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Current and future clinical applications of bone morphogenetic proteins in orthopaedic trauma surgery

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Abstract

Forty years after the discovery by Marshal R. Urist of a substance in bone matrix that has inductive properties for the development of bone and cartilage, there are now 15 individual human bone morphogenetic proteins (BMPs) that possess varying degrees of inductive activities. Two of these, BMP-2 and BMP-7, have become the subject of extensive research aimed at developing therapeutic strategies for the restoration and treatment of skeletal conditions. This has led to three different therapeutic preparations, each for a distinct clinical application. Non-union, open tibial fractures and spinal fusions are the three conditions for which there is clinical approval for use of BMPs. This article reviews the evidence supporting the therapeutic applications of BMPs as they are presently available and suggests future applications based on current research. Among the future directions discussed are percutaneous injections, protein carriers, advances in gene transfer technology and the use of BMPs to engineer the regeneration of skeletal parts.

Résumé

Quarante ans après la découverte par R. Marshal Urist d’une substance de la matrice osseuse ayant des propriétés d’induction du développement osseux et cartilagineux ont été recensés 15 types de BMP, avec des degrés variables de propriétés inductives. Deux d’entre-elles, la BMP2 et la BMP7 ont fait l’objet de recherches importantes et de développements dans des stratégies thérapeutiques de façon à restaurer de bonnes conditions osseuses et ont conduites à trois différentes préparations thérapeutiques pour des indications bien précises: qu’il s’agisse de pseudarthroses, de fractures ouvertes du tibia ou d’arthrodèses vertébrales. Ce travail passe en revue ces applications thérapeutiques et suggère de nouvelles applications basées sur les recherches actuelles. Parmi les différentes possibilités de recherches, sont discutées les injections percutanées, les protéines de transport, les technologies de transfert génique et les possibilité de régénération osseuse par les BMP.

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Acknowledgements

Paul Tornetta III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Boston University Medical Center, 720 Harrison Avenue, Suite 808, Boston, MA, 02118, USA

    Gavin B. Bishop & Thomas A. Einhorn

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  1. Gavin B. Bishop
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  2. Thomas A. Einhorn
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Correspondence to Gavin B. Bishop or Thomas A. Einhorn.

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Bishop, G.B., Einhorn, T.A. Current and future clinical applications of bone morphogenetic proteins in orthopaedic trauma surgery. International Orthopaedics (SICO 31, 721–727 (2007). https://doi.org/10.1007/s00264-007-0424-8

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