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Bone morphogenetic protein-2 for the treatment of congenital pseudarthrosis of the tibia or persistent tibial nonunion in children and adolescents: A retrospective study with a minimum 2-year follow-up

  • Clinical Applications of Biomaterials
  • Original Research
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Abstract

There is a lack of studies reporting on rhBMP-2 application in pediatric orthopaedics, although few reports demonstrated promising results of the use of rhBMP-2 in children, especially for spine fusion and for the treatment of congenital pseudarthrosis of the tibia. The objectives of this study were (1) to examine clinical and radiographic healing after rhBMP-2 application for the treatment of congenital pseudarthrosis of the tibia (CPT) or persistent tibial nonunion in children and adolescents, and (2) to investigate the safety of rhBMP-2 use in these cases. Therefore we reviewed the medical records of ten patients with a mean age of 8.6 years (2.3–21) with CPT (n = 7) or persistent tibial nonunion for at least six months (n = 3) who had been treated with rhBMP-2. Nine of ten patients had union at final follow-up, after a mean of 72.9 months (25–127). In the CPT group, primary healing of the pseudarthrosis occurred in six of seven patients at a mean of 5.2 months (3–12). Repeat rhBMP-2 application was performed in three patients; two patients had one additional application each, and one patient had three additional applications. Complications that may be attributed to the use of rhBMP-2 were seen in two of fifteen applications, including a compartmemt syndrome and a hematoma. In this retrospective case series rhBMP-2 has been used successfully to treat CPT or persistent tibial nonunion in pediatric patients. However, prospective randomized controlled trials are warranted to investigate the long-term efficacy and safety of rhBMP-2 use in these cases.

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    Authors and Affiliations

    1. Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

      Tim N. Hissnauer, Norbert Stiel, Michael Hoffmann & Johannes M. Rueger

    2. Department of Pediatric Orthopaedic Surgery, Children’s Hospital Hamburg-Altona, Hamburg, Germany

      Kornelia Babin, Martin Rupprecht, Ralf Stuecker & Alexander S. Spiro

    3. Department of Orthopaedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

      Kornelia Babin, Martin Rupprecht, Ralf Stuecker & Alexander S. Spiro

    Authors
    1. Tim N. Hissnauer
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    2. Norbert Stiel
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    3. Kornelia Babin
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    4. Martin Rupprecht
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    5. Michael Hoffmann
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    8. Alexander S. Spiro
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    Correspondence to Alexander S. Spiro.

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    Tim N. Hissnauer and Norbert Stiel have contributed equally to this work and therefore share first authorship.

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    Hissnauer, T.N., Stiel, N., Babin, K. et al. Bone morphogenetic protein-2 for the treatment of congenital pseudarthrosis of the tibia or persistent tibial nonunion in children and adolescents: A retrospective study with a minimum 2-year follow-up. J Mater Sci: Mater Med 28, 60 (2017). https://doi.org/10.1007/s10856-017-5868-9

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    • DOI: https://doi.org/10.1007/s10856-017-5868-9

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