B2A Polypeptide in Foot and Ankle Fusion

Foot and ankle fusion procedures often incorporate autogenous bone graft to help achieve bony union. Pain and morbidity associated with graft harvest have resulted in decreased autograft use as alternative bone graft substitutes have become available. Recently B2A peptide-coated ceramic granules have been developed and investigated. B2A, a bioactive synthetic multi-domain peptide acting on bone morphogenetic protein receptors of osteoblast precursor cells, amplifies the cell response to bone morphogenetic proteins. Use of B2A-granule has the additional benefit of eliminating autogenous bone graft donor site morbidity. The surgical technique of subtalar arthrodesis incorporating B2A-granule is described.