The Basic Science Behind the Clinical Success of the Induced Membrane Technique for Critical-Sized Bone Defects

Abstract

The induced membrane technique (IMT) takes advantage of an osteoinductive environment that is created by the placement of a cement spacer into a bone defect.» Most commonly, a polymethylmethacrylate (PMMA) spacer has been used, but spacers made from other materials have emerged and achieved good clinical outcomes.» The IMT has demonstrated good results for long-bone repair; however, more research is required in order to optimize union rates as well as delineate more precise indications and surgical timing.

Infected humeral shaft nonunion treatment with the induced membrane technique and a novel fixation construct: a case report

“…11 The IMT is a 2 stage method used to create a bioactive membrane in which bone graft can be placed to augment bony union. 5,12 In the first stage, all devitalized bone and soft tissue is thoroughly debrided, the remaining fracture with the bony defect are stabilized and a polymethylmethacrylate (PMMA) spacer is placed into the bony defect. Between the first and second stages, a bioactive membrane is formed around the PMMA spacer that becomes highly vascularized and secretes a combination of growth factors important for bone healing including bone morphogenic protein-2, transforming growth factor-b1, and vascular endothelial growth factor.…”