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Use of Bone Morphogenetic Proteins for Musculoskeletal Applications by Michael A. Mont, Phillip S. Ragland, Bridget Biggins, Gary Friedlaender, Tushar.

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Presentation on theme: "Use of Bone Morphogenetic Proteins for Musculoskeletal Applications by Michael A. Mont, Phillip S. Ragland, Bridget Biggins, Gary Friedlaender, Tushar."— Presentation transcript:

1 Use of Bone Morphogenetic Proteins for Musculoskeletal Applications by Michael A. Mont, Phillip S. Ragland, Bridget Biggins, Gary Friedlaender, Tushar Patel, Stephen Cook, Gracia Etienne, Andrew Shimmin, Robyn Kildey, David C. Rueger, and Thomas A. Einhorn J Bone Joint Surg Am Volume 86(suppl 2):41-55 December 1, 2004 ©2004 by The Journal of Bone and Joint Surgery, Inc.

2 Canine model showing a surgically created 2-cm defect. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

3 New bone formation was noted across all BMP-treated defects. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

4 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

5 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

6 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

7 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

8 A thirty-three-year-old man with an open fracture of the proximal part of the femoral diaphysis. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

9 Bone union was evident at nine months after treatment with rhOP-1. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

10 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

11 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

12 Computed tomography image made at nine months postoperatively, showing complete bone- bridging. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

13 Figs. 5-A, 5-B, and 5-C Use of rhOP-1 with cortical strut graft. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

14 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

15 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

16 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

17 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

18 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

19 Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

20 Preoperative radiograph of a twenty-seven-year-old man with osteonecrosis and early collapse of the femoral head. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

21 Intraoperative photograph of the femoral head, showing minimal cartilage damage despite post- collapse disease seen radiographically. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

22 Trapdoor created with an oscillating saw. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

23 Excavation of bone with a curet and burr. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

24 The cavity is packed with a combination of demineralized bone matrix, processed allograft incorporated with a mixture of BMPs, and a thermoplastic carrier, and the trapdoor is replaced. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

25 Postoperative radiograph showing preservation of the contour of the femoral head. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

26 Preoperative anteroposterior radiograph of the hip of a nineteen-year-old man with posttraumatic late-stage osteonecrosis of the femoral head. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

27 Photograph showing a large cartilage defect that was discovered intraoperatively. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

28 The femoral head after débridement and excavation of necrotic cartilage and bone. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

29 The defect was filled with rhOP-1, cancellous bone allograft, and autogenous bone marrow. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

30 Graft material sutured in place over the filled defect (Graft Jacket; Wright Medical Technology, Arlington, Tennessee). Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

31 External fixator placed to distract the joint (arthrodiastasis). Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.

32 Anteroposterior radiograph made six months postoperatively, showing an intact, spherical femoral head. Michael A. Mont et al. J Bone Joint Surg Am 2004;86:41-55 ©2004 by The Journal of Bone and Joint Surgery, Inc.


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