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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_23 | Pages 19 - 19
1 May 2013
Griffiths JT Lewis C Cannon L Lasrado I Hodkinson S Hand C
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The purpose of this study was to quantify the effect of BMP 7 and recombinant Human (rh) BMP 2 at stimulating bone formation and bone union in trauma and elective orthopaedic surgery.

Methods

We retrospectively reviewed the use of BMP 7 and rhBMP 2 at the Queen Alexandra Hospital between 2005 and 2012. The minimum follow up was three months. Inclusion criteria consisted of all patients who had failed to achieve previous surgical bone union and then received either BMP 7 or rhBMP 2 in an attempt to achieve bone union (as part of revision surgery). Patients who have not completed a minimum of three months follow up were excluded. Bone union was defined clinically and radiographically.

Results

17 patients were included (9 elective and 8 trauma patients). 9 patients received BMP2 (8 trauma and 1 elective) and 8 received rhBMP 2 (all elective). The average number of attempted fusions with autogenous bone graft prior to the use of BMP agent in the trauma and elective group was 2 and 3 respectively. The overall union rate following the use of BMP was 94.1%. 1 patient from the BMP 7 group (trauma patient) failed to unite. The union rate with BMP 7 and rhBMP 2 was 88.9% and 100% respectively. Following the use of BMP the average time to union was 117 days (BMP 7 124 days and rhBMP 2 112 days).


The Journal of Bone & Joint Surgery British Volume
Vol. 94-B, Issue 2 | Pages 210 - 214
1 Feb 2012
Griffiths JT Matthews L Pearce CJ Calder JDF

The incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE) is thought to be low following foot and ankle surgery, but the routine use of chemoprophylaxis remains controversial. This retrospective study assessed the incidence of symptomatic venous thromboembolic (VTE) complications following a consecutive series of 2654 patients undergoing elective foot and ankle surgery. A total of 1078 patients received 75 mg aspirin as routine thromboprophylaxis between 2003 and 2006 and 1576 patients received no form of chemical thromboprophylaxis between 2007 and 2010. The overall incidence of VTE was 0.42% (DVT, 0.27%; PE, 0.15%) with 27 patients lost to follow-up. If these were included to create a worst case scenario, the overall VTE rate was 1.43%. There was no apparent protective effect against VTE by using aspirin.

We conclude that the incidence of VTE following foot and ankle surgery is very low and routine use of chemoprophylaxis does not appear necessary for patients who are not in the high risk group for VTE.