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Panagiotopoulou VC, Santolini E, Jones E, Jha A, Giannoudis PV. Adhesives for treatment of bone fractures: A review of the state-of-the art. Injury 2022; 53 Suppl 2:S20-S25. [PMID: 33752878 DOI: 10.1016/j.injury.2021.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/29/2020] [Accepted: 02/10/2021] [Indexed: 02/02/2023]
Abstract
Treatment of fractures remains challenging and carries a high economical burden to both patients and society. In order to prevent some of the complications, the use of bone adhesives has been proposed, but up to date, bone adhesives are not part of the current clinical practice. Early results of use of bone cements and bone glues are promising, focusing in the areas of highly fragmented fractures, fixation of long bone fractures, filling bone voids and defects, promoting osseointegration, preventing non-union while maintaining the reduction of fracture fixation. This review aims to describe the state-of-the-art of the development, properties and use of adhesives in fracture treatment.
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Affiliation(s)
| | - Emmanuele Santolini
- Academic Unit of Trauma and Orthopaedics, University of Genoa, Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132 Genoa, Italy
| | - Elena Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Animesh Jha
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Peter V Giannoudis
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom; Leeds General Infirmary, Department of Trauma and Orthopaedic Surgery, University of Leeds, Leeds, United Kingdom
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Shi W, Bian L, Wu Y, Wang Z, Dai Y, Zhou Y, Meng P, Wang Q, Zhang Z, Zhao X, Zhao P, Lu X. Enhanced Bone Regeneration Using a ZIF-8-loaded Fibrin Composite Scaffold. Macromol Biosci 2021; 22:e2100416. [PMID: 34962099 DOI: 10.1002/mabi.202100416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/01/2021] [Indexed: 11/11/2022]
Abstract
In the present study, we fabricated fibrin-based biomaterials made of zeolite imidazole framework-8 (ZIF-8) and fibrin gel (Z-FG) with the aim of enhancing skull regeneration. X-ray diffraction (XRD), scanning electron microscopy (SEM), UV-vis spectrophotometry, Fourier transform infrared spectroscopy, and rheometry were used to characterize ZIF-8 and Z-FG. We investigated the influences of ZIF-8 on the physical properties of fibrin gel (porosity, modulus, and in vitro biodegradation), and we determined the effect of ZIF-8 concentration on fibrin gel properties in vitro by seeding ectomesenchymal stem cells (EMSCs) over Z-FG. EMSC osteogenic differentiation revealed higher expression of bone-related proteins and higher calcium deposition and alkaline phosphatase activity, indicating that Z-FG may be a good osteoinductive biomaterial. Furthermore, our results showed that the piezo channel and YAP signaling pathway were involved in the differentiation process. In addition, the in vivo results demonstrated that Z-FG increased bone formation in critical-sized calvarial defects in rats. Thus, the developed composite scaffold might be a suitable biomaterial for skull tissue engineering applications. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wentao Shi
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,Jiangnan University Neuroscience Center, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Lu Bian
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Yiqing Wu
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,Jiangnan University Neuroscience Center, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Zhe Wang
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, 212001, P. R. China
| | - Yao Dai
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, 212001, P. R. China
| | - Yanjun Zhou
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Pengfei Meng
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Qing Wang
- Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi, Jiangsu Province, 214122, P. R. China.,Affiliated Wuxi Clinical Medicine, Nantong University, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Zhijian Zhang
- School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, 212001, P. R. China
| | - Xijiang Zhao
- Affiliated Wuxi Second Hospital, Nanjing Medical University, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Peng Zhao
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China
| | - Xiaojie Lu
- Jiangnan University Affiliated Hospital, Wuxi, Jiangsu Province, 214122, P. R. China.,Jiangnan University Neuroscience Center, Wuxi, Jiangsu Province, 214122, P. R. China
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Karimi Ghahfarrokhi E, Meimandi-Parizi A, Oryan A, Ahmadi N. Effects of Combination of BMP7, PFG, and Autograft on Healing of the Experimental Critical Radial Bone Defect by Induced Membrane (Masquelet) Technique in Rabbit. THE ARCHIVES OF BONE AND JOINT SURGERY 2021; 9:585-597. [PMID: 34692943 DOI: 10.22038/abjs.2020.50852.2532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/02/2020] [Indexed: 01/08/2023]
Abstract
Background Healing of large segmental bone defects can be challenging for orthopedic surgeons. This research was conducted to provide further insight into the effects of BMP7 in combination with autograft and platelet fibrin glue (PFG) on bone regeneration by Masquelet technique (MT). Methods Twenty five domestic male rabbits, more than 6 months old, weighing 2.00±0.25 kg were randomly divided into five equal groups as follows: MT-blank cavity (without any biological or synthetic materials) (1), blank cavity (2), MT-autograft (3), MT-autograft-BMP7 (4), and MT-BMP7-PFG (5). A 20 mm segmental defect was made in radial bone in both forelimbs. The Masquelet technique was done in all groups except group 2. The study was evaluated by radiology, biomechanics, histopathology and scanning electron microscopy. Results The results showed that Masquelet technique enhanced the healing process, as, the structural and functional criteria of the injured bone showed significantly improved bone healing (P<0.05). Treatment by PFG-BMP7, Autograft-BMP7, and autograft demonstrated beneficial effects on bone healing. However, Autograft-BMP7 was more effective than autograft in healing of the radial defect in rabbits. Conclusion Our findings introduce the osteogenic materials in combination with Masquelet technique as an alternative for reconstruction of the big diaphyseal defects in the long bones in animal models. Our findings may be useful for clinical application in future.
