Does the extent of bone defects affect the time to reach full weight-bearing after treatment with the Masquelet technique?

J Frese; A P Schulz; B Kowald; U J Gerlach; K H Frosch; R Schoop

doi:10.1016/j.bbiosy.2024.100098

Does the extent of bone defects affect the time to reach full weight-bearing after treatment with the Masquelet technique?

Biomater Biosyst. 2024 Jul 8:15:100098. doi: 10.1016/j.bbiosy.2024.100098. eCollection 2024 Sep.

Authors

J Frese¹, A P Schulz^{2

3}, B Kowald², U J Gerlach¹, K H Frosch^{2

4}, R Schoop¹

Affiliations

¹ Department of Septic Bone and Joint Surgery, BG Hospital Hamburg, Bergedorfer Straße 10, Hamburg, 21033, Germany.
² Zentrum klinische Forschung, BG Klinikum Hamburg, Bergedorfer Str. 10, Hamburg, 21033, Germany.
³ Medical Faculty, University Lübeck, Ratzeburger Allee 160, Lübeck, 23562, Germany.
⁴ Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.

Abstract

Methodology: In a consecutive retrospective analysis of 190 patients treated with the Masquelet technique at the BG Klinikum Hamburg from January 2012 to January 2022, subgroup analysis for defect-specific features such as the extent and morphology of the defect were recorded, and their influence on the time to reach full weight-bearing of the affected limb was investigated.

Results and conclusion: A total of 217 defects were treated in 190 patients using the Masquelet technique. 70 % of all defects were in the tibia, followed by 22 % in the femur and only about 7 % in the upper extremity. The average length of all defects was 58 mm (+/- 31 mm), with the largest defect measuring 180 mm and the smallest measuring 20 mm. 89 % of the patients achieved full weight-bearing at the end of therapy. The average time from initiation of therapy to reaching safe full weight-bearing was 589 days. There was a significant correlation between defect length and time to reach full weight-bearing (p = 0.0134). These results could serve as a basis for creating a score for prognostics and evaluation of bone healing after treatment with the Masquelet technique. Additionally, the results could help guide indications for secondary stabilization using internal fixation.

Keywords: Bone defect treatment; Infection; Masquelet technique; Osteomyelitis.