Bone morphogenetic proteins in total hip arthroplasty, osteonecrosis and trauma surgery

Authors: Stiehl, James B1; Ulrich, Slif D; Seyler, Thorsten M; Bonutti, Peter M; Marker, David R; Mont, Michael A

Source: Expert Review of Medical Devices, Volume 5, Number 2, March 2008 , pp. 231-238(8)

Publisher: Expert Reviews

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Abstract:

This review provides an overview of the use of bone morphogenetic proteins to enhance bone healing and bone graft incorporation in difficult defects created from failed total hip arthroplasties, osteonecrosis of the femoral head and trauma. Multiple publications have demonstrated that bone morphogenetic proteins are osteoinductive in preclinical trials (i.e., animal models); however, there is controversy and limited understanding of the use of this technology in orthopedic surgical practice. The question remains as to whether they are useful in difficult fractures, nonunions and large defects created from failed total hip arthroplasty or femoral head osteonecrosis. There might be a small risk for infection by the process of introducing foreign materials in a clinical situation, but this has not yet been realized to date. In addition, these materials offer an advantage in large defects where there is not enough transplantable material available from the host. We believe that the use of these materials will become more widespread with newer carriers, minimally invasive applications and diminished commercial costs.

Keywords: BMP; bone graft; bone morphogenetic protein; hip; osteonecrosis; trauma

Document Type: Research article

DOI: 10.1586/17434440.5.2.231

Affiliations: 1: Orthopaedic Surgeon, Orthopedic Hospital of Wisconsin, 575 W River Woods Parkway, Milwaukee, WI 53212, USA., Email: jbstiehl@aol.com

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