Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions

Fuchs T, Stolberg-Stolberg J, Michel P, Garcia P, Amler S, Wähnert D, Raschke M (2021)
Journal of clinical medicine 10(19): 4597.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
Download
OA 985.71 KB
Autor*in
Fuchs, Thomas; Stolberg-Stolberg, Josef; Michel, Philipp ; Garcia, Patric; Amler, Susanne; Wähnert, Dirk; Raschke, Michael
Abstract / Bemerkung
BACKGROUND: Delayed fracture healing continues to cause significant patient morbidity and an economic burden to society. Biological stimulation of non-unions includes application of recombinant bone morphogenetic protein-2 (rhBMP-2). However, rhBMP-2 use continues to be a matter of controversy as literature shows scarce evidence for treatment effectiveness.
QUESTIONS: The objective of this study was to evaluate the effectiveness of rhBMP-2 treatment on long bone non-unions measuring union rate and time to union. Furthermore, we assess risk factors for treatment failure.
METHODS AND PATIENTS: A total of 91 patients with non-unions of long bones were treated with rhBMP-2 (n = 72) or standard care without BMP (n = 19) at our institution. Patient characteristics, comorbidities, nicotine consumption, and complications were recorded. Bone healing was assessed by plane X-rays and clinical examination. Patients were followed up with for 24 months.
RESULTS: Overall, there was significantly faster bone healing after rhBMP-2 application compared to the no-BMP group (p < 0.001; HR = 2.78; 95% CI 1.4-5.6). Union rates differed significantly between rhBMP-2 compared to the no-BMP group (89% vs. 47%; p < 0.001). At the humerus, there was neither a significantly higher union rate in the rhBMP-2 (83%) compared to the no-BMP group (50%) (p = 0.26; n = 12) nor a faster bone healing with a median time of 9 months in both groups (HR = 2.01; 95% CI 0.49-8.61; p = 0.315). The 33 femora treated using rhBMP-2 healed significantly faster than 9 femora in the no-BMP group (HR = 2.93; 95% CI 1.00-8.4; p = 0.023) with significant differences in union rate with 85% and 44%, respectively (p = 0.022). Regarding tibia non-unions, 25 out of 27 (93%) healed with a median of 9 months after rhBMP-2 application with no significant difference in the no-BMP group (33%) in time to union (p = 0.097) but a significantly higher union rate (p = 0.039). There was no effect of comorbidities, age, sex, soft tissue damage, or nicotine use on time to union, union rate, or secondary interventions.; CONCLUSION: Consistent with the literature, overall, significantly higher union rates with reduced time to union were achieved after rhBMP-2 application. Femoral and tibial non-unions in particular seem to profit from rhBMP-2 application.
Erscheinungsjahr
2021
Zeitschriftentitel
Journal of clinical medicine
Band
10
Ausgabe
19
Art.-Nr.
4597
eISSN
2077-0383
Page URI
https://pub.uni-bielefeld.de/record/2958354

Zitieren

Fuchs T, Stolberg-Stolberg J, Michel P, et al. Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of clinical medicine. 2021;10(19): 4597.
Fuchs, T., Stolberg-Stolberg, J., Michel, P., Garcia, P., Amler, S., Wähnert, D., & Raschke, M. (2021). Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of clinical medicine, 10(19), 4597. https://doi.org/10.3390/jcm10194597
Fuchs, T., Stolberg-Stolberg, J., Michel, P., Garcia, P., Amler, S., Wähnert, D., and Raschke, M. (2021). Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of clinical medicine 10:4597.
Fuchs, T., et al., 2021. Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of clinical medicine, 10(19): 4597.
T. Fuchs, et al., “Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions”, Journal of clinical medicine, vol. 10, 2021, : 4597.
Fuchs, T., Stolberg-Stolberg, J., Michel, P., Garcia, P., Amler, S., Wähnert, D., Raschke, M.: Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions. Journal of clinical medicine. 10, : 4597 (2021).
Fuchs, Thomas, Stolberg-Stolberg, Josef, Michel, Philipp, Garcia, Patric, Amler, Susanne, Wähnert, Dirk, and Raschke, Michael. “Effect of Bone Morphogenetic Protein-2 in the Treatment of Long Bone Non-Unions”. Journal of clinical medicine 10.19 (2021): 4597.
Alle Dateien verfügbar unter der/den folgenden Lizenz(en):
Creative Commons Namensnennung 4.0 International Public License (CC-BY 4.0):
Volltext(e)
Name
Access Level
OA Open Access
Zuletzt Hochgeladen
2021-11-25T14:31:59Z
MD5 Prüfsumme
5ca1c9cc2696f61b40a421cc2faff4cd

Export

Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®

Quellen

PMID: 34640615
PubMed | Europe PMC

Suchen in

Google Scholar