Induction of a Barrier Membrane to Facilitate Reconstruction of Massive Segmental Diaphyseal Bone Defects: An Ovine Model

Viateau, Véronique; Guillemin, G; Calando, Yolande; Logeart, Delphine; Oudina, Karim; Sedel, L.; Hannouche, Didier; Bousson, V.; Petite, Hervé

doi:10.1111/j.1532-950x.2006.00173.x

Cited by 124 publications

(112 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16 The lower limb was fitted with a short cylindrical cast (X-ray-penetrable polyethylene treated with polyurethane resin tape, Dynacast Optima; Smith þ Nephew, Covely, France) with an 8-mm-diameter steel walking bar. Casts were left in place for 6 weeks and 6 months after the first and second surgical procedures, respectively.…”

Section: Postoperative Managementmentioning

confidence: 99%

“…[8][9][10]12 In the first step, a PMMA spacer molded to match the size and shape of the defect is inserted into the defect, inducing formation of an encapsulating membrane that is well vascularized and contains Core binding factor alpha 1 (Cbfa1, an osteoblast-specific transcription factor essential to differentiation) positive cells. 16 Six weeks postsurgery, the spacer is removed, leaving a chamber that can be filled with granules of engineered bone and provide an appropriate environment favoring bone repair mechanisms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long‐bone critical‐size defects treated with tissue‐engineered grafts: A study on sheep

Viateau

Guillemin²,

Bousson

et al. 2007

Journal Orthopaedic Research

Self Cite

193

167

View full text Add to dashboard Cite

Standardized particulate bone constructs, obtained by expanding autologous mesenchymal stem cells (MSCs) onto coral granules in vitro, were transplanted into long-bone, critical-size defects in sheep. Control experiments were also performed in which autologous bone grafts were implanted. Defect cavities were lined with a preformed vascularized membrane (induced by temporarily inserting a cement spacer for 6 weeks prior to bone construct implantation), which served as a mold keeping the engineered bone granules in place. Radiographic, histological, and computed tomographic tests performed 6 months later showed that the osteogenic abilities of the engineered construct and autograft were significantly greater than those of coral scaffold alone. No significant differences were found between the amount of newly formed bone in defects filled with coral/MSCs and those filled with autograft, yet radiological scores differed significantly between the two groups (21% and 100% healed cortices, respectively). The present study on a clinically relevant animal model provides the first evidence that standardized particulate bone constructs can be used to repair large bone defects and that their osteogenic ability approaches that of bone autograft, the bone repair benchmark. By proving feasibility, the present study makes possible the treatment of segmental bone losses with bone constructs engineered from granules, a process which is much simpler than preparing customized massive constructs using computer-assisted techniques. Important parameters, such as the rate of scaffold resorption and the number of MSCs to be seeded on the scaffolds, need to be optimized before reaching pertinent definitive conclusions. ß

show abstract

Section: Postoperative Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐bone critical‐size defects treated with tissue‐engineered grafts: A study on sheep

Viateau

Guillemin²,

Bousson

et al. 2007

Journal Orthopaedic Research

Self Cite

193

167

View full text Add to dashboard Cite

show abstract

“…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%

“…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. Although bone resorption along with new bone formation are prerequisites to bone incorporation and remodeling, animal studies suggest the absence of inflammatory cells in this membrane [18] and that may minimize the amount of resorption. In our patient we could detect no resorption radiographically.…”

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

View full text Add to dashboard Cite

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.

show abstract

“…Bone defects are of particular relevance to the recovery and function of injured warriors [1]. This research addresses the treatment of segmental bone defects and methods that can be used to optimize the Masquelet induced membrane [2][3][4][5][6] technique to create a superior graft bed for bone regeneration. Using the Chronic Caprine Tibial Defect (CCTD) model, this study specifically aims to assess the effects of surgical technique and spacer design in optimizing the biology of the "Induced Membrane" (IM), and to define the characteristics of an optimal membrane with respect to the parameters of cell composition, histology, and gene expression.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects

Muschler¹

2014

View full text Add to dashboard Cite

Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time fo r review ing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and review ing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Director ate for Information Operations and Reports (0704 -0188), 1215 Jefferson Davis Highw ay, Suite 1204, Arlington, VA 22202-4302. Respondents should be aw are that notw ithstanding any other provision of law , no person shall be subject to any penalty for failing to comply w ith a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS.

show abstract

Induction of a Barrier Membrane to Facilitate Reconstruction of Massive Segmental Diaphyseal Bone Defects: An Ovine Model

Abstract: This model may be useful to evaluate new strategies in bone tissue engineering because the PMMA-induced membrane may help confine bone morphogenetic proteins, skeletal stem cells, or other agents to the defect cavity where they could be useful to enhance bone formation.

Cited by 124 publications

References 18 publications

Long‐bone critical‐size defects treated with tissue‐engineered grafts: A study on sheep

Long‐bone critical‐size defects treated with tissue‐engineered grafts: A study on sheep

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

Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects

Contact Info

Product

Resources

About