Clinical applications of bone morphogenetic proteins: current evidence.

Bone morphogenetic proteins (BMPs) were first described by Dr. Marshall Urist in 1965. Since 1988 a series of clinical studies and randomized clinical trials have evaluated the application of these molecules in humans. A comprehensive review of 30 clinical studies was performed to elicit the existing evidence of the English orthopaedic literature. BMPs appear to be efficacious as the reported success rates are equivalent and perhaps superior to those achieved with the gold standard methods of autografting. Clinical safety assessments have been even more encouraging with just a few reports of adverse events related to their use in clinical practice. There are certain controversies on the presented results of all the reviewed clinical series, which reflect the complexity of the osteoinductive and osteoconductive role of the BMPs, the ongoing quest for optimization of the dosing schemes and delivery carriers, as well as the multifactorial interactions during bone formation and remodeling.