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Affiliation(s)
| | | | - Ahmad Oryan
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Nasrollah Ahmadi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Do the Fibrin Scaffold and Growth Factors in Platelet-Rich Fibrin Play the Most Vital Roles in Bone Regeneration? A Critical Comment. J Craniofac Surg 2019; 30:1923-1926. [DOI: 10.1097/scs.0000000000005487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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Kobayashi E, Fujioka‐Kobayashi M, Saulacic N, Schaller B, Sculean A, Miron RJ. Effect of enamel matrix derivative liquid in combination with a natural bone mineral on new bone formation in a rabbit GBR model. Clin Oral Implants Res 2019; 30:542-549. [DOI: 10.1111/clr.13440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/09/2018] [Accepted: 09/22/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Eizaburo Kobayashi
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
- Department of Oral and Maxillofacial Surgery, School of Life, Dentistry at Niigata The Nippon Dental University Niigata Japan
| | - Masako Fujioka‐Kobayashi
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Nikola Saulacic
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Benoit Schaller
- Department of Cranio‐Maxillofacial Surgery, Inselspital, Bern University Hospital University of Bern Bern Switzerland
| | - Anton Sculean
- Department of Periodontology University of Bern Bern Switzerland
| | - Richard J. Miron
- Department of Periodontology University of Bern Bern Switzerland
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Mercan U, Sümer M, Uçak Semirgen S, Ballı U, Betil Kabak Y, Şenyurt Ö. Dentin greftinin yeni oluşan kemikteki kemik mineral yoğunluğu üzerindeki etkileri: deneysel bir hayvan çalışması. CUKUROVA MEDICAL JOURNAL 2018. [DOI: 10.17826/cumj.376439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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8
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Mehrabani D, Khodakaram-Tafti A, Shaterzadeh-Yazdi H, Zamiri B, Omidi M. Comparison of the regenerative effect of adipose-derived stem cells, fibrin glue scaffold, and autologous bone graft in experimental mandibular defect in rabbit. Dent Traumatol 2018; 34:413-420. [PMID: 30187637 DOI: 10.1111/edt.12435] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND/AIMS One of the main concerns for maxillofacial and orthopedic surgeons is finding a method to improve regeneration of large craniofacial bone defects. The aim of this study was to investigate the healing and regenerative effects of fibrin glue associated with adipose-derived stem cells (ADSCs) and fibrin glue scaffold alone with autologous bone grafts in experimental mandibular defects of the rabbit. METHODS Bilateral uni-cortical osteotomies were performed in the mandible of 20 male Dutch rabbits. The animals were randomly divided into 2 equal groups. In one group, the defect on the right side was treated by fibrin glue associated with ADSCs and the defect on the other side remained as the control. In another group, the defect on the right side was treated with fibrin glue and on the left side with autologous bone graft. After 28 and 56 days, five rabbits from each group were evaluated by computed tomography (CT) and histopathological examinations. RESULTS Coronal CT showed a remarkable reconstruction of cortical bone in the fibrin glue associated with ADSCs group at 28 and 56 days post-surgery. Histopathologically, new cortical bony bridge formation was seen increasingly in the fibrin glue, fibrin glue associated with ADSCs, and autologous bone graft groups after 28 days. Statistical analysis of the thickness of new cortical bone in the treatment versus control groups showed a significant difference between fibrin glue alone and fibrin glue associated with ADSCs groups (P = 0.02). No significant difference was found between the fibrin glue associated with ADSCs and the autologous bone graft groups (P > 0.05). CONCLUSIONS The healing process had a significant increase in the thickness of new cortical bone when fibrin glue scaffold associated with ADSCs was used.
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Affiliation(s)
- Davood Mehrabani
- Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Barbad Zamiri
- Department of Craniomaxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsa Omidi
- Department of Oral and Maxillofacial Radiology and Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Meimandi-Parizi A, Oryan A, Gholipour H. Healing potential of nanohydroxyapatite, gelatin, and fibrin-platelet glue combination as tissue engineered scaffolds in radial bone defects of rats. Connect Tissue Res 2018; 59:332-344. [PMID: 29035127 DOI: 10.1080/03008207.2017.1387541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Different biomaterials have been used in orthopedic surgery. Evaluation of biomaterials for bone healing promotion has been a wide area of research of the orthopedic field. Sixty critical size defects of 5 mm long were bilaterally created in the radial diaphysis of 30 rats. The animals were randomly divided into six equal groups as empty defect, autograft, nanohydroxyapatite (nHA), Gelatin (Gel)-nHA, fibrin-platelet glue (FPG)-nHA, and Gel-FPG-nHA groups (n = 10 in each group). Radiographs of each forelimb were taken postoperatively on the 1st day and then at the 28th and 56th days post injury. After 56 days, the rats were euthanized and their harvested healing bone samples were evaluated by histopathology, scanning electron microscopy, and biomechanical testing. All the treated defects demonstrated significantly superior new bone formation, remodeling, and bone tissue volume. Moreover, the defects treated with FPG-nHA showed significantly higher ultimate load, yield load, and stiffness. The Gel-FPG-nHA moderately improved bone regeneration that was not close to the autograft in some parameters, whereas FPG-nHA significantly improved bone healing closely comparable with the autograft group in most parameters. In conclusion, although all the nHA-containing scaffolds had some beneficial effects on bone regeneration, the FPG-nHA scaffold was more effective in improving the structural and functional properties of the newly formed bone and was more osteoinductive than the Gel and was comparable to the autograft. Therefore, the FPG can be regarded as a promising option to be used in conjunction with mineral scaffolds for bone tissue engineering.
