Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis
Abstract Background Bone morphogenetic proteins (BMPs) have strong bone induction properties and can promote healing of fractures and other defects. However, BMP treatment efficacy for long bone nonunion remains controversial. The aim of this meta-analysis was to synthetically evaluate the advantage...
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01805-4 |
| _version_ | 1811183880130002944 |
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| author | Yong-Qiang Zhou Hong-Liang Tu Yan-Ji Duan Xiao Chen |
| author_facet | Yong-Qiang Zhou Hong-Liang Tu Yan-Ji Duan Xiao Chen |
| author_sort | Yong-Qiang Zhou |
| collection | DOAJ |
| description | Abstract Background Bone morphogenetic proteins (BMPs) have strong bone induction properties and can promote healing of fractures and other defects. However, BMP treatment efficacy for long bone nonunion remains controversial. The aim of this meta-analysis was to synthetically evaluate the advantages and disadvantages of BMP plus bone grafting (observation group) versus autologous bone grafting (control group) for limb long bone nonunion. Methods PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Weipu Journal, Chinese Biomedical Literature, and WanFang were searched for randomized and non-randomized controlled trials published before November 2019. A meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 12.0. Results Five randomized and four non-randomized controlled trials involving 30–124 cases were included, with a total of 655 nonunion cases. There were no significant group differences in postoperative healing rate, infection, and secondary operation rates (P > 0.05), but the study group demonstrated significantly shorter mean healing time (WMD = − 1.27, 95%CI − 1.67 to − 0.88, P < 0.00001), a greater frequency of excellent/good post-treatment limb function (RR = 1.18, 95%CI 1.01–1.39, P = 0.04), and lower intraoperative blood loss (P < 0.05). Alternatively, the hospitalization cost was significantly higher in the study group (P < 0.01). Conclusions Bone morphogenetic protein is a viable alternative to autologous bone grafting, with potential advantages of accelerated fracture healing and improved postoperative function. |
| first_indexed | 2024-04-11T13:05:18Z |
| format | Article |
| id | doaj.art-b807459162504f7ca76915347c5dbf4c |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:05:18Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-b807459162504f7ca76915347c5dbf4c2022-12-22T04:22:49ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-07-0115111210.1186/s13018-020-01805-4Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysisYong-Qiang Zhou0Hong-Liang Tu1Yan-Ji Duan2Xiao Chen3The Department of Orthopedic Surgery, The First People’s Hospital of NeijiangThe Department of Orthopedic Surgery, The First People’s Hospital of NeijiangThe Department of Orthopedic Surgery, The First People’s Hospital of NeijiangThe Department of Orthopedic Surgery, The First People’s Hospital of NeijiangAbstract Background Bone morphogenetic proteins (BMPs) have strong bone induction properties and can promote healing of fractures and other defects. However, BMP treatment efficacy for long bone nonunion remains controversial. The aim of this meta-analysis was to synthetically evaluate the advantages and disadvantages of BMP plus bone grafting (observation group) versus autologous bone grafting (control group) for limb long bone nonunion. Methods PubMed, Embase, Web of Science, Cochrane Library, OVID, CNKI, Weipu Journal, Chinese Biomedical Literature, and WanFang were searched for randomized and non-randomized controlled trials published before November 2019. A meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 12.0. Results Five randomized and four non-randomized controlled trials involving 30–124 cases were included, with a total of 655 nonunion cases. There were no significant group differences in postoperative healing rate, infection, and secondary operation rates (P > 0.05), but the study group demonstrated significantly shorter mean healing time (WMD = − 1.27, 95%CI − 1.67 to − 0.88, P < 0.00001), a greater frequency of excellent/good post-treatment limb function (RR = 1.18, 95%CI 1.01–1.39, P = 0.04), and lower intraoperative blood loss (P < 0.05). Alternatively, the hospitalization cost was significantly higher in the study group (P < 0.01). Conclusions Bone morphogenetic protein is a viable alternative to autologous bone grafting, with potential advantages of accelerated fracture healing and improved postoperative function.http://link.springer.com/article/10.1186/s13018-020-01805-4Bone morphogenetic proteinAutologous bone graftNonunionLong boneMeta-analysis |
| spellingShingle | Yong-Qiang Zhou Hong-Liang Tu Yan-Ji Duan Xiao Chen Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb 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 | Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis |
| title_full | Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis |
| title_fullStr | Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis |
| title_full_unstemmed | Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis |
| title_short | Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis |
| title_sort | comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion a systematic review and meta analysis |
| topic | Bone morphogenetic protein Autologous bone graft Nonunion Long bone Meta-analysis |
| url | http://link.springer.com/article/10.1186/s13018-020-01805-4 |
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