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

Jie Xie,Haitao Long,Yihe Hu,Haoyi Wang,Min Zeng,Yong Zhu,Donghao Liu

doi:10.1038/s41598-020-76112-3

Jie Xie, Haitao Long + Show 5 more

Open Access

https://doi.org/10.1038/s41598-020-76112-3

Copy DOI

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.

Highlights

The exact mechanism of Masquelet technique is unknown
The quantitative analysis of mechanical test showed that the compression and tensile modulus in Fixation group were significantly higher than that of the Non-fixation group, and that the compression and tensile peak load in Fixation group were significantly higher than that of the Non-fixation group (Fig. 4), which indicated that the internal plate could provide additional topical stability
Through gross histology we found that a translucent and membrane-like fibrotic capsule was formed around PMMA, and that connective tissue formed in the bone defects in the control group, which is consistent with the literature reported[15,19]

Summary

Introduction

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. 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. In order to solve these problems, several studies show that the membrane has structural characteristics and osteogenic potentials It is not just offering a physical barrier and a rich vascular network, and numerous osteoprogenitor cells and a local source of key biochemical factors, such as BMP2, and TGF-β11–13. We hypothesize that an increase in fixation strength will results in superior Masquelet membrane with significance in osteogenic and angiogenic factors expression

Methods

Results

Discussion

Conclusion