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The Journal of Bone and Joint Surgery (American) 85:89-95 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Orthopaedic Applications

Recombinant Human Bone Morphogenetic Protein-2: Use in Spinal Fusion Applications

Harvinder S. Sandhu, MD and Safdar N. Khan, MD

Corresponding author: Harvinder S. Sandhu, MD
Spinal Surgery Service, The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021. E-mail address: sandhuh@hss.edu

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Medtronic Sofamor Danek. In addition, one or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Medtronic Sofamor Danek). Also, a commercial entity (Medtronic Sofamor Danek) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

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It has been several decades since Marshall Urist's discovery of osteoinductive activity within demineralized bone protein extracts. Initially described in Science in 1965 1 , Dr. Urist's remarkable discovery, an unexpected byproduct of intended research on the competitive binding of radionucleotides during bone mineralization, suggested that morphogenetic activity resides among certain bone-matrix-derived proteins; this work continued with Urist's later identification of the active molecules as bone morphogenetic proteins 2,3 . This was followed, in 1988, by the isolation of an individual protein, BMP-2, from a purified extract and its recombinant production 4 . The long-awaited clinical use and commercial availability of bone morphogenetic proteins (BMPs) have only recently approached reality.

Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been tested for use in spinal fusion in several completed prospective, randomized clinical trials, beginning in 1997. After rhBMP-2 was demonstrated to be equivalent to autogenous iliac bone graft with regard to both fusion rate and . . . [Full Text of this Article]


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