Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

Liu, Xuanzhe; Min, Hong; Chai, Yimin; Yu, Xin; Wen, Gen

doi:10.3389/fsurg.2022.1000340

Cited by 3 publications

(1 citation statement)

References 37 publications

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“…Masquelet's technique has been applied in human patients for reconstruction of severe segmental bone defects, treatment of osteomyelitis, and infected or recalcitrant non-unions through a two-stage approach [1][2][3][4] . The first stage includes the induced membrane development after the debridement of tissues and the application of a polymethyl methacrylate (PMMA) cement spacer 1,5 .…”

Section: Introductionmentioning

confidence: 99%

Use of F18 bioglass putty for induced membrane technique in segmental bone defect of the radius in rabbits

Silva Júnior,

Rahal,

Coris

et al. 2024

Acta Cir. Bras.

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To evaluate the inductive capacity of F18 bioglass putty on the induced membrane technique in a segmental bone defect of the rabbit's radius. Methods: Ten female Norfolk at 24 months of age were used. The animals were randomly separated based on postoperative time points: five rabbits at 21 and four at 42 days. A 1-cm segmental bone defect was created in both radii. The bone defects were filled with an F18 bioglass putty. Results: Immediate postoperative radiographic examination revealed the biomaterial occupying the segmental bone defect as a well-defined radiopaque structure with a density close to bone tissue. At 21 and 42 days after surgery, a reduction in radiopacity and volume of the biomaterial was observed, with particle dispersion in the bone defect region. Histologically, the induced membrane was verified in all animals, predominantly composed of fibrocollagenous tissue. In addition, chondroid and osteoid matrices undergoing regeneration, a densely vascularized tissue, and a foreign body type reaction composed of macrophages and multinucleated giant cells were seen. Conclusion: the F18 bioglass putty caused a foreign body-type inflammatory response with the development of an induced membrane without expansion capacity to perform the second stage of the Masquelet technique.

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Section: Introductionmentioning

confidence: 99%

Use of F18 bioglass putty for induced membrane technique in segmental bone defect of the radius in rabbits

Silva Júnior,

Rahal,

Coris

et al. 2024

Acta Cir. Bras.

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Outcomes of Infected Non-unions of Distal Femur Managed with the Masquelet Method and Ilizarov Ring Fixator

Rathod,

Krishnamurthy,

Shivanna

et al. 2024

JOIO

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The Expression Level of Inflammation-Related Genes in Patients With Bone Nonunion and the Effect of BMP-2 Infected Mesenchymal Stem Cells Combined With nHA/PA66 on the Inflammation Level of Femoral Bone Nonunion Rats

Huang,

Zhang,

Jing

et al. 2024

Physiol Res

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Bone nonunion delays fracture end repair and is associated with inflammation. Although bone nonunion can be effectively repaired in clinical practice, many cases of failure. Studies have confirmed that BMP-2 and nHA/PA66 repaired bone defects successfully. There are few studies on the effects of the combined application of BMP-2 and NHA/PA66 on bone nonunion osteogenesis and inflammation. We aimed to investigate the expression level of inflammation-related genes in patients with bone nonunion and the effect of BMP-2-infected mesenchymal stem cells combined with nHA/PA66 on the level of inflammation in femur nonunion rats. We searched for a gene expression profile related to bone nonunion inflammation (GSE93138) in the GEO public database. Bone marrow mesenchymal stem cells (MSCs) of SD rats were cultured and passed through. We infected the third generation of MSCs with lentivirus carrying BMP-2 and induced the infected MSCs to bone orientation. We detected the expression level of BMP-2 by RT-PCR and the cell viability and alkaline phosphatase (ALP) activity by CCK8 and then analyzed the cell adhesion ability. Finally, the levels of related inflammatory factors, including C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and Erythrocyte Sedimentation Rate (ESR), were detected in nonunion rats. Our findings: The patients with nonunion had up-regulated expression of 26 differentially inflammatory genes. These genes are mainly enriched in innate immune response, extracellular region, calcium ion binding, Pantothenate and CoA biosynthesis pathways. The expression level of BMP-2 in the Lenti-BMP-2 group was higher (vs. empty lentivirus vector group: t=5.699; vs. uninfected group t=3.996). The cell activity of the MSCs + BMP-2 + nHA/PA66 group increased gradually. After being combined with nHA/PA66, MSCs transfected with BMP-2 spread all over the surface of nHA/PA66 and grew into the material pores. MSCs + BMP-2 + nHA/PA66 cells showed positive ALP staining, and the OD value of ALP was the highest. The levels of CRP, IL-6, TNF-α, and ESR in the MSCs + BMP-2 + nHA/PA66 group were lower than those in the MSCs and MSCs + nHA/PA66 group but higher than those in MSCs + BMP-2 group. The above comparisons were all P˂0.05. The findings demonstrated that the expression level of inflammation-related genes increased in the patients with bone nonunion. The infection of MSCs by BMP-2 could promote the directed differentiation of MSCs into osteoblasts in the bone marrow of rats, enhance the cell adhesion ability and ALP activity, and reduce inflammation in rats with bone nonunion.

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Masquelet technique with radical debridement and alternative fixation in treatment of infected bone nonunion

Cited by 3 publications

References 37 publications

Use of F18 bioglass putty for induced membrane technique in segmental bone defect of the radius in rabbits

Use of F18 bioglass putty for induced membrane technique in segmental bone defect of the radius in rabbits

Outcomes of Infected Non-unions of Distal Femur Managed with the Masquelet Method and Ilizarov Ring Fixator

The Expression Level of Inflammation-Related Genes in Patients With Bone Nonunion and the Effect of BMP-2 Infected Mesenchymal Stem Cells Combined With nHA/PA66 on the Inflammation Level of Femoral Bone Nonunion Rats

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