The Combination of Demineralized Bone Matrix and Platelet Rich Plasma Used for The Treatment of Long Bone non-unions: Preliminary Data of a Case Series

Background: Although a variety of bone graft substitutes have been introduced into the treatment of bone non-unions, results from current clinical evidences are various and contradicting. This paper presents our experience and the outcomes about the combination of demineralized bone matrix (DBM) and platelet rich plasma (PRP) used as a bone graft substitute in the surgical treatment of long bone non-unions. Methods: : Data of this retrospective study was reviewed and collected from a consecutive case series involving 16 patients who had a long bone non-union and treated in our department from October 2018 to May 2019. DMB and PRP were applied as a bone defect filler during the index operation. Patients’ demographics, postoperative complications and the result of bone union were evaluated. Results: : The postoperative drainage exceeding 48 hours were demonstrated in 6 patients, but all removed within 7 days. Immediate postoperative complications were noted in 3 patients. Two of them developed incision exudation and delayed incision healing (exceed 2 weeks) and was cured with a course of local wound care. No graft rejection, heterotopic ossification or other complications were noted. Bony union was identified clinically and radiographically in 15 of the 16 patients, with a mean time of 7.5 months. Conclusions: : The present study found low incidence of postoperative complications and satisfactory bony healing rate could be achieved in the treatment of long bone non-unions augmented with the combination of DBM and PRP. Although these findings might indicate the promising future of this treatment protocol, larger and higher quality studies should also be executed to assess its routine use.