The Mechanism of Action of Induced Membranes in Bone Repair

Abstract

The induced membranes have osteogenesis-improving capabilities. These capabilities, however, appear to decrease over time. We speculate that the optimal time for performing second-stage surgery may be within a month after implantation of foreign material.

Reconstrucción de defectos óseos segmentarios postraumáticos mediante técnica de inducción de membrana

“…Este tejido denominado membrana inducida está ricamente vascularizada, y conformada por colágeno Tipo I y células fibroblásticas externamente e internamente semejante a un epitelio sinovial; la membrana secreta factores de crecimiento en alta concentración (21,22). Esta membrana mejora la incorporación del injerto óseo.…”

“…El espaciador induce la formación de la membrana de Masquelet, que es un tejido vascularizado rico en factores de crecimiento como el factor de crecimiento del endotelio vascular (VEGF) y factor de crecimiento transformante beta (TGF-ß1) (21,22). La segunda etapa se realiza entre cuatro a ocho semanas después: se retira el espaciador preservando cuidadosamente la membrana inducida y se sustituye por injerto óseo esponjoso autólogo, La función de la membrana inducida es rodear al injerto óseo y nutrirlo, evitando su reabsorción.…”

CORR Insights®: Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

“…Although the induced membrane method has been well-studied and reported on in the last 12 years [1,8], the technique has usually been described in adults and primarily employed for posttraumatic defects. Pelissier et al [5] reported that the best timing for the active membrane effectiveness, with highest cytokine concentrations, is 4 weeks to 6 weeks after placement of the antibiotic-cement implant.…”

Effects of Local Antibiotic Delivery from Porous Space Maintainers on Infection Clearance and Induction of an Osteogenic Membrane in an Infected Bone Defect

“…1,2 Masquelet describes induced membranes as an ''in situ growth factor delivery system'' and many subsequent studies have demonstrated the intrinsic bioactivity of membranes grown around PMMA space maintainers. 1,3 Intrinsic membrane factors that can ultimately promote bone growth in the second reconstructive stage include osteogenic and angiogenic growth factors and pro-and anti-inflammatory cytokines. [3][4][5] The presence of these factors has been demonstrated in both human and animal induced membranes over PMMA.…”

“…1,3 Intrinsic membrane factors that can ultimately promote bone growth in the second reconstructive stage include osteogenic and angiogenic growth factors and pro-and anti-inflammatory cytokines. [3][4][5] The presence of these factors has been demonstrated in both human and animal induced membranes over PMMA. 3,[5][6][7] Ultimately, this membrane serves as an endogenously derived depot of growth factors for the second stage of reconstruction, which involves the removal of the PMMA construct and definitive reconstruction with a graft or flap.…”