PROGRESS OF Masquelet TECHNIQUE TO REPAIR BONE DEFECT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YIN Qudong , SUN Zhenzhong , GU Sanjun.

Department of Orthopaedics, Wuxi No.9 People’s Hospital, Wuxi Jiangsu, 214062, P.R.China. Corresponding author: YIN Qudong, E-mail: yqdwxs@163.com;

Corresponding author：

Keywords：

Bone defect; Bone cement; Bone graft; Masquelet technique

DOI：

10.7507/1002-1892.20130277

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Objective To summarize the progress of Masquelet technique to repair bone defect. Methods The recent literature concerning the application of Masquelet technique to repair bone defect was extensively reviewed and summarized. Results Masquelet technique involves a two-step procedure. First, bone cement is used to fill the bone defect after a thorough debridement, and an induced membrane structure surrounding the spacer formed; then the bone cement is removed after 6-8 weeks, and rich cancellous bone is implanted into the induced membrane. Massive cortical bone defect is repaired by new bone forming and consolidation. Experiments show that the induced membrane has vascular system and is also rich in vascular endothelial growth factor, transforming growth factor β1, bone morphogenetic protein 2, and bone progenitor cells, so it has osteoinductive property; satisfactory results have been achieved in clinical application of almost all parts of defects, various types of bone defect and massive defect up to 25 cm long. Compared with other repair methods, Masquelet technique has the advantages of reliable effect, easy to operate, few complications, low requirements for recipient site, and wide application. Conclusion Masquelet technique is an effective method to repair bone defect and is suitable for various types of bone defect, especially for bone defects caused by infection and tumor resection.

Citation： YIN Qudong,SUN Zhenzhong,GU Sanjun.. PROGRESS OF Masquelet TECHNIQUE TO REPAIR BONE DEFECT. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(10): 1273-1276. doi: 10.7507/1002-1892.20130277 Copy

