In vivo study on the healing of bone defects treated with bone marrow stromal cells, platelet‐rich plasma, and freeze‐dried bone allografts, alone and in combination

Abstract

The repair of confined trabecular bone defects in rabbits treated by autologous bone marrow stromal cells (BMSC), platelet-rich plasma (PRP), freeze-dried bone allografts (FDBA) alone and in combination (BMSC þ PRP; FDBA þ BMSC; FDBA þ PRP; FDBA þ PRP þ BMSC) was compared. A critical size defect was created in the distal part of the femurs of 48 adult rabbits. Histology and histomorphometry were used in the evaluation of healing at 2, 4, and 12 weeks after surgery. The healing rate (%) was calculated by measuring the residual bone defect area. Architecture of the newly formed bone was compared with that of bone at the same distal femur area of healthy rabbits. The defect healing rate was higher in PRP þ BMSC, FDBA þ PRP, FDBA þ BMSC, and FDBA þ PRP þ BMSC treatments, while lower values were achieved with PRP treatment at all experimental times. The highest bone-healing rate at 2 weeks was achieved with FDBA þ PRP þ BMSC treatment, which resulted significantly different from PRP (p < 0.05) and BMSC (p < 0.05) treatments. At 4 weeks, the bone-healing rate increased except for PRP treatment. Finally, the bone-healing rate of FDBA þ PRP, FDBA þ BMSC, and FDBA þ PRP þ BMSC was significantly higher than that of PRP at 12 weeks (p < 0.05). At 12 weeks, significant differences still existed between PRP, BMSC, and FDBA groups and normal bone (p < 0.05). These results showed that the combination of FDBA, BMSC and PRP permitted an acceleration in bone healing and bone remodeling processes. ß

Bone Marrow Aspirate Concentrate and Platelet-rich Plasma Enhanced Bone Healing in Distraction Osteogenesis of the Tibia

“…The differentiation of osteoblasts from bone marrow cells is well described and standardized [26]. The PRP is rich in various growth factors released from platelets, which have been reported to increase vascular ingrowth and mitogenic effects on boneforming cells [4,11,28,57]. Second, because of the autogenous properties, their application can avoid possible complications, such as immunogenic reactions and disease transmissions, which can come from allogenic or synthetic materials.…”

“…Among the locally applied substances, bone marrow cells are rich in mononucleated cells, which are reported to have high potentiality in bone healing [26,45,53]. Also, PRP has many osteoinductive growth factors that are released from platelets [7,11,39], although some controversy exists as to whether it really helps bone healing. However, there have been only very limited clinical reports on their local injection in distraction osteogenesis [30,55].…”

Efficacy of minimally invasive techniques for enhancement of fracture healing: evidence today

“…The findings reported have been favourable [21,83]. In segmental bone defects of canine ulna the animals treated with autologous bone marrow united in contrast with the untreated control animals which developed nonunions [42].…”

“…The combination though appeared to be more potent compared to each of them alone. BM combined with platelet-rich plasma and freeze-dried bone allografts could serve as an alternative treatment modality [21].…”

Acidic preparations of lysed platelets upregulate proliferative pathways in osteoblast-like cells as demonstrated by genome-wide microarray analysis

“…The local environment in the initial fracture hematoma is acidic, which later becomes more alkaline as the healing progress [1]. Platelet-rich plasma and platelet derivates contain several potent growth factors and have, therefore, been used for growth stimulation of a variety of mesenchymal cells [2][3][4][5]. Platelet preparations have also been used clinically to stimulate bone formation and wound healing [6][7][8].…”