Enhanced Tibial Osteotomy Healing with Use of Bone Grafts Supplemented with Platelet Gel or Platelet Gel and Bone Marrow Stromal Cells

Dallari, Dante; Savarino, L.; Stagni, Cesare; Cenni, E.; Cenacchi, Annarita; Fornasari, Pier Maria; Albisinni, Ugo; Rimondi, Eugenio; Baldini, Nicola; Giunti, Armando

doi:10.2106/jbjs.f.01026

Cited by 126 publications

(88 citation statements)

References 35 publications

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“…Under these circumstances, our aim in this animal model was to influence the osseointegration process with the use of PRP. Previous studies have reported controversial results regarding the effectiveness of PRP in bone healing [15,[31][32][33], but none was supported by level I clinical evidence. Consistently, in the two time periods in our study, there were no histological differences in osseointegration that were shown to be responsible for failures [8].…”

Section: Discussionmentioning

confidence: 96%

The effect of platelet-rich plasma on osteochondral defects treated with mosaicplasty

Altan

Aydın

Erkoçak

et al. 2014

International Orthopaedics (SICOT)

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Purpose This study investigated the efficacy of platelet-rich plasma (PRP) on articular surfaces on which the mosaicplasty technique was performed. Our hypothesis was that PRP can accelerate the osseointegration process and enhance the quality of articular integrity after the mosaicplasty procedure. Methods Standard defects were created in the femoral groove of both patellofemoral joints of 12 New Zealand rabbits. PRP solution was placed inside the defect before fixation of the osteochondral autografts and injected inside the involved joint after capsular closure of the tested knees. The contralateral knees served as the control sides. The animals were euthanized three or six weeks after mosaicplasty, and both limbs were assessed according to Pineda's histological grading scale. Significance level was set at p≤0.05 a priori, and the Mann-Whitney U test was used for statistical analysis. Results Histologic findings at the interface between the transferred autograft and the original cartilage revealed better integration of the adjacent surfaces in the mosaicplasty with PRP group three weeks after the procedure; the difference was significant (p<0.05). However, no significant difference in the transition zone was observed between the groups six weeks after the experiment (p=0.59). Conclusions Our animal model showed that adjunctive use of PRP produced a better healing response and resulted in superior histological scores after three weeks compared with the mosaicplasty-only procedure. Interpretation of our results is important in terms of rapid return to previous activity levels. Thus, application of PRP can represent a valid therapeutic option for improving the efficacy of mosaicplasty by stimulating the local healing response.

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Section: Discussionmentioning

confidence: 96%

The effect of platelet-rich plasma on osteochondral defects treated with mosaicplasty

Altan

Aydın

Erkoçak

et al. 2014

International Orthopaedics (SICOT)

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“…Encouraging results have been reported with the use of PRP, bone marrow stromal cells and growth factors [9,19,28], associated both with bone grafting and with bone substitute augmentation. Nevertheless, the use of plasma products still remains experimental and their efficacy compared to autologous iliac crest graft has not been demonstrated yet [9].…”

Section: Debated Issuesmentioning

confidence: 99%

Results of high tibial osteotomy: review of the literature

Amendola

Bonasia

2009

International Orthopaedics (SICOT)

327

305

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The aim of this review is to evaluate long-term follow-up and survival analysis studies regarding high tibial osteotomies (HTO) for the treatment of medial knee arthritis. Despite the good number of studies available, comparison and pooling of the results are challenging because of the different evaluation systems and techniques used. However, in general, published studies on HTO report good long-term results with a correct patient selection and a precise surgical technique. Based on our findings, the ideal candidate for an HTO is a young patient (<60 years of age), with isolated medial osteoarthritis, with good range of motion and without ligamentous instability. Furthermore, the literature review shows that the outcomes gradually deteriorate with time.

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“…Iliac crest autograft are considered the "gold standard," but considering the donor site morbidity, bone substitutes can be a good choice because of their osteoconductive, osteoinductive, and osteogenic properties, and also if there is still some concern about their mechanical property and biological degradability [49,50]. Encouraging results have been reported with the use of PRP and marrow stromal cells in association both with bone grafting and bone substitute augmentation, although they are still experimental [51].…”

Section: Medial Closing Wedgementioning

confidence: 99%

Distal femoral osteotomy

Rosso¹,

Margheritini

2014

Curr Rev Musculoskelet Med

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Osteotomies around the knee are well-recognized treatments for unloading the affected compartment in cases of lower limb malalignment. There are few papers in the literature describing the outcomes of distal femoral osteotomy (DFO), as compared with the studies reporting on high tibial osteotomy (HTO), probably because valgus malalignment is less common than the varus one. There is still debate as to what the correct indication is and which surgical techniques lead to the best outcomes in performing a DFO. Besides, it is still controversial whether patellofemoral arthritis should be considered as a contraindication to performing a DFO, as well as in HTO. In this article, we will summarize the indications for DFO, the surgical techniques reported in the literature, and their outcomes.

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Enhanced Tibial Osteotomy Healing with Use of Bone Grafts Supplemented with Platelet Gel or Platelet Gel and Bone Marrow Stromal Cells

Abstract: Adding a platelet gel or a platelet gel combined with bone marrow stromal cells to lyophilized bone chips increases the osteogenetic potential of the lyophilized bone chips and may be a useful tool in the treatment of patients with massive bone loss.

Cited by 126 publications

References 35 publications

The effect of platelet-rich plasma on osteochondral defects treated with mosaicplasty

The effect of platelet-rich plasma on osteochondral defects treated with mosaicplasty

Results of high tibial osteotomy: review of the literature

Distal femoral osteotomy

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