Induced membranes secrete growth factors including vascular and osteoinductive factors and could stimulate bone regeneration.
Based on a new concept, a procedure combining induced membranes and cancellous autografts allows the reconstruction of wide diaphyseal defects. In the first stage of this procedure, a cement spacer is inserted into the defect; the spacer is responsible for the formation of a pseudo-synovial membrane. In the second stage, the defect is reconstructed two months later by an autologous cancellous bone graft. The aim of this study was to evaluate the histological and biochemical characteristics of these membranes induced in rabbits. Histological studies carried out two, four, six, and eight weeks following implantation revealed a rich vascularization. Qualitative and quantitative immunochemistry showed production of growth factors (VEGF, TGFbeta1) and osteoinductive factors (BMP-2). Maximum BMP-2 production was obtained four weeks after the implantation, and, at this time, induced membranes favored human bone marrow stromal cell differentiation to the osteoblastic lineage. Should these results be confirmed in humans, bone reconstruction could be carried out earlier than previously thought and in better conditions than expected, the membrane playing the role of an in situ delivery system for growth and osteoinductive factors.
Pelissier
Ph
P
Service de Chirurgie Plastique, Hôpital, Pellegrin-Tondu 33076 Bordeaux, France. philippe.pelissier@chu-bordeaux.fr
Masquelet
A C
AC
Bareille
R
R
Pelissier
S Mathoulin
SM
Amedee
J
J
D000818:Animals; D001843:Bone Cements; D001854:Bone Marrow Cells / Q000166:cytology; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins / Q000378:metabolism; D001861:Bone Regeneration / Q000502:physiology*; D016025:Bone Transplantation / Q000379:methods*; D002454:Cell Differentiation; D002455:Cell Division; D006133:Growth Substances / Q000378:metabolism*; D011817:Rabbits; D017154:Stromal Cells / Q000166:cytology; D013583:Synovial Membrane / Q000378:metabolism*; D016212:Transforming Growth Factor beta / Q000378:metabolism; D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
C525718:BMP2 protein, human; D001843:Bone Cements; D055396:Bone Morphogenetic Protein 2; D019485:Bone Morphogenetic Proteins; D006133:Growth Substances; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D042461:Vascular Endothelial Growth Factor A