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Affiliation(s)
- Abdolhamid Meimandi-Parizi
- a Division of Surgery, Department of Clinical Sciences, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
| | - Ahmad Oryan
- b Department of Pathology, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
| | - Hojjat Gholipour
- a Division of Surgery, Department of Clinical Sciences, School of Veterinary Medicine , Shiraz University , Shiraz , Iran
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10
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The effects of gelatin, fibrin-platelet glue and their combination on healing of the experimental critical bone defect in a rat model: radiological, histological, scanning ultrastructural and biomechanical evaluation. Cell Tissue Bank 2017; 19:341-356. [PMID: 29264693 DOI: 10.1007/s10561-017-9679-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 12/12/2017] [Indexed: 01/09/2023]
Abstract
Fibrin-platelet glue (FPG) is a blood derivative, in which platelets and fibrinogen are concentrated in a small plasma volume, by differential centrifugation and precipitation. It can form a three-dimensional and biocompatible fibrin scaffold with a myriad of growth factors and proteins that are released progressively to the local environment and contribute to the accelerated postoperative bone healing. Gelatin (Gel) is a derivative of collagen and can promote cell adhesion and proliferation due to its unique sequence of amino acids, so it is suitable for bone tissue applications. This study examined the effects of Gel, FPG and their combinations as bone scaffold on the healing of surgically created critical-size defects in rat radius. Fifty critical size defects of 5 mm long were bilaterally created in the radial diaphysis of 25 rats. The animals were randomly divided into five equal groups as empty defect, autograft, Gel, FPG and Gel-FPG groups (n = 10 in each group). Radiographs of each forelimb were taken postoperatively on the 1st day and then at the 28th and 56th days post injury to evaluate bone formation, union and remodeling of the defect. After 56 days, the rats were euthanized and their harvested healing bone samples were evaluated by histopathology, scanning electron microscopy (SEM) and biomechanical testing. The results of present study showed that the Gel alone did not significantly affect bone healing and regeneration; however, the Gel treated defects promoted healing more than those that were left untreated (negative control). Furthermore, the FPG-enhanced grafts provided a good scaffold containing numerous growth factors for proliferation of osteoinduction and was effective in improving the structural and functional properties of the newly formed bone more than that of the untreated and also the Gel treated groups. Incorporation of Gel into the FPG scaffold improved healing potential of the FPG scaffold; however, it was still inferior to the autograft (positive control). Although the Gel-FPG scaffolds had best effectiveness during bone regeneration, it still needs to be further enhanced by incorporation of the ceramic and osteoinductive biomaterials.
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Implications of anticoagulants and gender on cell counts and growth factor concentration in platelet-rich plasma and platelet-rich gel supernatants from rabbits. Vet Comp Orthop Traumatol 2017; 29:115-24. [DOI: 10.3415/vcot-15-01-0011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: Our objectives were as follows: 1) to validate a protocol for producing rabbit platelet-rich plasma (PRP); 2) to determine the influence of two anticoagulants, sodium citrate and acid-citrate-dextrose solution A, and gender on cell count in PRP and growth factor concentration in pure platelet-rich gel supernatants; 3) to correlate the variables evaluated.Methods: Whole blood from 18 New Zealand rabbits (9 males and 9 females) was obtained with sodium citrate and acid- citrate-dextrose solution A for processing PRP fractions (A and B), which were evaluated for haematology. The PRP fractions were either activated with calcium gluconate or lysated with a detergent. The concentrations of transforming growth factor beta 1 and platelet-derived growth factor BB were assayed by ELISA.Results: The sodium citrate PRP-B had significantly higher counts of platelets in comparison to PRP-A and whole blood obtained with the same anticoagulant and the homologous acid-citrate-dextrose solution A PRP fraction. The sodium citrate PRP-A had a significantly higher count of leukocytes compared to the homologous acid-citrate-dextrose solution A fraction. All the PRP fractions had a significant leuko-reduction when compared to whole blood. The sodium citrate PRP-A fraction from female rabbits had significantly lower platelet counts and significantly higher leukocyte counts than the same acid-citrate-dextrose solution A fraction. Growth factor concentration was not affected by the type of anticoagulant or gender.Clinical significance: The type of anticoagulant and gender affected the cell counts in PRP, but they did not influence the growth factor concentration. More complete rabbit PRP studies should be performed before evaluating this type of substance in models of disease.
