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Osteosynthesis and Trauma Care 2003; 11(3): 126-130
DOI: 10.1055/s-2003-42607
Original Article

© Georg Thieme Verlag Stuttgart · New York

Clinical Efficacy of Bone Morphogenetic Proteins

M. F. Termaat1 , T. J. Blokhuis1 , F. C. Den Boer1 , F. C. Bakker1 , P. Patka1 , H. J. T. M. Haarman1
  • 1Departments of Surgery/Traumatology, VU University Medical Center, Amsterdam, The Netherlands
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Publication History

Publication Date:
29 September 2003 (online)

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Abstract

Fracture healing is a time-consuming process, concerning a relative young patient population. Five to 10 per cent of the fractures develop a complicated bone healing process resulting in either a delayed union or a non-union. The associated morbidity and costs related to fracture healing are considerable and treatment methods to accelerate the bone healing process have been studied intensively over the last decades. Several treatment methods for accelerating bone healing have been proposed, but one of the most promising techniques is the application of bone morphogenetic proteins (BMPs). The BMPs were first described in 1965 by Urist, and these growth factors are capable of inducing de novo bone formation when implanted at heterotopic sites. Their osteoinductive capacity has been well-established in animal experiments. Some of the members of the BMP family, BMP-2 (InductOs™) and BMP-7/OP-1 (Osigraft™), have demonstrated their effectiveness and safety in clinical applications such as accelerating fresh fracture healing, treatment of bone defects and non-unions, and promoting spinal fusion. So, BMPs will offer a great therapeutic potential for replacing or augmenting current surgical strategies for the enhancement of bone repair in the forthcoming years.

Key words

Clinical trials - BMPs - spinal fusion - fresh fracture healing - bone defects - non-unions

References

  • 1 Burkus J K, Dorchak J D, Sanders D L. Radiographic assessment of interbody fusion using recombinant human bone morphogenetic protein type 2.  Spine. 2003;  28 372-377
    CrossrefPubMedSearch in Google Scholar
  • 2 Burkus J K, Gornet M F, Dickman C A, Zdeblick T A. Anterior lumbar interbody fusion using rhBMP-2 with tapered interbody cages.  J Spinal Disord Tech. 2002;  15 337-349
    CrossrefPubMedSearch in Google Scholar
  • 3 Cook S D, Wolfe M W, Salkeld S L, Rueger D C. Effect of recombinant human osteogenic protein-1 on healing of segmental defects in non-human primates.  J Bone Joint Surg [Am]. 1995;  77 734-750
    PubMedSearch in Google Scholar
  • 4 Den Boer F C, Patka P, Bakker F C, Haarman H JTM. Current concepts of fracture healing, delayed unions, and non-unions.  Osteosynthesis and Trauma Care. 2002;  10 1-8
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Friedlaender G E, Perry C R, Cole J D. et al . Osteogenic protein-1 (bone morphogenetic protein-7) in the treatment of tibial nonunions.  J Bone Joint Surg [Am]. 2001;  83 (Suppl 1) S151-S158
    PubMedSearch in Google Scholar
  • 6 Geesink R G, Hoefnagels N H, Bulstra S K. Osteogenic activity of OP-1 bone morphogenetic protein (BMP-7) in a human fibular defect.  J Bone Joint Surg [Br]. 1999;  81 710-718
    PubMedSearch in Google Scholar
  • 7 Govender S, Csimma C, Genant H K. et al . Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomised study of four hundred and fifty patients.  J Bone Joint Surg [Am]. 2002;  84 2123-2134
    PubMedSearch in Google Scholar
  • 8 Johnsson R, Stromqvist B, Aspenberg P. Randomized radiostereometric study comparing osteogenic protein-1 (BMP-7) and autograft bone in human noninstrumented posterolateral lumbar fusion: 2002 Volvo Award in clinical studies.  Spine. 2002;  27 2654-2661
    CrossrefPubMedSearch in Google Scholar
  • 9 Laursen M, Hoy K, Hansen E S, Gelineck J, Christensen F B, Bunger C E. Recombinant bone morphogenetic protein-7 as an intracorporal bone growth stimulator in unstable thoracolumbar burst fractures in humans: preliminary results.  Eur Spine J. 1999;  8 485-490
    CrossrefPubMedSearch in Google Scholar
  • 10 Lieberman J R, Daluiski A, Einhorn T A. The role of growth factors in the repair of bone. Biology and clinical applications.  J Bone Joint Surg [Am]. 2002;  84 1032-1044
    PubMedSearch in Google Scholar
  • 11 McKee M, Schemitsch E, Waddel J. et al .The effect of human recombinant bone morphogenic protein (rhBMP-7) on the healing of open tibial shaft fractures: Results of a multi-center, prospective, randomised clinical trial. Orthopaedic Trauma Association: Annual Meeting, Toronto 2002
  • 12 Patel T C, Vaccaro A R, Trumees E. Two-years follow-up on a safety and efficacy study of OP-1 (rhBMP-7) as an adjunct to posterolateral lumbar fusion. Proceedings of the North American Spine Society 16th Annual Meeting, 2001
  • 13 Poynton A R, Lane J M. Safety profile for the clinical use of bone morphogenetic proteins in the spine.  Spine. 2002;  27 40-48
    CrossrefPubMedSearch in Google Scholar
  • 14 Riedel G E, Valentin-Opran A. Clinical evaluation of rhBMP-2/ACS in orthopedic trauma: a progress report.  Orthopedics. 1999;  22 663-665
    PubMedSearch in Google Scholar
  • 15 Sciadini M F, Johnson K D. Evaluation of recombinant human bone morphogenetic protein-2 as a bone-graft substitute in a canine segmental defect model.  J Orthop Res. 2000;  18 289-302
    CrossrefPubMedSearch in Google Scholar
  • 16 Vaccaro A R, Anderson D G, Toth C A. Recombinant human osteogenic protein-1 (bone morphogenetic protein-7) as an osteoinductive agent in spinal fusion.  Spine. 2002;  27 S59-S65
    CrossrefPubMedSearch in Google Scholar

Marco F. Termaat M. D. 

Department of Surgery/Traumatology

VU University Medical Center

P.O. Box 70 57

1007 MB Amsterdam

The Netherlands

Phone: +31/20/4 44 02 68

Fax: +31/20/4 44 02 74

Email: mf.termaat@vumc.nl