A meta-analysis of the Masquelet technique and the Ilizarov bone transport method for the treatment of infected bone defects in the lower extremities.

Abstract

<b>Purpose:</b>To compare the clinical outcomes of the Masquelet technique and Ilizarov bone transport method for the treatment of patients with infected bone defects in the lower extremities. <b>Methods:</b> Eligible studies were searched from six databases until 12 April 2021. Data extraction was independently conducted by two investigators, which was followed by a quality assessment. Weighted mean difference (WMD) and 95% confidence interval (CI) were used to analyze continuous variables, while odds ratio (OR) and 95% CI were used to analyze categorical variables. All statistical analyses were conducted using RevMan 5.3 and Stata 12.0. <b>Results:</b> Thirteen articles were included in this meta-analysis. There was a significant difference observed in hospitalization costs (WMD [95% CI] = -1.75 [-2.50, -0.99] thousand US dollar, <i>p</i> < 0.00,001), final union time (WMD [95% CI] = -4.54 [-6.91, -2.17] months, <i>p</i> = 0.0002), time to full weight bearing (WMD [95% CI] = -1.73 [-3.36, -0.10] months, <i>p</i> = 0.04), quality of life (WMD [95% CI] = 7.70 [4.74, 10.67], <i>p</i> < 0.00,001), and the risk of complications (OR [95%CI] = 0.39 [0.19, 0.79], <i>p</i> = 0.009) between the Masquelet and Ilizarov groups. No significant differences in other outcomes were observed between the two groups. <b>Conclusion:</b> Masquelet technique exhibited the advantages in the lower hospitalization cost, shorter final union time, shorter time to full weight bearing, lower rate of complications, and better post-operative quality of life, compared with Ilizarov bone transport method. However, this finding should be confirmed in large-scale clinical samples.