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Induced membrane maintains its osteogenic properties even when the second stage of Masquelet’s technique is performed later

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

A Correction to this article was published on 30 October 2019

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Abstract

Purpose

Previous clinical studies have shown the effectiveness of bone repair using two-stage surgery called the induced membrane (IM) technique. The optimal wait before the second surgery is said to be 1 month. We have been successfully performing the IM technique while waiting an average of 6 months to carry out the second stage. We hypothesised that the IM maintains its beneficial capabilities, even at a later second stage, and that there is no relation between the speed of bone union and the wait between the first and second stage. We sought to explore the biological properties of ‘older’ IMs sampled to substantiate our clinical observations.

Methods

Thirty-four patients with a critical size defect were treated with the IM technique. In seven of these patients, pieces of the IM were collected 4.2–14.7 months after the first surgery. IM-derived cell phenotype and osteogenic potential were investigated using in vitro studies (n = 4) while IM nature and function were investigated by histology and immunohistochemistry (n = 3).

Results

The median wait before the second surgery was 5.8 months [range 1.2–14.7] and bone healing occurred at 7.6 months [range 2.5–49.9] for 26 patients. IMs aged 4.2–14.7 months contained mesenchymal stromal cells with in vitro osteogenic potential and corresponded to a multipotent tissue with osteogenic and chondrogenic capabilities contributing to osteogenesis over time.

Conclusion

This preliminary study suggests the IM retains its powerful osteogenic properties over time and that waiting longer between the two surgeries does not delay bone union.

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Change history

  • 30 October 2019

    The original version of this article unfortunately contained a mistake. The presentation and legends of Figs. 4 and 5 were incorrect. The corrected versions are given below. The original article has been corrected.

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Acknowledgements

The authors thank Fiona Ecarnot (EA3920, University Hospital Besancon, France) and Joanne Archambault, PhD for editorial assistance.

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Authors and Affiliations

  1. Orthopaedic and Traumatology Surgery Department, University Hospital of Besancon, Besancon, France

    Florelle Gindraux, François Loisel, Michael Bourgeois, Pauline Sergent, Gregoire Leclerc, Laurent Obert & Isabelle Pluvy

  2. Nanomedicine Lab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besancon, France

    Florelle Gindraux, François Loisel, Benoit de Billy, Frederic Auber, Laurent Obert & Isabelle Pluvy

  3. Laboratory of Bioengineering and Biomechanics for Bone Articulation (B2OA-UMR CNRS 7052), University Paris Diderot, Paris, France

    Karim Oudina & Hervé Petite

  4. Novotec, Bron, France

    Martine Melin

  5. Paediatric Surgery Department, University Hospital of Besancon, Besancon, France

    Benoit de Billy & Frederic Auber

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  1. Florelle Gindraux
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Correspondence to Florelle Gindraux.

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Additional information

The original version of this article was revised: The presentation and legends of Figs. 4 and 5 were incorrect. The original article has been corrected.

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Gindraux, F., Loisel, F., Bourgeois, M. et al. Induced membrane maintains its osteogenic properties even when the second stage of Masquelet’s technique is performed later. Eur J Trauma Emerg Surg 46, 301–312 (2020). https://doi.org/10.1007/s00068-019-01184-4

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