1.陆军军医大学第二附属医院骨科,重庆 400037
2.内江市第二人民医院骨科,四川 内江 641000
Published:25 October 2024,
Received:05 July 2024,
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徐皓月,杨明辉,黄飞等.诱导膜技术治疗下肢骨缺损的研究进展[J].局解手术学杂志,2024,33(10):922-926.
XU Hao-yue,YANG Ming-hui,HUANG Fei,et al.Research progress of induced membrane technique in the treatment of lower limb bone defect[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):922-926.
徐皓月,杨明辉,黄飞等.诱导膜技术治疗下肢骨缺损的研究进展[J].局解手术学杂志,2024,33(10):922-926. DOI: 10.11659/jjssx.07E024024.
XU Hao-yue,YANG Ming-hui,HUANG Fei,et al.Research progress of induced membrane technique in the treatment of lower limb bone defect[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(10):922-926. DOI: 10.11659/jjssx.07E024024.
骨缺损是指骨感染、骨肿瘤、先天性疾病或严重创伤导致的骨结构缺失。由于高能量损伤发生率增加和自身解剖结构特点,下肢骨缺损尤其常见,成为创伤骨科领域的研究难点。传统的治疗方案主要包括带血管蒂的腓骨移植技术、开放植骨技术和骨搬运技术等,但这些技术都存在固有的不足。近年来,诱导膜技术因其操作步骤标准化、简单高效而逐渐用于重建节段性骨缺损。诱导膜技术分为两个阶段:第一阶段是生成具有生物效应的诱导膜,第二阶段是将骨填充物(自体骨、异体骨、人工骨或生物活性物质等)填充到缺损区域,填充后,使用特定的固定方法将骨填充物固定在原有的骨骼结构中。本文对诱导膜技术的基础研究以及国内外治疗下肢骨缺损的相关研究进展进行了综述,旨在讨论其潜在的基础和临床发展方向。
Bone defect refers to the loss of bone structure caused by bone infections, bone tumors, congenital diseases, or severe trauma. Due to the increased incidence of high-energy injuries and the characteristics of anatomical structure, lower limb bone defects are particularly common and become the research difficulties in the field of traumatic orthopedics.Traditional treatment options include vascularized fibular grafting, open bone grafting, and bone transport technique, but these techniques have inherent limitations. In recent years, induced membrane technique has gradually been used for the reconstruction of segmental bone defects due to its standardized, simple and efficient operation procedures. Induced membrane technique consists two stages: the first stage is to generate an induced membrane with biological effects, the second stage is to fill the defect area with bone fillers (autologous bone, allogeneic bone, artificial bone or bioactive substances, etc.),then the filled bone graft material is fixed to the existing bone structure by specific fixation methods. In this paper, the basic research of induced membrane technique and the related research progress in the treatment of lower limb bone defect at home and abroad are reviewed, aiming to discuss its potential development direction for basis and clinic.
诱导膜下肢骨缺损骨移植研究进展
induced membranelower limb bone defectbone transplantationresearch progress
Sivakumar R, Mohideen MG, Chidambaram M, et al. Management of large bone defects in diaphyseal fractures by induced membrane formation by Masquelet's technique[J]. J Orthop Case Rep, 2016,6(3):59-62. doi: 10.13107/jocr.2250-0685.508http://dx.doi.org/10.13107/jocr.2250-0685.508.
刘凯, 刘彦士, 蔡飞宇,等. 外固定架联合带蒂游离腓骨移植修复股骨感染性骨缺损[J]. 创伤外科杂志,2021,23(11):805-809. doi: 10.3969/j.issn.1009-4237.2021.11.002http://dx.doi.org/10.3969/j.issn.1009-4237.2021.11.002.
Masquelet A, Kanakaris NK, Obert L, et al. Bone repair using the masquelet technique[J]. J Bone Joint Surg Am,2019,101(11):1024-1036. doi: 10.2106/JBJS.18.00842http://dx.doi.org/10.2106/JBJS.18.00842.
