Is Masquelet Technique A Successful Viable Treatment In Reconstructing Large Tumor Bone Gaps in Adolescent and Adult?

Document Type : RESEARCH PAPER

Authors

1 Lady Hardinge Medical College, Delhi, India

2 Maulana Azad Medical College, Delhi, India

Abstract

Objectives: The reconstruction of large bony defect caused by tumor resection can be managed by 
different technique like bone graft, Masquelet technique, mega-prosthesis etc. Literature lacks studies 
discussing Masquelet technique in tumor cases especially pertaining to infected tumor in adults. We 
aimed to determine 1) How often and how fast is the bone healing achieved after resection greater than 
10 cm bone in tumour patient’s using Masquelet technique?, 2) Whether Masquelet technique can 
achieve optimum outcomes in adult infected cases too?
Methods: We reviewed 154 patients of benign & malignant tumour managed by us between 2013 and 2019. 
Patients belonging to all the age group with infected tumor/diaphysial tumor/periarticular tumor, where single stage 
surgery or mega-prosthesis is not a viable option and were treated with Masquelet technique for reconstructing a 
bone defect of at least 10 cm were included in our study. We evaluated outcomes of eight patients for four 
parameters i.e. bony union, healing index, number of re-do surgeries required and limb length discrepancy.
Results: Mean age of our study group was 20.25 years and patients followed for mean duration of 3.36 years. 
Mean bone loss after tumor resection was 13.1 cm (range = 11.5 cm to 15 cm). There was no sign of recurrence of 
tumor in any patient at the time of last follow up. Average time required to achieve bony union was 23.25 months 
(mean healing index of 1.67 months/cm). All but one patient achieved bony union. Mean limb length discrepancy 
seen was 1.44cm. Infected cases showed low healing index with higher percentage of re-do surgeries.
Conclusion: Induced membrane technique is quick, safe and reliable alternative method of reconstruction to megaprosthesis in cases with all age group where risk of failure of mega-prosthesis is high, either due to infection or 
shorter expected lifespan of prosthesis. However, obtaining union can be a difficult preposition in infected tumor 
cases and multiple surgeries may be required to get the desired result even after two stages. However, a 
comparative study with large sample size is required to further validate our results.
 Level of evidence: IV

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 11, Issue 5
May 2023
Pages 348-355

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History

  • Receive Date: 16 July 2022
  • Revise Date: 13 November 2022
  • Accept Date: 12 January 2023

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