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BMP-7 IN INFECTED NON-UNION



Abstract

Introduction and Objectives: Septic non-union can present a variety of problems for the surgeon, the most common being loss of bone continuity and persistence of infection. When conventional treatments fail we begin to use new bone tissue engineering techniques. The aim of this study is to present our experience over the last 5 years with 50 cases of infected non-union in which we used BMP-7.

Materials and Methods: Between 2002 and 2007 we used BMP-7 in 50 patients according to the protocol established by Friedlaender in 2001. Each patient was treated with allograft and BMP-7 and the same surgical technique was used in every case. Follow-up exams were carried out every 2 months with different control X-rays, analysis and cultures were performed to assess the evolution of consolidation and the end of infection.

Results: We achieved the desired consolidation in almost 70% of cases with good functionality of the affected limbs and freedom from infection. On the other hand, in 30% of cases we did not achieve expected consolidation and we saw that infection still persisted.

Discussion and Conclusions: The most critical and influential parameters affecting the end-result of treatment of infected non-union with BMP-7 are persistence of infection, poor vascularization, inadequate stabilization, and defective coverage of the subcutaneous tissue adjacent to the non-union focus.

The abstracts were prepared by E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedic Surgery and Traumatology (Revista Española de Cirugía Ortopédica y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología, calle Fernández de los Ríos 108, 28015-Madrid, Spain