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局部机械稳定性对兔桡骨缺损模型中 Masquelet 膜形成的影响。

Effects of topical mechanical stability on the formation of Masquelet membrane in a rabbit radial defect model.

机构信息

Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410008, Hunan, China.

出版信息

Sci Rep. 2020 Nov 3;10(1):18939. doi: 10.1038/s41598-020-76112-3.

DOI:10.1038/s41598-020-76112-3
PMID:33144701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7609590/
Abstract

The exact mechanism of Masquelet technique is unknown. This study intends to explore the effects of topical mechanical stability on the formation of Masquelet membrane. Segmental radius shaft defect was created in all rabbits, which were filled with polymethylmethacrylate (PMMA) in Non-fixation group, and with PMMA fixed with plates in Fixation group, and subjected to no disposal in control group. The topical stability of PMMA and plates were monitored via X-ray and mechanical test. And the membranes were excised for further Histological, IHC and Western-Blotting analysis 4 and 6 weeks post-operatively. X-ray revealed no sign of plates loosening, or shift of PMMA. Mechanical tests revealed superior topical stability by plates. Pathological examinations suggested that vascularized and osteogenic membranes were formed around PMMA. IHC and Western-Blotting analysis revealed that both Fixation and Non-fixation group exerted significant effects on the expression of Ki67, COL I, and CD31 positive cells, as well as the protein expression of osteogenic (RUNX2, ALP) and angiogenic (VEGFA, TGF-β1) factors. And compared with membrane in Non-fixation group, Fixing PMMA spacer with plates caused a significant increase in osteogenic and angiogenic expression. This study indicates that rigid fixation provided by plate in Masquelet technique positively alters the quality of membrane formed surrounding PMMA, in terms of significantly osteogenic and angiogenic potential.

摘要

Masquelet 技术的确切机制尚不清楚。本研究旨在探讨局部机械稳定性对 Masquelet 膜形成的影响。所有兔子均造成节段性桡骨骨干缺损，非固定组用聚甲基丙烯酸甲酯（PMMA）填充，固定组用钢板固定 PMMA，对照组不做任何处理。通过 X 射线和机械试验监测 PMMA 和钢板的局部稳定性。术后 4 周和 6 周，切除膜进行进一步的组织学、免疫组化和 Western-Blotting 分析。X 射线显示无钢板松动或 PMMA 移位的迹象。机械试验显示钢板具有更好的局部稳定性。病理检查表明 PMMA 周围形成了血管化和成骨膜。免疫组化和 Western-Blotting 分析显示，固定组和非固定组均对 Ki67、COL I 和 CD31 阳性细胞的表达以及成骨（RUNX2、ALP）和血管生成（VEGFA、TGF-β1）因子的蛋白表达产生显著影响。与非固定组的膜相比，用钢板固定 PMMA 间隔物导致成骨和成血管表达显著增加。本研究表明，Masquelet 技术中钢板提供的刚性固定可显著改变 PMMA 周围形成的膜的质量，从而显著提高成骨和成血管的潜力。

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Int Orthop. 2020 Feb;44(2):391-398. doi: 10.1007/s00264-019-04453-4. Epub 2019 Dec 3.
2
Reconstruction of large segmental bone defects in rabbit using the Masquelet technique with α-calcium sulfate hemihydrate.应用 α-半水硫酸钙骨水泥的 Masquelet 技术重建兔大段骨缺损。
J Orthop Surg Res. 2019 Jun 26;14(1):192. doi: 10.1186/s13018-019-1235-5.
3
Induced membrane technique for the treatment of severe acute tibial bone loss: preliminary experience at medium-term follow-up.
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Int Wound J. 2023 Apr;20(4):1020-1032. doi: 10.1111/iwj.13955. Epub 2022 Oct 2.
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The induced membrane technique in animal models: a systematic review.动物模型中的诱导膜技术：一项系统综述。
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