BMP-2 vs PDGF for nonunions

Описание: BMP-2 vs PDGF for nonunions — this new Bone & Joint Journal study finally gives us a head-to-head comparison using clinically relevant carriers. And the results weren’t even close.
In a critical-sized femoral defect model, BMP-2 achieved 100% radiographic union, complete cortical bridging on micro-CT, and the only biomechanically meaningful bone across the defect. PDGF? Only 20% radiographic union and essentially no measurable mechanical strength in torsion testing.
That aligns with what we see clinically in foot and ankle surgery:• PDGF is excellent for cellular proliferation and angiogenesis• But it does not consistently drive osteogenic differentiation• In biologically compromised bone, PDGF alone rarely moves the needle
BMP-2 remains the most potent osteoinductive biologic we have access to. It changes the biology of a nonunion, not just the environment around it.
For surgeons dealing with:• Atrophic nonunion• Failed arthrodesis• Revision charcot reconstructions• Metabolic bone deficiencies• Segmental defects• Diabetic or neuropathic bone
—understanding this hierarchy matters.
PDGF supports bone healing. BMP-2 creates bone.They aren’t interchangeable, and this study demonstrates that difference with clarity.
⚠️ Of course, this was an acute defect model — not a chronic human nonunion — so clinical translation must be thoughtful. But as a biologic principle, the study reinforces what we already know:When you need true osteogenesis, BMP-2 is in a different league.
References: Raleigh et al., Bone Joint J 2025;107-B:744–751.