1.	Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
2.	Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am, 2010, 41(1): 27-37.
3.	Giannoudis PV, Faour O, Goff T, et al. Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury, 2011, 42(6): 591-598.
4.	Pelissier P, Masquelet AC, Bareille R, et al. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res, 2004, 22(1): 73-79.
5.	Fitoussi F, Masquelet AC, Rigal S, et al. Inter-tibiofibular graft for traumatic segmental bone defect of the tibia. Orthop Traumatol Surg Res, 2012, 98(2): 214-219.
6.	Masquelet AC, Obert L. Induced membrane technique for bone defects in the hand and wrist. Chir Main, 2010, 29 Suppl 1: S221-224.
7.	Zwetyenga N, Catros S, Emparanza A, et al. Mandibular reconstruction using induced membranes with autologous cancellous bone graft and HA-betaTCP: animal model study and preliminary results in patients. Int J Oral Maxillofac Surg, 2009, 38(12): 1289-1297.
8.	Klaue K, Knothe U, Anton C, et al. Bone regeneration in long-bone defects: tissue compartmentalisation? In vivo study on bone defects in sheep. Injury, 2009, 40(Suppl 4): S95-102.
9.	Viateau V, Guillemin G, Calando Y, et al. Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg, 2006, 35(5): 445-452.
10.	Pelissier P, Martin D, Baudet J, et al. Behaviour of cancellous bone graft placed in induced membranes. Br J Plast Surg, 2002, 55(7): 596-598.
11.	柳海晓, 徐华梓, 张宇, 等. 骨水泥表面粗糙度对诱导膜组织学特性的影响. 中国骨伤, 2012, 28(8): 662-666.
12.	Flamans B, Pauchot J, Petite H, et al. Use of the induced membrane technique for the treatment of bone defects in the hand or wrist, in emergency. Chir Main, 2010, 29(5): 307-314.
13.	Apard T, Bigorre N, Cronier P, et al. Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res, 2010, 96(5): 549-553.
14.	Donegan DJ, Scolaro J, Matuszewski PE, et al. Staged bone grafting following placement of an antibiotic spacer block for the management of segmental long bone defects. Orthopedics, 2011, 34(11): e730-735.
15.	Karger C, Kishi T, Schneider L, et al. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res, 2012, 98(1): 97-102.
16.	Rezzouk J, Leclerc J, Leger O, et al. Bone reconstruction with induced membrances and cancellous autograft: results in 18 cases of osteitis. J Bone Joint Surg (Br), 2005, 87(Suppl 2): 98.
17.	Powerski M, Maier B, Frank J, et al. Treatment of severe osteitis after elastic intramedullary nailing of a radial bone shaft fracture by using cancellous bone graft in Masquelet technique in a 13-year-old adolescent girl. J Pediatr Surg, 2009, 44(8): E17-19.
18.	Woon CY, Chong KW, Wong MK. Induced membrances—a staged technique of bone-grafting for segmental bone loss: a report of two case and literature review. J Bone Joint Surg (Am), 2010, 92(1): 196-201.
19.	Biau DJ, Pannier S, Masquelet AC, et al. Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res, 2009, 467(2): 572-577.
20.	Chotel F, Nguiabanda L, Braillon P, et al. Induced membrane technique for reconstruction after bone tumor resection in children: a preliminary study. Orthop Traumatol Surg Res, 2012, 98(3): 301-308.
21.	Villemagne T, Bonnard C, Accadbled F, et al. Intercalary segmental reconstruction of long bones after malignant bone tumor resection using primary methyl methacrylate cement spacer interposition and secondary bone grafting: the induced membrane technique. J Pediatr Orthop, 2011, 31(5): 570-576.
22.	Zappaterra T, Ghislandi X, Adam A, et al. Induced membrane technique for the reconstruction of bone defects in upper limb. A prospective single center study of nine cases. Chir Main, 2011, 30(4): 255-263.
23.	Uzel AP, Lemonne F, Casoli V. Tibial segmental bone defect reconstruction by Ilizarov type bone transport in an induced membrane. Orthop Traumatol Surg Res, 2010, 96(2): 194-198.
24.	O’Malley NT, Kates SL. Advances on the Masquelet technique using a cage and nail construct. Arch Orthop Trauma Surg, 2012, 132(2): 245-248.
25.	Stafford PR, Norris BL. Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases. Injury, 2010, 41(Suppl 2): S72-77.
26.	Huffman LK, Harris JG, Suk M. Using the bi-masquelet technique and reamer-irrigator-aspirator for post-traumatic foot reconstruction. Foot Ankle Int, 2009, 30(9): 895-899.
27.	De Biase P, Campanacci DA, Beltrami G, et al. Scaffolds combined with stem cells and growth factors in healing of pseudotumoral lesions of bone. Int J Immunopathol Pharmacol, 2011, 24(1 Suppl 2): 11-15.

1. Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
2. Masquelet AC, Begue T. The concept of induced membrane for reconstruction of long bone defects. Orthop Clin North Am, 2010, 41(1): 27-37.
3. Giannoudis PV, Faour O, Goff T, et al. Masquelet technique for the treatment of bone defects: tips-tricks and future directions. Injury, 2011, 42(6): 591-598.
4. Pelissier P, Masquelet AC, Bareille R, et al. Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration. J Orthop Res, 2004, 22(1): 73-79.
5. Fitoussi F, Masquelet AC, Rigal S, et al. Inter-tibiofibular graft for traumatic segmental bone defect of the tibia. Orthop Traumatol Surg Res, 2012, 98(2): 214-219.
6. Masquelet AC, Obert L. Induced membrane technique for bone defects in the hand and wrist. Chir Main, 2010, 29 Suppl 1: S221-224.
7. Zwetyenga N, Catros S, Emparanza A, et al. Mandibular reconstruction using induced membranes with autologous cancellous bone graft and HA-betaTCP: animal model study and preliminary results in patients. Int J Oral Maxillofac Surg, 2009, 38(12): 1289-1297.
8. Klaue K, Knothe U, Anton C, et al. Bone regeneration in long-bone defects: tissue compartmentalisation? In vivo study on bone defects in sheep. Injury, 2009, 40(Suppl 4): S95-102.
9. Viateau V, Guillemin G, Calando Y, et al. Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model. Vet Surg, 2006, 35(5): 445-452.
10. Pelissier P, Martin D, Baudet J, et al. Behaviour of cancellous bone graft placed in induced membranes. Br J Plast Surg, 2002, 55(7): 596-598.
11. 柳海晓, 徐华梓, 张宇, 等. 骨水泥表面粗糙度对诱导膜组织学特性的影响. 中国骨伤, 2012, 28(8): 662-666.
12. Flamans B, Pauchot J, Petite H, et al. Use of the induced membrane technique for the treatment of bone defects in the hand or wrist, in emergency. Chir Main, 2010, 29(5): 307-314.
13. Apard T, Bigorre N, Cronier P, et al. Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res, 2010, 96(5): 549-553.
14. Donegan DJ, Scolaro J, Matuszewski PE, et al. Staged bone grafting following placement of an antibiotic spacer block for the management of segmental long bone defects. Orthopedics, 2011, 34(11): e730-735.
15. Karger C, Kishi T, Schneider L, et al. Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res, 2012, 98(1): 97-102.
16. Rezzouk J, Leclerc J, Leger O, et al. Bone reconstruction with induced membrances and cancellous autograft: results in 18 cases of osteitis. J Bone Joint Surg (Br), 2005, 87(Suppl 2): 98.
17. Powerski M, Maier B, Frank J, et al. Treatment of severe osteitis after elastic intramedullary nailing of a radial bone shaft fracture by using cancellous bone graft in Masquelet technique in a 13-year-old adolescent girl. J Pediatr Surg, 2009, 44(8): E17-19.
18. Woon CY, Chong KW, Wong MK. Induced membrances—a staged technique of bone-grafting for segmental bone loss: a report of two case and literature review. J Bone Joint Surg (Am), 2010, 92(1): 196-201.
19. Biau DJ, Pannier S, Masquelet AC, et al. Case report: reconstruction of a 16-cm diaphyseal defect after Ewing’s resection in a child. Clin Orthop Relat Res, 2009, 467(2): 572-577.
20. Chotel F, Nguiabanda L, Braillon P, et al. Induced membrane technique for reconstruction after bone tumor resection in children: a preliminary study. Orthop Traumatol Surg Res, 2012, 98(3): 301-308.
21. Villemagne T, Bonnard C, Accadbled F, et al. Intercalary segmental reconstruction of long bones after malignant bone tumor resection using primary methyl methacrylate cement spacer interposition and secondary bone grafting: the induced membrane technique. J Pediatr Orthop, 2011, 31(5): 570-576.
22. Zappaterra T, Ghislandi X, Adam A, et al. Induced membrane technique for the reconstruction of bone defects in upper limb. A prospective single center study of nine cases. Chir Main, 2011, 30(4): 255-263.
23. Uzel AP, Lemonne F, Casoli V. Tibial segmental bone defect reconstruction by Ilizarov type bone transport in an induced membrane. Orthop Traumatol Surg Res, 2010, 96(2): 194-198.
24. O’Malley NT, Kates SL. Advances on the Masquelet technique using a cage and nail construct. Arch Orthop Trauma Surg, 2012, 132(2): 245-248.
25. Stafford PR, Norris BL. Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions: a review of 25 cases. Injury, 2010, 41(Suppl 2): S72-77.
26. Huffman LK, Harris JG, Suk M. Using the bi-masquelet technique and reamer-irrigator-aspirator for post-traumatic foot reconstruction. Foot Ankle Int, 2009, 30(9): 895-899.
27. De Biase P, Campanacci DA, Beltrami G, et al. Scaffolds combined with stem cells and growth factors in healing of pseudotumoral lesions of bone. Int J Immunopathol Pharmacol, 2011, 24(1 Suppl 2): 11-15.

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PROGRESS OF Masquelet TECHNIQUE TO REPAIR BONE DEFECT

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