19 studies (12 RCTs, 6 prospective cohorts, 3 retrospective cohorts) were included in this investigation on the efficacy of BMP-2 and BMP-7 in bony healing following acute fracture or nonunion. The results indicated that there was no significant difference between BMP and non-BMP-treated groups regarding union rate of healing time following treatment for either acute fractures or acute open fractures. In tibial nonunions, BMP-7 significantly increased union rate. With BMP, union rates were similar to that of autograft, and significantly higher when compared to standard of care groups. Overall, the need for secondary surgery was lower with BMP treated groups, and infection rates were similar to that of non-BMP-treated groups.