186
· DOS Abstracts
Bone autograft versus recombinant human BMP-
2 (rhBMP-2) at bone docking-site in tibial bone
transport. A randomized clinical trial (RCT).
Søren Kold, Martin Lind, Susanne Jølck, Knud Christensen
Department of Orthopaedics, Aalborg University Hospital
Background:
Bone autograft is applied at the bone- docking site to increase
the union-rate and decrease the time to union after bone transport. However,
harvesting of the bone autograft results in donor-site morbidity. rhBMP-2
might replace the need for bone autograft.
Purpose / Aim of Study:
We investigated the union-rate and the risk of re-
fracture of the bone docking site treated with open debridement and applica-
tion of either bone autograft or rhBMP-2.
Materials and Methods:
41 patients treated for segmental defects of the
tibia with bone transport in a circular frame were randomized to either bone au-
tograft (n=21) or rhBMP-2 (n=20) at the docking site. Patients were followed
with monthly radiographs. Union was defined as presence of bone callus in 3 out
of 4 cortices as well as bony bridge in 3 out of 4 cortices. The minimum follow-
up after frame removal was 12 months.
Findings / Results:
Radiographic union occurred in 21 out of 21 treated with
autograft and in 20 out 20 treated with rhBMP-2. Mean time to union in months
was 7 (range: 4 – 9) with autograft and 7 (range: 4 – 9) with rhBMP-2. Mean
time in hospital stay in days was 6 (range: 2 – 12) with autograft and 5 (range
1 – 16) with rhBMP-2. There were no clinical signs of infection at the docking
site in either group. Refracture at the docking site after frame removal occurred
in one patient in the autograft group compared with 2 patients in the rhBMP-2
group (p=0.5). The risk of refracture was higher when the docking site was lo-
cated at the mid- diaphyseal tibia (3 out of 15) compared to the metaphyseal
tibia (0 out of 26) (p=0.02).
Conclusions:
No differences in radiographic union rate or time to union were
found between autograft and rhBMP-2. Refracture at the docking site occurred
in 3 out of 41 cases, and mid- diaphyseal docking might carry a higher risk of
refracture compared with metaphyseal docking.
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