From two stages to one: acceleration of the induced membrane (Masquelet) technique using human acellular dermis for the treatment of non-infectious large bone defects

  • Introduction: The induced membrane technique for the treatment of large bone defects is a two-step procedure. In the first operation, a foreign body membrane is induced around a spacer, then, in the second step, several weeks or months later, the spacer is removed and the Membrane pocket is filled with autologous bone material. Induction of a functional biological membrane might be avoided by initially using a biological membrane. In this study, the effect of a human acellular dermis (hADM, Epiflex, DIZG gGmbH) was evaluated for the treatment of a large (5 mm), plate-stabilised femoral bone defect. Material and Methods: In an established rat model, hADM was compared to the two-stage induced membrane technique and a bone defect without membrane cover. Syngeneous spongiosa from donor animals was used for defect filling in all groups. The group size in each case was n = 5, the induction time of the membrane was 3–4 weeks and the healing time after filling of the defect was 8 weeks. Results: The ultimate loads were increased to levels comparable with native bone in both membrane groups (hADM: 63.2% ± 29.6% of the reference bone, p < 0.05 vs. no membrane, induced membrane: 52.1% ± 25.8% of the reference bone, p < 0.05 vs. no membrane) and were significantly higher than the control group without membrane (21.5%). The membrane groups were radiologically and histologically almost completely bridged by new bone formation, in contrast to the control Group where no closed osseous bridging could be observed. Conclusion: The use of the human acellular dermis leads to equivalent healing results in comparison to the two-stage induced membrane technique. This could lead to a shortened therapy duration of large bone defects.

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Author:René VerboketORCiDGND, Maximilian LeibleinGND, Maren Carina JankoORCiDGND, Alexander Schaible, Jan C. BruneGND, Katrin SchröderORCiD, Heilani Myriam WidadGND, Charlotte FremdlingGND, Yannic Busche, Tanja Irrle, Ingo MarziORCiDGND, Christoph Heinrich Eugen NauGND, Dirk HenrichORCiDGND
Parent Title (English):European journal of trauma and emergency surgery
Place of publication:Berlin ; Heidelberg
Document Type:Article
Date of Publication (online):2020/01/13
Date of first Publication:2020/01/13
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/10/20
Tag:Acellular dermis; Induced membrane technique; Masquelet technique
Page Number:11
First Page:317
Last Page:327
Open Access funding provided by Projekt DEAL.
Funding: AO-Germany Research fellowship 2017 (Maximilian Leiblein), DIZG, Berlin, Germany and German Institute for Cell and Tissue Replacement.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0