Platelet-Rich Fibrin Enhances Fracture Healing in Tibial Long Bone: An Experiment in Rabbit

Abstract

Background: Fracture on long bone is a complicated case to manage. Bone graft procedure involving growth factors has been widely studied with promising results. Recently, platelet-rich fibrin (PRF) has been introduced as having potential in healing process. This study aimed to explore the quality of fracture healing on long bones treated with bone graft with and without PRF combination. Methods: This study was conducted between October to November 2018 on 18 rabbits that were divided into 2 groups. A 5 mm fracture was created on tibial bones and the fracture was stabilized using a 2.0 mm mini plate. The defect was then treated by an autogenic bone graft with and without PRF. Histological analysis was conducted 3 weeks after the treatment and a scoring was performed using the Salkeld system. The quality of union; cortex development and remodeling; and bone graft incorporation and new bone formation were then analyzed. Results: There were significant differences between fractures in rabbits given PRF than those without PRF in terms of union quality (p 0.040), cortex growth and remodeling (p 0.0001), bone graft and new bone union (p 0.0001), as well as in the total Salkeld score (p 0.0001). Conclusion: PRF given with bone graft therapy can enhance the quality of fracture healing of a long bone. Further studies on how the PRF content influences fracture healing process needs to be performed to further explore this effect.

Effect of Glycogen Synthase Kinase Antagonists-3 on bone regeneration in comparison to Injectable Platelets Rich-Fibrin: Histomorphometric and biomarkers results

“…Group (G/i-PRF) revealed thickened trabecular bone with interconnected marrow cavities. Mostly, islands of woven bone intermingled with areas of osteons and lamellar bone were seen , enhanced mature bone area % and upregulated ALP, OCN and OPN gene expression compared to control which was consistent with El-kabbany A & Abdelsalam E, (15) who reported a significant increase in the amount of newly formed bone with the i-PRF group, and in accordance with a Hidajat et al (41) , where i-PRF were able to enhance the quality of fracture healing of a long bone in rabbits in terms of union quality, cortex growth and remodeling and bone graft and new bone union . i-PRF bone regenerative potential may be attributed to the increased concentration of platelets, leukocytes, and growth factors that initiate the migration and proliferation of osteoblasts, prompting tissue regeneration (42,43) .…”