For A.M. Release Wed., March 15, 2000
Paper 59
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Joanne Swanson
Cindy Oertel, 847 384-4139
Lisa Doty, [email protected]
BMP augments healing of difficult upper arm injuries
ORLANDO, Fla.--Human bone morphogenetic protein (h-BMP) added to a surgical treatment for injuries to the humerus, the long bone connecting the shoulder and the elbow in the upper arm, appears to augment healing in fractures that are unresponsive to other treatments, it was reported here today at the 67th annual meeting of the American Academy of Orthopaedic Surgeons. HBMP is theorized to act as a stimulus to turn primitive cells into bone forming cells.
Orthopaedic researchers combined human BMP with allograft bone to a rigid internal fixation that incorporated hardware such as plates and screws to increase stability of the nonunion fixation and promote the healing of the upper arm fractures. Failure of closed or operative treatment of fractures of the humerus often leads to disabling and painful nonunions following the fracture, reported study author Eric E. Johnson, MD, department of orthopaedic surgery, UCLA Center for Health Sciences, Los Angeles, Calif. "Our results confirm BMP-augmented grafting is an ideal implant for augmenting treatment of atrophic humeral nonunion," he said.
Since 1983, orthopaedic surgeons at UCLA have used BMP-augmented grafting after other medical and surgical interventions failed to fix the fracture, Dr. Johnson explained.
Researchers prospectively followed 17 patients with surgical resistant nonunions of the humerus in a long-term study of the results of BMP-augmented treatments. The series consisted of 13 female and four male patients (average age: 58 years). The average number of failed surgeries revised to BMP implantation was two per patient.
Prior to surgery, all of the patients experienced significant pain and disability. The patients had an average healing time of three months following implantation of h-BMP and plate stabilization.
In 15 patients, the orthopaedic surgeons delivered the BMP and used a structural graft component to augment fixation in the humeral bone. In two patients, the BMP was delivered in powder form.
"Sixteen patients achieved union with BMP-augmented treatments," Dr. Johnson said. "There were no allergic, immunogenic, neoplastic or infectious complications in these patients." The orthopaedic researchers found the functional outcome was good to excellent in the majority of patient cases.
The one patient who failed the treatment was the only patient in which the BMP allograft was not incorporated directly into the plate fixation of the nonunion, Dr. Johnson reported.
Co-authors of the study, all from the UCLA Center for Health Sciences, Los Angeles, Calif., are Manish V. Patel, MD, and Marshall R. Urist, MD.
In the first year of the United Nations-declared Bone and Joint Decade (2000-2010) (http://www.boneandjointdecade.org), the Academy is holding its annual meeting at the Orange County Convention Center, Orlando, March 15-19.
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