贾乐.Masquelet技术修复骨缺损应用及研究进展[J].西南医科大学学报,2020,43(4):421-424. doi: 10.3969/j.issn.2096-3351.2020.04.020http://dx.doi.org/10.3969/j.issn.2096-3351.2020.04.020
Raven TF, Moghaddam A, Ermisch C, et al. Use of Masquelet technique in treatment of septic and atrophic fracture nonunion[J]. Injury, 2019,50(Suppl 3):40-54. doi: 10.1016/j.injury. 2019.06.018http://dx.doi.org/10.1016/j.injury.2019.06.018.
陈星宇,徐永清,杨晓勇, 等. 膜诱导技术治疗胫骨慢性感染性骨缺损的临床疗效[J].中华骨与关节外科杂志,2022,15(3):196-201. doi:10.3969/j.issn.2095-9958.2022.03.06http://dx.doi.org/10.3969/j.issn.2095-9958.2022.03.06.
郑继远, 梁劭行, 梁泽隆,等. 膜诱导技术结合Ca(OH)2-PMMA治疗节段性骨缺损的研究进展[J]. 海南医学院学报,2024,30(11):868-872. doi: 10.13210/j.cnki.jhmu.20231012.002http://dx.doi.org/10.13210/j.cnki.jhmu.20231012.002.
Guimarães J, Scorza B, Machado J, et al. Characterization of the masquelet induced membrane technique in a murine segmental bone defect model[J]. Rev Bras Ortop (Sao Paulo),2023,58(5):e798-e807. doi: 10.1055/s-0043-1771490http://dx.doi.org/10.1055/s-0043-1771490.
Toth Z, Roi M, Evans E, et al. Masquelet technique: effects of spacer material and micro-topography on factor expression and bone regeneration[J]. Ann Biomed Eng, 2019,47(1):174-189. doi: 10.1007/s10439-018-02137-5http://dx.doi.org/10.1007/s10439-018-02137-5.
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[J]. Eur J Trauma Emerg Surg, 2020,46(2):301-312. doi: 10.1007/s00068-019-01184-4http://dx.doi.org/10.1007/s00068-019-01184-4.
Durand M, Barbier L, Mathieu L, et al. Towards understanding therapeutic failures in masquelet surgery: first evidence that defective induced membrane properties are associated with clinical failures[J]. J Clin Med,2020,9(2):450. doi: 10.3390/jcm9020450http://dx.doi.org/10.3390/jcm9020450.
Xie J, Liu D, Wang H, et al. Effects of topical mechanical stability on the formation of Masquelet membrane in a rabbit radial defect model[J]. Sci Rep,2020,10(1):18939. doi: 10.1038/s41598-020-76112-3http://dx.doi.org/10.1038/s41598-020-76112-3.
Takase K, Fukui T, Oe K, et al. Effect of low-intensity pulsed ultrasound on osteogenic differentiation of human induced membrane-derived cells in Masquelet technique[J]. Injury, 2023, 54(6): 1444-1450. doi: 10.1016/j.injury.2023.04.004http://dx.doi.org/10.1016/j.injury.2023.04.004.
邓雄伟, 韩杰. 诱导膜技术治疗感染性骨不连的优势与问题[J]. 中国组织工程研究,2021,25(10):1604-1608. doi:10.3969/j.issn. 2095-4344.3071http://dx.doi.org/10.3969/j.issn.2095-4344.3071
曹飞,惠敏,董西玲,等.载银纳米羟基磷灰石/聚己内酯复合纳米纤维支架的制备及成骨抗菌性能[J].中国组织工程研究,2022,26(34):5461-5467.doi: 10.12307/2022.456http://dx.doi.org/10.12307/2022.456
刘一鸣,赵云,韩梅,等.功能化聚乳酸-羟基乙酸共聚物基骨组织再生诱导膜的制备及其在大鼠颌骨缺损重建中的应用[J].华西口腔医学杂志,2022,40(5):522-531.doi:10.7518/hxkq. 2022.05.004http://dx.doi.org/10.7518/hxkq.2022.05.004.