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Effect of Blood Component Coatings of Enosseal Implants on Proliferation and Synthetic Activity of Human Osteoblasts and Cytokine Production of Peripheral Blood Mononuclear Cells. Mediators Inflamm 2016; 2016:8769347. [PMID: 27651560 PMCID: PMC5019932 DOI: 10.1155/2016/8769347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 05/04/2016] [Accepted: 05/25/2016] [Indexed: 12/23/2022] Open
Abstract
The study monitored in vitro early response of connective tissue cells and immunocompetent cells to enosseal implant materials coated by different blood components (serum, activated plasma, and plasma/platelets) to evaluate human osteoblast proliferation and synthetic activity and inflammatory response presented as a cytokine profile of peripheral blood mononuclear cells (PBMCs) under conditions imitating the situation upon implantation. The cells were cultivated on coated Ti-plasma-sprayed (Ti-PS), Ti-etched (Ti-Etch), Ti-hydroxyapatite (Ti-HA), and ZrO2 surfaces. The plasma/platelets coating supported osteoblast proliferation only on osteoconductive Ti-HA and Ti-Etch whereas activated plasma enhanced proliferation on all surfaces. Differentiation (BAP) and IL-8 production remained unchanged or decreased irrespective of the coating and surface; only the serum and plasma/platelets-coated ZrO2 exhibited higher BAP and IL-8 expression. RANKL production increased on serum and activated plasma coatings. PBMCs produced especially cytokines playing role in inflammatory phase of wound healing, that is, IL-6, GRO-α, GRO, ENA-78, IL-8, GM-CSF, EGF, and MCP-1. Cytokine profiles were comparable for all tested surfaces; only ENA-78, IL-8, GM-CSF, and MCP-1 expression depended on materials and coatings. The activated plasma coating led to uniformed surfaces and represented a favorable treatment especially for bioinert Ti-PS and ZrO2 whereas all coatings had no distinctive effect on bioactive Ti-HA and Ti-Etch.
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Evaluation of the effects of platelet-rich fibrin on bone regeneration in diabetic rabbits. J Craniomaxillofac Surg 2016; 44:126-33. [DOI: 10.1016/j.jcms.2015.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/14/2015] [Accepted: 11/20/2015] [Indexed: 01/05/2023] Open
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New and emerging strategies in platelet-rich plasma application in musculoskeletal regenerative procedures: general overview on still open questions and outlook. BIOMED RESEARCH INTERNATIONAL 2015; 2015:846045. [PMID: 26075269 PMCID: PMC4436449 DOI: 10.1155/2015/846045] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 02/07/2023]
Abstract
Despite its pervasive use, the clinical efficacy of platelet-rich plasma (PRP) therapy and the different mechanisms of action have yet to be established. This overview of the literature is focused on the role of PRP in bone, tendon, cartilage, and ligament tissue regeneration considering basic science literature deriving from in vitro and in vivo studies. Although this work provides evidence that numerous preclinical studies published within the last 10 years showed promising results concerning the application of PRP, many key questions remain unanswered and controversial results have arisen. Additional preclinical studies are needed to define the dosing, timing, and frequency of PRP injections, different techniques for delivery and location of delivery, optimal physiologic conditions for injections, and the concomitant use of recombinant proteins, cytokines, additional growth factors, biological scaffolds, and stems cells to develop optimal treatment protocols that can effectively treat various musculoskeletal conditions.
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Lin CT, Chen SG, Chang SC. Salvage of a recurrent phalangeal non-union with bone defect using autologous platelet glue and corticocancellous bone graft. J Hand Surg Eur Vol 2015; 40:422-3. [PMID: 24092898 DOI: 10.1177/1753193413507521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- C-T Lin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - S-G Chen
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - S-C Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Bulam H, Ayhan S, Sezgin B, Zinnuroglu M, Konac E, Varol N, Findikcioglu K, Tuncer S, Cenetoglu S. The Inhibitory Effect of Platelet-Rich Plasma on Botulinum Toxin Type-A: An Experimental Study in Rabbits. Aesthetic Plast Surg 2015; 39:134-40. [PMID: 25413010 DOI: 10.1007/s00266-014-0418-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Combination treatments of botulinum toxin type-A and other rejuvenation agents or instruments are gradually becoming more popular. After observing a high incidence of therapy failure following simultaneous applications of botulinum toxin type-A and platelet-rich plasma mesotherapy, we aimed to investigate whether PRP has an inhibitory effect on botulinum toxin type-A. METHODS Twenty-four New Zealand white rabbits were divided into 4 groups, and the anterior auricular muscle and overlying skin were used for injections. Groups I and II both received onabotulinumtoxinA intramuscular injections. In addition, autologous platelet-rich plasma mesotherapy was performed in Group I while Group II received saline mesotherapy. Group III was designed as the in vitro mixture group in which onabotulinumtoxinA and platelet-rich plasma were mixed and then administered intramuscularly. Group IV received saline within the mixture instead of platelet-rich plasma. The contralateral ears of all the rabbits served as control and were only treated with onabotulinumtoxinA. Visual evaluation of ear positions and electroneuromyographic studies were done prior to all procedures and at day 14. Anterior auricular muscles were harvested at day 14 and were evaluated with quantitative real-time PCR. RESULTS Visual and electroneuromyographic studies revealed less onabotulinumtoxinA activity in Groups I and III. When platelet-rich plasma was administered through skin mesotherapy, onabotulinumtoxinA activity failure was more severe in comparison with direct contact. No significant difference in SNAP-25 mRNA expression through quantitative real-time PCR was observed between groups. CONCLUSION Although we could not explain the exact mechanism underlying this interaction, platelet-rich plasma applications result in less onabotulinumtoxinA muscle paralysis activity.
