Repair of segmental defects of the tibia with cancellous bone grafts augmented with human bone morphogenetic protein. A preliminary report.

Human bone morphogenetic protein (hBMP) is a bone cell differentiation-inducing factor. Six patients with traumatic segmental three- to 17-cm tibial defects developed solid union by implantation of hBMP and autogeneic cancellous grafts and stabilization. There were no allergic, infectious, or surgical complications. If hBMP augmentation in biodegradable delivery systems can be established by a prospective, randomized, double-blind investigation, the incidence of successful bone graft operations for treatment of large segmental defects would be measurably improved.

[1]  R. Maurer,et al.  Multistaged surgical management of posttraumatic segmental tibial bone loss. , 1987, Clinical orthopaedics and related research.

[2]  T. Schmalzried,et al.  Bone repair induced by bone morphogenetic protein in ulnar defects in dogs. , 1986, The Journal of bone and joint surgery. British volume.

[3]  M. Urist,et al.  Induced regeneration of calvaria by bone morphogenetic protein (BMP) in dogs. , 1985, Clinical orthopaedics and related research.

[4]  J. Connolly Common avoidable problems in nonunions. , 1985, Clinical orthopaedics and related research.

[5]  M. Urist,et al.  Bone cell differentiation and growth factors. , 1983, Science.

[6]  A. Weiland,et al.  Use of free vascularized bone grafts in the treatment of bone tumors. , 1983, Clinical orthopaedics and related research.

[7]  H. Mankin,et al.  Clinical experience with allograft implantation. The first ten years. , 1983, Clinical orthopaedics and related research.

[8]  C. Straatsma,et al.  Fractures and Other Injuries , 1959 .

[9]  M. Urist,et al.  Immunologic evidence of a bone morphogenetic protein in the milieu intérieur. , 1985, Annales de biologie clinique.

[10]  D. Mears,et al.  The results of 39 fractures complicated by major segmental bone loss and/or leg length discrepancy. , 1984, The Journal of trauma.

[11]  M. Hunkapiller,et al.  Purification of bovine bone morphogenetic protein by hydroxyapatite chromatography. , 1984, Proceedings of the National Academy of Sciences of the United States of America.

[12]  R. Heppenstall Constant direct-current treatment for established nonunion of the tibia. , 1983, Clinical orthopaedics and related research.

[13]  M. Urist,et al.  A quantitative analysis of new bone formation by induction in compositive grafts of bone marrow and bone matrix. , 1980, Clinical Orthopaedics and Related Research.