Henrich D, Seebach C, Nau C, et al. Establishment and characterization of the Masquelet induced membrane technique in a rat femur critical-sized defect model[J]. J Tissue Eng Regen Med, 2016,10(10):E382-E396. doi: 10.1002/term.1826http://dx.doi.org/10.1002/term.1826.
Caballé-Serrano J, Abdeslam-Mohamed Y, Munar-Frau A, et al. Adsorption and release kinetics of growth factors on barrier membranes for guided tissue/bone regeneration: a systematic review[J]. Arch Oral Biol, 2019, 100:57-68. doi: 10.1016/j.archoralbio. 2019.02.006http://dx.doi.org/10.1016/j.archoralbio.2019.02.006.
李树源,周琦石,李悦,等.骨水泥间隔器表面微观形貌改变对诱导膜内成骨因子表达的影响[J].中国组织工程研究,2020,24(10):1502-1507.doi:10.3969/j.issn.2095-4344.2217http://dx.doi.org/10.3969/j.issn.2095-4344.2217.
Tao ZS, Li TL, Xu HG, et al. Hydrogel contained valproic acid accelerates bone-defect repair via activating Notch signaling pathway in ovariectomized rats[J]. J Mater Sci Mater Med,2021,33(1):4. doi: 10.1007/s10856-021-06627-2http://dx.doi.org/10.1007/s10856-021-06627-2.
Lee S, Remark LH, Josephson AM, et al. Notch-Wnt signal crosstalk regulates proliferation and differentiation of osteoprogenitor cells during intramembranous bone healing[J]. NPJ Regen Med,2021,6(1):29. doi: 10.1038/s41536-021-00139-xhttp://dx.doi.org/10.1038/s41536-021-00139-x.
Xue G, Zhang Y, Xie T, et al. Cell adhesion-mediated piezoelectric self-stimulation on polydopamine-modified poly(vinylidene fluoride) membranes[J]. ACS Appl Mater Interfaces,2021,13(15):17361-17371. doi: 10.1021/acsami.1c02457http://dx.doi.org/10.1021/acsami.1c02457.
Tetzel L, Guyard M. Saving the lower limb with GlassBONE™ - successful surgical revision of pseudarthrosis after infected open proximal tibia fracture type IIIC with bioactive glass grafting - A case report[J].Trauma Case Rep,2021,31:100382.doi:10.1016/j.tcr. 2020.100382http://dx.doi.org/10.1016/j.tcr.2020.100382.
Lin H, Li Z, Xie Z, et al. An anti-infection and biodegradable TFRD-loaded porous scaffold promotes bone regeneration in segmental bone defects: experimental studies[J]. Int J Surg,2024,110(6):3269-3284. doi: 10.1097/JS9.0000000000001291http://dx.doi.org/10.1097/JS9.0000000000001291.
Fenelon M, Etchebarne M, Siadous R, et al. Comparison of amniotic membrane versus the induced membrane for bone regeneration in long bone segmental defects using calcium phosphate cement loaded with BMP-2[J]. Mater Sci Eng C Mater Biol Appl,2021,124:112032. doi: 10.1016/j.msec.2021.112032http://dx.doi.org/10.1016/j.msec.2021.112032.
McBride-Gagyi S, Toth Z, Kim D, et al. Altering spacer material affects bone regeneration in the Masquelet technique in a rat femoral defect[J]. J Orthop Res, 2018:10.1002/jor.23866.doi: 10.1002/jor.23866http://dx.doi.org/10.1002/jor.23866.
韩凤平, 李怀任, 常文利, 等. 生物材料在Masquelet技术中的应用[J].中国组织工程研究,2024,28(10):1634-1640.doi: 10.12307/2024.365http://dx.doi.org/10.12307/2024.365
Olvera-Huertas AJ, Costela-Ruiz VJ, García-Recio E, et al. The effect of chlorhexidine, amoxicillin, and clindamycin on the growth and differentiation of primary human osteoblasts[J]. Int J Oral Maxillofac Implants,2022,37(2):283-288. doi: 10.11607/jomi.9253http://dx.doi.org/10.11607/jomi.9253.
