Platelet-rich plasma, bone marrow and chitosan in minimally invasive plate osteosynthesis of canine tibia fractures - a randomized study

Abstract

The goal of this study was to analyse the effects of percutaneous application of platelet rich plasma (PRP), autologous bone marrow concentrate (BM) and chitosan gel (CHI) on bone consolidation following minimally invasive plate osteosynthesis (MIPO) of the fractures of the tibia in dogs. Client-owned dogs (n = 30) with tibial fracture were divided into four treatment groups – Group 1 (control), Group 2 (BM), Group 3 (PRP) and Group 4 (CHI). The biomaterial specific to each group was injected at the fracture site immediately after the MIPO procedure. Serial radiographs were used to determine the fracture line and the development of periosteal callus immediately after surgery and at 15, 30, 60, 90 and 120 days post-surgery. There was no significant difference (P > 0.05) in the degree of oedema or grade of lameness between the groups. Grade 4 (minimum) or 5 lameness (absent) was observed in 70% of animals from all groups at 15 days post-surgery. The biomaterials PRP, BM and CHI combined with MIPO contribute to bone consolidation of tibial fractures in dogs and do not cause adverse reactions or fracture complications. Bone marrow concentrate results in shorter bone consolidation time.

Percutaneous application of allogeneic adipose-derived mesenchymal stem cell in dogs submitted to minimally invasive plate osteosynthesis of the tibia

“…It is believed that the addition of AD-MSC cell therapy to the MIPO, preserves an appropriate biological environment at the fracture site for cell signaling, neoangiogenesis stimulation and osteogenesis. Filgueira et al 18 used bone marrow graft and platelet-rich plasma injected percutaneously at the fracture site in association with the MIPO technique. In the above-mentioned study, there were no cases of rejection, inflammation or complications related to percutaneous application, showing this to be a simple, effective and safe route of cell delivery.…”

Bridge Plating for Simple Tibial Fractures Treated by Minimally Invasive Plate Osteosynthesis

“…Bone healing was evaluated using the modified Radiographic Union Scale for Tibial fractures (mRUST) (Litrenta et al, 2015), considering clinical union when there was a bone bridge on three of four bone cortices on two orthogonal radiographic views. As adapted from Filgueira et al (2019), the following parameters were also evaluated over time, by scores: periosteal reaction, cortical and medullary re-establishment, bone callus volume, presence of bridging callus, and remodeling. The presence of associations between the time of clinical union and the bone maturity (logistic regression), bridge plate ratio, and plate working length (variance analysis -ANOVA) variables was also evaluated.…”

Bridge plating for simple tibial fractures treated by minimally invasive plate osteosynthesis

“…Bone healing was evaluated using the modified Radiographic Union Scale for Tibial fractures (mRUST) (Litrenta et al, 2015), considering clinical union when there was a bone bridge on three of four bone cortices on two orthogonal radiographic views. As adapted from Filgueira et al (2019), the following parameters were also evaluated over time, by scores: periosteal reaction, cortical and medullary re-establishment, bone callus volume, presence of bridging callus, and remodeling. The presence of associations between the time of clinical union and the bone maturity (logistic regression), bridge plate ratio, and plate working length (variance analysis -ANOVA) variables was also evaluated.…”

“…Considering that high-strain fractures would respond better in more rigid environments (Perren, 2002), we believe that LCPs have promoted, to some degree, more stability than would be expected for bridge construction with a DCP plate, potentially favoring bone healing. Further studies should be conducted to better clarify the locking implant mechanisms, for micromotion control, especially in clinical scenarios (Gardner et al, 2005;Xue et al, 2016).…”