Comparison of the clinical effectiveness of Bone Morphogenic Protein (BMP) -2 and -7 in the adjunct treatment of lower limb nonunions

Haubruck, Patrick; Tanner, Michael C.; Vlachopoulos, Wasilios; Hagelskamp, Saskia; Miska, Matthias; Ober, Julian; Fischer, Christian; Schmidmaier, Gerhard

doi:10.1016/j.otsr.2018.08.008

Cited by 52 publications

(34 citation statements)

References 25 publications

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“…Overall, we found ten studies which met our inclusion criteria, including five retrospective cohort or case–control studies [4, 6, 9, 12, 13], three prospective cohort studies [10, 11, 55] and two case reports [7, 8]. One study was excluded (case report by Dilogo et al.…”

Section: Resultsmentioning

confidence: 99%

The ‘diamond concept’ for long bone non-union management

2019

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Long bone non-union continues to be a significant worldwide problem. Since its inception over a decade ago, the ‘diamond concept’, a conceptual framework of what is essential for a successful bone healing response, has gained great acceptance for assessing and planning the management of fracture non-unions. Herein, we discuss the epidemiology of non-unions, the basic science of bone healing in the context of the diamond concept, the currently available results and areas for future research.

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Section: Resultsmentioning

confidence: 99%

The ‘diamond concept’ for long bone non-union management

2019

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“…One-step treatment consists of debridement of the non-union and surrounding avital tissue, de-novo osteosynthesis with a suitable and biomechanically stable implant, filling of the osseous defect with autologous bone graft and occasional application of additional growth factors such as bone morphogenic protein 2 or 7 (3.3 mg BMP-7 or 4 mg BMP-2). 18,19 Typically, Masquelet therapy consists of two surgical procedures or steps; however, if an infection is detected the first step is repeated until asepsis is achieved. In detail, the individual steps involve the following aspects:…”

Section: Surgical Treatmentmentioning

confidence: 99%

<p>Non-Union Treatment Based on the “Diamond Concept” Is a Clinically Effective and Safe Treatment Option in Older Adults</p>

Tanner

Hagelskamp

Vlachopoulos

et al. 2020

CIA

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Background: Patients >60 years suffering from non-unions are often unable to perform activities of daily living and often become dependent on nursing care. Evidence regarding treatment options and outcome is nonexistent. This study sought to determine the clinical effectiveness and safety of one-or two-step non-union therapy in elderly patients. Methods: This study was a single-site retrospective database analysis of older adults with long bone non-unions treated via "diamond concept". All medical records of patients receiving surgical treatment of non-unions between 01/01/2010 and 31/12/2016 were reviewed. Clinical and radiological outcome subsequent to non-union therapy were evaluated. Results: A total of 76 patients (37 patients were treated with one-step and 39 patients with Masquelet therapy) suffering from a non-union older than 60 years treated between 01/01/2010 and 31/12/2016 in our institution were included into the current study. Bone consolidation was achieved in 91.9% after one-step and 76.9% after the Masquelet therapy. Analysis of age as a risk factor in the outcome of non-union therapy revealed no significant differences in patients treated with the one-step procedure according to the "diamond concept". On the contrary, age had a significant negative influence on the outcome of the Masquelet therapy (p = 0.027). Conclusion: Non-union therapy according to the "diamond concept" is an effective and reliable treatment option in elderly patients. According to findings of the current study, older adults suffering from an infected non-union benefit from a two-stage procedure, whereas in patients suffering from a non-infected non-union, a one-step surgical treatment is beneficial.

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“…Toosi et al precisely described in a review a range of growth factors and cytokines provided by bone resident MSCs to support cell growth following injury and demonstrated how GF signaling plays a critical role in regulating osteogenesis, chondrogenesis and bone/mineral homeostasis [57]. It is known that the delivery of exogenous GFs, i.e., BMP-2, to the non-union bone fracture site remarkably improves healing results [58].…”

Section: Conditioning Systems Composites and Growth Factorsmentioning

confidence: 99%

Ceramic Scaffolds in a Vacuum Suction Handle for Intraoperative Stromal Cell Enrichment

Busch

Herten

Haversath³

et al. 2020

IJMS

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During total joint replacement, high concentrations of mesenchymal stromal cells (MSCs) are released at the implantation site. They can be found in cell–tissue composites (CTC) that are regularly removed by surgical suction. A surgical vacuum suction handle was filled with bone substitute granules, acting as a filter allowing us to harvest CTC. The purpose of this study was to investigate the osteopromotive potential of CTC trapped in the bone substitute filter material during surgical suction. In the course of 10 elective total hip and knee replacement surgeries, β-tricalcium-phosphate (TCP) and cancellous allograft (Allo) were enriched with CTC by vacuum suction. Mononuclear cells (MNC) were isolated from the CTC and investigated towards cell proliferation and colony forming unit (CFU) formation. Furthermore, MSC surface markers, trilineage differentiation potential and the presence of defined cytokines were examined. Comparable amounts of MNC and CFUs were detected in both CTCs and characterized as MSC‰ of MNC with 9.8 ± 10.7‰ for the TCP and 12.8 ± 10.2‰ for the Allo (p = 0.550). CTCs in both filter materials contain cytokines for stimulation of cell proliferation and differentiation (EGF, PDGF-AA, angiogenin, osteopontin). CTC trapped in synthetic (TCP) and natural (Allo) bone substitute filters during surgical suction in the course of a joint replacement procedure include relevant numbers of MSCs and cytokines qualified for bone regeneration.

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Comparison of the clinical effectiveness of Bone Morphogenic Protein (BMP) -2 and -7 in the adjunct treatment of lower limb nonunions

Cited by 52 publications

References 25 publications

The ‘diamond concept’ for long bone non-union management

The ‘diamond concept’ for long bone non-union management

<p>Non-Union Treatment Based on the “Diamond Concept” Is a Clinically Effective and Safe Treatment Option in Older Adults</p>

Ceramic Scaffolds in a Vacuum Suction Handle for Intraoperative Stromal Cell Enrichment

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