Bone morphogenic protein-2 use in revision total hip arthroplasty with acetabular defects.

Abstract:

INTRODUCTION:The restoration of acetabular bone stock during revision hip arthroplasty remains a challenge. There have been no clinical series reporting the efficacy of bone morphogenic protein-2 (rhBMP-2) in the revision hip setting. METHODS:We retrospectively reviewed the radiographs and records of 15 patients who received rhBMP-2 mixed with allograft bone chips (+BMP), and 14 who received allograft bone chips alone (-BMP) for their acetabular defect during revision total hip arthroplasty with a mean two-year follow up. Radiographs were evaluated for acetabular defect size, superior cup migration, and changes in the lateral cup abduction angle. Modified Harris hip scores were used for evaluation of clinical outcomes. RESULTS:Patients in the +BMP group compared to the -BMP group had significantly larger amounts of cancellous bone chips used (72.1 ± 35.5 cc vs. 38.6 ± 14.1 cc; p = 0.003). Mean rhBMP-2 used per case was 7.4 ± 3.1 mg in the +BMP group. Three patients in the -BMP group had cup migration which was not observed in the +BMP group. Mean Harris hip scores (HHS) improved post-operatively in both groups (40.1 ± 20.9 to 71.9 ± 19, p < .0001). No local adverse reaction was noted in the +BMP group. CONCLUSION:rhBMP-2 had modest clinical benefit in the setting of revision THA. Cost of this synthetic biologic versus the added clinical benefit should be carefully considered when being used in the revision hip setting.

journal_name

Int Orthop

authors

Nodzo SR,Boyle KK,Pavlesen S,Rachala S

doi

10.1007/s00264-017-3671-3

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

783-789

issue

4

eissn

0341-2695

issn

1432-5195

pii

10.1007/s00264-017-3671-3

journal_volume

42

pub_type

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