The indications and use of bone morphogenetic proteins in foot, ankle, and tibia surgery

Tissue engineering is an area of rapid growth. Tissue engineering in orthopedic surgery involves the use of growth factors, mesenchymal stem cells, and scaffolds, individually or in combination, toward the growth and restoration of various musculoskeletal tissues, such as ligaments, tendons, muscles, nerves, and bone. These advances are constantly evolving in foot and ankle surgery as well. Bone morphogenetic proteins (BMPs) have played an integral role in the advancement of tissue engineering strategies across multiple orthopedic subspecialities and have proved to play a role in the development of bone and musculoskeletal tissues. BMPs have recently been applied in several areas of foot and ankle surgery, including acute fracture augmentation, nonunions, and arthrodesis, with promising results. This article reviews the key aspects of clinical translation of strategies in tissue engineering as well as current applications and results of BMP use in tibia, foot, and ankle surgery. Future applications of BMP and novel materials in foot and ankle surgery are also reviewed.