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Günay A, Arpağ OF, Atilgan S, Yaman F, Atalay Y, Acikan I. Effects of caffeic acid phenethyl ester on palatal mucosal defects and tooth extraction sockets. Drug Des Devel Ther 2014; 8:2069-74. [PMID: 25364232 PMCID: PMC4211858 DOI: 10.2147/dddt.s67623] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim The purpose of this study was to evaluate the effects of caffeic acid phenethyl ester (CAPE) on palatal mucosal defects and tooth extraction sockets in an experimental model. Materials and methods Forty-two male Sprague-Dawley rats with a mean age of 7 weeks and weighing 280–490 g were used in this study. The rats were randomly divided into two groups: group A (the control group, n=21) and group B (the experimental group, n=21). Under anesthesia with ketamine (8 mg/100 g, intraperitoneally), palatal mucosal defects were created and tooth extraction was performed in the rats in groups A and B. Group A received no treatment, whereas group B received CAPE. CAPE was injected daily (10 μmol/kg, intraperitoneally). The rats were killed on days 7, 14, and 30 after the procedures. Palatal mucosa healing and changes in bone tissue and fibrous tissue were evaluated histopathologically. Result Pairwise comparisons showed no statistically significant difference between days 7 and 14 in either group (P>0.05). At day 30, bone healing was significantly better in group B (CAPE) than in group A (control) (P<0.05). Fibrinogen levels at day 30 were significantly higher in group A (control) than in group B (CAPE) (P<0.05). Pairwise comparisons showed no statistically significant difference in palatal mucosa healing levels between days 7 and 14 in both groups (P>0.05). Conclusion In conclusion, the findings of this study suggest that CAPE can significantly improve tooth socket healing.
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Affiliation(s)
- Ahmet Günay
- Department of Periodontology, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Osman Fatih Arpağ
- Department of Periodontology, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Serhat Atilgan
- Department of Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Ferhan Yaman
- Department of Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Yusuf Atalay
- Department of Maxillofacial Surgery, Faculty of Dentistry, Kocatepe University, Afyon, Turkey
| | - Izzet Acikan
- Department of Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
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Sevim KZ, Yazar M, Irmak F, Tekkeşin MS, Yildiz K, Sirvan SS. Use of Platelet-Rich Plasma Solution Applied With Composite Chondrocutaneous Graft Technique: An Experimental Study in Rabbit Model. J Oral Maxillofac Surg 2014; 72:1407-19. [DOI: 10.1016/j.joms.2014.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/03/2014] [Accepted: 01/04/2014] [Indexed: 01/07/2023]
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The use of platelet-rich plasma in plastic surgery: a systematic review. J Plast Reconstr Aesthet Surg 2012; 66:301-11. [PMID: 23238115 DOI: 10.1016/j.bjps.2012.11.009] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 08/08/2012] [Accepted: 11/15/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The study's aim was to evaluate the available evidence regarding the use of platelet-rich plasma in plastic and reconstructive surgery, through implementation of a systematic review of the literature. DATA SOURCES PubMed and The Cochrane Library were searched using MeSH terms: 'platelet rich plasma' and 'plastic surgery' for all publications up to July 2011. All English, German, French and Dutch papers were included. In addition, the reference lists of relevant articles were searched for potentially appropriate publications. STUDY SELECTION Included studies needed to report on topics related to plastic and reconstructive surgery, mentioning at least one clinical end point. Both in vivo and in vitro comparative studies, performed in humans or animals, were included. A total of 82 publications were found, of which 40 studies met the inclusion criteria and were relevant to be used in this systematic review. DATA EXTRACTION Data from retrieved studies were reviewed and tabulated according to year of publication, study design, human or animal studies, characteristics of the population, mode of application, outcomes and preparation method. DATA SYNTHESIS A total of 15 randomised controlled trials and 25 case-control studies were found. Thirty-six publications demonstrated favourable outcomes with the use of platelet-rich plasma. The included articles were divided into three topics related to plastic surgery: wound healing, fat grafting and bone grafting. CONCLUSIONS This systematic review describes a substantially beneficial effect of platelet-rich plasma for several indications, including a better wound healing rate, an increased survival rate of fat grafts and an enhancement of bone graft regeneration.
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Schettino AM, Franco D, Franco T, Filho JMT, Vendramin FS. Use of autologous fibrin glue (platelet-poor plasma) in abdominal dermolipectomies. Aesthetic Plast Surg 2012; 36:1296-301. [PMID: 23052382 DOI: 10.1007/s00266-012-9978-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 07/17/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Autologous plasma is endowed with properties that speed up healing, hemostasis, and adhesiveness, in addition to growth factors. Through an established protocol, it was possible to isolate thrombin, as well as the platelet-rich plasma (PRP) and platelet-poor plasma (PPP) fractions. The purpose of this study was to analyze autologous use of thrombin and PPP to foster adhesion between an abdominal dermoadipose flap and the aponeurotic surface in abdominal dermolipectomies. METHODS The data from 40 patients who underwent abdominal dermolipectomies were analyzed, with 20 patients using thrombin and autologous PPP (Plasma group) and 20 patients with no intervention (Control group). An attempt was made to assess adhesive power by quantifying the serohematic liquid volume gauged during the postoperative days (POD), and also noting the incidence of seroma. Other variables such as age and body mass index (BMI) were also analyzed. RESULTS The reduction in the aspiration drain debit was statistically relevant only on the first POD in the Plasma group. There was no reduction in the incidence of seroma in these patients. Similarly, age and BMI did not influence these outcomes. CONCLUSION The PPP fostered adhesion between the abdominal dermoadipose flap and the aponeurotic surface only on the first POD and had no influence whatsoever on the incidence of seroma. There are few reports on the use of PPP for plastic surgery, particularly the autologous type, opening up possibilities for further research projects to expand its use. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266.
