SLR - October 2011 - Brian T. Dix
Reference: Argintar, E., Edwards, S., Delahay, J. (2011). Bone morphogenetic proteins in orthopaedic trauma surgery. Injury, 42, 730-734.
Scientific Literature Review
Reviewed by: Brian T. Dix, DPM
Residency Program: The Western Pennsylvania Hospital, Pittsburgh, PA
Podiatric Relevance:
This study reviews how bone morphogenetic proteins (BMPs) can be used in acute tibial fractures and tibial non-unions.
Methods:
The study design was a review of prospectively randomized clinical trials involving acute tibial fractures and prospectively randomized clinical trials involving tibial nonunions.
Results:
Randomized clinical trials of over 500 patients involving acute tibial fractures treated with BMP confirmed superior function, less secondary interventions, faster time to union, enhanced wound healing, and a decreased infection rate. Furthermore, a randomized clinical trial with over 120 patients with tibial nonunions received either autograft or BMP and the results showed statistical equality between both groups with regard to clinical and radiographic union, even though more tobacco smokers were in the BMP group.
Conclusions:
The application of BMP presently has two FDA-approved indications: (1) treatment of acute tibial fractures treated with intramedullary fixation and (2) treatment of long bone nonunions. However, the usage of BMP must be weighed against the significant expenses related with their application. More prospective randomized clinical trials must be undertaken to validate and amplify the role of BMP in the situation of trauma and nonunions.