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Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures

The two-stage Masquelet induced-membrane technique (IMT) consists of cement spacer-driven membrane induction followed by an autologous cancellous bone implantation in this membrane to promote large bone defect repairs. For the first time, this study aims at correlating IMT failures with physiologica...

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Autores principales: Durand, Marjorie, Barbier, Laure, Mathieu, Laurent, Poyot, Thomas, Demoures, Thomas, Souraud, Jean-Baptiste, Masquelet, Alain-Charles, Collombet, Jean-Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073843/
https://www.ncbi.nlm.nih.gov/pubmed/32041238
http://dx.doi.org/10.3390/jcm9020450
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author Durand, Marjorie
Barbier, Laure
Mathieu, Laurent
Poyot, Thomas
Demoures, Thomas
Souraud, Jean-Baptiste
Masquelet, Alain-Charles
Collombet, Jean-Marc
author_facet Durand, Marjorie
Barbier, Laure
Mathieu, Laurent
Poyot, Thomas
Demoures, Thomas
Souraud, Jean-Baptiste
Masquelet, Alain-Charles
Collombet, Jean-Marc
author_sort Durand, Marjorie
collection PubMed
description The two-stage Masquelet induced-membrane technique (IMT) consists of cement spacer-driven membrane induction followed by an autologous cancellous bone implantation in this membrane to promote large bone defect repairs. For the first time, this study aims at correlating IMT failures with physiological alterations of the induced membrane (IM) in patients. For this purpose, we compared various histological, immunohistochemical and gene expression parameters obtained from IM collected in patients categorized lately as successfully (Responders; n = 8) or unsuccessfully (Non-responders; n = 3) treated with the Masquelet technique (6 month clinical and radiologic post-surgery follow-up). While angiogenesis or macrophage distribution pattern remained unmodified in non-responder IM as compared to responder IM, we evidenced an absence of mesenchymal stem cells and reduced density of fibroblast-like cells in non-responder IM. Furthermore, non-responder IM exhibited altered extracellular matrix (ECM) remodeling parameters such as a lower expression ratio of metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinases (TIMP-1) mRNA as well as an important collagen overexpression as shown by picrosirius red staining. In summary, this study is the first to report evidence that IMT failure can be related to defective IM properties while underlining the importance of ECM remodeling parameters, particularly the MMP-9/TIMP-1 gene expression ratio, as early predictive biomarkers of the IMT outcome regardless of the type of bone, fracture or patient characteristics.
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spelling pubmed-70738432020-03-19 Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures Durand, Marjorie Barbier, Laure Mathieu, Laurent Poyot, Thomas Demoures, Thomas Souraud, Jean-Baptiste Masquelet, Alain-Charles Collombet, Jean-Marc J Clin Med Article The two-stage Masquelet induced-membrane technique (IMT) consists of cement spacer-driven membrane induction followed by an autologous cancellous bone implantation in this membrane to promote large bone defect repairs. For the first time, this study aims at correlating IMT failures with physiological alterations of the induced membrane (IM) in patients. For this purpose, we compared various histological, immunohistochemical and gene expression parameters obtained from IM collected in patients categorized lately as successfully (Responders; n = 8) or unsuccessfully (Non-responders; n = 3) treated with the Masquelet technique (6 month clinical and radiologic post-surgery follow-up). While angiogenesis or macrophage distribution pattern remained unmodified in non-responder IM as compared to responder IM, we evidenced an absence of mesenchymal stem cells and reduced density of fibroblast-like cells in non-responder IM. Furthermore, non-responder IM exhibited altered extracellular matrix (ECM) remodeling parameters such as a lower expression ratio of metalloproteinase-9 (MMP-9)/tissue inhibitor of metalloproteinases (TIMP-1) mRNA as well as an important collagen overexpression as shown by picrosirius red staining. In summary, this study is the first to report evidence that IMT failure can be related to defective IM properties while underlining the importance of ECM remodeling parameters, particularly the MMP-9/TIMP-1 gene expression ratio, as early predictive biomarkers of the IMT outcome regardless of the type of bone, fracture or patient characteristics. MDPI 2020-02-06 /pmc/articles/PMC7073843/ /pubmed/32041238 http://dx.doi.org/10.3390/jcm9020450 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Durand, Marjorie
Barbier, Laure
Mathieu, Laurent
Poyot, Thomas
Demoures, Thomas
Souraud, Jean-Baptiste
Masquelet, Alain-Charles
Collombet, Jean-Marc
Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title_full Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title_fullStr Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title_full_unstemmed Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title_short Towards Understanding Therapeutic Failures in Masquelet Surgery: First Evidence that Defective Induced Membrane Properties are Associated with Clinical Failures
title_sort towards understanding therapeutic failures in masquelet surgery: first evidence that defective induced membrane properties are associated with clinical failures
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073843/
https://www.ncbi.nlm.nih.gov/pubmed/32041238
http://dx.doi.org/10.3390/jcm9020450
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