engleski

Recombinant human bone morphogenetic protein-7 (rhBMP-7) in the treatment of scaphoid nonunions with proximal pole sclerosis

The aim of this clinical study was to test if the rhBMP-7 could enhance radiographic and clinical healing and removal of sclerosis in scaphoid non-unions containing sclerotic bone. Eighteen patients with scaphoid non-union at the proximal pole were randomly assigned to three treatment groups: (I) autologous iliac bone graft (n=6), (II) autologous iliac bone graft with rhBMP-7 (n=6), and (III) allogeneic iliac bone graft with rhBMP-7 (n=6). Clinical, radiographic, and scintigraphic assessments were performed throughout the follow-up period of 24 months. Performance of both autologous and allogeneic bone implants were improved by rhBMP-7. Radiographic healing time was reduced from 9 weeks in group without rhBMP-7 to 4 weeks in groups with rhBMP-7. Replacement of sclerotic bone by well-vascularised bone in rhBMP-7 treated patients was confirmed with helical CT scans and scintigraphy. The application of rhBMP-7 with an allograft bone implant equalized the clinical outcome in healing of the scaphoid non-union with the autologous graft procedure. Use of an allograft avoids autograft donor site morbidity and results in a shorter postoperative immobilization and consequently better clinical results.

scaphoid nonunion; BMP-7; Matti-Russe

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