Induced membrane technique using beta-tricalcium phosphate for reconstruction of femoral and tibial segmental bone loss due to infection: technical tips and preliminary clinical results.

Abstract

This study aimed to provide preliminary evidence regarding effectiveness of grafting beta-tricalcium phosphate (β-TCP) combined with a cancellous autograft for treating nonunion of long bones in the lower extremity due to infection by evaluating clinical and radiological outcomes. We retrospectively reviewed the clinical and radiological results in seven patients (six men, one woman; median age 39years) treated by the induced membrane technique for nonunion of the femur or tibia due to infection. In the second stage of the procedure, the bony defect was filled with a combination of autologous cancellous bone and β-TCP, which were mixed in approximately the same proportions. The time interval between the second stage of the procedure and bone healing was investigated. Radiographic characteristics including maximum bone gap and radiographic apparent bone gap were evaluated. The median follow-up period was 14months. Bone healing was achieved in a median of sixmonths after the second procedure. The median maximum bone gap and radiographic apparent bone gap were 55mm and 34mm, respectively. Use of β-TCP, which has osteoconductive ability, with an autograft provided good clinical and radiological outcomes. The findings of this preliminary study suggest the potential of β-TCP as a useful bone substitute for autografts in the induced membrane technique. Our findings suggest that β-TCP may be an effective extender when using the induced membrane technique.