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Resorbable polylactide membrane for the treatment of segmental bone defects
Nickolas J Nahm1, Janet D Conway2
1Department of Orthopaedic Surgery, Childrens's Hospital and Medical Center and University of Nebraska Medical Center, Omaha, NE 68114, United States of America.
Injury
|December 2, 2021
Summary
Resorbable polylactide membrane combined with bone morphogenic protein-2 (BMP-2) and autograft effectively treated segmental bone defects up to 12 cm. Ten of eleven patients achieved bone union, though some required repeat grafting.
Area of Science:
- Orthopedics
- Biomaterials Science
- Regenerative Medicine
Background:
- Segmental bone defects pose significant clinical challenges.
- Resorbable polylactide membranes have shown promise in animal models and craniomaxillofacial surgery for bone defect treatment.
- This study evaluates the efficacy of resorbable polylactide membrane in conjunction with bone morphogenic protein-2 (BMP-2) and autograft for segmental bone defects.
Purpose of the Study:
- To assess the safety and effectiveness of using resorbable polylactide membrane, BMP-2, and autograft for treating segmental bone defects.
- To determine the union rates and outcomes in patients with large bone defects treated with this combination therapy.
- To compare the findings with existing bone defect treatment modalities.
Main Methods:
- Retrospective review of 11 patients with segmental bone defects treated between 2010 and 2019.
- Utilized resorbable polylactide membrane, bone morphogenic protein-2 (BMP-2), and autograft for treatment.
- Collected data on patient demographics, surgical details, defect size, etiology, and radiographic union.
Main Results:
- Eleven patients with median defect size of 6 cm (range 3-12 cm) were included, with defects in the tibia, femur, or forearm.
- Common etiologies included osteomyelitis (7 patients), oncologic resection (3 patients), and post-traumatic aseptic nonunion (1 patient).
- Ten out of eleven patients achieved radiographic union at a median of 17 months; 7 patients required reoperation, with 6 needing repeat grafting.
Conclusions:
- Resorbable polylactide membrane with BMP-2 and autograft is a safe and effective method for bone graft containment in segmental bone defects up to 12 cm.
- The treatment achieved a high union rate (10/11 patients) with outcomes comparable to the induced membrane technique.
- Further prospective randomized studies are recommended to compare resorbable polylactide membrane with the induced membrane technique for optimal treatment strategies.
