8 RCTs (1113 patients) comparing the use of bone morphogenetic proteins (BMPs) to conventional treatment methods for acute tibial fractures or tibial non-unions were included in this meta-analysis. The purpose of the study was to determine if BMPs improved the rate of union or decreased surgical revision rate compared to various standard practices. BMPs were found to significantly increase union rates and decrease revision rates when used for the treatment of acute tibial fractures but provided no additional benefit to treatment of tibial non-unions. The use of BMPs had no significant influence on the rate of infection for either type of injury when compared to standard care practices. It should be noted that majority of studies included in the acute fracture analyses only evaluated BMPs in open fractures and that both analyses for acute and non-union fractures were limited by the number of available randomized controlled trials.