scholarly journals Introduction of a New Surgical Method to Improve Bone Healing in a Large Bone Defect by Replacement of the Induced Membrane by a Human Decellularized Dermis Repopulated with Bone Marrow Mononuclear Cells in Rat

Materials ◽  
2020 ◽  
Vol 13 (11) ◽  
pp. 2629
Author(s):  
Maximilian Leiblein ◽  
Tobias Kolb ◽  
Lion Christian ◽  
Katrin Schröder ◽  
Ceyhan Yaman ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Healing ◽  
Mononuclear Cells ◽  
Biomechanical Analysis ◽  
Bone Marrow Mononuclear Cells ◽  
Induced Membrane ◽  
Masquelet Technique ◽  
Membrane Technique ◽  
Large Bone ◽  
Decellularized Dermis

The Masquelet technique for the treatment of large bone defects is a two-stage procedure based on an induced membrane. We eliminate the first surgical step by using a decellularized dermal skin graft (Epiflex®) populated with bone marrow mononuclear cells (BMC), as a replacement for the induced membrane. The aim of this study was to demonstrate the feasibility of this technology and provide evidence of equivalent bone healing in comparison to the induced membrane-technique. Therefore, 112 male Sprague–Dawley rats were allocated in six groups and received a 10 mm femoral defect. Defects were treated with either the induced membrane or decellularized dermis, with or without the addition of BMC. Defects were then filled with a scaffold (β-TCP), with or without BMC. After a healing time of eight weeks, femurs were taken for histological, radiological and biomechanical analysis. Defects treated with Epiflex® showed increased mineralization and bone formation predominantly in the transplanted dermis surrounding the defect. No significant decrease of biomechanical properties was found. Vascularization of the defect could be enhanced by addition of BMC. Considering the dramatic reduction of a patient’s burden by the reduced surgical stress and shortened time of treatment, this technique could have a great impact on clinical practice.

scholarly journals Radiological and clinical outcomes using induced membrane technique combined with bone marrow concentrate in the treatment of chronic osteomyelitis of immature patients

2021 ◽  
Vol 10 (1) ◽  
pp. 31-40
Author(s):  
Jie Shen ◽  
Dong Sun ◽  
Shengpeng Yu ◽  
Jingshu Fu ◽  
Xiaohua Wang ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Healing ◽  
Chronic Osteomyelitis ◽  
Young Patients ◽  
Bone Defects ◽  
Healing Time ◽  
Induced Membrane ◽  
Membrane Technique ◽  
Induced Membrane Technique ◽  
Large Bone

Aims Treatment of chronic osteomyelitis (COM) for young patients remains a challenge. Large bone deficiencies secondary to COM can be treated using induced membrane technique (IMT). However, it is unclear which type of bone graft is optimal. The goal of the study was to determine the clinical effectiveness of bone marrow concentrator modified allograft (BMCA) versus bone marrow aspirate mixed allograft (BMAA) for children with COM of long bones. Methods Between January 2013 and December 2017, 26 young patients with COM were enrolled. Different bone grafts were applied to repair bone defects secondary to IMT procedure for infection eradication. Group BMCA was administered BMCA while Group BMAA was given BMAA. The results of this case-control study were retrospectively analyzed. Results Patient infection in both groups was eradicated after IMT surgery. As for reconstruction surgery, no substantial changes in the operative period (p = 0.852), intraoperative blood loss (p = 0.573), or length of hospital stay (p = 0.362) were found between the two groups. All patients were monitored for 12 to 60 months. The median time to bone healing was 4.0 months (interquartile range (IQR) 3.0 to 5.0; range 3 to 7) and 5.0 months (IQR 4.0 to 7.0; range 3 to 10) in Groups BMCA and BMAA, respectively. The time to heal in Group BMCA versus Group BMAA was substantially lower (p = 0.024). Conclusion IMT with BMCA or BMAA may attain healing in large bone defects secondary to COM in children. The bone healing time was significantly shorter for BMCA, indicating that this could be considered as a new strategy for bone defect after COM treatment. Cite this article: Bone Joint Res 2021;10(1):31–40.

Cell-Based Therapy by Implanted Human Bone Marrow-Derived Mononuclear Cells Improved Bone Healing of Large Bone Defects in Rats

2015 ◽  
Vol 21 (9-10) ◽  
pp. 1565-1578 ◽  
Author(s):  
Caroline Seebach ◽  
Dirk Henrich ◽  
Alexander Schaible ◽  
Borna Relja ◽  
Manfred Jugold ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Healing ◽  
Mononuclear Cells ◽  
Bone Defects ◽  
Human Bone ◽  
Human Bone Marrow ◽  
Cell Based Therapy ◽  
Large Bone ◽  
Large Bone Defects

scholarly journals Modified Masquelet Technique Using Allogeneic Graft for a Gustilo-Anderson Type III-A Open Fracture of the Femur with an 8 cm Bone Defect

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hichem Issaoui ◽  
Mohammed Reda Fekhaoui ◽  
Moheddin Jamous ◽  
Alain-Charles Masquelet
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Bony Union ◽  
Induced Membrane ◽  
Masquelet Technique ◽  
Membrane Technique ◽  
Defect Area ◽  
Induced Membrane Technique ◽  
Large Bone

The induced membrane technique was initially described by Masquelet et al. in 1986 as a treatment for tibia nonunion; then, it became one of the established methods in the management of bone defects. Several changes have been made to this technique and have been used in different contexts and different methodologies. We present the case of a 16-year-old girl admitted to our department for a polytrauma after a motorcycle accident. She presented a Gustilo III-A open fracture of the right femoral shaft with a large bone defect of 8 centimeters that we treated with a modified Masquelet technique. In the first stage, an Open Reduction and Internal Fixation of the fracture was made using a 4,5 mm Dynamic Compression Plate and a PMMA cement was inserted at the bone defect area. The second stage was done after 11 weeks, and the defect area was filled exclusively with bone allograft from a bone bank. Complete bony union was seen at 60 weeks of follow-up. After the removal of the implants by another surgeon, the patient presented an atraumatic fracture of the neoformed bone that we treated with intramedullary femoral nailing associated with a local autograft using reaming debris. A complete bony union was achieved after 12 weeks with a complete range of motion of the hip and knee. The stability given to the fracture is essential because it influences the quality of the induced membrane and Masquelet has recommended high initial fixation rigidity to promote incorporation of the graft. It is recommended to delay the second stage of this technique after 8 weeks, especially in femoral reconstruction, to optimize the quality of the induced membrane. Several studies used a modified induced membrane technique to recreate a traumatic large bone defect, and all of them used an autologous bone graft alone or an enriched bone graft. In this case, the use of allograft exclusively seems to be as successful as an autologous or enriched bone graft. Now, with the advent of bone banks, it is possible to get an unlimited amount of allograft, so additional research and large studies are necessary before giving recommendations.

Sign in / Sign up

Export Citation Format

Share Document