Abstract
Introduction: Bone Morphogenic Proteins (BMP’s) are a family of bone-matrix polypeptides isolated from a variety of mammalian species. Implantation of osteogenic proteins induces a sequence of cellular events that leads to the formation of new bone.
Recombinant human osteogenic protein-1 (rhOP1 or BMP-7) has now been produced and is commercially available.
Rationale: OP.1 has been used in our centre since early 2003 and we now report on our experience with its use in the treatment of fracture non unions in a general orthopaedic trauma setting.
Methodology/Results: OP1 has been used in 19 fracture non unions, the commonest site being the tibia but also in the humerus and forearm. Five of these cases had previous autologous bone grafting. There was one case of deep MRSA infection in a proximal humerus fracture. There were no complications associated with the use of OP1 and specifically there were no instances of symptomatic heterotopic bone formation. Eighteen fractures went on to clinical and radiological union.
Conclusions: Autogenous bone is the current standard in the management of fracture non union because of its high osteogenic potential and biocompatibility. Donor site morbidity and quantity remain drawbacks. The use of OP.1 in the treatment of tibial non unions is well documented in the literature but there is little written about its use in other sites.
We are encouraged by our early experiences with the use of OP1 in numerous anatomical sites and apart from issues of cost would see great potential for further use.
The abstracts were prepared by Emer Agnew, Secretary to the IOA. Correspondence should be addressed to him at Irish Orthopaedic Association Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
