Role of Recombinant Human Bone Morphogenetic Protein-2 on Hindfoot Arthrodesis

Despite advances in our understanding of bone healing physiology and surgical techniques, delayed union and nonunion still occur at a considerable rate after the treatment of hindfoot arthrodesis. Although bone graft has been used frequently, there is increasing appeal of BMPs owing to the morbidity associated with harvesting bone graft and the innate osteoinductive abilities of BMPs. Effective treatment of nonunions with BMPs has been shown in multiple animal studies. Although limited in number, human clinical studies using BMPs to treat nonunions have also shown success. The only study investigating the use of rhBMP-2 in hindfoot arthrodesis found a significant increase in the fusion rate compared with controls. In addition, treatment with BMPs is cost effective and the complications from their use remain low. Overall, rhBMP-2 is a safe and effective bone-healing adjunct in hindfoot arthrodesis surgery.