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Role of Platelet-derived Growth Factor in Hindfoot Fusion

Glazebrook, Mark MSc, PhD, MD, FRCS(C), Dip Sports Med.*; Daniels, Timothy R. MD, FRCS(C); Abidi, Nicholas A. MD; Younger, Alastair MSc MD, FRCSC§; DiGiovanni, Christopher W. MD

Techniques in Foot & Ankle Surgery:
doi: 10.1097/BTF.0b013e3182469626
Special Focus: Role of Platelet-Rich Plasma and rhPDGF in Foot and Ankle Surgery
Abstract

Bone healing that is orchestrated by osteoblasts and osteoclasts is regulated by a complex interaction between biochemical factors such as cytokines and growth factors. One of the critical early growth factors that have an influence on healing is platelet-derived growth factor (PDGF). PDGF is a family of polypeptides that has the ability to attract and stimulate the metabolic activity of mesenchymal cells, stimulating a repair process that includes increased bone formation. Recently, a fully synthetic bone graft material composed of recombinant human platelet-derived growth factor and a β-tricalcium phosphate matrix under the name Augment Bone Graft was shown to be a safe alternative to autogenous bone graft for hindfoot fusion operations. This review provides an overview of the role of PDGF in the biology of bone healing and examines the clinical utility and most recent literature regarding efficacy of the use of PDGF as a safe alternative to autogenous bone graft for hindfoot fusion operations. Finally, the surgical procedure of ankle arthrodesis is described as an example of how PDGF may be used for surgical treatment of end-stage hindfoot arthritis.

Author Information

*Department of Orthopaedic Foot & Ankle Reconstructive Surgery and Sports Medicine, Halifax, Nova Scotia

Head of Foot & Ankle Program, University of Toronto, ON, Canada

Santa Cruz Orthopaedic Institute, Capitola, CA

§Department of Orthopaedics, University of British, Columbia

Department of Orthopaedic Surgery, The Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, Providence, RI

C.D. and M.K. are consultants to BioMimetic Therapeutics Inc. All authors have participated in clinical trials sponsored by BioMimetic Therapeutics Inc. M.G., T.D., C.D., N.A., have received consulting funds and all authors have reconceived research funding from Biomimetic Therapeutis.

Address correspondence and reprint requests to Mark Glazebrook, MSc, PhD, MD, FRCS(C), Dip Sports Med., Queen Elizabeth II Health Sciences Center, Halifax Infirmary (Suite 4867), 1796 Summer Street, Halifax, Nova Scotia B3H 3A7. E-mail: markglazebr@ns.sympatico.ca.

© 2012 Lippincott Williams & Wilkins, Inc.