Nicolas Söhling (Frankfurt / DE), Miriam Heilani (Frankfurt / DE), Charlotte Fremdling (Frankfurt / DE), Alexander Schaible (Frankfurt / DE), Katrin Schröder (Frankfurt / DE), Jan C. Brune (Berlin / DE), Ingo Marzi (Frankfurt / DE), Dirk Henrich (Frankfurt / DE), René D. Verboket (Frankfurt / DE)
Abstract text (incl. references and figure legends)
The classic two-stage Masquelet technique is a widely used and effective procedure for the treatment of large bone defects. Our group could show that the induced membrane can be replaced by a decellularized dermis (DD) (Epiflex, DIZG). Thus, one procedure can be avoided and the two-stage procedure can be turned into a one-stage procedure. Previously, syngeneic cancellous bone (SCB) was used to fill the membrane wrapped around a 5 mm femoral defect in the rat. Translated to clinical conditions, this means additional trauma in terms of cancellous bone harvesting by RIA or iliac crest harvesting. The focus of this work was to clarify whether the syngeneic cancellous bone can be replaced by granular (G) or fibrous (f) demineralized bone matrix (DBM) and whether additional colonization with bone marrow mononuclear cells (BMC) leads to improved bone healing.
In 125 Sprague-Dawley rats (in 10 groups), a critical femoral bone defect 5 mm in length was stabilized with a plate and then encased in decellularised dermis. Filling with syngeneic cancellous bone served as a control group. Subsequently, the defect was filled with SCB, GDBM or f-DBM, with or without BMC. After a healing period of eight weeks, the femurs were harvested and subjected to histological, radiological, and biomechanical analysis.
The results show equal bone formation and bone stability for the BMC-populated DD group compared to control. With one exception, the filling has no significant influence. The use of BMC colonized DD and BMC colonized f-DBM as filling shows a significantly higher bone density (p<0.05). The results suggest that the use of BMC colonized membranes and BMC colonized filling material in the single stage masquelet technique can eliminate the need for SCB. This would result in significantly less surgical trauma.
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This research was in part funded by the German Institute for Cell and Tissue Replacement (DIZG, gemeinnützige GmbH), 12555 Berlin, Germany. Institutional