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Outcome of nonunion fractures in dogs treated with fixation, compression resistant matrix, and recombinant human bone morphogenetic protein-2

Journal: Veterinary and Comparative Orthopaedics and Traumatology (VCOT)
ISSN: 0932-0814
DOI: https://doi.org/10.3415/VCOT-16-05-0082
Issue: 2017: Issue 2 2017
Pages: 153-159
Ahead of Print: 2017-01-17

Outcome of nonunion fractures in dogs treated with fixation, compression resistant matrix, and recombinant human bone morphogenetic protein-2

A. M. Massie (1), A. S. Kapatkin (2), M. C. Fuller (2, 3), F. J. M. Verstraete (2), B. Arzi (2)

(1) University of California-Davis, Veterinary Medical Teaching Hospital, Davis, CA, USA; (2) University of California-Davis, Department of Surgical & Radiological Sciences, Davis, CA, USA; (3) Airdrie, Alberta, Canada

Keywords

bone regeneration, nonunion, BMP-2, bone morphogenetic protein 2, compression resistant matrix

Summary

Objectives: To report the use of compression resistant matrix (CRM) infused with recombinant human bone morphogenetic protein (rhBMP-2) prospectively in the healing of nonunion long-bone fractures in dogs. Methods: A longitudinal cohort of dogs that were presented with nonunion fractures were classified and treated with CRM soaked with rhBMP-2 and fracture fixation. They were followed with serial radiographs and evaluated for healing times and complications according to the time frame and definitions previously established for orthopaedic clinical cases. Results: Eleven nonunion fractures in nine dogs were included. Median healing time was 10 weeks (range: 7–20 weeks). Major perioperative complications due to bandage morbidity were encountered in two of 11 limbs and resolved. All other complications were minor. They occurred perioperatively in eight of 11 limbs. Minor follow-up complications included short-term in one of two limbs, mid-term in one of three, and long-term in four of five limbs. Nine limbs returned to full function and two limbs returned to acceptable function at the last follow-up. Clinical significance: Nonunion fractures given a poor prognosis via standard-of-care treatment were successfully repaired using CRM with rhBMP-2 accompanying fixation. These dogs, previously at high risk of failure, returned to full or acceptable function.

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