Recombinant human bone morphogenetic protein 2 (rhBMP-2)
Definitions
rhBMP-2
Member of transforming growth factors-β super family of proteins
Used in surgery to decrease time of graft union and to reduce morbidity from nonunion
These types of proteins have roles in cell proliferation, differentiation, apoptosis, and embryologic development
BMP induces differentiation of undifferentiated mesenchymal cells into osteogenic cells and enhances function of osteoblasts
BMP-induced endochondral ossification → undifferentiated mesenchymal cells develop into chondrocytes
Chondrocytes lay down cartilage, which is later resorbed by chondroblasts
Allows osteoblasts to begin new bone formation
BMPs also have role in regulation of osteoclastogenesis
This regulation can lead to stimulation of bone resorption
rhBMP-2 commercially supplied in USA as INFUSE bone graft (Medtronic)
Delivered on absorbable collagen sponge
FDA approved for use with LT-CAGE (Medtronic) device for anterior lumbar interbody fusion
rhBMP-7 commercially available as OP-1 putty (Olympus Biotech)
IMAGING
General Features
DIFFERENTIAL DIAGNOSIS
Selected References
Liu S et al: Comparative clinical effectiveness and safety of bone morphogenetic protein versus autologous iliac crest bone graft in lumbar fusion: a meta-analysis and systematic review. Spine (Phila Pa 1976). 45(12):E729-E41, 2020
Dettori JR et al: Longer follow-up continues to reveal no increased risk of cancer with the use of recombinant human bone morphogenetic protein in spine fusion. Spine J. 19(10):1640-7, 2019
Fu R et al: Effectiveness and harms of recombinant human bone morphogenetic protein-2 in spine fusion: a systematic review and meta-analysis. Ann Intern Med. 158(12):890-902, 2013
Simmonds MC et al: Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion: a meta-analysis of individual-participant data. Ann Intern Med. 158(12):877-89, 2013
Carragee EJ et al: A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine J. 11(6):471-91, 2011
Garrett MP et al: Formation of painful seroma and edema after the use of recombinant human bone morphogenetic protein-2 in posterolateral lumbar spine fusions. Neurosurgery. 66(6):1044-9; discussion 1049, 2010
Mroz TE et al: Complications related to osteobiologics use in spine surgery: a systematic review. Spine (Phila Pa 1976). 35(9 Suppl):S86-104, 2010
Agarwal R et al: Osteoinductive bone graft substitutes for lumbar fusion: a systematic review. J Neurosurg Spine. 11(6):729-40, 2009
Carragee EJ et al: Pseudomorbidity in iliac crest bone graft harvesting: the rise of rhBMP-2 in short-segment posterior lumbar fusion. Spine J. 9(11):873-9, 2009
Valdes MA et al: Recombinant bone morphogenic protein-2 in orthopaedic surgery: a review. Arch Orthop Trauma Surg. 129(12):1651-7, 2009
Benglis D et al: A comprehensive review of the safety profile of bone morphogenetic protein in spine surgery. Neurosurgery. 62(5 Suppl 2):ONS423-31; discussion ONS431, 2008
McKay WF et al: A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE Bone Graft). Int Orthop. 31(6):729-34, 2007
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
TERMINOLOGY
Abbreviations
Recombinant human bone morphogenetic protein 2 (rhBMP-2)
Definitions
rhBMP-2
Member of transforming growth factors-β super family of proteins
Used in surgery to decrease time of graft union and to reduce morbidity from nonunion
These types of proteins have roles in cell proliferation, differentiation, apoptosis, and embryologic development
BMP induces differentiation of undifferentiated mesenchymal cells into osteogenic cells and enhances function of osteoblasts
BMP-induced endochondral ossification → undifferentiated mesenchymal cells develop into chondrocytes
Chondrocytes lay down cartilage, which is later resorbed by chondroblasts
Allows osteoblasts to begin new bone formation
BMPs also have role in regulation of osteoclastogenesis
This regulation can lead to stimulation of bone resorption
rhBMP-2 commercially supplied in USA as INFUSE bone graft (Medtronic)
Delivered on absorbable collagen sponge
FDA approved for use with LT-CAGE (Medtronic) device for anterior lumbar interbody fusion
rhBMP-7 commercially available as OP-1 putty (Olympus Biotech)
IMAGING
General Features
DIFFERENTIAL DIAGNOSIS
Selected References
Liu S et al: Comparative clinical effectiveness and safety of bone morphogenetic protein versus autologous iliac crest bone graft in lumbar fusion: a meta-analysis and systematic review. Spine (Phila Pa 1976). 45(12):E729-E41, 2020
Dettori JR et al: Longer follow-up continues to reveal no increased risk of cancer with the use of recombinant human bone morphogenetic protein in spine fusion. Spine J. 19(10):1640-7, 2019
Fu R et al: Effectiveness and harms of recombinant human bone morphogenetic protein-2 in spine fusion: a systematic review and meta-analysis. Ann Intern Med. 158(12):890-902, 2013
Simmonds MC et al: Safety and effectiveness of recombinant human bone morphogenetic protein-2 for spinal fusion: a meta-analysis of individual-participant data. Ann Intern Med. 158(12):877-89, 2013
Carragee EJ et al: A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine J. 11(6):471-91, 2011
Garrett MP et al: Formation of painful seroma and edema after the use of recombinant human bone morphogenetic protein-2 in posterolateral lumbar spine fusions. Neurosurgery. 66(6):1044-9; discussion 1049, 2010
Mroz TE et al: Complications related to osteobiologics use in spine surgery: a systematic review. Spine (Phila Pa 1976). 35(9 Suppl):S86-104, 2010
Agarwal R et al: Osteoinductive bone graft substitutes for lumbar fusion: a systematic review. J Neurosurg Spine. 11(6):729-40, 2009
Carragee EJ et al: Pseudomorbidity in iliac crest bone graft harvesting: the rise of rhBMP-2 in short-segment posterior lumbar fusion. Spine J. 9(11):873-9, 2009
Valdes MA et al: Recombinant bone morphogenic protein-2 in orthopaedic surgery: a review. Arch Orthop Trauma Surg. 129(12):1651-7, 2009
Benglis D et al: A comprehensive review of the safety profile of bone morphogenetic protein in spine surgery. Neurosurgery. 62(5 Suppl 2):ONS423-31; discussion ONS431, 2008
McKay WF et al: A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE Bone Graft). Int Orthop. 31(6):729-34, 2007
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