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Case Reports
. 2018 Jan 12;4(2):162-168.
doi: 10.1016/j.artd.2017.12.004. eCollection 2018 Jun.

Abundant heterotopic bone formation following use of rhBMP-2 in the treatment of acetabular bone defects during revision hip arthroplasty

Alexander Arzeno  1 , Tim Wang  1 , James I Huddleston 3rd  1
Affiliations
Case Reports

Abundant heterotopic bone formation following use of rhBMP-2 in the treatment of acetabular bone defects during revision hip arthroplasty

Alexander Arzeno et al. Arthroplast Today. .

Abstract

Revision hip arthroplasty in the setting of periacetabular bone loss presents a significant challenge, as options for restoring bone loss are limited. Recombinant human bone morphogenetic protein-2 may offer a solution by promoting bone growth to restore bone stock before implant reimplantation. Here we present a case of a patient with a periprosthetic acetabulum fracture, resulting in pelvic discontinuity as the result of significant periacetabular bone loss. Using a staged approach, periacetabular bone stock was nearly entirely reconstituted using recombinant BMPs and allograft, which resulted in stable fixation, but with abundant heterotopic bone formation. Recombinant BMP-2 offers a useful tool for restoring bone stock in complex hip arthroplasty revision cases with periacetabular bone loss; however, caution must be used as overabundant bone growth as heterotopic ossification may result.

Keywords: Bone defects; Revision arthroplasty; rhBMP-2.

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Figures

Figure 1
Figure 1
Preoperative pelvic radiographs. Anteroposterior (AP) (a), inlet (b), outlet (c), obturator oblique (d), and iliac oblique (e) images.
Figure 2
Figure 2
Postoperative radiograph taken immediately after the first staged surgery.
Figure 3
Figure 3
Two months after explant and bone grafting postoperative radiographs of the pelvis (a), hip AP (b), and lateral (c).
Figure 4
Figure 4
Radiographs taken after the second stage of the procedure. Immediately postoperative (a), 8 months postoperative AP pelvis (b), AP hip (c), and lateral hip (d).
Figure 5
Figure 5
BMP gene transcription pathway.
See this image and copyright information in PMC

References

    1. Urist M.R. Bone: formation by autoinduction. Science. 1965;150(3698):893. - PubMed
    1. Ebara S., Nakayama K. Mechanism for the action of bone morphogenetic proteins and regulation of their activity. Spine (Phila Pa 1976) 2002;27(16 Suppl 1):S10. - PubMed
    1. ten Dijke P., Fu J., Schaap P., Roelen B.A. Signal transduction of bone morphogenetic proteins in osteoblast differentiation. J Bone Joint Surg Am. 2003;85-A Suppl 3:34. - PubMed
    1. Sampath T.K., Reddi A.H. Homology of bone-inductive proteins from human, monkey, bovine, and rat extracellular matrix. Proc Natl Acad Sci U S A. 1983;80(21):6591. - PMC - PubMed
    1. Wozney J.M., Rosen V., Celeste A.J. Novel regulators of bone formation: molecular clones and activities. Science. 1988;242(4885):1528. - PubMed

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