Shamie Arya Nick, Yazdanshenas Hamed, Johnson Eric Egan
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of Los Angeles, CA, USA.
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of Los Angeles, CA, USA; Departments of Orthopaedic Surgery and Family Medicine, Charles R. Drew University of Medicine and Science, CA, USA; Department of Family Medicine, David Geffen School of Medicine, University of Los Angeles, CA, USA.
J Clin Orthop Trauma. 2017 Jan-Mar;8(1):59-62. doi: 10.1016/j.jcot.2016.10.008. Epub 2016 Nov 16.
The bone morphogenetic protein (BMP) has emerged as a suitable alternative to autogenous cancellous bone grafting and despite current knowledge about its mechanism; few studies provide evidence about the long-term safety of BMP. The aim of this investigation is to determine if BMP implantation is a safe and effective agent in a long-term setting for the treatment of patients with resistant non-unions and failed arthrodesis. This study is a retrospective case series study that was conducted on 55 patients who had received BMP. Collected data included all related surgical history, and clinical and X-ray data both pre-operatively and post-operatively. All patients were scheduled for follow-up evaluations at one week and 1, 3, 6, and 12 months post-operatively. Seven patients (13%) experienced adverse events related to their surgery with hBMP. Six patients (11%) experienced persistent non-union; five of these underwent further revision surgery. One patient (2%) developed an infected non-union. No patients experienced tumor induction, allergic reaction to hBMP. The remaining 48 patients achieved osseous union within six months of hBMP implantation. This study differs from previous studies that the use of hBMP is a safe and efficacious treatment method for resistant non-unions and failed arthrodesis in the long-term setting.
骨形态发生蛋白(BMP)已成为自体松质骨移植的一种合适替代物,尽管目前对其作用机制已有了解,但很少有研究提供BMP长期安全性的证据。本研究的目的是确定在长期治疗中,BMP植入对于治疗难治性骨不连和关节融合失败的患者是否是一种安全有效的药物。本研究是一项回顾性病例系列研究,对55例接受BMP治疗的患者进行了研究。收集的数据包括所有相关手术史以及术前和术后的临床及X线数据。所有患者均计划在术后1周、1、3、6和12个月进行随访评估。7例患者(13%)发生了与使用重组人骨形态发生蛋白(rhBMP)手术相关的不良事件。6例患者(11%)出现持续性骨不连,其中5例接受了进一步的翻修手术。1例患者(2%)发生了感染性骨不连。没有患者出现肿瘤诱导或对rhBMP的过敏反应。其余48例患者在rhBMP植入后6个月内实现了骨愈合。本研究与以往研究的不同之处在于,在长期治疗中,使用rhBMP是治疗难治性骨不连和关节融合失败的一种安全有效的治疗方法。