Bone grafting with recombinant human bone morphogenetic protein-2 or autologous platelet-rich plasma versus simple bone grafting for repair of bone defects

doi:10.3969/j.issn.2095-4344.1270

Abstract

Abstract:

BACKGROUND: Both bone morphogenetic protein-2 and platelet-rich plasma can promote bone healing. However, little is reported on application of bone morphogenetic protein-2 or platelet-rich plasma to induced membrane technique in basic research and clinical studies.

OBJECTIVE: To investigate the clinical efficacy of bone grafting with recombinant human bone morphogenetic protein-2 or autologous platelet-rich plasma versus simple bone grafting in the repair of bone defects during a phase II surgery using induced membrane technique.

METHODS: 59 patients with bone defects who received treatment in the First Affiliated Hospital of Guangzhou University of Chinese Medicine during January 2013-January 2018 were included in this study. Following phase I surgery with induced membrane technique, these patients were assigned to receive phase II surgery: autologous bone grafting with recombinant human bone morphogenetic protein-2 (group A, n=20), autologous bone grafting with autologous platelet-rich plasma (group B, n=21), autologous bone grafting (group C, n=18). Postoperative complications (recurrent infection, joint stiffness, muscle atrophy, persistent pain, etc.) were recorded. Bone healing time and osteophyte score were evaluated by X-rays. This study was approved by the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, China.

RESULTS AND CONCLUSION: (1) All 59 patients were followed up for 11-40 months. (2) The average bone healing time was (29.30±4.54), (28.71±5.37), and (35.50±7.37) weeks in the groups A, B and C, respectively. The average bone time in the groups A and B was significantly shorter than that in the group C (P < 0.05). (3) At 6 months after surgery, the osteophyte scores in the groups A and B were significantly higher than those in the group C (9.50±1.43, 9.14±0.85, 7.83±1.42, P < 0.05). (4) There were two cases of deep infection and one case of bone resorption in the group A. There was one case of deep infection and one case of residual knee stiffness with moderate pain in the group B. There were four cases of infection, three cases of bone resorption, delayed healing and one case of residual knee stiffness and muscle atrophy in the group C. The number of complications in the groups A and B was significantly less than that in the group C (P < 0.05). (5) The results suggest that application of bone morphogenetic protein-2 or autologous platelet-rich plasma to phase II induced membrane technique for repair of bone defects can accelerate bone healing and obtain encouraging repair efficacy with a few postoperative complications.

Key words: bone morphogenetic protein, platelet-rich plasma, bioengineering material, growth factor, induced membrane, bone defect, bone graft, bone repair

CLC Number:

R459.9

Li Shuyuan, Zhou Qishi, Li Yue, Chen Chao, Chen Jiaqi, Zhou Hongliang, Yang Jiabao. Bone grafting with recombinant human bone morphogenetic protein-2 or autologous platelet-rich plasma versus simple bone grafting for repair of bone defects[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(22): 3463-3468.

Figures/Tables 5

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