Treatment of Congenital Pseudarthrosis of the Tibia with Recombinant Human Bone Morphogenetic Protein-7 (rhBMP-7): A Report of Five Cases

Lee, Francis Young-In; Sinicropi, S.; Lee, Fred Suin; Vitale, Michael G.; Roye, David P.; Choi, In Ho

doi:10.2106/jbjs.d.02201

Cited by 61 publications

(55 citation statements)

References 39 publications

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“…In two further recent studies on the use of IM rodding, the initial union was achieved in 18 of 21 patients [10] and four of 12 patients [26]. The use of BMP with IM rodding failed to achieve union in four of five patients [27]. Of particular note is that all patients are united at the time of followup and at the time of writing of this manuscript (Tables 1, 2).…”

Section: Discussionmentioning

confidence: 82%

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Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Thabet

Paley

Kocaoğlu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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The results of treatment of congenital pseudarthrosis of the tibia (CPT) are frequently unsatisfactory because of the need for multiple operations for recalcitrant nonunion, residual deformities, and limb-length discrepancies (LLD). Although the etiology of CPT is basically unknown, recent reports suggest the periosteum is the primary site for the pathologic processes in CPT. We hypothesized complete excision of the diseased periosteum and the application of a combined approach including free periosteal grafting, bone grafting, and intramedullary (IM) nailing of both the tibia and fibula combined with Ilizarov fixation would improve union rates and reduce refracture rates. We retrospectively reviewed 20 patients at two centers. The minimum followup was 2 years (mean, 4.3 years; range, 2-10

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Section: Discussionmentioning

confidence: 82%

“…Recently, bone morphogenetic protein (BMP) [27,37] and Table 1. Crawford [9] III (3) IV (2) 6 (0.6-13)…”

Section: Introductionmentioning

confidence: 99%

Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Thabet

Paley

Kocaoğlu

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Other methods include direct current or pulsed electromagnetic field, ipsilateral transfer of the fibula or contralateral free vascularized fibular transfer, circular external fixation, IM rodding, and combined external fixation and IM rodding. More recently, bone morphogenic protein (BMP) [28] and bisphosphonate therapy [20,39] have been used. The results of all these methods have been variable.…”

Section: Introductionmentioning

confidence: 99%

Congenital Pseudarthrosis of the Tibia: Combined Pharmacologic and Surgical Treatment Using Biphosphonate Intravenous Infusion and Bone Morphogenic Protein with Periosteal and Cancellous Autogenous Bone Grafting, Tibio-Fibular Cross Union, Intramedullary

Paley¹

2012

Bone Grafting

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“…There are over 30 of them, but only two have been developed for application in mankind and produced by genetic engineering: the recombining BMP2 and BMP7. The use of rhBMP in pseudarthrosis of the tibia seems promising in the light of initial observations published about children [12][13][14][15][16][17][18]45] and the results obtained in adults [1,2]. In children, the question arises as to the early and long-term side effects.…”

Section: Application Of Bmpmentioning

confidence: 99%

“…The results obtained using BMPs in adults, particularly in the case of pseudarthrosis of long bones, have opened up the perspective of applying these proteins to children in certain highly complex situations. A few authors have reported their experience in compassionate indications, especially CPT [12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: A case series and meta-analysis

Dohin

Köhler²

2012

Journal of Children's Orthopaedics

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Purpose A type 2 recombinant human bone morphogenetic protein (rhBMP2) and Masquelet's procedure were used in three children presenting with congenital pseudarthrosis of the tibia (CPT). Recent studies on CPT suggested the presence in situ of pathologic tissues promoting pseudarthrosis. The authors hypothesized that large segmental resection of pseudarthrosis could improve prognosis of the CPT. Masquelet's procedure and rhBMP2 have been advocated for the treatment of long bone defect. Method The authors report three cases of CPT in children treated with Masquelet's procedure and application of rhBMP2. They analyzed all published cases of CPT similarly treated. Results In the present study, Masquelet's procedure did not improve the results in the treatment of CPT, but segmental bone reconstruction was possible. Bone healing was obtained in three out of the five applications of rhBMP2. In one case, the patient's parents asked for leg amputation. Analysis of the 33 published cases with the application of BMP in CPT points to a 62 % healing rate in this pathology. Conclusion The authors confirmed that segmental bone reconstruction is possible in CPT using Masquelet's procedure. In the literature, the success rate of the application of rhBMP in CPT appears to be lower than the healing rate usually reported without BMP. Nevertheless, the strict selection of patients, limited number of cases, and their heterogeneity make interpreting the results difficult. However, the theoretical risk which the children are exposed to during the use of BMP makes rigorous selection of the indications necessary. Finally, the interest of rhBMP2 application in Masquelet's procedure remained to be proven.

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Treatment of Congenital Pseudarthrosis of the Tibia with Recombinant Human Bone Morphogenetic Protein-7 (rhBMP-7): A Report of Five Cases

Cited by 61 publications

References 39 publications

Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Periosteal Grafting for Congenital Pseudarthrosis of the Tibia: A Preliminary Report

Congenital Pseudarthrosis of the Tibia: Combined Pharmacologic and Surgical Treatment Using Biphosphonate Intravenous Infusion and Bone Morphogenic Protein with Periosteal and Cancellous Autogenous Bone Grafting, Tibio-Fibular Cross Union, Intramedullary

Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: A case series and meta-analysis

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