Evidence map›Paper›PMID 41316346›Full record

SynthesisEuropean journal of medical research2025

Bone morphogenetic protein, platelet-rich plasma, and bone marrow aspiration concentrate in the treatment of bone delayed union or nonunion: a systematic review and network meta-analysis of randomized controlled trials.

Xinan Wang, Ying Zhang

Abstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Xinan WangBone Trauma Surgery Department, People's Hospital of Bayingol Mongol Autonomous Prefecture, Korla, 841000, Xinjiang, China.
Ying ZhangDepartment of Orthopedics, The Affiliated Hospital Southwest Medical University, Luzhou, 646000, Sichuan, China. Zying20242024@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe clinical treatment of delayed healing/nonunion of bones is challenging, and traditional surgery combined with autologous cancellous bone (ACB) grafting has limitations, including donor site complications and poor functional prognosis. This network meta-analysis (NMA) aims to compare the efficacy and safety of bone morphogenetic protein (BMP), platelet-rich plasma (PRP), and bone marrow aspirate concentrate (BMAC) in the treatment of delayed union or nonunion.

methodsSearch was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases up to July 1, 2025. Randomized controlled trials (RCTs) evaluating the treatment of adult bone delayed healing/nonunion with PRP, BMP, or BMAC were included. The primary outcomes included healing time, healing rate, and the incidence of adverse events (AEs). NMA was performed using STATA 16.0, and the efficacy and safety of the interventions were ranked based on the surface under the cumulative ranking curve (SUCRA).

resultsA total of 15 RCTs involving 1286 patients were included. Compared to standard treatment (ST), both PRP and BMP interventions demonstrated shorter healing times and higher healing rates. The SUCRA ranking indicated that PRP + ACB (P = 93.6%) and PRP + BMAC (P = 91.6%) were most likely the optimal strategies for shortening healing time and improving healing rates, respectively. In terms of AEs incidence, PRP + BMAC showed the highest SUCRA probability for reducing AEs (P = 99.8%).

conclusionsBMP and PRP significantly reduced the time to complete healing and improved healing rates compared to the ST group, without increasing the risk of AEs. Among combination therapies, PRP + ACB may have the greatest potential for shortening healing time, while PRP + BMAC may be optimal for improving healing rates and reducing AEs. However, large-scale RCTs are needed in the future to validate the best intervention strategies for different sites and patient subgroups.

Indexed as

Bone Marrow TransplantationBone Morphogenetic ProteinsFractures, UnunitedPlatelet-Rich PlasmaFracture HealingHumansRandomized Controlled Trials as TopicBone Morphogenetic ProteinsBone marrow aspiration concentrateBone morphogenetic proteinDelayed unionNetwork meta-analysisNonunionPlatelet-rich plasma

Identifiers

PMID41316346
PMCPMC12664161

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.