Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis
Abstract Background The recombinant human bone morphogenetic protein (rhBMP) is a common graft substitute for treating cases of long bone nonunion. However, the feasibility of combining an autologous bone graft (ABG) with rhBMPs remains uncertain. Thus, this systematic review and meta-analysis aimed...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-022-03185-3 |
| _version_ | 1817987202120941568 |
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| author | Chengxin Xie Chenglong Wang Yu Huang Qinglong Li Xin Tian Wenwen Huang Dong Yin |
| author_facet | Chengxin Xie Chenglong Wang Yu Huang Qinglong Li Xin Tian Wenwen Huang Dong Yin |
| author_sort | Chengxin Xie |
| collection | DOAJ |
| description | Abstract Background The recombinant human bone morphogenetic protein (rhBMP) is a common graft substitute for treating cases of long bone nonunion. However, the feasibility of combining an autologous bone graft (ABG) with rhBMPs remains uncertain. Thus, this systematic review and meta-analysis aimed to evaluate the synergistic effect of ABG and rhBMPs on the healing of long bone nonunion. Methods A systematic literature search was performed on PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. Two authors independently screened the studies, extracted data, and assessed the quality of the trials. Statistical analyses were performed using Stata 12.0. Results Of the 202 citations, five studies involving a total of 394 cases met the eligibility criteria; thus, they were included in this study. The pooled data revealed no significant differences among the groups in terms of postoperative healing rate (risk ratio [RR] = 1.01, 95% confidence interval [CI] = 0.96–1.06, P = 0.744), healing time (standardised mean difference = − 0.20, 95% CI = − 0.95–0.56, P = 0.610), and pain (RR = 1.44, 95% CI = 0.25–8.29, P = 0.681). The combination of ABG and rhBMPs resulted in good limb function (RR = 1.31, 95% CI = 1.04–1.66, P = 0.023). Conclusions The combination of ABG and rhBMPs did not result in the healing of long bone nonunion and pain reduction. Nevertheless, it conferred good limb function. Thus, the findings in this study are insufficient to support the use of rhBMPs as an adjuvant to ABG. |
| first_indexed | 2024-04-14T00:18:52Z |
| format | Article |
| id | doaj.art-646fbad4ede74d659521b58e08aeefd4 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T00:18:52Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-646fbad4ede74d659521b58e08aeefd42022-12-22T02:23:02ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-06-0117111110.1186/s13018-022-03185-3Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysisChengxin Xie0Chenglong Wang1Yu Huang2Qinglong Li3Xin Tian4Wenwen Huang5Dong Yin6Department of Orthopedics, Taizhou Hospital of Zhejiang Province & Taizhou Hospital Affiliated to Wenzhou Medical UniversityDepartment of Joint Surgery and Sports Medicine, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Traumatic Surgery & Microsurgery & Hand Surgery, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Traumatic Surgery & Microsurgery & Hand Surgery, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Joint Surgery and Sports Medicine, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Joint Surgery and Sports Medicine, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionDepartment of Joint Surgery and Sports Medicine, Guangxi Academy of Medical Sciences & The People’s Hospital of Guangxi Zhuang Autonomous RegionAbstract Background The recombinant human bone morphogenetic protein (rhBMP) is a common graft substitute for treating cases of long bone nonunion. However, the feasibility of combining an autologous bone graft (ABG) with rhBMPs remains uncertain. Thus, this systematic review and meta-analysis aimed to evaluate the synergistic effect of ABG and rhBMPs on the healing of long bone nonunion. Methods A systematic literature search was performed on PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. Two authors independently screened the studies, extracted data, and assessed the quality of the trials. Statistical analyses were performed using Stata 12.0. Results Of the 202 citations, five studies involving a total of 394 cases met the eligibility criteria; thus, they were included in this study. The pooled data revealed no significant differences among the groups in terms of postoperative healing rate (risk ratio [RR] = 1.01, 95% confidence interval [CI] = 0.96–1.06, P = 0.744), healing time (standardised mean difference = − 0.20, 95% CI = − 0.95–0.56, P = 0.610), and pain (RR = 1.44, 95% CI = 0.25–8.29, P = 0.681). The combination of ABG and rhBMPs resulted in good limb function (RR = 1.31, 95% CI = 1.04–1.66, P = 0.023). Conclusions The combination of ABG and rhBMPs did not result in the healing of long bone nonunion and pain reduction. Nevertheless, it conferred good limb function. Thus, the findings in this study are insufficient to support the use of rhBMPs as an adjuvant to ABG.https://doi.org/10.1186/s13018-022-03185-3Bone morphogenetic proteinAutologous bone graftNonunionLong boneMeta-analysis |
| spellingShingle | Chengxin Xie Chenglong Wang Yu Huang Qinglong Li Xin Tian Wenwen Huang Dong Yin Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Bone morphogenetic protein Autologous bone graft Nonunion Long bone Meta-analysis |
| title | Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis |
| title_full | Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis |
| title_fullStr | Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis |
| title_full_unstemmed | Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis |
| title_short | Therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion: a systematic review and meta-analysis |
| title_sort | therapeutic effect of autologous bone grafting with adjuvant bone morphogenetic protein on long bone nonunion a systematic review and meta analysis |
| topic | Bone morphogenetic protein Autologous bone graft Nonunion Long bone Meta-analysis |
| url | https://doi.org/10.1186/s13018-022-03185-3 |
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