Selection of Graft Expanders for the Second Stage of the Induced Membrane Technique. Issue 1 (March 2016)

• Record Type: Journal Article
• Authors: Schmidmaier, Gerhard; Miska, Matthias; Zietzschmann, Seven; Moghaddam, Arash
• Is Part Of: Techniques in orthopaedics. Volume 31:Issue 1(2016)
• Publication Date: 2016-03
• Subjects: Masquelet technique -- BMP -- bone substitute -- TCP -- RIA -- autologous bone -- nonunion -- infection; Orthopedics -- Periodicals; 617.47
• DOI: 10.1097/BTO.0000000000000161
• Languages: English
• ISSNs: 0885-9698

Abstract

Abstract : In the second stage of the induced membrane technique (Masquelet), a bone gap remains after debridement and removal of the bone cement spacer. For a successful therapy, the bone gap has to be filled with an adequate substrate. Autologous bone grafts represent the gold standard and seem to be the optimal filling material with several essential abilities for callus formation: osteogenic cells, osteoinductive, and osteoconductive properties. Regarding the limited availability, several alternatives have come on the market for the use in human bone defects. Allograft from donor bone and synthetic substitutes are easily accessible and of nearly unlimited availability ready to use. Despite of these advantages, they lack osteogenic potential and in most cases they also lack osteoinductive properties. Although they are still not the optimal replacement for autologous bone grafts, we recommend the combination of synthetic bone substitutes and growth factors with autologous bone to increase the amount of filling material and to maximize the healing potential in complex cases treated with the Masquelet technique. The ideal bone graft would have to unify all these properties without disadvantages and has to be subject of further investigations.