Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration

Pélissier, P.; Masquelet, A. C.; Bareille, Reine; Pélissier, Serge; Amédée, Joëlle

doi:10.1016/s0736-0266(03)00165-7

Cited by 515 publications

(407 citation statements)

References 25 publications

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“…High concentration rates of growth factors have been found in the membrane's cells, especially transforming growth factor b (TGFb), vascular endothelial growth factor (VEGF), and specific bone growth factors such as BMP-2. The membrane promotes human mesenchymal cell proliferation and differentiation into bone-forming cells [26]. In addition to this biological function, the induced membrane also prevents soft tissue protrusion in the defect, retains the bone graft in place and protects it against resorption, thus creating a favorable environment for bone engraftment.…”

Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Pannier

Péjin

Dana

et al. 2013

Journal of Children's Orthopaedics

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Purpose The purpose of this study was to evaluate the two-stage surgical technique combining induced membrane, spongy autograft and intramedullary fixation for the treatment of congenital pseudarthrosis of the tibia (CPT). Methods Three boys and two girls were treated by this technique between 2003 and 2008. All patients had type IV CPT in Crawford's classification. Four of them had a limited dystrophic form, whereas one case presented an extensive tibia bone dystrophy. The average age of patients at the time of surgery was 23 months (range 10-30 months), with an average follow-up of 5.8 years (range 2.4-8.1 years). Results Satisfactory tibial bony union was achieved in all cases at the last follow-up. Bone healing was obtained in the four limited forms after an average term of 4 months. One patient suffered from a non-displaced fracture that healed by casting in a usual period of time. The patient with an extensive dystrophic bone had to undergo a secondary inter-tibiofibular bone graft to finally achieve bone union. Conclusions The preliminary results show that this technique is successful in CPT. It may be used even in young children and offers a good alternative to other treatments available, avoiding external fixation and the technical difficulties of microvascular surgery.

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Section: Discussionmentioning

confidence: 99%

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Pannier

Péjin

Dana

et al. 2013

Journal of Children's Orthopaedics

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“…Histological studies on rabbits demonstrated extensive Implementation of the Masquelet Technique in Complicated Septic Non-union of the Ulna-A case Report 296 neovascularisation in the bone defect, whereas immunohistochemical studies denoted production of growth hormones (VEGF,TGF-b1) in a time period of two weeks, as well as the osteoinductive growth hormone BMP-2 (bone morphogenetic protein 2), with peak output at 9 weeks [3,[5][6][7][8][9][10]. These molecules are vital to bone formation, metabolism and remodelling [6]. The interior part of this "pseudomembrane" imitates epithelium and the exterior part includes fibroblasts, myoblasts and collagen [4].…”

Section: Discussionmentioning

confidence: 99%

Implementation of the Masquelet Technique in Complicated Septic Non-union of the Ulna—A Case Report

Kyriakopoulos¹,

Trintafyllopoulos²,

Kostakos³

et al. 2016

JPP

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Long bone septic non-union by MRSA (methicillin-resistant Staphylococcus aureus) is always a challenge for the orthopaedic society. Traditional treatment options include distraction osteogenesis methods and vascularised bone grafting. These techniques require a high level of expertise and are frequently involved with a variety of side effects or complications. We present a rare case of ulnar fracture complicated by MRSA infection that led to septic non-union. We treated the septic non union with the technique of induced membrane formation (Masquelet technique). A 33 year old male presented to the outpatient clinic, 2 months after internal fixation of a Gustillo I fracture of the left forearm. There was pus discharge from the operative wound and specimen culture was positive for MRSA. Initially the patient received conservative treatment with antibiotics for a period of one month. However, the patient returned with the same clinical presentation. The patient was then treated with hardware removal of the ulna and debridement of the septic non-union. The formed 5 cm bone defect was filled with cement spacer and the ulnar bone was fixed with external fixation. Eight weeks later, the spacer was removed and the bone gap was filled with autologous cancellous bone graft from iliac crest. Five months after grafting, the patient was reviewed. No clinical or functional problems were noted and osseous consolidation of the ulnar bone was confirmed in plain x-rays. The Masquelet technique is a promising alternative treatment for the management of infected long bone non-unions of the upper extremity.

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“…Animal studies show the membrane is richly vascularized by numerous small capillaries and with high concentrations of growth factors (vascular endothelial growth factor, transforming growth factor-b1), osteoblast precursors (CBFA1+), and osteoinductive (bone morphogenetic protein-2) factors when compared with control subjects [17,18]. Moreover, the membrane induced by cement shows an absence of inflammatory cells [18], as opposed to membrane induced by silicone interposition [10] which may prevent deleterious graft resorption.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Reconstruction of a 16-cm Diaphyseal Defect after Ewing's Resection in a Child

Biau

Pannier

Masquelet

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Numerous options exist for intercalary segmental reconstruction after bone tumor resection. We present the extension of a recently developed surgical twostage technique that involves insertion of a cement spacer, induction of a membrane, and reconstruction of the defect with cancellous and cortical bone autograft in a 12-year-old child. The boy was referred to our center for treatment of a right femoral diaphyseal Ewing's sarcoma. The first stage involved resection of the tumor and reconstruction with a locked intramedullary nail and a polymethylmethacrylate cement spacer. Seven months after the initial procedure during which adjuvant chemotherapy was given, the second-stage procedure was performed. The cement was removed and cancellous and cortical bone autograft was grafted in the membrane created around the cement spacer. Touchdown weightbearing was allowed immediately, partial weightbearing was resumed 6 weeks after the operation, and full weightbearing was allowed 4 months later. Successive plain radiographs showed rapid integration of the autograft to the host bone with bone union and cortical reconstitution. The principle of the induced membrane reconstruction seems applicable to intercalary segmental reconstruction after bone tumor resection in children.

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Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration

Cited by 515 publications

References 25 publications

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia: Preliminary results of five cases

Implementation of the Masquelet Technique in Complicated Septic Non-union of the Ulna—A Case Report

Case Report: Reconstruction of a 16-cm Diaphyseal Defect after Ewing's Resection in a Child

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