10 cm3: USD 850/
5 cm3 USD 470
? + +
10 cm3: USD 850/
5 cm3 USD 470
10cm3: USD 1,150
6 strips: USD 1,109/
3 strips: USD 683
10 cm3: USD 525
Friedlaender et al.  evaluated rhOP-1 (BMP-7), comparing clinical and radiographic results in the treatment of tibial nonunion in a controlled, prospective, randomized, and partially blinded clinical trial. They inserted intramedullary rods packed with either rhOP-1 in a type I collagen carrier or with fresh bone autograft. They determined there were no statistically significant differences in the results at 9 months, with 81 and 85% clinical success (respective) and 75 and 84% radiographic success (respective). Interestingly, postoperative osteomyelitis rates at the nonunion site were greater in the autograft group (21% in autograft patients, 3% in OP-1 patients).
Different anatomical sites may require different substitutes. Special consideration must be given to variables of the involved kinetics with different locations, the effects of medications, the impact of disease processes, and of aging on the efficacy of function [2, 3, 6].
Objective measures determining utility of any bone-stabilizing product must certainly include cost containment issues centered around operating room functions, including time required for the procedure, duration of needed anesthesia, supplies used/needed, and length of stay in recovery and in hospital (table 4).
As always, success of fusion depends on many factors, but is maximized by the basic tenets of properly prepared sites, exposed cancellous bone, mechanical loading and stability.
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Gregory R. Trost, MD
Department of Neurological Surgery
University of Wisconsin-Madison
600 Highland Ave, Madison, WI 53792-3232 (USA)
Tel. +1 608 263 1410, E-Mail [email protected]
Haid RW Jr, Subach BR, Rodts GE Jr (eds): Advances in Spinal Stabilization. Prog Neurol Surg. Basel, Karger, 2003, vol 16, pp 39-54
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