Nau C, Seebach C, Trumm A, et al. Alteration of Masquelet's induced membrane characteristics by different kinds of antibiotic enriched bone cement in a critical size defect model in the rat's femur[J]. Injury, 2016,47(2):325-334. doi: 10.1016/j.injury.2015. 10.079http://dx.doi.org/10.1016/j.injury.2015.10.079.
Xie J, Wang W, Fan X, et al. Effects of PMMA spacer loaded with varying vancomycin concentrations on bone regeneration in the Masquelet technique[J]. Sci Rep, 2022,12(1):4255. doi: 10.1038/s41598-022-08381-zhttp://dx.doi.org/10.1038/s41598-022-08381-z.
Migliorini F, Cuozzo F, Torsiello E, et al. Autologous bone grafting in trauma and orthopaedic surgery: an evidence-based narrative review[J]. J Clin Med,2021,10(19):4347. doi: 10.3390/jcm10194347http://dx.doi.org/10.3390/jcm10194347.
Yang P, Xing J, Liu J, et al. Individual tissue-engineered bone in repairing bone defects: a 10-year follow-up study[J]. Tissue Eng Part A,2020,26(15-16):896-904. doi: 10.1089/ten.TEA.2019. 0287http://dx.doi.org/10.1089/ten.TEA.2019.0287.
Sasaki G, Watanabe Y, Yasui Y, et al. Clinical and radiological assessment of the induced membrane technique using beta-tricalcium phosphate in reconstructive surgery for lower extremity long bone defects[J]. Bone Joint J,2021,103-B(3):456-461. doi: 10.1302/0301-620X.103B3.BJJ-2020-1542.R1http://dx.doi.org/10.1302/0301-620X.103B3.BJJ-2020-1542.R1.
Nik Md Noordin Kahar N, Ahmad N, Jaafar M, et al. A review of bioceramics scaffolds for bone defects in different types of animal models: HA and β-TCP[J]. Biomed Phys Eng Express,2022,8(5).doi: 10.1088/2057-1976/ac867fhttp://dx.doi.org/10.1088/2057-1976/ac867f.
Wu Y, Shi X, Zi S, et al. The clinical application of customized 3D-printed porous tantalum scaffolds combined with Masquelet's induced membrane technique to reconstruct infective segmental femoral defect[J]. J Orthop Surg Res, 2022,17(1):479. doi: 10.1186/s13018-022-03371-3http://dx.doi.org/10.1186/s13018-022-03371-3.
Gamieldien H, Ferreira N, Birkholtz FF, et al. Filling the gap: a series of 3D-printed titanium truss cages for the management of large, lower limb bone defects in a developing country setting[J]. Eur J Orthop Surg Traumatol, 2023,33(3):497-505. doi: 10.1007/s00590-022-03434-5http://dx.doi.org/10.1007/s00590-022-03434-5.
买吾拉江·麦麦江, 祖丽胡马尔·艾合麦提. 铰刀-灌洗-抽吸技术在骨缺损植骨中的应用研究进展[J].创伤外科杂志,2023,25(9):715-719. doi: 10.3969/j.issn.1009-4237.2023.09.014http://dx.doi.org/10.3969/j.issn.1009-4237.2023.09.014
Bilal Ö, Topak D, Kınaş M, et al. Epidermal growth factor or platelet-rich plasma combined with induced membrane technique in the treatment of segmental femur defects: an experimental study[J]. J Orthop Surg Res, 2020,15(1):601. doi: 10.1186/s13018-020-02142-2http://dx.doi.org/10.1186/s13018-020-02142-2.
