Innovative strategies for the management of long bone infection: a review of the Masquelet technique

Chadayammuri, Vivek; Hake, Mark E.; Mauffrey, Cyril

doi:10.1186/s13037-015-0079-0

Cited by 70 publications

(57 citation statements)

References 47 publications

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“…3,8,17,37,47,51 The two-stage procedure relies on a vascularized foreign-body membrane created during the first stage to provide a permissive environment for morselized bone graft incorporation during the second stage. Without the membrane, grafts larger than 4 to 6 cm in length are typically resorbed.…”

Section: Introductionmentioning

confidence: 99%

Masquelet Technique: Effects of Spacer Material and Micro-topography on Factor Expression and Bone Regeneration

et al. 2018

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We and others have shown that changing surface characteristics of the spacer implanted during the first Masquelet stage alters some aspects of membrane development. Previously we demonstrated that titanium spacers create membranes that are better barriers to movement of solutes >70kDa in size than polymethyl methacrylate (PMMA) induced-membranes, and roughening creates more mechanically compliant membranes. However, it is unclear if these alterations affect the membrane’s biochemical environment or bone regeneration during the second stage. Ten-week-old, male Sprague-Dawley rats underwent an initial surgery to create an externally stabilized 6mm femoral defect. PMMA or titanium spacers with smooth (~1um) or roughened (~8um) surfaces were implanted. Four weeks later, rats were either euthanized for membrane harvest or underwent the second Masquelet surgery. Titanium spacers induced thicker membranes that were similar in structure and biochemical expression. All membranes were bilayered with the inner layer having increased factor expression (BMP2, TGFβ, IL6, and VEGF). Roughening increased overall IL6 levels. Ten-weeks post-engraftment, PMMA-smooth induced membranes better supported bone regeneration (60% union). The other groups only had 1 or 2 that united (9–22%). There were no significant differences in any microCT or dynamic histology outcome. In conclusion, this study suggests that the membrane’s important function in the Masquelet technique is not simply as a barrier. There is likely a critical biochemical, cellular, or vascular component as well.

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Section: Introductionmentioning

confidence: 99%

Masquelet Technique: Effects of Spacer Material and Micro-topography on Factor Expression and Bone Regeneration

et al. 2018

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“…To avoid this two-stage procedure, antibiotics have also been incorporated into bone substitutes, such as hydroxyapatite (HA), tricalcium phosphate (TCP) and calcium sulphates (CaS) [12,13]. Another well known method to manage infected bone is a two-stage treatment, by the name of Masquelet technique, where an antibioticcontaining PMMA spacer is implanted in the first stage and the induced membrane compartment is grafted with autograft in the second stage after removal of the spacer [14,15].…”

Section: Introductionmentioning

confidence: 99%

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Stoor¹,

Frantzén²

2017

Biomedical Glasses

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Bacterial infection of bone tissue and bone marrow, referred to as osteomyelitis, is a challenging clinical problem. In this study we analysed the influence of the granule size of the bone substitute bioactive glass (BAG) S53P4 and the novel putty material containing BAG S53P4 on four clinically important bacteria associated with osteomyelitis; Staphylococcus aureus, methicillin resistant Staphylococuus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa. Reference materials were the frequently used biomaterial in surgical bone grafting procedures; tricalcium phosphate and an inert glass. Powder of BAG S53P4 was used as a positive control. The materials were incubated with bacterial suspension and the viability of the microbes was determined as colony forming units after cultivation on agar plates. All pathogens lost their viability in contact with the BAG S53P4 granules and the powder of the BAG S53P4. The reference materials tricalcium phosphate and the inert glass had no effect on the viability of the bacteria. The BAG S53P4 putty containing 0.5-0.8 mm granules did not show any antibacterial effect on any of the tested bacteria. New putty compositions need to be investigated to obtain antibacterial properties for this novel bone regeneration biomaterial.

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“…Follow-up ranged from 14 to 23 years. Reproduced with permission from Chadayammuri et al 25 Copyright Ó 2015, the Authors. The average size of the bone defect after debridement was 13 cm (6-25 cm).…”

Section: Resultsmentioning

confidence: 99%

“…Reproduced with permission from Chadayammuri et al 25 Copyright Ó 2015, the Authors. Initial treatment was performed at an outside facility and included multiple procedures for irrigation and debridement followed by open reduction and internal fixation.…”

Section: Resultsmentioning

confidence: 99%

Reconstruction of Long Bone Infections Using the Induced Membrane Technique

Mauffrey

Hake

Chadayammuri

et al. 2016

Journal of Orthopaedic Trauma

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Innovative strategies for the management of long bone infection: a review of the Masquelet technique

Cited by 70 publications

References 47 publications

Masquelet Technique: Effects of Spacer Material and Micro-topography on Factor Expression and Bone Regeneration

Masquelet Technique: Effects of Spacer Material and Micro-topography on Factor Expression and Bone Regeneration

Influence of bioactive glass S53P4 granules and putty on osteomyelitis associated bacteria in vitro

Reconstruction of Long Bone Infections Using the Induced Membrane Technique

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