Authors' objectives:

To determine what evidence exists regarding the efficacy and safety of bone morphogenic proteins.

To use the evidence as the basis for an industrial insurance coverage decision.

Authors' results and conclusions: Bone morphogenic proteins 2 and 7 have been studied in treating nonunion of long bones. Several randomized controlled trials have compared bone morphogenic proteins (BMP) to autograft in the treatment of both open and closed tibial fractures. Patients with closed tibial fractures showed similar outcomes regardless of treatment regimen. Tibial nonunions also showed similar outcomes. Data from one randomized controlled trial suggested that open tibial fractures benefited from treatment with BMP compared to standard of care. Patients who received the BMP implants tended to have shorter operative times and shorter hospital stays. However, the differences were not always statistically significant. In addition, patients with BMP implants did not experience donor site pain in comparison to autograft patients. Two small case series studies have been published in the area of femoral nonunion. The patients in the two studies tended to have complex fractures that had positive outcomes following BMP treatment. However, it cannot be determined whether BMP had a significant causal effect on outcomes since the studies did not include comparison groups. Randomized controlled trials of BMP in spinal fusions compared to autograft have shown similar outcomes regardless of treatment. In addition, patients with BMP implants did not experience donor site pain in comparison to autograft patients.

Authors' recommendations: Published evidence suggests that procedures with bone morphogenic proteins 2 and 7 produce clinical outcomes similar to procedures with autografts. Conventional autograft procedures may result in longer operative time and greater donor site pain compared to procedures with BMP.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.lni.wa.gov/ClaimsIns/Files/OMD/BmpTa092903.pdf

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Washington State Department of Labor and Industries (WSDLI)

Contact Address: Box 44321, 7273 Linderson Way SW, Olympia, WA, USA 98504-4321. Tel: 1(360)902-5227

Contact Name: mojo235@LNI.wa.gov

Contact Email: mojo235@LNI.wa.gov

Copyright: Washington State Department of Labor and Industries