the variability in efficiency of some products and the adverse effects. Currently, considering osteoinductive properties, safety and availability, the DBM seems to offer several advantages. However, if DBM and rhBMPs are useful in some indications, their effectiveness and safety can be improved and more evidence-based studies are needed to better define the indications.
authors.affiliation: Orthopaedic Research Laboratory (LROT) and Musculoskeletal Tissue Bank (BTE), Department of Orthopaedic Surgery, Hôpital Erasme, Université Libre de Bruxelles (ULB), 808, route de Lennik, Brussels, B-1070, Belgium, mhinsenk@ulb.ac.be.
authors.forename: Maurice
authors.initials: M
authors.lastname: Hinsenkamp
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Collard
mesh_terms: D001672:Biocompatible Materials; D001857:Bone Matrix / Q000637:transplantation*; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D009985:Orthopedics
chemical_list: D001672:Biocompatible Materials; D019485:Bone Morphogenetic Proteins