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Affiliation(s)
- Angélica Maria Schettino
- Federal University of Rio de Janeiro, Rua Professor Gabizo, 101 apto. 202-Tijuca, Rio de Janeiro, CEP: 20271-063, Brazil.
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Franco D, Franco T, Schettino AM, Filho JMT, Vendramin FS. Protocol for obtaining platelet-rich plasma (PRP), platelet-poor plasma (PPP), and thrombin for autologous use. Aesthetic Plast Surg 2012; 36:1254-9. [PMID: 22936376 DOI: 10.1007/s00266-012-9957-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Accepted: 06/11/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Plasma has been widely studied and used in many different situations to speed up healing with better tissue adherence and hemostasis. Research projects are now attempting to isolate platelet-rich plasma (PRP) and platelet-poor plasma (PPP), making better use of their properties, particularly during operations and for wounds that are slow to heal. In view of the wide diversity of industrial machines and extraction protocols, together with the variety of industrially produced biologic glues, this article suggests an option for obtaining PRP, PPP, and human thrombin for autologous use. METHODS A way of obtaining PRP, PPP, and thrombin is reproduced through a protocol defined and established by the authors. Autologous thrombin and plasma were obtained through the collection and successive centrifugation of ten whole blood samples, until the desired hemocomponents were isolated, followed by quantitative and qualitative analyses of the elements obtained. RESULTS The mean platelet concentration obtained was 6.03 × 10(8) platelets/ml, with a mean thrombin concentration of 33.54 nM, both values compatible with reports in the literature when different protocols are applied. CONCLUSIONS The protocol described is a good option for the preparation and application of PRP, PPP, and autologous thrombin, particularly as they can be obtained simultaneously, eliminating the possibilities of viral contamination and allergic reactions. Moreover, the cost of this procedure is low, it is easy to perform, and replicable. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article.
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Affiliation(s)
- Diogo Franco
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Bettega G, Schir E. [Contribution of platelet concentrates to oral and maxillo-facial surgery]. ACTA ACUST UNITED AC 2012; 113:205-11. [PMID: 22818655 DOI: 10.1016/j.stomax.2012.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 05/25/2012] [Indexed: 01/30/2023]
Abstract
INTRODUCTION We evaluated the clinical contribution of platelet concentrates to oral and maxillo-facial surgery. MATERIAL AND METHOD This bibliographic research was made using the PubMed MeSH database with the following keywords: "platelet rich fibrin" (PRF), "platelet rich plasma" (PRP), "bone", "facial bone", "dental implant", and "blood platelet". The research was made without any date or language limitation since English summaries were available. All summaries were read to evaluate the relevance of the article. Only original articles and case reports were considered. The articles were classified as "in vitro studies", "animal experiments", or "clinical studies". The research was stopped on March 22, 2012. RESULTS One hundred and sixty-nine articles were validated after excluding irrelevant articles, reviews, technical notes, and articles without English or French summaries. Seventeen were in vitro studies, 61 animal experiments, and 91 clinical studies. One hundred and ten complete articles were read to complete summary data. The data of in vitro studies univocally supports of using platelet concentrates. The data from animal experiment studies was less consensual and the validity of animal models was contested. The disparity of clinical study designs and the lack of rigorous methodology did not allow clearly determining platelet concentrate benefits for oral and maxillo-facial surgery. DISCUSSION PRF or PRP clinical benefit has not been clearly demonstrated yet. French regulations relative to their use should be clarified.
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Affiliation(s)
- G Bettega
- Service de chirurgie plastique et maxillo-faciale, hôpital A.-Michallon, BP 217, 38043 Grenoble cedex, France.
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COMPARATIVE STUDY ON USE OF PLATELET-RICH PLASMA ALONE AND IN COMBINATION WITH ALPHA-TRICALCIUM PHOSPHATE CEMENT FOR BONE REPAIR IN RATS. Rev Bras Ortop 2012; 47:505-12. [PMID: 27047859 PMCID: PMC4799469 DOI: 10.1016/s2255-4971(15)30137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Accepted: 07/31/2011] [Indexed: 11/20/2022] Open
Abstract
Objectives: To evaluate the effect of alpha-tricalcium phosphate (α-TCP) cement combined with platelet-rich plasma (PRP) on osteogenesis, and to compare the results with use of PRP alone. Methods: A bilateral defect was produced in rat femurs and was filled with one of two types of treatments (PRP or α-TCP + PRP). The outcomes were evaluated after four and eight weeks. Radiographic images provided values for the lesion area, and histology (picrosirius staining) indicated the area of new bone formation. Results: The means relating to the lesion area of the α-TCP + PRP group (2.64 ± 2.07 and 1.91 ± 0.93 mm2, after four and eight weeks, respectively) showed numerically better but non-significant results (p > 0.05) than those seen in the PRP group (5.59 mm 2 ± 2.69 and 3.23 ± 1.46 mm 2, after four and eight weeks, respectively). The mean new bone formation rates were 62.7% ± 12.1 and 79.01% ± 6.25 in the PRP group, and 73.3% ± 12.7 and 85.86% ± 10.45 in α-TCP + PRP group, after four and eight weeks, respectively (p > 0.05). Conclusion: The data from this study suggest that treatment with α-TCP cement combined with PRP does not show any significant difference in comparison with PRP alone. However, there is a possible early effect on bone regeneration when the two biomaterials are applied together.
