Recombinant human platelet-derived growth factor-BB versus autologous bone graft in foot and ankle fusion: A systematic review and meta-analysis.
Today, autogenous bone graft (ABG) is still considered as the gold standard for joint fusion. Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) which is of chemotactic and mitogenic to mesenchymal stem cells and possesses outstanding osteogenetic potentials has been used for ankle and foot fusion in recent years. The goal of this article is to evaluate the safety and efficacy of rhPDGF-BB versus ABG in foot and ankle fusion. The PubMed MEDLINE, EMBASE, Web of Science, and Cochrane Library were systematic searched. Finally, three randomized controlled trials (RCTs) with 634 patients were enrolled in this study. Results of radiologic effectiveness which included CT and radiographic union rates revealed that there was no significant difference between rhPDGF-BB approach and ABG approach. Analysis of clinical results held the same outcomes expect that ABG group was superior in long-term Short Form-12 physical component scores. The pooled results also demonstrated that rhPDGF-BB was as safe as ABG in foot and ankle surgery. However, autograft harvesting procedure has some drawbacks such as donor-site pain and morbidity, additional operation time, blood loss, and scarring, which can be overcome by rhPDGF-BB. Thus, rhPDGF-BB is a viable alternative to autograft in foot and ankle fusion surgery. Yet, more high-quality RCTs with long-term follow-up are still required to make the final conclusion.
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: hansunsz@yahoo.com.
Han
H
Sun
Nursing College, Liaoning Medical University, No. 40, Section 3, Songpo Road, Guta District of Jinzhou City, Liaoning Province, 121001, China. Electronic address: lilnyxy@163.com.
Pei-Pei
PP
Lu
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: 37601745@qq.com.
Ping-Hui
PH
Zhou
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: 359720750@qq.com.
Si-Wei
SW
Sun
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: htzhangsz@163.com.
Hong-Tao
HT
Zhang
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: 459105267@qq.com.
Yi-Jie
YJ
Liu
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: 15106202869@163.com.
Xu
X
Yang
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: 29240818@qq.com.
Xiao-Feng
XF
Shen
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 188 Shizi Street Gusu District of Suzhou City, Jiangsu Province, 215006, China. Electronic address: yanghlsz@163.com.
Hui-Lin
HL
Yang
D043925:Angiogenesis Inducing Agents / Q000627:therapeutic use*; D000843:Ankle Joint; D001174:Arthrodesis; D000077214:Becaplermin; D016025:Bone Transplantation; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020574:Proto-Oncogene Proteins c-sis / Q000627:therapeutic use*; D014182:Transplantation, Autologous
D043925:Angiogenesis Inducing Agents; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin
Ankle fusion; Autogenous bone graft; Meta-analysis; Platelet derived growth factor