Circumferential bone grafting around an absorbable gelatin sponge core reduced the amount of grafted bone in the induced membrane technique for critical-size defects of long bones

Cho, Jae-Woo; Kim, Jin-Il; Cho, Won Tae; Kim, Jin Kak; Song, Jungbin; Kim, Hyung Jin; Masquelet, A. C.; Oh, Jong Keon

doi:10.1016/j.injury.2017.08.012

Cited by 39 publications

(25 citation statements)

References 56 publications

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“…After removing the duplicates, 243 studies were screened, and 30 studies were included in the second phase to assess their eligibility. Eleven reports [10][11][12][15][16][17][18][19][20][21][22] of individual patient data (total of 115 patients) were used for this study. The flow chart of the selection process is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, only few studies provided detailed data regarding comorbidities, bone healing times, and weightbearing times of individual patient; we tried to contact the authors of each study to obtain this information, but our efforts were unsuccessful. Geographical trends in bone graft selections were evident; for example, RIA bone grafts were used much less often in Asia [20][21][22]. There was no explanation for this finding, but it might have been related to the different health insurance policies in Asian countries compared to those in European countries or the United States.…”

Section: Discussionmentioning

confidence: 98%

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The Induced Membrane Technique for the Management of Segmental Tibial Defect or Nonunion: A Systematic Review and Meta-Analysis

Hsu

Chen

Chan

et al. 2020

BioMed Research International

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Purpose. To identify the predicting factors for union and infection after applying the induced membrane technique (IMT) for segmental tibial defects. Methods. A systematic review was carried out following the PRISMA guidelines. All databases were searched for articles published between January 2000 and February 2018 using the keywords “Masquelet technique” and “induced membrane technique.” Studies in English reporting more than 5 cases with accessible individual patient data were included. A meta-analysis was performed. Odds ratios (OR) with 95% confidence intervals were calculated. Results. After reviewing, 11/243 studies (115 patients) were finally selected. The mean age of the patients was 43.6 years (range: 18-84 years), and the mean length of the tibial defect was 5.5 cm (range: 0-20 cm). The multivariate logistic regression analysis revealed that the risk factors of postoperative infection after IMT were infected nonunion (p=0.0160) and defect length ≥7 cm (p=0.0291). Patients with postoperative infection after IMT had a lower union rate (p=0.0003). Additionally, the use of an antibiotic polymethyl methacrylate cement spacer reduced the need for surgical revision (p=0.0127). Multiple logistic regression indicated no direct association between the union rate and length of the bone defect. Conclusions. IMT is a reliable and reproducible treatment for segmental tibial defects. However, initial infected nonunion and defect length greater than 7 cm are risk factors for post-IMT infection, and post-IMT infection was statistically related to nonunion.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

The Induced Membrane Technique for the Management of Segmental Tibial Defect or Nonunion: A Systematic Review and Meta-Analysis

Hsu

Chen

Chan

et al. 2020

BioMed Research International

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“…Long bone non-union treatment is always a challenge, due to the frequent multifactorial underlying cause [11][12][13][14][15][16] . While surgical treatment by means of appropriate fixation is frequently successful in case of hypertrophic non-unions, biological support is strictly needed when the non-union is not hypertrophic, confirming a certain limitation to regenerate bone at the injury site.…”

Section: Discussionmentioning

confidence: 99%

Early efficacy evaluation of mesenchymal stromal cells (MSC) combined to biomaterials to treat long bone non-unions

Gómez‐Barrena

Padilla-Eguiluz

Rosset

et al. 2020

Injury

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Background and study aim: Advanced therapy medicinal products (ATMP) frequently lack of clinical data on efficacy to substantiate a future clinical use. This study aims to evaluate the efficacy to heal long bone delayed unions and non-unions, as secondary objective of the EudraCT 2011-005441-13 clinical trial, through clinical and radiological bone consolidation at 3, 6 and 12 months of follow-up, with subgroup analysis of affected bone, gender, tobacco use, and time since the original fracture. Patients and methods: Twenty-eight patients were recruited and surgically treated with autologous bone marrow derived mesenchymal stromal cells expanded under Good Manufacturing Practices, combined to bioceramics in the surgical room before implantation. Mean age was 39 ± 13 years, 57% were males, and mean Body Mass Index 27 ± 7. Thirteen (46%) were active smokers. There were 11 femoral, 4 humeral, and 13 tibial non-unions. Initial fracture occurred at a mean ± SD of 27.9 ± 31.2 months before recruitment. Efficacy results were expressed by clinical consolidation (no or mild pain if values under 30 in R This paper is part of a Supplement supported by The Orthopaedic Surgery and Traumatology Spanish Society (SECOT).

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“…This technique was first proposed by Masquelet in the 1970s, and several modified procedures have been developed in subsequent years. [25][26][27][28][29][30][31][32][33] Regarding surgical outcomes following this technique, most studies have shown satisfactory results. However, there are still two challenges to be overcome.…”

Section: Discussionmentioning

confidence: 99%

<p>A Three-Dimensional Printed Polycaprolactone Scaffold Combined with Co-Axially Electrospun Vancomycin/Ceftazidime/Bone Morphological Protein-2 Sheath-Core Nanofibers for the Repair of Segmental Bone Defects During the Masquelet Procedure</p>

Lee

Hsu

et al. 2020

IJN

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Introduction: Masquelet proposed a new solution for the healing of segmental bone defects, thus minimizing the disadvantages associated with traditional bone grafting. However, a major factor leading to the failure of this technique pertains to be the residual infection. Accordingly, we developed an antibiotic-and osteo-inductive agent-loaded composite scaffold to solve this problem. Methods: A mesh-like polycaprolactone scaffold was prepared using a lab-exploited solutiontype three-dimensional printer, and hybrid sheath-core structured poly(lactic-co-glycolic-acid) nanofibers were fabricated using co-axial electrospinning technology. Vancomycin, ceftazidime, and bone morphological protein (BMP)-2 were employed. The in vitro and in vivo (rabbit fracture model) release patterns of applied agents from the composite scaffold were investigated. Results: The results revealed that the drug-eluting composite scaffold enabled the sustainable release of the medications for at least 30 days in vitro. Animal tests demonstrated that a high concentration of medications was maintained. Abundant growth factors were induced within the bioactive membrane stimulated by the applied scaffold. Finally, satisfactory bone healing potential was observed on radiological examination and biomechanical evaluation. Discussion: The developed composite scaffold may facilitate bone healing by inducing bioactive membrane formation and yielding high concentrations of antibiotics and BMP-2 during the Masquelet procedure.

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Circumferential bone grafting around an absorbable gelatin sponge core reduced the amount of grafted bone in the induced membrane technique for critical-size defects of long bones

Cited by 39 publications

References 56 publications

The Induced Membrane Technique for the Management of Segmental Tibial Defect or Nonunion: A Systematic Review and Meta-Analysis

The Induced Membrane Technique for the Management of Segmental Tibial Defect or Nonunion: A Systematic Review and Meta-Analysis

Early efficacy evaluation of mesenchymal stromal cells (MSC) combined to biomaterials to treat long bone non-unions

<p>A Three-Dimensional Printed Polycaprolactone Scaffold Combined with Co-Axially Electrospun Vancomycin/Ceftazidime/Bone Morphological Protein-2 Sheath-Core Nanofibers for the Repair of Segmental Bone Defects During the Masquelet Procedure</p>

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