A Augmentasi Biologis dalam Penyembuhan Fraktur Tibia: Tinjauan Literatur Sistematis Tentang Efektivitas Plasma Kaya Trombosit, Konsentrat Aspirat Sumsum Tulang, dan Adjuvan Biologis Lainnya terhadap Pemulihan Radiologis dan Fungsional

Authors

  • Ardian Riza Andalas University /Dr. M.Djamil General Hospital, Padang, Indonesia/ Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia https://orcid.org/0009-0001-3860-5238
  • Noverial Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia
  • Muhammad Pramana Khalilul Harmi Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia
  • Mutia Sari Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia
  • Mustafa Kamal Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

DOI:

https://doi.org/10.56260/sciena.v5i2.315

Keywords:

fraktur tibia, nonunion, augmentasi biologis, PRP, BMAC, rhBMP-2, rhBMP-7, tinjauan sistematis

Abstract

Latar Belakang: Fraktur tibia memiliki angka nonunion hingga 30%, terutama pada kasus terbuka atau distal. Augmentasi biologis seperti plasma kaya trombosit (PRP), konsentrat aspirat sumsum tulang (BMAC), dan protein morfogenetik tulang rekombinan (rhBMP) semakin digunakan, namun bukti klinisnya masih terfragmentasi [1,2]. Tujuan: Mensintesis bukti klinis terkini mengenai efikasi, keamanan, dan indikasi optimal adjuvan biologis dalam penyembuhan fraktur tibia. Metode: Tinjauan literatur sistematis dilakukan mengikuti panduan PRISMA 2020. Pencarian di PubMed menghasilkan 27 catatan; setelah penyaringan, 16 studi klinis (10 uji acak terkontrol, 6 observasional) yang melibatkan >1.800 pasien dimasukkan [3]. Hasil: rhBMP-2 (12 mg) mengurangi intervensi sekunder sebesar 44% pada fraktur tibia terbuka, tetapi tidak bermanfaat pada fraktur tertutup [4,5]. rhBMP-7 non-inferior dibanding autograft pada nonunion tibia dan mempercepat penyembuhan fraktur distal [6–8]. PRP dan BMAC mencapai angka penyatuan 90–93% dalam studi kecil dengan prosedur minim invasif [9,10]. Hormon pertumbuhan meningkatkan marker biokimia tanpa manfaat klinis [11]. Tidak ditemukan efek samping mayor.Kesimpulan: Efektivitas augmentasi biologis bergantung pada konteks klinis: rhBMP-2 untuk fraktur terbuka, rhBMP-7 untuk nonunion/distal, dan PRP/BMAC sebagai alternatif berbiaya rendah. Standardisasi protokol diperlukan sebelum adopsi luas terapi seluler.

Author Biographies

Ardian Riza , Andalas University /Dr. M.Djamil General Hospital, Padang, Indonesia/ Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

Department of Orthopaedics and Traumatology, Faculty of Medicine

Noverial, Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

Department of Orthopaedics and Traumatology

Muhammad Pramana Khalilul Harmi, Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

Department of Orthopaedics and Traumatology

Mutia Sari, Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

Department of Orthopaedics and Traumatology

Mustafa Kamal, Kartika Docta Surgical Specialty Hospital, Padang ,Indonesia

Department of Orthopaedics and Traumatology,

References

. Heckman JD, Sarasohn-Kahn J. The economics of treating tibia fractures: the cost of delayed unions. Bull Hosp Jt Dis. 1997;56(2):63–72.

. Phieffer LS, Goulet JA. Delayed unions of the tibia. J Bone Joint Surg Am. 2006;88(1):206–216.

. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

. Govender S, Csimma C, Genant HK, et al. Recombinant human bone morphogenetic protein-2 for treatment of open tibial fractures: a prospective, controlled, randomized study of four hundred and fifty patients. J Bone Joint Surg Am. 2002;84(12):2123–2134.

. Aro HT, Wipplinger C, Mica L, et al. Efficacy and safety of recombinant human bone morphogenetic protein-2/calcium phosphate matrix for closed tibial diaphyseal fracture: a prospective, randomized, double-blind trial. J Bone Joint Surg Am. 2013;95(23):2090–2098.

. Friedlaender GE, Perry CR, Cole JD, et al. Osteogenic protein-1 (bone morphogenetic protein-7) in the treatment of tibial nonunions. J Bone Joint Surg Am. 2001;83-A Suppl 1:249–255.

. Maniscalco P, Gambera D, Bertone C, et al. RhBMP-7 accelerates the healing in distal tibial fractures treated by external fixation. Acta Biomed. 2007;78(3):188–194.

. Ristiniemi J, Flinkkilä T, Hyvönen P, et al. RhBMP-7 accelerates the healing in distal tibial fractures treated by external fixation. Acta Orthop. 2007;78(Suppl 326):24–30.

. Eicher A, Ursavaş HT, Bilgili MG, et al. Platelet-rich plasma versus exchange intramedullary nailing in treatment of long bone oligotrophic nonunions. Eur J Orthop Surg Traumatol. 2018;28(1):131–137.

. Dallari D, Stagni C, Rani N, et al. Effectiveness of bone marrow aspirate concentrate (BMAC) as adjuvant therapy in the surgical treatment of congenital pseudoarthrosis of the tibia: a retrospective comparative study. Chir Org Mov. 2020;34(4 Suppl 3):S207–S213.

. Haffner E, Schmidmaier G, Moghaddam A, et al. Biochemical markers of bone turnover in tibia fracture patients randomly assigned to growth hormone or placebo. Bone. 2011;49(5):1047–1052.

Downloads

Published

2026-03-03

How to Cite

Riza, A., Noverial, Khalilul Harmi, M. P. ., Sari, M., & Kamal, M. . (2026). A Augmentasi Biologis dalam Penyembuhan Fraktur Tibia: Tinjauan Literatur Sistematis Tentang Efektivitas Plasma Kaya Trombosit, Konsentrat Aspirat Sumsum Tulang, dan Adjuvan Biologis Lainnya terhadap Pemulihan Radiologis dan Fungsional. Scientific Journal, 5(2), 181–190. https://doi.org/10.56260/sciena.v5i2.315

Issue

Vol. 5 No. 2 (2026): SCIENA Volume V No 2, March 2026

Section

Systematic Literature Review

License

Copyright (c) 2026 Ardian Riza , Noverial, Muhammad Pramana Khalilul Harmi, Mutia Sari, Mustafa Kamal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Most read articles by the same author(s)