Related Experiment Video
Updated: Mar 15, 2026
Polyelectrolyte Complex for Heparin Binding Domain Osteogenic Growth Factor Delivery
Published on: August 22, 2016
Complication Rates After Bone Morphogenetic Protein (BMP) Use in Orthopaedic Surgery in Children: A Concise
Sumeet Garg1, James J McCarthy, Ryan Goodwin
1*Division of Orthopaedic Surgery, Children's Hospital Colorado, Aurora, CO †Division of Orthopaedic Surgery, Cincinnati Children's Hospital, Cincinnati ‡Division of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH §Division of Orthopaedic Surgery, Children's Hospital of Philadelphia ∥Division of Orthopaedic Surgery, Shriners Hospital for Children, Philadelphia ¶Division of Orthopaedic Surgery, Penn State Hersey Medical Center, Hershey, PA.
Insights
Complications occurred in 21% of pediatric patients receiving bone morphogenetic protein (BMP). Further research is needed to confirm BMP as the direct cause of these adverse events in children.
Area of Science:
- Pediatric Orthopedics
- Biomaterials in Surgery
- Surgical Safety
Background:
- Bone morphogenetic protein (BMP) use is linked to complications in adults, but data in children is limited.
- This study addresses the safety of BMP in pediatric patients.
Purpose of the Study:
- To evaluate the complication rates associated with bone morphogenetic protein (BMP) use in pediatric patients.
- To determine the incidence of adverse events following BMP application in children across multiple institutions.
Main Methods:
- Retrospective review of medical records from 2000-2013 at 5 institutions.
- Inclusion criteria: patients under 18 years old who received BMP.
- Data collected included demographics, surgical details, and postoperative outcomes.
Main Results:
- 312 pediatric patients received BMP for various procedures (spinal fusion, pars repair, etc.).
- Overall complication rate was 21% (65/312), with 55% of these requiring revision surgery.
- Major complications included infection (13%) and implant failure (13%); minor complications like wound dehiscence occurred in 9%.
Conclusions:
- Multicenter data indicates a notable rate of complications following BMP use in pediatric populations.
- Causality between BMP and complications requires further investigation.
Background:
The use of bone morphogenetic protein (BMP) has been associated with a number of complications in adult patients. However, this association is less established in children. The aim of this study was to evaluate the safety of BMP use in children by determining the complication rates after BMP use at multiple institutions.
Methods:
In a retrospective study (2000 to 2013), the medical records of all patients who received BMP at any of the 5 institutions were reviewed. Demographic information, preoperative data, and postoperative follow-up data were collected on those patients who were under the age of 18 at the time of surgery.
Results:
A total of 312 pediatric patients underwent surgery with BMP application during the study period. The surgical procedures consisted of 228 spinal fusions, 39 pars repairs, 33 nonunion repair, and 12 other various procedures. Overall 21% (65/312) of patients who had BMP utilized had a complication. Fifty-five percent (36/65) of patients with a complication required a revision surgery. The average follow-up was 27 months (range, 3 to 96 mo); 80% of patients had a follow-up period of >12 months. The average age at the time of surgery was 13 years (range, 1 to 17 y). Males and females were almost equally represented in the study: 143 males (46%) and 168 females (54%). Of the patients who received BMP, 9% had minor complications and 13% had major complications. Wound dehiscence without infection was the most common minor complication and occurred in 59% (16/27) of patients with minor complications. Infection and implant failures were the most frequent major complications, occurring in 38% (15/39) and 33% (13/39) of patients with major complications, respectively. Five of 312 (2%) patients had neurological injury, 3 of which were only temporary.
Conclusions:
This multicenter study demonstrates a relatively high rate of complications after the use of BMP in children. However, further study is needed to attribute the complications directly to the use of BMP.
Level Of Evidence:
Level IV.
More Related Videos
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...