scholarly journals Comparison between Tonifying Kidney Yang and Yin in Treating Segmental Bone Defects Based on the Induced Membrane Technique: An Experimental Study in a Rat Model

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Zhen Shen ◽  
Zehua Chen ◽  
Xiaodong Shi ◽  
Tao Wang ◽  
Minling Huang ◽  
...  
Keyword(s):  
Bone Repair ◽  
Bone Defects ◽  
Treated Group ◽  
Control Group ◽  
Induced Membrane ◽  
Membrane Technique ◽  
The Difference ◽  
Segmental Bone ◽  
Stage 1 ◽  
Segmental Bone Defects

Tonifying kidney therapy consisting of tonifying kidney yang and yin is the basic principle of Chinese medicine in treating segmental bone defects (SBDs). Previous studies have demonstrated the presence of the differences between tonifying kidney yang and yin in bone metabolism of osteoporosis and distraction osteogenesis models. However, whether the difference between the two tonifying kidney methods in bone repair for the induced membrane (IM) technique occurs or what is the difference remain unclear. Angiogeneic-osteogenic coupling plays an important role in bone repair and the induced membrane couples angiogenesis with the later osteogenesis during the IM process. This study aimed at investigating the effects of tonifying kidney yang (total flavonoids of Rhizoma Drynariae, TFRD) and yin (plastrum testudinis extract, PTE) on angiogenesis and osteogenesis in the IM-treated SBDs. Rats of 6 mm tibia bone defect model treated with IM were divided into five groups: the control group, the model group, the tonifying kidney yang group (TFRD-treated group), the tonifying kidney yin group (PTE-treated group), and the western medicine group. At 4 weeks after insertion of the polymethylmethacrylate (PMMA), three caudal vertebrae from the tail in each rat were implanted into the 6 mm defect gap. Radiographical, histological, immunohistochemical, and immunofluorescent analyses were performed to assess bone and vessel formation at 4 or 12 weeks after insertion of the PMMA, respectively. Our results revealed that TFRD and PTE were beneficial to both angiogenesis and osteogenesis. TFRD exerted a better effect on angiogenesis than PTE and achieved a better result in stage 1 rather than in stage 2 of IM, whereas PTE was superior to TFRD in osteogenesis and achieved a better result in stage 2 instead of stage 1. Collectively, these findings elucidated the beneficial effects of tonifying kidney yang and yin on angiogenesis and osteogenesis of SBD repair during the IM process, as well as the difference that tonifying kidney yang surpasses tonifying kidney yin in angiogenesis while tonifying kidney yin outperforms tonifying kidney yang in osteogenesis, which suggests that the combination between the application of tonifying kidney yang method in stage 1 of IM and tonifying kidney yin method in stage 2 may achieve better repair efficiency.

Is induced membrane technique effective in reconstruction of mandibular segmental bone defects? An experimental study

2021 ◽  
Author(s):  
Ezgi Yüceer-Çetiner ◽  
Nilüfer Özkan ◽  
Mehmet Emin Önger ◽  
Mustafa Yavuz Gülbahar ◽  
Metehan Keskin
Keyword(s):  
Experimental Study ◽  
Bone Defects ◽  
Induced Membrane ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Comparison between the induced membrane technique and distraction osteogenesis in treating segmental bone defects: An experimental study in a rat model

PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0226839 ◽  
Author(s):  
Zhen Shen ◽  
Haixiong Lin ◽  
Guoqian Chen ◽  
Yan Zhang ◽  
Zige Li ◽  
...  
Keyword(s):  
Experimental Study ◽  
Distraction Osteogenesis ◽  
Rat Model ◽  
Bone Defects ◽  
Induced Membrane ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Analysis of the early therapeutic effects and healing outcomes of segmental bone defects in the ankle joint treated with the induced membrane/wrapped bone grafting technique

2020 ◽  
Author(s):  
Wenbin Zhao ◽  
Maopeng Wang ◽  
Xingshi Lin ◽  
Feng Tu ◽  
Dongfeng Zhao
Keyword(s):  
Body Temperature ◽  
Bone Cement ◽  
Ankle Joint ◽  
Bone Defects ◽  
Micro Ct ◽  
Induced Membrane ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

Abstract BackgroundThe current research explores the early therapeutic efficacy and healing outcomes of segmental bone defects in the ankle joint treated with induced membrane technique. MethodsA segmental bone defect model of ankle joint was first constructed by removing 2mm bone from the ankle joint of the rat, and then the induced membrane treatment was performed in two steps: the first step was to implant polymethyl methacrylate bone cement after thorough debridement, followed by the second step to remove bone cement after membrane formation and to replace with the rat’s autologous cancellous bone. The physiological indicators (body temperature and body weight) of the rats and the TNF-α and CRP in the blood were monitored post-surgery, and the efficacy was analyzed based on the above combining Micro-CT and X-ray analysis. Postoperative histological analysis of the tissue morphology of partial induced membrane was performed in rats at 2, 4, 6, and 8 weeks to evaluate the tissue status at the sites of bone defect. ResultsResults showed that the rats survived well after operation: the body temperature slowly decreased, and the CRP was also gradually reduced to normal; the 12-week Micro-CT and palpation indicated a satisfying bone healing trend; histological studies found calcified tissue in the second week post-operation, and vascular network was established in the induced sites at 8 weeks.ConclusionThe study proves that the induced membrane technique can effectively treat segmental bone defects of ankle joint, and is less prone to infection.

