{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T12:45:25Z","timestamp":1781354725126,"version":"3.54.1"},"reference-count":38,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2009,7,1]],"date-time":"2009-07-01T00:00:00Z","timestamp":1246406400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> The purpose of this study was to evaluate the effect of rhBMP-2 on bone healing in patients who undergo high-risk ankle &amp; hindfoot fusions. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods:<\/jats:title><jats:p> Patients who underwent high-risk, elective ankle and hindfoot fusions treated with rhBMP-2 augmentation were reviewed for clinical outcomes and complications. A total of 112 fusion sites (69 patients) were reviewed for analysis. The mean age of the patients was 52 years (range, 21 to 84 years). There were 37 males (53%) and 32 females (47%). Forty-four patients (64%) were smokers and 13 patients (19%) were diabetic. A history of high-energy trauma was present in 47 (68%) patients and avascular necrosis of the talus was present in 22 patients (32%). Forty-five patients (65%) had multiple risk-factors. The exclusion criteria were peripheral vascular disease, infection, and patients who were not available for the usual follow-up protocol. Internal and\/or external fixation was utilized for ankle and hindfoot fusions. Bone graft was used only for patients who had defects or malalignment. Postoperatively, nonweightbearing radiographs were taken every 2 to 4 weeks (3 views per site). When plain radiographic union was evident, a confirmatory CT scan was obtained. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Overall, 108 fusion sites went on to union (96% union rate) at a mean time of 11 weeks (as assessed by a CT scan) [ankle joint at 10 weeks; subtalar joint at 12.3 weeks; talonavicular joint at 12.7 weeks and calcaneocuboid joint at 10.9 weeks]. Different union times between ankle, subtalar, talonavicular, and calcaneocuboid joint were not significant ( p = 0.2571, Kruskal-Wallis Test Nonparametric ANOVA). All sites: [No graft] vs. [Autograft] vs. [Allograft]: p = 0.2421 (Kruskal-Wallis Test Nonparametric ANOVA), were not statistically significant. Complications included nonunion in 5 of 112 joints in 3 patients (4% joint nonunion rate; 4% patient nonunion rate) [subtalar joint, n = 2; talonavicular joint, n = 1; and calcaneocuboid joint, n = 1]. Two patients had wound complications and one other patient had a deep infection; all were successfully treated with local wound care, negative-pressure dressings and antibiotics. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> We believe rhBMP-2 is an effective adjunct for bone healing in patients who undergo high-risk ankle and hindfoot fusions. Low complication rates were observed in this study. Level of Evidence: IV, Retrospective Case Series <\/jats:p><\/jats:sec>","DOI":"10.3113\/fai.2009.0597","type":"journal-article","created":{"date-parts":[[2009,7,11]],"date-time":"2009-07-11T13:04:08Z","timestamp":1247317448000},"page":"597-603","source":"Crossref","is-referenced-by-count":63,"title":["Recombinant Bone Morphogenetic Protein-2 (rhBMP-2) in High-Risk Ankle and Hindfoot Fusions"],"prefix":"10.1177","volume":"30","author":[{"given":"Christopher","family":"Bibbo","sequence":"first","affiliation":[{"name":"Marshfield, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipak V.","family":"Patel","sequence":"additional","affiliation":[{"name":"Marshfield, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle D.","family":"Haskell","sequence":"additional","affiliation":[{"name":"Marshfield, 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