The Comparative Efficacy of the Masquelet versus Titanium Mesh Cage Reconstruction Techniques for the Treatment of Large Long Bone Deficiencies
Abstract
The study comprises a randomized two-arm, single center clinical trial conducted at the Department of Orthopaedic Surgery & Rehabilitation, University of Texas Medical Branch, Galveston, TX, with a primary objective to assess and compare the functional outcome of patients with large segmental bone defects reconstructed with the Masquelet technique (MT) versus the titanium mesh cage technique (TMCT). The secondary objectives include the radiographic determination of defect healing, and comparative assessment of cost and resource expenditures between the two techniques. From 9 patients with segmental defects presented to our institution over the initial 12-month trial period, 4 met the study eligibility criteria and were enrolled: 1 MT, 2 TMCT, 1 voluntary withdrawal from surgical treatment. One MT-treated patient had a defect due to a close-range, highcaliber gunshot injury to the distal femur, and at 5-month followup demonstrates very successful functional and radiographic outcome. One TMCT-treated patient had an iatrogenic resection of an infected nonunion of the humerus mid-shaft, and at 1- month followup demonstrates uneventful healing. A second TMCT-treated patient with an iatrogenic resection of proximal tibia osteomyelitis had a serious adverse event. At 2 weeks post TMCT reconstruction, the patient developed significant tissue necrosis over the defect which resulted in an above-knee amputation as per the patient s request. There are 2 additional eligible patients who are currently in pre-reconstruction phase of the defect management. Eligible patient identification and enrollment for the trial is actively ongoing.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2014
- Accession Number
- ADA613981
Entities
People
- Ronald W. Lindsey
- Zbigniew Gugala
Organizations
- University of Texas at Austin