The Masquelet Technique: Is Bone Regeneration Influenced by Biological Sex?

PURPOSE: Existing studies predominantly represent male patients, and no gender-specific analysis has been performed on treatment outcomes. This study aimed to investigate the influence of sex on the therapeutic outcomes of the Masquelet technique. MATERIALS AND METHODS: This retrospective cohort study included 58 women and 113 men treated with the Masquelet technique at the BG Klinikum Hamburg (BGKH) between July 2011 and June 2021. No sex-specific treatment protocols were employed at BGKH. The defect location and size, indication for the Masquelet technique, occurrence of complications and surgical revisions, microbial colonisation of the defect site, secondary stabilisation strategies, as well as the achievement and time to full weight-bearing were systematically assessed. RESULTS: The analysis revealed no significant difference in the percentage of patients achieving full weight-bearing capacity between male and female cohorts (p = 0.611). Specifically, 90.3% of men and 87.9% of women attained full weight-bearing capacity. The time to achieve full weight-bearing capacity averaged 21 months for both sexes. The complication rates were not significantly different, with 57% for men and 50% for women (p = 0.422). CONCLUSION: Fundamental factors such as age, comorbidities, defect size, and defect localisation did not substantially differ between male and female patient cohorts in this study. Consequently, the results suggest that biological sex does not exert a discernible influence on the therapeutic outcomes of the Masquelet technique.