The Use of rhBMP-2 for the Treatment of Congenital Pseudarthrosis of the Tibia

Richards, B. Stephens; Oetgen, Matthew E.; Johnston, Charles E.

doi:10.2106/jbjs.h.01667

Cited by 68 publications

(49 citation statements)

References 13 publications

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“…Compression was maintained at the pseudarthrosis site and a proximal lengthening was carried out via a percutaneous osteotomy. In those patients who failed to heal with a circular frame, a bone wrap (iliac crest outer table cortical sheet scored to permit bending) was wired around the pseudarthrosis site with BMP-2 (Induct Os; Wyeth Europa, Maidenhead, UK) being placed between the pseudarthrosis and the bone graft [19][20][21][22][23]. The BMP-2 and bone wraps were reserved for resistant cases and were additional to an existing circular external fixator or concurrent with the application of an external fixator.…”

Section: Methodsmentioning

confidence: 99%

Congenital pseudarthrosis of the tibia: The results of an evolving protocol of management

Nicolaou

Ghassemi

Hill

2013

Journal of Children's Orthopaedics

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Purpose This retrospective cohort study assesses the outcomes of a protocol of management, based on the recommendations of the European Paediatric Orthopaedic Society (EPOS) multi-centre study, for the management of congenital pseudarthrosis of the tibia. Methods Utilising an incremental protocol of bracing, intramedullary rods and circular frame fixation with or without bone morphogenetic protein-2 (BMP-2), 11 patients had reached skeletal maturity or had follow up of 5 years from radiological union of the pseudarthrosis. Demographic data, deformity parameters before and after treatment, and functional outcome scores were recorded. Results Ten of the 11 patients successfully healed and two sustained a refracture. All deformity parameters improved and a mean leg length discrepancy of 2.5 cm (range 0–7.5 cm) existed at the time of the last follow up. Some pseudarthroses healed with deformity correction and rod insertion alone. Six of the 11 patients had a confirmed diagnosis of neurofibromatosis and nine had sustained a fracture before 4 years of age. Refracture was associated with malalignment after healing. Conclusion This method of treatment provides a successful stepwise protocol for the management of this complex disorder, avoiding the use of aggressive limb reconstruction techniques at a young age in some cases. Level of evidenceCase series Level IV.

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Section: Methodsmentioning

confidence: 99%

Congenital pseudarthrosis of the tibia: The results of an evolving protocol of management

Nicolaou

Ghassemi

Hill

2013

Journal of Children's Orthopaedics

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“…Postoperatif xray kaynama durumunu değerlendirmeye yardımcı olur. [10,11] Tedavi: Özellikle Tip II KPT de neonatal dönemde stres kırığını önlemek için tam temaslı kontakt bresy/ POP kullanılabilir. Psödoartroz oluştuktan sonra cerrahi prosedür-ler devreye girer.…”

Section: Cerrahiunclassified

Child with a Lower Extremity Trouble

başal¹

2015

Orthopaedics and Sports Medicine Guide for Researchers

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“…The chance for union after grafting is independent of the presence of underlying neurofi bromatosis. Using recombinant human bone morphogenic protein to aid healing at the bone graft site may help ameliorate some complications [ 45 ].…”

Section: Congenital Pseudarthrosis Of the Tibia (Tibial Dysplasia)mentioning

confidence: 99%

The Lower Extremity: Congenital and Developmental Conditions

Prince

2014

Pediatric Orthopedic Imaging

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This chapter fi rst discusses normal variants in the knee and lower leg, covering topics such as distal femoral epiphyseal ossifi cation variants, benign cortical defects, cortical desmoids, tibial tuberosity development, and growth recovery lines. Variants of the fabella, patella, and patellofemoral articulation are discussed, as well as both congenital and developmental patellar instability. The chapter then presents congenital limb anomalies such as femoral bifurcation and duplication, longitudinal defi ciency of the tibia, and longitudinal defi ciency of the fi bula. Bowing and alignment disorders follow, with sections on various forms of tibial and fi bular bowing, and knee dislocation and hyperextension. Discussion of aberrant alignment includes physiological bowing, infantile tibia vara, rickets, genu valgum, and long bone rotational abnormalities. The chapter concludes with a discussion of leg-length discrepancy.Variable osseous development leads to a changing appearance of the bones of the lower extremity during childhood. In order to recognize pathology, it is important to understand the ranges of normal. Developmental abnormalities of the lower extremity have a wide range of severity and can have signifi cant impact on patient function.

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The Use of rhBMP-2 for the Treatment of Congenital Pseudarthrosis of the Tibia

Cited by 68 publications

References 13 publications

Congenital pseudarthrosis of the tibia: The results of an evolving protocol of management

Congenital pseudarthrosis of the tibia: The results of an evolving protocol of management

Child with a Lower Extremity Trouble

The Lower Extremity: Congenital and Developmental Conditions

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