Department of Orthopedics, Taizhou Hospital of Zhejiang Province & Taizhou Hospital Affiliated to Wenzhou Medical University, No.150 Ximen Road, Linhai, 317000, Zhejiang Province, China.
Department of Joint Surgery and Sports Medicine, Guangxi Academy of Medical Sciences & The People's Hospital of Guangxi Zhuang Autonomous Region, No.6 Taoyuan Road, Nanning, 530001, Guangxi Zhuang Autonomous Region, China.
J Orthop Surg Res. 2022 Jun 3;17(1):298. doi: 10.1186/s13018-022-03185-3.
The recombinant human bone morphogenetic protein (rhBMP) is a common graft substitute for treating cases of long bone nonunion. However, the feasibility of combining an autologous bone graft (ABG) with rhBMPs remains uncertain. Thus, this systematic review and meta-analysis aimed to evaluate the synergistic effect of ABG and rhBMPs on the healing of long bone nonunion.
A systematic literature search was performed on PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. Two authors independently screened the studies, extracted data, and assessed the quality of the trials. Statistical analyses were performed using Stata 12.0.
Of the 202 citations, five studies involving a total of 394 cases met the eligibility criteria; thus, they were included in this study. The pooled data revealed no significant differences among the groups in terms of postoperative healing rate (risk ratio [RR] = 1.01, 95% confidence interval [CI] = 0.96-1.06, P = 0.744), healing time (standardised mean difference = - 0.20, 95% CI = - 0.95-0.56, P = 0.610), and pain (RR = 1.44, 95% CI = 0.25-8.29, P = 0.681). The combination of ABG and rhBMPs resulted in good limb function (RR = 1.31, 95% CI = 1.04-1.66, P = 0.023).
The combination of ABG and rhBMPs did not result in the healing of long bone nonunion and pain reduction. Nevertheless, it conferred good limb function. Thus, the findings in this study are insufficient to support the use of rhBMPs as an adjuvant to ABG.
重组人骨形态发生蛋白（rhBMP）是治疗长骨骨不连的常用移植物替代物。然而，自体骨移植物（ABG）与 rhBMP 联合使用的可行性尚不确定。因此，本系统评价和荟萃分析旨在评估 ABG 和 rhBMP 联合治疗长骨骨不连的协同作用。
对 PubMed、Web of Science、Cochrane 图书馆和中国国家知识基础设施进行系统文献检索。两位作者独立筛选研究、提取数据并评估试验质量。使用 Stata 12.0 进行统计分析。
在 202 条引文中有 5 项研究共纳入 394 例患者符合纳入标准，因此被纳入本研究。汇总数据显示，在术后愈合率（风险比 [RR] = 1.01，95%置信区间 [CI] = 0.96-1.06，P = 0.744）、愈合时间（标准化均数差 [SMD] = -0.20，95%CI = -0.95-0.56，P = 0.610）和疼痛（RR = 1.44，95%CI = 0.25-8.29，P = 0.681）方面，各组之间无显著差异。ABG 和 rhBMP 联合使用可获得良好的肢体功能（RR = 1.31，95%CI = 1.04-1.66，P = 0.023）。
ABG 和 rhBMP 联合使用并不能促进长骨骨不连的愈合和减轻疼痛。然而，它确实可以改善肢体功能。因此，本研究的结果不足以支持 rhBMP 作为 ABG 的辅助治疗。
