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The use of recombinant human bone morphogenetic protein-2 for the treatment of a delayed union following femoral neck open-wedge osteotomy

Axel W.A. Baltzer, Martin S. Ostapczuk, Daniel Stosch, Markus Granrath
  • Axel W.A. Baltzer
    Königsallee, Centre for Molecular Orthopaedics, Düsseldorf, Germany | axel@baltzer.at
  • Martin S. Ostapczuk
    Heinrich-Heine-University Düsseldorf, Germany
  • Daniel Stosch
    Königsallee, Centre for Molecular Orthopaedics, Düsseldorf, Germany
  • Markus Granrath
    Königsallee, Centre for Molecular Orthopaedics, Düsseldorf, Germany

Abstract

Although the clinical potential of bone morphogenetic proteins (BMPs) has been known for decades, their use in humans has only been approved for a limited number of orthopaedic conditions. Promising results in animals demonstrate the utility of BMP-2 in regional bone repair without using osteoconductors. To our knowledge, no comparable human case has been described. We report the case of a 50- year-old who suffered a femoral neck fracture. After 9 months of extensive treatment, he was still not pain-free. The following open-wedge osteotomy resulted in a therapy-resistant delayed union. We therefore conducted 4 computer tomography-guided injections of recombinant human (rh) BMP-2 into the bone gap. No osteoconductor was employed. Six weeks later, there was a 55-60% defect filling. Followup examination showed a complete union of the bone defect. Our case report shows that in a complicated delayed union rhBMP-2 can be successfully used to induce bone formation without any osteoconductor.

Keywords

rhBMP-2, delayed union, femoral neck fracture, open-wedge osteotomy, extracorporeal shock-wave therapy

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Submitted: 2012-02-04 00:15:56
Published: 2012-03-22 11:20:38
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Copyright (c) 2012 Axel W.A. Baltzer, Martin S. Ostapczuk, Daniel Stosch, Markus Granrath

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