Establishment and characterization of the Masquelet induced membrane technique in a rat femur critical-sized defect model
Establishment and characterization of the Masquelet induced membrane technique in a rat femur critical-sized defect model
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DOI：
10.1002/term.1826
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发表时间：
2016-10-01
影响因子：
3.3
通讯作者：
Marzi, I.
中科院分区：
文献类型：
--
作者：
Henrich, D.;Seebach, C.;Marzi, I.
Masquelet诱导膜技术用于重建大骨干缺损已被证明是一种有前途的临床治疗方法，但对这些膜的细胞、组织学和生物化学组成以及它们如何产生这种积极的临床结果知之甚少。我们比较了细胞组成，组织学变化和生长因子的表达，在诱导后2，4和6周，在股骨骨缺损周围和皮下口袋中诱导的膜，以及骨膜。我们发现，骨缺损周围形成的膜与皮下囊袋中形成的膜相似;然而，两者在结构特征、血管位置和总体厚度方面与骨膜有显著差异。在股骨缺损处（在2周时）和骨膜中诱导的膜含有在皮下诱导的膜中未发现的间充质干细胞（MSC; STRO-1+）。与皮下诱导的膜相比，在股骨缺损周围诱导的膜中BMP-2、TGF β和VEGF显著升高，而在任一部位诱导的膜中均未检测到SDF-1。我们发现，成骨和新生血管的活动大多消退了6周的膜形成在这两个网站。结果表明，诱导膜的细胞组成和生长因子含量取决于诱导膜的位置，与骨膜不同。膜中的成骨和新生血管活性在2 - 4周之间最大，6周后消退。基于这一点，如果在Masquelet技术中早期用骨移植物替换PMMA骨水泥，可能会实现更好和更快的骨愈合。版权所有（C）2013约翰威利父子有限公司
The Masquelet induced membrane technique for reconstructing large diaphyseal defects has been shown to be a promising clinical treatment, yet relatively little is known about the cellular, histological and biochemical make-up of these membranes and how they produce this positive clinical outcome. We compared cellular make-up, histological changes and growth factor expression in membranes induced around femur bone defects and in subcutaneous pockets at 2, 4 and 6 weeks after induction, and to the periosteum. We found that membranes formed around bone defects were similar to those formed in subcutaneous pockets; however, both were significantly different from periosteum with regard to structural characteristics, location of blood vessels and overall thickness. Membranes induced at the femur defect (at 2 weeks) and in periosteum contain mesenchymal stem cells (MSCs; STRO-1+) which were not found in membranes induced subcutaneously. BMP-2, TGF beta and VEGF were significantly elevated in membranes induced around femur defects in comparison to subcutaneously induced membranes, whereas SDF-1 was not detectable in membranes induced at either site. We found that osteogenic and neovascular activity had mostly subsided by 6 weeks in membranes formed at both sites. It was conclude that cellular composition and growth factor content in induced membranes depends on the location where the membrane is induced and differs from periosteum. Osteogenic and neovascular activity in the membranes is maximal between 2 and 4 weeks and subsides after 6. Based on this, better and quicker bone healing might be achieved if the PMMA cement were replaced with a bone graft earlier in the Masquelet technique. Copyright (C) 2013 John Wiley & Sons, Ltd.