Treatment of Large Segmental Bone Defects with Reamer-Irrigator-Aspirator Bone Graft: Technique and Case Series

2010 ◽  
Vol 41 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Todd A. McCall ◽  
David S. Brokaw ◽  
Bradley A. Jelen ◽  
D. Kevin Scheid ◽  
Angela V. Scharfenberger ◽  
...  
Keyword(s):  
Bone Graft ◽  
Case Series ◽  
Bone Defects ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Use of Tantalum Trabecular Metal Cones for Management of Nonunion of the Distal Femur with Segmental Bone Defects: Technique and Case Series

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Alan W Reynolds ◽  
Patricia R Melvin ◽  
Eric J Yakish ◽  
Nicholas Sotereanos ◽  
Gregory T Altman ◽  
...  
Keyword(s):  
Distal Femur ◽  
Case Series ◽  
Bone Defects ◽  
Autologous Bone Graft ◽  
Trabecular Metal ◽  
Non Union ◽  
Segmental Bone ◽  
Keywords Femur ◽  
Segmental Bone Defects

Introduction: Segmental bone loss in the distal femur presents a challenge for reconstruction regardless of etiology. Use of tantalum trabecular metal cones with intramedullary fixation and autologous bone graft may be used as a salvage technique in difficult situations where other options have either been exhausted or are unavailable. Case Report: Surgical planning and technique for this approach to reconstruction are described. A retrospective review of five cases with >1 year of follow-up was performed to provide radiographic and clinical outcomes. All five patients had satisfactory outcomes with clinical union and retention of implants at final follow-up (average >4 years). Conclusions: Use of tantalum metal cones for reconstruction of distal femur nonunion with segmental bone defects can be a successful technique in a complex group of patients. Keywords: Femur, bone defect, non-union, induced membrane, tantalum.

scholarly journals Application of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yunhong Ma ◽  
Sanjun Gu ◽  
Qudong Yin ◽  
Haifeng Li ◽  
Yongwei Wu ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Bone Defects ◽  
Cancellous Bone Graft ◽  
Segmental Bone ◽  
Segmental Bone Defects

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

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Yi-Hsun Yu ◽  
Ren-Chin Wu ◽  
Demei Lee ◽  
Che-Kang Chen ◽  
Shih-Jung Liu
Keyword(s):  
Bone Graft ◽  
Bone Defects ◽  
Artificial Membrane ◽  
Union Rate ◽  
Segmental Bone Defect ◽  
Additional Surgery ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

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.

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

2018 ◽  
Author(s):  
Yi-Hsun Yu ◽  
Ren-Chin Wu ◽  
Demei Lee ◽  
Che-Kang Chen ◽  
Shih-Jung Liu
Keyword(s):  
Bone Graft ◽  
Bone Defects ◽  
Artificial Membrane ◽  
Segmental Bone Defect ◽  
Additional Surgery ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Segmental Bone ◽  
Without Bone Graft ◽  
Segmental Bone Defects

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 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 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.

scholarly journals Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

2020 ◽  
Author(s):  
Lan Li ◽  
Jianping Shi ◽  
Kaiwei Ma ◽  
Jing Jin ◽  
Peng Wang ◽  
...  
Keyword(s):  
Bone Defects ◽  
Printing Technology ◽  
Segmental Bone ◽  
Segmental Bone Defects

Experimental study on repair of large segmental bone defects of goat femur by nano calcium-deficient hydroxyapatite-multi (amino acid) copolymer membrane tubes

2021 ◽  
pp. 088532822110002
Author(s):  
Yan Xiong ◽  
Hong Duan ◽  
Bin Zhang ◽  
Cheng Ren ◽  
Zeping Yu ◽  
...  
Keyword(s):  
Amino Acid ◽  
Bone Defects ◽  
Torsional Stiffness ◽  
Control Group ◽  
Allogenic Bone ◽  
Acid Copolymer ◽  
Membrane Tube ◽  
Segmental Bone ◽  
Experimental Group ◽  
Segmental Bone Defects

Objective The purpose of this study was to observe feasibility of nano calcium-deficient hydroxyapatite-multi (amino acid) copolymer (n-CDHA-MAC) membrane tubes in repairing goat femurs’ large defects. Methods Twelve goats were divided into two groups, whose femurs were created 30 mm segmental bone defects and then implants were performed. In experimental group, the bone defect of right femur was reconstructed by n-CDHA-MAC membrane tube, while left side was reconstructed by allogenic bone tube in control group. Every three goats were sacrificed at 4, 8, 16, 24 weeks after operation respectively. General observation, X-ray analysis, histology, Scanning electron microscope (SEM) examination and protein level comparison of BMP-2 were conducted to evaluate the effects of repairing segmental bone defects. Results All goats recovered well from anesthesia and surgical interventions. The radiographic evaluations showed that periosteal reaction outside of the membrane tubes and allogenic bone tubes were observed 4 weeks after surgery. At 16 weeks, callus was continuously increased in experimental group, which was more obvious than control group. At 24 weeks, callus outside of the membrane tubes connected together. Histologic evaluation showed fibro-cartilage callus was evolved into bony callus in experimental group, which was more obvious than control group at 8 and 16 weeks. The protein expression level of BMP-2 increased at 4, 8 weeks and peaked at 16 weeks in experimental groups. There were statistical differences at 8 and 16 weeks ( P < 0.05). At each time point in 8, 16, 24 weeks after surgery, the bending stiffness, torsional stiffness and compressive strength of the two groups were similar, and there was no significant difference ( P > 0.05). Conclusions This novel surface degradation n-CDHA-MAC membrane tube has good ability to maintain enough membrane space, which can provide long-term and stable biomechanical support for large bone defects and integrate well with the surrounding bone.

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