Orthopaedic and Traumatology Surgery Service, University Hospital of Besancon, France; NanomedicineLab, Imagery and Therapeutics (EA 4662), SFR FED 4234, University of Franche-Comté, Besancon, France.
Orthopaedic and Traumatology Surgery Service, University Hospital of Besancon, France.
Placenta. 2017 Nov;59:116-123. doi: 10.1016/j.placenta.2017.06.340. Epub 2017 Jun 23.
Previous clinical studies have shown the efficacy of a two-stage surgical procedure - the induced membrane (IM) technique - for reconstruction of large bone defects or bone non-union. The first stage involves radical debridement and insertion of a cement spacer into the bone defect. The second stage, performed weeks to months later, consists of removing the spacer while leaving the foreign body membrane induced by the cement in place, and then filling the cavity with bone autograft. The IM has been shown to (1) act as a protective physical barrier by preventing bone autograft resorption and (2) act as a bioreactor by promoting healing through revascularisation and growth factor secretion, and by concentrating mesenchymal stem cells (MSC) with osteogenic properties. New solutions to reduce this surgical procedure to a single step are being explored, for example by using an IM-like bioactive and protective barrier inserted into the bone defect at the same time as bone graft.
先前的临床研究表明，两阶段手术方法——诱导膜（IM）技术——对于重建大的骨缺损或骨不连是有效的。第一阶段包括彻底清创和将骨水泥间隔器插入骨缺损部位。第二阶段在数周或数月后进行，包括在去除间隔器的同时保留由水泥诱导的异物膜，然后用骨自体移植物填充腔。IM 已被证明 (1) 作为一种保护性物理屏障，防止骨自体移植物吸收，(2) 通过促进血管生成和生长因子分泌以及浓缩具有成骨特性的间充质干细胞（MSC）来作为生物反应器，从而促进愈合。目前正在探索减少这种手术过程为单一步骤的新方法，例如同时将类似诱导膜的生物活性和保护性屏障插入骨缺损部位，同时进行骨移植。
