Induced Membranes-A Staged Technique of Bone-Grafting for Segmental Bone Loss

Woon, Colin Yi-Loong; Chong, K.W.; Wong, Michael

doi:10.2106/jbjs.i.00273

Cited by 62 publications

(15 citation statements)

References 8 publications

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“…Previous studies have demonstrated that induced membranes have a highly vascularized inner layer [11], which our synthetic BIM successfully mimicked. We produced a pre-vascularized HUVEC/UM inner layer in the BIM.…”

Section: Discussionmentioning

confidence: 75%

“…In addition, pluripotent stem cells are present in the membrane along with various growth factors such as vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) [10], which are known to be important in fracture healing. Studies have also demonstrated that the membrane is well vascularized and a large number of vessels are present in the fibrous inner layer [11, 12]. These studies suggest that the induced membrane plays a role in osteogenesis as well as vascularization of the bone graft [10, 11].…”

Section: Introductionmentioning

confidence: 99%

“…Studies have also demonstrated that the membrane is well vascularized and a large number of vessels are present in the fibrous inner layer [11, 12]. These studies suggest that the induced membrane plays a role in osteogenesis as well as vascularization of the bone graft [10, 11]. …”

Section: Introductionmentioning

confidence: 99%

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Fabrication, vascularization and osteogenic properties of a novel synthetic biomimetic induced membrane for the treatment of large bone defects

Liu

Kang

Browne

et al. 2014

Bone

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The induced membrane has been widely used in the treatment of large bone defects but continues to be limited by a relatively lengthy healing process and a requisite two stage surgical procedure. Here we report the development and characterization of a synthetic biomimetic induced membrane (BIM) consisting of an inner highly pre-vascularized cell sheet and an outer osteogenic layer using cell sheet engineering. The pre-vascularized inner layer was formed by seeding human umbilical vein endothelial cells (HUVECs) on a cell sheet comprised of a layer of undifferentiated human bone marrow-derived mesenchymal stem cells (hMSCs). The outer osteogenic layer was formed by inducing osteogenic differentiation of hMSCs. In vitro results indicated the undifferentiated hMSCs cell sheet facilitated the alignment of HUVECs and significantly promoted the formation of vascular-like networks. Furthermore, seeded HUVECs rearranged the extracellular matrix produced by hMSCs sheet. After subcutaneously implantation, the composite constructs showed rapid vascularization and anastomosis with the host vascular system, forming functional blood vessels in vivo. Osteogenic potential of the BIM was evidenced by immunohistochemistry staining of osteocalcin, tartrate-resistant acid phosphatase (TRAP) staining, and alizarin red staining. In summary, the synthetic BIM showed rapid vascularization, significant anastomoses, and osteogenic potential in vivo. This synthetic BIM has the potential for treatment of large bone defects in the absence of infection.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

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Fabrication, vascularization and osteogenic properties of a novel synthetic biomimetic induced membrane for the treatment of large bone defects

Liu

Kang

Browne

et al. 2014

Bone

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“…Vascularized bone grafts either require microsurgical anastomosis (free) or are limited by pedicle length (pedicled) and have accompanying donor site morbidity (both free and pedicled) [25, 26]. On the other hand, antibiotic-impregnated spacers (Masquelet technique) do not require specialized equipment; can be used easily by surgeons with varying experience and capability; and are applicable to patients with bone loss of epiphyseal, metaphyseal, or diaphyseal origin [27]. …”

Section: Discussionmentioning

confidence: 99%

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

Qiu

Chen

et al. 2017

BMC Musculoskelet Disord

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BackgroundCement spacers (Masquelet technique) have traditionally been used for the treatment of segmental bone defects. However, no reports have used cement spacers for the treatment of small/partial segmental bone defects associated with osteomyelitis and compared the outcomes with cement beads.MethodsWe retrospectively analysed 40 patients with post-traumatic osteomyelitis of the tibia who underwent treatment, which was performed in two stages. In the first stage, thorough debridement was performed, and bone defects were filled with either antibiotic-impregnated cement beads (bead group, 18 patients) or spacers (spacer group, 22 patients). In the second stage, the cement beads or spacers were removed (for the spacer group, the induced membrane formed by the spacer was preserved) and the bone defects were filled with cancellous autografts.ResultsAll patients in the bead group had small/partial segmental bone defects after debridement, while 3 patients in the spacer group had large/segmental bone defects.The mean volume of bone defects of the spacer group (40.4 cm3) was significantly larger than that of the bead group (32.4 cm3). The infection control rate (88.9%,16/18 vs 90.9%, 20/22), bone healing time (8.5 months vs 7.5 months) and complication rates (22.2%, 4/18 vs 27.2%, 6/22) were comparable between bead group and spacer group.ConclusionThe results of this study suggest that cement spacers may have an infection control rate comparable to cement beads in the treatment of bone defects associated with post-traumatic osteomyelitis. Furthermore, cement spacers could be used for the reconstruction of small/partial segmental bone defects as well as for large/segmental bone defects, whereas cement beads were not suitable for the reconstruction of large/segmental bone defects.

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“…In addition, psychological and emotional problems are common [2,3]. In cases where sepsis occurs, tissue necrosis may result in scarring, growth plate damage and amputations of digits and limbs [4,5] and permanent renal failure [6]. Septic shock is also linked to a greater likelihood of psychiatric disorder [7].…”

Section: Introductionmentioning

confidence: 99%

The health, social and educational needs of children who have survived meningitis and septicaemia: the parents’ perspective

et al. 2013

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BackgroundSurvivors of bacterial meningitis and septicaemia can experience a range of after-effects. There is little published research on the needs and provision of aftercare for children surviving bacterial meningitis and septicaemia.MethodsMixed methods study employing a survey and follow-up interviews with a sample of survey participants recruited from Meningitis Research Foundation’s member database and social media.ResultsOf 194 eligible survey respondents, 77% reported at least moderate short-term after-effects, and 57% a need for aftercare or support. Most parents reported that their child received a hearing test (98%) and follow-up appointment with a paediatrician (66%). Psychosocial after-effects were most common and the greatest need was for educational support. About half of participants felt their children’s needs for aftercare were met. We conducted interviews with 18 parents. Findings suggest access could be limited by: parents’ inability to navigate systems in place, child’s age, and delayed identification of sequelae. Parents felt a comprehensive explanation of possible after-effects on discharge from hospital was required, and found uncertain prognoses difficult. Good communication between professionals enabled a service tailored to the child’s needs.ConclusionsOur study supports the NICE and SIGN guidelines and highlights areas for improvement in the aftercare of these children.

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Induced Membranes-A Staged Technique of Bone-Grafting for Segmental Bone Loss

Cited by 62 publications

References 8 publications

Fabrication, vascularization and osteogenic properties of a novel synthetic biomimetic induced membrane for the treatment of large bone defects

Fabrication, vascularization and osteogenic properties of a novel synthetic biomimetic induced membrane for the treatment of large bone defects

Outcomes of cement beads and cement spacers in the treatment of bone defects associated with post-traumatic osteomyelitis

The health, social and educational needs of children who have survived meningitis and septicaemia: the parents’ perspective

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