THE ROLE OF OSIGRAFT IN THE TREATMENT OF LIMB PSEUDOARTHROSIS

The authors present their experience using osteogenic protein 1 (OP-1; “Osigraft”) in the treatment of recalcitrant atrophic pseudoarthrosis (PA) of the limbs in patients in whom osteosynthesis surgery failed at least two to four, and more, times. All patients with PA who were treated showed a preoperative radiographic pattern of severe bone atrophy surrounding the peri-fracture zone, without evident signs of reparative activity. All osteosynthesis hardware showed clear evidence of mechanical failure (rupture or mobilisation) so they were changed in all patients during the surgery. From January 2003 to February 2004 we used Osigraft to treat 10 patients with an atrophic PA at the following level: two femurs, three humera, one forearm, three tibiae (1/4 distal) and one tibia (1/3 medium). Osigraft was associated in seven patients with an autograft and in three patients with an allograft plus platelet growth factors (one distal femur, one distal tibia and one humerus). Mean age of patients was 38 years (ran...