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First performed by Dr. Masquelet in the mid\u20101980s, MIMT has shown great promise to revolutionize critical\u2010sized bone defect repair and has several advantages over its alternative, distraction osteogenesis (DO). Also, its success in extremely challenging cases (defects\u2009&gt;\u200915\u2009cm) suggests that its study could lead to discovery of novel biological mechanisms that might be at play during segmental defect healing and fracture non\u2010union. MIMT's advantages over DO have led to a world\u2010wide increase in MIMT procedures over the past decades. However, MIMT often needs to be repeated and so the average initial success rate in adults lags significantly behind that of DO (86% vs 95%, respectively). The autologous foreign\u2010body membrane created during the first stage by the immune system's response to a polymethyl methacrylate\u00a0bone cement spacer is critical to supporting the morselized bone graft implanted in the second stage. However, the biological and\/or physical mechanisms by which the membrane supports graft to bone union are unclear. This lack of knowledge makes refining MIMT and improving the success rates through technique improvements and patient selection a significant challenge and hinders wider adoption. In this review, current knowledge from basic, translational, and clinical studies is summarized. The dynamics of both stages under normal conditions as well as with drug or material perturbations is discussed along with perspectives on high\u2010priority future research directions.<\/jats:p>","DOI":"10.1002\/jor.24978","type":"journal-article","created":{"date-parts":[[2020,12,31]],"date-time":"2020-12-31T14:01:29Z","timestamp":1609423289000},"page":"707-718","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":175,"title":["Masquelet's induced membrane technique: Review of current concepts and future directions"],"prefix":"10.1002","volume":"39","author":[{"given":"Andrea I.","family":"Alford","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daemeon","family":"Nicolaou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Saint Louis University  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Hake","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2652-7997","authenticated-orcid":false,"given":"Sarah","family":"McBride\u2010Gagyi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Saint Louis University  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2009.07.011"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00842"},{"issue":"3","key":"e_1_2_6_4_1","first-page":"346","article-title":"Reconstruction of the long bones by the induced membrane and spongy 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