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.

scholarly journals Evaluation of poly(lactide-co-glycolide)/hydroxyapatite nanofibres for reconstruction of critical-sized segmental bone defects in a canine model

2017 ◽  
Vol 62 (No. 6) ◽  
pp. 325-332
Author(s):  
SY Heo ◽  
HY Kim ◽  
NS Kim
Keyword(s):  
Bone Mass ◽  
Bone Defects ◽  
Canine Model ◽  
Control Group ◽  
Bone Scaffold ◽  
Micro Ct ◽  
Beagle Dogs ◽  
Defect Sites ◽  
Segmental Bone ◽  
Segmental Bone Defects

The treatment of segmental bone defects is a challenging problem for both human and veterinary medicine. Various biomaterials have successfully been used to treat these defects. Numerous recent in vitro studies have shown the potential of treating bone tissues using poly(lactide-co-glycolide)/hydroxyapatite (PLGA/HAp) nanofibres, which are fabricated using electrospinning. The purpose of this study was to evaluate the possibility of using a bone scaffold of PLGA/HAp nanofibres to repair critical-sized segmental bone defects in a canine model. The experimental bone defects were created in a 15 mm-long region of the radius. The area of the defect in each of 10 Beagle dogs was treated with a transplant of PLGA/HAp nanofibres in gelatin. The control group consisted of five Beagle dogs with similar defect sites that were not treated. Radiological and histological examinations were used to monitor the response of PLGA/HAp nanofibre-treated canine bone. Micro-computed tomography (micro-CT) was used to evaluate bone mass parameters 18 weeks after treatment in the experimental bone defect group. Our radiological and histological results showed that the PLGA/HAp nanofibre is biodegradable in the defect sites and replaces new bone tissue. Micro-CT showed that bone mass parameters were significantly (P &lt; 0.05) increased in the critical-sized segmental bone defects of PLGA/HAp nanofibre-treated animals as compared to those of untreated animals. Based on these results, we conclude that PLGA/HAp nanofibres may be used as a bone scaffold biomaterial in canines.

scholarly journals Defectos óseos segmentarios infectados en huesos largos: tratamiento con técnica de Masquelet.[Masquelet technique for the treatment of infected segmental long-bone defects]

2019 ◽  
Vol 84 (1) ◽  
pp. 15-26
Author(s):  
Germán Garabano ◽  
César Pesciallo ◽  
Alfredo Montero Vinces ◽  
Diego José Gómez ◽  
Fernando Bidolegui ◽  
...  
Keyword(s):  
Bone Defect ◽  
Average Length ◽  
Recurrent Infection ◽  
Bone Defects ◽  
Long Bone ◽  
Reconstruction Technique ◽  
Masquelet Technique ◽  
Membrane Technique ◽  
Segmental Bone ◽  
Segmental Bone Defects

Introducción: Los defectos óseos segmentarios infectados son entidades de complejo tratamiento. La técnica de Masquelet representa una alternativa para estos casos. El objetivo de este estudio retrospectivo, multicéntrico fue mostrar los resultados clínicos y radiológicos obtenidos con esta técnica de reconstrucción en defectos óseos segmentarios infectados de fémur y tibia, caracterizar los defectos tratados y describir los diferentes aspectos de la técnica quirúrgica.Materiales y Métodos: Analizamos a 24 pacientes (14 hombres y 10 mujeres; edad promedio 36.16 años [rango 18-67]) tratados con la técnica de Masquelet, operados entre 2011 y 2016. El seguimiento promedio fue de 16.5 meses (rango 12-27) desde el segundo tiempo quirúrgico. Se analizaron el hueso afectado, la longitud del defecto (en cm), el tiempo de consolidación y el control del proceso infeccioso.Resultados: La longitud del defecto óseo tratado fue, en promedio, de 5,7 cm (rango 3-12), fue superior a 4 cm en el 50% de los casos, el defecto óseo segmentario de mayor tamaño en la tibia fue de 12 cm y de 10 cm en el fémur. Se logró la consolidación ósea en todos los casos, en 4.5 meses. Un paciente presentó una recidiva del proceso infeccioso a los 12 meses de la consolidación.Conclusiones: La técnica de Masquelet o de la membrana inducida ofrece una alternativa razonable y sencilla para un problema altamente desafiante como son los defectos óseos segmentario infectados. La tasa de consolidación es superior al 90% aun en casos complejos. ABSTRACTIntroduction: Infected segmental bone defects are challenging conditions which require a complex treatment. The Masquelet technique is an alternative for these cases. The aim of this retrospective, multicenter study was to show the clinical and radiological outcomes achieved with the use of this reconstruction technique in infected femoral and tibial segmental defects in order to characterize the defects treated and describe different aspects of this surgical approach.Methods: We analyzed 24 patients (14 men and 10 women; average age 36.16 years [range 18-67]) treated with the Masquelet technique between 2011 and 2016. The average follow-up was 16.5 months (range 12-27) from the second surgical stage. We analyzed the affected bone, defect length (cm), consolidation time and infection control.Results: Average length of treated bone defect was 5.7 cm (range 3-12), exceeding 4 cm in 50% of the cases. The largest segmental bone defect was 12 cm at the tibia and 10 cm at the femur. Bone consolidation was achieved in all cases, on an average of 4.5 months. One patient presented a recurrent infection 12 months after successful consolidation.Conclusions: The Masquelet technique, or induced membrane technique, offers a reasonable and simple alternative to a highly challenging problem, such as infected segmental bone defects, achieving a consolidation rate greater than 90% even in complex cases.

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.

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