Table 3.

Clinical studies carried out using BMPs for bone tissue engineering.

Clinical Studies Using BMP-2
Authors		Type of Fracture	Methods	Findings
Herford, A.S. and Boyne, P.J. [309]		Mandibular Continuity Defect	Patients were treated with rhBMP-2 alone or in conjunction with collagen carrier without concomitant bone material.	Successful osseous restoration of critical sized edentulous area was observed which was then followed by prosthetic treatment.
Sweeny, L., Lancaster, W.P., Dean, N.R., Magnuson, J.S., Carroll, W.R., Louis, P.J., Rosenthal, E.L. [310]		Mandible	Test Group: Standard treatment plus rhBMP-2.	There was no significant difference in the measured outcomes between the two groups.
			Control Group: Standard treatment without use of rhBMP-7.
Govender, S., et al [311]		Open Tibial Shaft Fractures	Control Group: Received standard of care.	The implant containing 1.5 mg/mL rhBMP-2 was significantly superior to standard of care in accelerating fracture and wound healing, reducing of rate of infections and frequency of secondary interventions. It also reduced the overall invasiveness of the procedure.
			Test Group: Received standard of care with implant containing rhBMP-2 in concentration of 0.75 mg/mL or 1.5 mg/mL.
Tressler, M.A., Richards, J.E., Sofianos, D., Comrie, F.K., Kregor, P.J., Obremskey, W.T. [312]		Long Bone Non-unions	Patients were given standard treatment with iliac crest bone graft or rhBMP-2.	No statistically significant difference was observed in rate of healing and postoperative infection. Iliac bone graft resulted in significantly more intraoperative blood loss and longer operative procedures.
Bibbo, C., Patel, D.V., Haskell, M.D. [313]		High risk ankle and hind foot fusion	Patients were treated with standard of care in conjunction with rhBMP-2.	Successful union was achieved in 96% fracture sites. The authors concluded that rhBMP-2 is an effective adjunct for treatment of high risk ankle and hind foot fusions.
Clinical Studies Using BMP-7
Authors	Type of Fracture		Methods	Findings
Moghaddam, A., Elleser, C., Biglari, B., Wentzensen, A., Zimmermann, G. [314]	Long Bone Non-unions		Patients who had atrophic non-union of long bones were treated with rhBMP-7 in a Type 1 Collagen carrier without concomitant bone graft material, with bone graft and bone graft and osteosynthesis revision.	Successful union was observed in 82% fractures. Healing was confirmed clinically as well as radiographically.
Dohin, B., Dahan-Oliel, N., Fassier, F., Hamdy, R. [315]	Persistent non-union involving different bones		OP-1 (BMP-7) with Type 1 Collagen carrier was used in conjunction with standard of care.	Clinical and radiographical evidence of bone healing was observed in 74% patients. The authors concluded that OP-1 stimulates healing of persistent non-union without serious adverse effects.
Moghaddam-Alvandi, A., Zimmermann, G., Büchler, A., Elleser, C., Biglari, B., Grützner, P.A., Wölfl, C.G. [316]	Non-union in Long Bones		rhBMP-7 was applied in non-union fracture of long bones. Before application of rhBMP-7 patients had already underwent surgical treatment an average of 3.3 times.	Proper bone healing was observed in 92% fracture sites. The authors concluded that although rhBMP-7 may not be used in all non-union cases, it appears to be effective in treatment of complex cases.
Nicodemo, A., Capella, M., Deregibus, M., Massè, A. [317]	Non-union Sacral Fracture		Patients who had previously failed to respond to standard of care were treated with rhBMP-7 as an adjunct to standard of care.	The use of rhBMP-7 resulted in successful healing of fractures which had previously failed to heal with traditional surgical techniques.