Citation Information :
Papanna MC, Saldanha KA, Kurian B, Fernandes JA, Jones S. The use of recombinant morphogenic protein-2(rhBMP-2) in children undergoing revision surgery for persistent non-union. 2016; 11 (1):53-58.
The purpose of the study was to evaluate the safety and efficacy with the use of BMP-2 for treating persistent non-unions in children with underlying complex conditions. Between October 2006 and November 2010 in our unit, 15 patients were treated with rhBMP-2 to enhance bone union. There were nine females and six males with a mean age of 9.5 years (range 4–15) at time of surgery. Seventy-five per cent of the patients required revision of internal fixation with insertion of rhBMP-2 to the non-union site, and the reminder had freshening of the non-union site with rhBMP-2 application. Patients had undergone a mean of 2 (1–5) operations prior to implantation of rhBMP-2. All the patients in the study group were available for review with mean follow-up of 44 months (range 21–70). The mean time to union was 16 weeks (range 10–28 weeks). No adverse events related to BMP-2 application were noted in our study group. Healing occurred clinically and radiographically in 16 of the 17 sites. Our study demonstrates that BMP-2 enhances healing of the persistent non-unions without any adverse events
Megas P (2005) Classification of non-union. Injury 36(Supp 4):S30-S37
Phieffer LS, Goulet JA (2006) Delayed unions of the tibia. JBJS [Am] 88(1):206-216
Goulet JA, Senunas LE, DeSilva GL, Greenfield ML (1997) Autogenous iliac crest bone graft. Complications and functional assessment. CORR 339:76-81
Schnee CL, Freese A, Weil RJ (1997) Analysis of harvest morbidity and radiographic outcome using autograft for anterior cervical fusion. Spine 22:222-227
De Biase P, Capanna R (2005) Clinical applications of BMPs. Injury 36(Suppl 3):S43-S46
Govender S, Csimma C, Genant HK, Valentin-Opran A, Amit Y, Arbel R (2002) BMP-2 Evaluation in Surgery for Tibial Trauma (BESTT) Study Group. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am 84:2123-2134
Boden SD, Kang J, Sandhu H, Heller JG (2002) Use of recombinant human bone morphogenetic protein-2 to achieve posterolateral lumbar spine fusion in humans: a prospective, randomized clinical pilot trial: 2002 Volvo Award in clinical studies. Spine 27:2662-2673
Burkus JK, Transfeldt EE, Kitchel SH, Watkins RG, Balderston RA (2002) Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2. Spine 27:2396-2408
Jones AL, Bucholz RW, Bosse MJ, Mirza SK, Lyon TR, Webb LX (2006) Recombinant human BMP-2 and allograft compared with autogenous bone graft for reconstruction of diaphyseal tibial fractures with cortical defects. A randomized, controlled trial. J Bone Joint Surg Am 88:1431-1441
Krause F, Younger A, Weber M (2008) Recombinant human BMP-2 and allograft compared with autogenous bone graft for reconstruction of diaphyseal tibial fractures with cortical defects. J Bone Joint Surg Am 90:1168
Abd-El-Barr MM, Cox JB, Antonucci MU, Bennett J, Murad GJ, Pincus DW (2011) Recombinant human bone morphogenetic protein-2 as an adjunct for spine fusion in a pediatric population. Pediatr Neurosurg 47(4):266-271
Oetgen ME, Richards BS (2010) Complications associated with the use of bone morphogenetic protein in pediatric patients. J Pediatr Orthop 30:192-198
Ritting AW, Weber EW, Lee MC (2012) Exaggerated inflammatory response and bony resorption from BMP-2 use in a pediatric forearm non-union. J Hand Surg Am 37(2):316-321
Dohin B, Dahan-Oliel N, Fassier F, Hamdy R (2009) Enhancement of difficult nonunion in children with osteogenic protein-1 (OP-1): early experience. Clin Orthop Relat Res 467(12):3230-3238
Lee FY, Sinicropi SM, Lee FS, Vitale MG, Roye DP Jr, Choi IH (2006) Treatment of congenital pseudarthrosis of the tibia with recombinant human bone morphogenetic protein-7 (rhBMP-7). A report of five cases. J Bone Joint Surg Am 88(3):627-633
Birke O, Schindeler A, Ramachandran M, Cowell CT, Munns CF, Bellemore M (2010) Preliminary experience with the combined use of recombinant bone morphogenetic protein and bisphosphonates in the treatment of congenital pseudarthrosis of the tibia. J Child Orthop 4(6):507-517
Fabeck L, Ghafil D, Gerroudj M, Baillon R, Delincé P (2006) Bone morphogenetic protein-7 in the treatment of congenital pseudarthrosis of the tibia. J Bone Joint Surg Br 88:116-118
Spiro AS, Babin K, Lipovac S, Stenger P, Mladenov K, Rupprecht M (2011) Combined treatment of congenital pseudarthrosis of the tibia, including recombinant human bone morphogenetic protein-2: a case series. J Bone Joint Surg Br 93(5):695-699
Richards BS, Oetgen ME, Johnston CE (2010) The use of rhBMP-2 for the treatment of congenital pseudarthrosis of the tibia: a case series. J Bone Joint Surg [Am] 92-A:177-185
Friedlaender GE, Perry CR, Cole JD, Cook SD, Cierny G, Muschler GF (2001) Osteogenic protein-1 (Bone morphogenetic protein-7) in the treatment of tibial nonunions. J Bone Joint Surg Am 83-A(suppl 1):S151-S158
Geesink RG, Hoefnagels NH, Bulstra SK (1999) Osteogenic activity of OP-1 bone morphogenetic protein (BMP-7) in a human fibular defect. J Bone Joint Surg Br 81(4):710-718
Dobbs MB, Rich MM, Gordon JE, Szymanski DA, Schoenecker PL (2005) Use of an intramedullary rod for the treatment of congenital pseudarthrosis of the tibia. Surg Tech Suppl 1(Pt 1):33-40
