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Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis

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Abstract

We randomly assigned 17 patients with scaphoid non-union at the proximal pole to three treatment groups: (1) autologous iliac graft (n=6), (2) autologous iliac graft + osteogenic protein-1 (OP-1; n=6), and (3) allogenic iliac graft + OP-1 (n=5). Radiographic, scintigraphic, and clinical assessments were performed throughout the follow-up period of 24 months. OP-1 improved the performance of both autologous and allogenic bone implants and reduced radiographic healing time to 4 weeks compared with 9 weeks in group 1. Helical CT scans and scintigraphy showed that in OP-1-treated patients sclerotic bone was replaced by well-vascularised bone. The addition of OP-1 to allogenic bone implant equalised the clinical outcome with the autologous graft procedure. Consequently the harvesting of autologous graft can be avoided.

Résumé

Nous avons réparti 17 malades avec une pseudarthrose du pôle proximal du scaphoide en trois groupes aléatoires de traitement: (1) greffe autologue iliaque (n=6), (2) greffe autologue iliaque + protéine osteogenique-1 (OP-1; n=6), et (3) greffe allogène iliaque + OP-1 (n=5). L’estimation radiographique, scintigraphique et clinique a été exécutée pendant une période de suivi de 24 mois. L’OP-1 a amélioré la performance des autogreffes et des allogreffes osseuses et a réduit le temps curatif radiographique à 4 semaines, comparé à 9 semaines dans le groupe traité uniquement avec de l’os autologues. Chez les malades traités avec l’OP-1, la tomodensitométrie hélicoïdale et la scintigraphie ont montré que l’os scléreux était remplacé par de l’os bien vascularisé. L’addition d’OP-1 à la greffe allogène a égalisé le résultat clinique avec la procédure de greffe autologue et a permis de supprimer le temps de prise de greffe.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Salata 11, 10000, Zagreb, Croatia

    R. Bilic, M. Jelic & M. Pecina

  2. Laboratory for Mineralized Tissues, Department of Anatomy, School of Medicine, University of Zagreb, Salata 11, 10000, Zagreb, Croatia

    P. Simic, M. Jelic, S. Martinovic & S. Vukicevic

  3. Department of Radiology, School of Medicine, University of Zagreb, Salata 11, 10000, Zagreb, Croatia

    R. Stern-Padovan

  4. Department of Nuclear Medicine, School of Medicine, University of Zagreb, Salata 11, 10000, Zagreb, Croatia

    D. Dodig

  5. Stryker Biotech, Claus Sluterweg 125 B2, 2012 WS, Haarlem, The Netherlands

    H. Pompe van Meerdervoort

  6. Department of Medical Statistics, Epidemiology and Medical Informatics, School of Medicine, University of Zagreb, Salata 11, 10000, Zagreb, Croatia

    D. Ivankovic

Authors
  1. R. Bilic
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  2. P. Simic
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  3. M. Jelic
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  4. R. Stern-Padovan
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  5. D. Dodig
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  6. H. Pompe van Meerdervoort
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  7. S. Martinovic
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  8. D. Ivankovic
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  9. M. Pecina
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  10. S. Vukicevic
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Corresponding author

Correspondence to S. Vukicevic.

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Bilic, R., Simic, P., Jelic, M. et al. Osteogenic protein-1 (BMP-7) accelerates healing of scaphoid non-union with proximal pole sclerosis. International Orthopaedics (SICO 30, 128–134 (2006). https://doi.org/10.1007/s00264-005-0045-z

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  • DOI: https://doi.org/10.1007/s00264-005-0045-z

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