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Okamoto SI, Ikeda T, Sawamura K, Nagae M, Hase H, Mikami Y, Tabata Y, Matsuda KI, Kawata M, Kubo T. Positive effect on bone fusion by the combination of platelet-rich plasma and a gelatin β-tricalcium phosphate sponge: a study using a posterolateral fusion model of lumbar vertebrae in rats. Tissue Eng Part A 2011; 18:157-66. [PMID: 21819268 DOI: 10.1089/ten.tea.2011.0283] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
We developed a novel method for bone fusion by combining platelet-rich plasma (PRP) and a gelatin β-tricalcium phosphate (β-TCP) sponge. The PRP is an autologous concentration of platelets that includes several growth factors. The gelatin β-TCP sponge comprises gelatin and β-TCP, thus enabling the sustained release of growth factors and osteoconduction. To evaluate this method, we generated a posterolateral fusion model of lumbar vertebrae in rats and divided it into five groups by implanting the following materials between transverse processes of vertebrae, (1) the gelatin β-TCP sponge with PRP (PRP sponge), (2) the gelatin β-TCP sponge with platelet-poor plasma, (3) gelatin hydrogel with PRP, (4) autologous iliac bone (autograft), and (5) no material was implanted as a control. The assessment of bone fusion by a radiographic assessment, a biomechanical test, microcomputed tomography, and histological evaluations demonstrated that there were no significant differences between the PRP sponge and the autograft groups regarding the osteogenic effect. Subsequent examinations revealed that no significant differences existed between the PRP sponge and the autograft groups in either biomechanical stiffness or the bone volume over time; whereas the radiographic and histological composition underwent similar changes in the fusion process. These results indicate that the PRP sponge could, therefore, be potentially useful as an attractive and less invasive method for bone fusion.
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Affiliation(s)
- Shin-ichi Okamoto
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Schuckert KH, Jopp S, Osadnik M. The use of platelet rich plasma, bone morphogenetic protein-2 and different scaffolds in oral and maxillofacial surgery - literature review in comparison with own clinical experience. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2011; 2:e2. [PMID: 24421984 PMCID: PMC3886066 DOI: 10.5037/jomr.2011.2102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 01/18/2011] [Indexed: 12/16/2022]
Abstract
Objectives The purpose of this article was to review and critically assess the use of
platelet rich plasma, recombinant human bone morphogenetic protein-2 and
different scaffolds (i.e. tricalciumphosphate, polycaprolactone,
demineralized bone matrix and anorganic bovine bone mineral) in oral and
maxillofacial surgery comparing the relevant literature and own clinical
experience. Material and Methods A literature review was conducted using MEDLINE, MEDPILOT and COCHRANE
DATABASE OF SYSTEMATIC REVIEWS. It concentrated on manuscripts and overviews
published in the last five years (2006-2010). The key terms employed were
platelet rich plasma, bone morphogenetic proteins and their combinations
with the above mentioned scaffolds. The results of clinical studies and
animal trials were especially emphasized. The statements from the literature
were compared with authors’ own clinical data. Results New publications and overviews demonstrate the advantages of platelet rich
plasma in bone regeneration. The results from the literature review were
discussed and compared with the publications detailing authors' own
experiences. Conclusions A favourable outcome concerning newly grown bone was achieved combining
platelet rich plasma in addition to optimal matrices with or without
recombinant human bone morphogenetic protein-2, depending on the clinical
case. As a consequence, the paradigm shift from transplantation of
autogenous bone to bone tissue engineering appears promising.
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Affiliation(s)
- Karl-Heinz Schuckert
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Stefan Jopp
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
| | - Magdalena Osadnik
- Institute Indente - Institute of Innovative Oral Surgery and Medicine, Centre for Tissue Engineering Hannover Germany
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26
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Yilmaz S, Kabadayi C, Ipci SD, Cakar G, Kuru B. Treatment of intrabony periodontal defects with platelet-rich plasma versus platelet-poor plasma combined with a bovine-derived xenograft: a controlled clinical trial. J Periodontol 2010; 82:837-44. [PMID: 21138357 DOI: 10.1902/jop.2010.100503] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study is to assess the healing outcomes of intrabony defects after treatment with platelet-rich plasma (PRP) versus platelet-poor plasma (PPP) combined with bovine-derived xenograft (BDX). METHODS Using a split-mouth design, a total of 79 intrabony defects with an intrabony component of ≥3 mm in 20 patients were treated either with PRP/BDX (group 1) or PPP/BDX (group 2). At baseline and 12 months after surgery, plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, recession, and probing and radiographic bone levels were recorded. RESULTS After 12 months, groups 1 and 2 presented a mean PD reduction of 3.87 ± 0.86 and 3.76 ± 0.80 mm, recession of 1.35 ± 0.68 and 1.58 ± 0.54 mm, attachment gain of 2.51 ± 0.97 and 2.18 ± 0.87 mm, clinical bone gain of 2.18 ± 0.86 and 2.09 ± 0.89 mm, and radiographic bone gain of 2.11 ± 0.87 and 2.19 ± 0.96 mm, respectively. Intergroup differences were found to be insignificant. CONCLUSIONS Within its limits, these results suggest that the outcomes of the treatment after PRP/BDX and PPP/BDX applications in intrabony defects are similar. When the platelet counts are taken into consideration, PPP seems to demonstrate similar clinical efficacy as the PRP.
