Induced membrane technique in the treatment of infected tibial bone defect: a retrospective study

Abstract

Introduction: The induced membrane technique (IMT) is a two-stage procedure dedicated to reconstruction of bone defects of the limbs. The aim of this study was to investigate the effect of IMT in the treatment of infected tibial bone defect. Patients and methods: A retrospective study was performed among the patients treated using IMT for infected tibial bone defect between 2017 and 2020. The complications were recorded, and the bone defect union and the functional results were evaluated by Paley method. All patients were followed up for at least one year. Results We included 12 patients (11 males) with a mean age of 44.5 years (range 19 to 65). The mean length of bone defect was 26.7 mm (range 10 to 60). The mean interval between the stage one and the stage two of the procedure was 11.8 weeks (range 4 to 32). At a mean follow-up of 18.08 months (range 12 to 32), bone union was achieved in all cases in a mean time of 8 months (range 5 to 16) without infection recurrence, where one patient received additional bone grafting. The joint function recovered well for the patients and the rate of functionally excellent and good results was 9/12. Conclusion IMT in the treatment of infected tibial bone defect offers the advantages of simple operation, rapid healing of bone defects, and low recurrence rate of infection.

Distraction osteogenesis versus induced membrane technique for infected tibial non-unions with segmental bone loss: a systematic review of the literature and meta-analysis of available studies

“…One-hundred and fifty-four ( n = 154) articles were ultimately retrieved for full-text review. After applying the eligibility criteria, 122 articles were excluded, leaving a final 32 primary studies [ 17 – 20 , 30 – 57 ] for analysis, as summarised in the PRISMA flowchart (Fig. 1 ).…”

“…The only available data pertaining to tibial NUs were used in the pooled analysis [ 39 ]. The remaining articles included single-intervention cohorts of either the Ilizarov method ( n = 22) [ 30 – 38 , 40 , 42 – 51 , 53 , 56 ] or the Mq technique ( n = 8) [ 17 – 20 , 41 , 52 , 55 , 57 ].…”

“…crest: 13 + Allog: 13 27 Lotzien [ 52 ] 33 (13–69) 7.9 (1–22) Free flaps: 19, Local flaps: 4 nr 10.3 (4–21) RIA: 30, Il crest: 18, BMP: 2, Allog. 23 28 Gupta [ 53 ] > 9 months nr Local muscle flaps in some cases (not specified) Not specified nr 3 29 Rohilla [ 54 ] DO: 31.6 (24–37) MQ: 30.4 (24–36) nr STSG or flaps: 7 DO: 2 wks IV 2 wks: oral MQ: 2 wks IV 2 wks: oral DO: 9.4 (6–12) MQ: 16.3 (13–18) nr Il crest: 12 30 Yang [ 20 ] 18 (12–32) 1 (0–3) nr 6 wks after 2nd stage nr Il. crest: 12 ± Allog 31 Ozpolat [ 55 ] 24.6 (13–40) 2.8 (1–6) Free flaps: 3, Local flaps: 4 2–4 wks IV, + 2 wks PO nr Il.…”

“…With regards to LoE, there were 2 RCTs (Level I) [ 43 , 54 ], 5 prospective cohort studies (Level II) [ 32 , 45 , 47 , 48 , 53 ] 7 retrospective comparative studies (Level III) [ 17 , 31 , 39 , 40 , 46 , 49 , 50 ] and 18 retrospective cohort studies (Level IV) [ 18 – 20 , 30 , 33 – 38 , 41 , 42 , 44 , 51 , 52 , 55 – 57 ] (Table 3 ). The overall risk of bias of both randomised prospective trials [ 43 , 54 ] was high, according to the RoB2 tool (Table 3 ).…”

“…Variable results have been reported in the literature, with the Masquelet (Mq) technique used in the treatment of infected tibial defects of up to 28 cm. The overall success rate (union plus infection elimination) ranged from 45 to 100%, with the unplanned reoperation rate between 2 and 58% [ 17 – 20 ].…”