Artificial Membrane Induced by Novel Biodegradable Nanofibers in the Masquelet Procedure for Treatment of Segmental Bone Defects

Abstract

The Masquelet induced-membrane technique for the treatment of segmental bone defects includes a two-stage surgical procedure, and polymethylmethacrylate (PMMA) plays a major role in the treatment. However, the PMMA spacer must be surgically removed. Here, we investigated the potential of poly(lactic-co-glycolic acid) (PLGA) nanofibers, a biodegradable material to replace the PMMA spacer, allowing the bioactive membrane to be induced and the spacer to degrade without the additional surgery on a rabbit femoral segmental bone defect model. PLGA nanofibers were shown to degrade completely six weeks after implantation in the investigated animals, and a thick membrane was found to circumferentially fold around the segmental bone defects. Results from image studies demonstrated that, in the group without the bone graft, all studied femurs exhibited either nonunion or considerable malunion. In contrast, the femurs in the bone graft group had a high union rate without considerable deformities. Histological examinations suggested that the membranous tissue in this group was rich in small blood vessels and the expression of BMP2 and VEGF increased. Our results demonstrate that the biodegradable PLGA nanofibers may be useful for replacing the PMMA spacer as the bioactive-membrane inducer, facilitating the process of healing and removing the need for repeated surgeries.

Systematic literature review of in vivo rat femoral defect models using biomaterials to improve the induced membrane technique: a comprehensive analysis

“…Finally, this systematic review focused on a single model to identify biomaterials that provided best results in IMT improvement. Other models are studied in this field notably the rabbit model that could bring additional data ( 29 ). Other strategies were not included in this work such as genetic studies ( 30 , 31 , 32 ), subcutaneous implantation of biomaterials ( 33 ), and other localization of bone defects ( 34 ).…”

Advances in materials used for minimally invasive treatment of vertebral compression fractures

“…In their study, Yu et al found that the addition of fibrous PLGA to bone defects effectively improved the brittleness of CPC. A two-fold increase in toughness was observed in addition to a moderate improvement in compressive strength (Yu et al, 2018;Cai et al, 2023) (Figure 6). PLGA is effective in improving the handling properties of bone cement; it has also been widely used as a drug delivery system for molecules such as proteins, peptides, and genes due to its excellent carrier properties.…”

Management of uncontained bone voids with Calcium Sulphate Ceramic (Modified Masquelet / Modified AMIC with Cerament Bio-Composite) Case report and review of literature

“…Masquelet twostage procedure has the drawback of second procedure of removal of the PMMA spacer. To replace the PMMA spacer, Yi-Hsun Yu and colleagues has used biodegradable nanofibers in Masquelet procedure for treatment of segmental bone defects in animals [4]. We successfully used Septocoll E, an absorbable equine collagen fleece to work as pseudo membrane which has not been previously reported.…”