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Affiliation(s)
- Selcuk Yilmaz
- Department of Periodontology, Dental Faculty, Yeditepe University, Istanbul, Turkey.
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Kretlow JD, Spicer PP, Jansen JA, Vacanti CA, Kasper FK, Mikos AG. Uncultured marrow mononuclear cells delivered within fibrin glue hydrogels to porous scaffolds enhance bone regeneration within critical-sized rat cranial defects. Tissue Eng Part A 2010; 16:3555-68. [PMID: 20715884 DOI: 10.1089/ten.tea.2010.0471] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
For bone tissue engineering, the benefits of incorporating mesenchymal stem cells (MSCs) into porous scaffolds are well established. There is, however, little consensus on the effects of or need for MSC handling ex vivo. Culture and expansion of MSCs adds length and cost, and likely increases risk associated with treatment. We evaluated the effect of using uncultured bone marrow mononuclear cells (bmMNCs) encapsulated within fibrin glue hydrogels and seeded into porous scaffolds to regenerate bone over 12 weeks in an 8-mm-diameter, critical-sized rat cranial defect. A full factorial experimental design was used to evaluate bone formation within model poly(L-lactic acid) and corraline hydroxyapatite scaffolds with or without platelet-rich plasma (PRP) and bmMNCs. Mechanical push-out testing, microcomputed tomographical analyses, and histology were performed. PRP showed no benefit for bone formation. Cell-laden poly(L-lactic acid) scaffolds without PRP required significantly greater force to displace from surrounding tissues than control (cell-free) scaffolds, but no differences were observed during push-out testing of coral scaffolds. For bone volume formation as analyzed by microcomputed tomography, significant positive overall effects were observed with bmMNC incorporation. These data suggest that bmMNCs may provide therapeutic advantages in bone tissue engineering applications without the need for culture, expansion, and purification.
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Affiliation(s)
- James D Kretlow
- Department of Bioengineering, Rice University, Houston, Texas, USA
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Muschler GF, Raut VP, Patterson TE, Wenke JC, Hollinger JO. The design and use of animal models for translational research in bone tissue engineering and regenerative medicine. TISSUE ENGINEERING PART B-REVIEWS 2010; 16:123-45. [PMID: 19891542 DOI: 10.1089/ten.teb.2009.0658] [Citation(s) in RCA: 191] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This review provides an overview of animal models for the evaluation, comparison, and systematic optimization of tissue engineering and regenerative medicine strategies related to bone tissue. This review includes an overview of major factors that influence the rational design and selection of an animal model. A comparison is provided of the 10 mammalian species that are most commonly used in bone research, and existing guidelines and standards are discussed. This review also identifies gaps in the availability of animal models: (1) the need for assessment of the predictive value of preclinical models for relative clinical efficacy, (2) the need for models that more effectively mimic the wound healing environment and mass transport conditions in the most challenging clinical settings (e.g., bone repair involving large bone and soft tissue defects and sites of prior surgery), and (3) the need for models that allow more effective measurement and detection of cell trafficking events and ultimate cell fate during the processes of bone modeling, remodeling, and regeneration. The ongoing need for both continued innovation and refinement in animal model systems, and the need and value of more effective standardization are reinforced.
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Affiliation(s)
- George F Muschler
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
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Cui G, Li J, Lei W, Bi L, Tang P, Liang Y, Tao S, Wang Y. The mechanical and biological properties of an injectable calcium phosphate cement-fibrin glue composite for bone regeneration. J Biomed Mater Res B Appl Biomater 2010; 92:377-85. [PMID: 19904823 DOI: 10.1002/jbm.b.31525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Calcium phosphate cement (CPC) that can be injected to form a scaffold in situ has promise for the repair of bone defects. However, its low-strength limits the CPC to non-stress-bearing repairs. Fibrin glue (FG) with good sticking property and biocompatibility is possible used to reinforce the CPC. The objective of this study was to investigate the effects of FG on the mechanical and biological properties of CPC in an injectable CPC-FG composite. The initial setting time of this CPC-FG was delayed compared with the CPC control at different powder/liquid (P/L) mass ratio (p > 0.05). At a P/L of 5, the strength was (38.41 +/- 4.32) MPa for the CPC-FG, much higher than (27.42 +/- 2.85) MPa for the CPC alone (p < 0.05). SEM showed bone marrow stromal cells (BMSCs) with healthy spreading and anchored on the CPC-FG composite. After 14 days, the alkaline phosphatase (ALP) activity was (538 +/- 33) for the BMSCs on the CPC-FG and (517 +/- 27) for the BMSCs on the CPC alone. Both ALPs were higher than the baseline ALP (93 +/- 10) for the undifferentiated BMSCs (p < 0.05). The results demonstrate that this stronger CPC-FG scaffold may be useful for stem cell-based bone regeneration in moderate load-bearing orthopedic applications.
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Affiliation(s)
- Geng Cui
- Institute of Orthopedics, General Hospital of PLA, Beijing 100853, People's Republic of China
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