| Autor: |
Matthias Miska, Saskia Hagelskamp, Julian Ober, Gerhard Schmidmaier, Christian Fischer, Wasilios Vlachopoulos, Patrick Haubruck, Michael C. Tanner |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Revue de Chirurgie Orthopédique et Traumatologique. 104:832-833 |
| ISSN: |
1877-0517 |
| DOI: |
10.1016/j.rcot.2018.09.124 |
| Popis: |
Background Substantial evidence exists demonstrating the individual effectiveness of both rhBMP-2 and -7 in the treatment of nonunions, data comparing the clinical effectiveness of adjunct rhBMP-2 and -7 remains scarce. Therefore, we examined our large single-center case series to compare the clinical effectiveness of both rhBMP-2 and -7 in nonunion therapy aiming to answer: (1) Does a certain type of BMP have an advantageous effect on radiological outcome of applied lower limb nonunion therapy? (2) Does application of a certain type of BMP have an advantageous effect on radiological outcome of infected lower limb nonunions? (3) Are there any additional risk factors associated with inferior outcome in context with an adjunct BMP treatment? Hypothesis Both BMPs have the same effect on the radiological outcome of surgically treated lower limb nonunions. Patients and methods Single-center retrospective database analysis of a case series of patients with lower limb long-bone nonunions receiving either a one- or two-stage (Masquelet-) procedure based on the “diamond concept” with application of rhBMP-2 or -7. The “diamond concept” summarizes core factors that need to be present to achieve bone healing. In particular, these factors relate to the optimization of the mechanical (stability) and biological environment (sufficient osteogenic and angiogenic cells, osteoconductive scaffolds and growth factors). All medical data from patients that received surgical treatment between 01/01/2010 and 31/12/2016 were assessed. In total, 356 patients were treated with BMPs and 156 patients 18 years or older with nonunion of their tibia or femur having a follow-up of at least 1 year were included. Consolidation in context with type of rhBMP was compared and the influence of relevant risk factors assessed. Results Consolidation rate was significantly higher in patients treated with rhBMP-2 (rhBMP-2: 42/46 (91%) vs. rhBMP-7: 64/110 (58%); p Discussion Patients who received rhBMP-2 for the treatment of tibial nonunions and as part of the two-stage treatment had a significantly higher rate of healing compared to patients treated with rhBMP-7 regardless of infection. Level of evidence III, retrospective case-control study. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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