李树源, 周琦石, 李悦, 等. 重组人骨形态发生蛋白2、富血小板血浆联合植骨与单纯植骨修复骨缺损的比较[J].中国组织工程研究,2019,23(22):3463-3468. doi: 10.3969/j.issn.2095-4344.1270http://dx.doi.org/10.3969/j.issn.2095-4344.1270,
郭艳琴.LIPUS调控纳泡释放SDF-1α在骨再生早期血管形成中的实验研究[D].太原:山西医科大学,2023.doi: 10.27288/d.cnki.gsxyu.2023.000010http://dx.doi.org/10.27288/d.cnki.gsxyu.2023.000010.
Korstjens CM, Rutten S, Nolte PA, et al. Low-intensity pulsed ultrasound increases blood vessel size during fracture healing in patients with a delayed-union of the osteotomized fibula[J]. Histol Histopathol, 2018,33(7):737-746. doi: 10.14670/HH-11-972http://dx.doi.org/10.14670/HH-11-972.
Bayat M, Virdi A, Rezaei F, et al. Comparison of the in vitro effects of low-level laser therapy and low-intensity pulsed ultrasound therapy on bony cells and stem cells[J]. Prog Biophys Mol Biol, 2018,133:36-48. doi: 10.1016/j.pbiomolbio.2017.11.001http://dx.doi.org/10.1016/j.pbiomolbio.2017.11.001.
Vigouroux F,Mezzadri G,Parot R,et al.Vascularised fibula or induced membrane to treat congenital pseudarthrosis of the tibia: a multicentre study of 18 patients with a mean 9.5-year follow-up[J]. Orthop Traumatol Surg Res, 2017,103(5):747-753. doi: 10.1016/j.otsr.2017.05.005http://dx.doi.org/10.1016/j.otsr.2017.05.005.
Meselhy MA, Elhammady AS, Singer MS. Outcome of induced Membrane technique in treatment of failed previously operated congenital pseudarthrosis of the tibia[J]. Orthop Traumatol Surg Res, 2020,106(5):813-818. doi: 10.1016/j.otsr.2019.11.033http://dx.doi.org/10.1016/j.otsr.2019.11.033.
Klein C, Gindraux F, Masquelet AC, et al. Questions about using the induced membrane technique to manage cases of congenital tibial pseudarthrosis[J]. Cells, 2023,12(14):1918. doi: 10.3390/cells12141918http://dx.doi.org/10.3390/cells12141918.
Zhang H, Fu J, Jie S, et al. Induced membrane technique versus one-stage autografting in management of atrophic nonunion of long bone in the lower limb: clinical and health burden outcomes[J]. J Orthop Surg Res, 2023,18(1):853. doi: 10.1186/s13018-023-04296-1http://dx.doi.org/10.1186/s13018-023-04296-1.
向杜磊, 王鑫宇, 刘兵, 等. Masquelet膜诱导技术治疗股骨干骨折术后无菌性骨不连的临床观察[J].局解手术学杂志,2020,29(7):582-586.doi: 10.11659/jjssx.03E020043http://dx.doi.org/10.11659/jjssx.03E020043.
Fitoussi F, Ilharreborde B. Is the induced-membrane technique successful for limb reconstruction after resecting large bone tumors in children?[J]. Clin Orthop Relat Res, 2015,473(6):2067-2075. doi: 10.1007/s11999-015-4164-6http://dx.doi.org/10.1007/s11999-015-4164-6.
Rougereau G, Marty-Diloy T, Pietton R, et al. Induced-membrane reconstruction after calcaneum's Ewing sarcoma in children: a report of 3 cases[J]. J Foot Ankle Surg, 2022,61(4):e5-e8. doi: 10.1053/j.jfas.2021.09.020http://dx.doi.org/10.1053/j.jfas.2021.09.020.
Sharma A, Sharma A, Tomar S, et al. Is Masquelet technique a successful viable treatment in reconstructing large tumor bone gaps in adolescent and adult?[J]. Arch Bone Jt Surg, 2023,11(5):348-355.doi: 10.22038/ABJS.2023.66690.3178http://dx.doi.org/10.22038/ABJS.2023.66690.3178
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