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Ciobanu P, Danciu M, Pascu A, Gardikiotis I, Forna N, Sirbu MT, Calistru AE, Puha B, Veliceasa B, Sirbu PD. Experimental Study on Rats with Critical-Size Bone Defects Comparing Effects of Autologous Bone Graft, Equine Bone Substitute Bio-Gen ® Alone or in Association with Platelet-Rich Fibrin (PRF). Polymers (Basel) 2024; 16:1502. [PMID: 38891449 PMCID: PMC11175103 DOI: 10.3390/polym16111502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND A critical-sized bone defect (CsBD) is considered one that will not heal spontaneously and requires reconstruction. This study aims to compare the results of using different bone reconstructive techniques and to study the potential of platelet-rich fibrin (PRF) to enhance the healing properties of a bone substitute (BS). METHODS In this experimental study on rats, the treatment of critical-sized bone defects was carried out by analysing four groups: a control group in which the bone defect was left empty; a group treated with Bio-Gen®; another group in which the defect was treated with PRF in combination with Bio-Gen®; and the last that was treated with autologous bone graft (ABG). The defects were evaluated by microcomputed tomography (µCT) and then histomorphometrically. RESULTS From both the histological and imagistic point of view, the best results were registered in the ABG group, followed by the group treated with Bio-Gen® with PRF, Bio-Gen® group, and control group, with statistically significant differences. CONCLUSIONS A 5 mm defect in the rat radius can be considered critical. ABG showed the best results in treating the bone defect. PRF significantly enhanced the efficacy of Bio-Gen®.
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Affiliation(s)
- Petru Ciobanu
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Mihai Danciu
- Department of Morphofunctional Sciences I—Morphopathology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Andrei Pascu
- Department of Morphofunctional Sciences I—Morphopathology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Ioannis Gardikiotis
- Advanced Center for Research and Development in Experimental Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Norin Forna
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Mihnea Theodor Sirbu
- Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Anca-Elena Calistru
- Research Institute for Agriculture and Environment, Iasi University of Life Science, 700490 Iasi, Romania
| | - Bogdan Puha
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Bogdan Veliceasa
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
| | - Paul-Dan Sirbu
- Department of Surgery II—Orthopedics and Traumatology, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700454 Iasi, Romania
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Ranjan R, Kumar R, Jeyaraman M, Arora A, Kumar S, Nallakumarasamy A. Autologous platelet-rich plasma in the delayed union of long bone fractures - A quasi experimental study. J Orthop 2023; 36:76-81. [PMID: 36620095 PMCID: PMC9817092 DOI: 10.1016/j.jor.2022.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/15/2022] [Accepted: 12/28/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Fractures of long bones unite without any complication except for 2%-10% which may lead to delayed or non-union of the fracture. Management of delayed union of fractures poses a great challenge for orthopaedic surgeons. Platelet-rich plasma (PRP) is an autologous blood-derived biological agent, which delivers growth factors, cytokines, and bio-micro molecules at supraphysiologic concentrations at the site of tissue injury, thus potentiating the body's healing efforts. Various studies and research have proved the osteogenic activity of PRP. The growth factors present in the PRP induce the locally available resilient progenitor or stem cells and convert the atrophic environment into a trophic environment. Materials and methods We investigated the safety and efficacy of autologous PRP injection in the delayed union of long bone fractures. A total of 25 cases of delayed union of long bone fractures were augmented with 3 doses of autologous PRP at 3 weekly intervals and were followed up for 12 months. All the cases were documented with pre-and post-procedural and 12th -month visual analog score (VAS) and Warden's score. Results Out of 25 cases, 21 (84.00%) cases showed good union of fracture with adequate callus formation by 10-12 weeks with 3 doses of autologous PRP injections. The mean pre-procedural VAS and Warden's score at the final follow-up showed statistically significant results (p < 0.05). No other complications were noted due to autologous PRP application among the study participants during the study period except for 3 cases (2 cases of non-union, and 1 case of implant failure). Conclusion Results of the current study suggest that autologous injection of PRP might be a safe and effective therapeutic tool for the management of delayed union of long bone fractures.
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Affiliation(s)
- Rajni Ranjan
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Rakesh Kumar
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Madhan Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu, India
- Department of Biotechnology, School of Engineering and Technology, Sharda University, Greater Noida, Uttar Pradesh, India
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
| | - Arunabh Arora
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Sudhir Kumar
- Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Arulkumar Nallakumarasamy
- Indian Stem Cell Study Group (ISCSG) Association, Lucknow, Uttar Pradesh, India
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Rodham P, Giannoudis PV. Innovations in orthopaedic trauma: Top advancements of the past two decades and predictions for the next two. Injury 2022; 53 Suppl 3:S2-S7. [PMID: 36180258 DOI: 10.1016/j.injury.2022.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/22/2022] [Accepted: 09/02/2022] [Indexed: 02/02/2023]
Abstract
The first Trauma and Orthopaedic unit dates back to 1780, originally dedicated to the treatment of children's deformities. The specialty has subsequently become multifaceted, with a plethora of subspecialty areas of which orthopaedic trauma is the most commonly practiced. Recently there has been a significant demand for an evidence base with more than 130,000 of the 162,000 publications in the last century occurring within the past 20 years. This narrative review will summarise some of the more landmark changes within orthopaedic trauma that have been made within the past 20 years, whilst also attempting to predict where the specialty will continue to develop as we move forward.
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Affiliation(s)
- Paul Rodham
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, Leeds LS1 3EX, United Kingdom; NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Peter V Giannoudis
- Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Clarendon Wing, Floor D, Great George Street, Leeds General Infirmary, Leeds LS1 3EX, United Kingdom; NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, United Kingdom.
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Rani N, Perut F, Granchi D, Sante GD, Pennello E, Mazzotta A, Dallari D, Baldini N. Ultrasound-guided injection of platelet-rich plasma or cord blood platelet-rich plasma in nonunion: a randomized controlled trial. Regen Med 2022; 17:271-281. [PMID: 35291806 DOI: 10.2217/rme-2021-0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the ability of autologous platelet-rich plasma (PRP) and cord blood PRP (PRPc) to accelerate bone healing. Patients & methods: 71 patients with mechanically stable nonunion were treated weekly (3 consecutive weeks) with ultrasound-guided percutaneous injections of PRP or PRPc in a controlled randomized clinical trial. The primary outcome was healing (12 months) and secondary outcomes were radiological evolution (2 and 6 months) and changes in pain intensity (6 months). Results & conclusion: Bone consolidation was assessed over time without significant differences between PRP and PRPc treatment. In patients with persistent nonunion, pain perception decreased more after PRP treatment. PRPc appears to be a valid alternative when specific clinical conditions suggest avoiding the use of autologous blood products.
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Affiliation(s)
- Nicola Rani
- Reconstructive Orthopaedic Surgery & Innovative Techniques, Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Francesca Perut
- BST Biomedical Sciences & Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Donatella Granchi
- BST Biomedical Sciences & Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Giuseppe Di Sante
- Reconstructive Orthopaedic Surgery & Innovative Techniques, Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Enrico Pennello
- Reconstructive Orthopaedic Surgery & Innovative Techniques, Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Alessandro Mazzotta
- Reconstructive Orthopaedic Surgery & Innovative Techniques, Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Dante Dallari
- Reconstructive Orthopaedic Surgery & Innovative Techniques, Musculoskeletal Tissue Bank, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy
| | - Nicola Baldini
- BST Biomedical Sciences & Technologies Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, 40136, Italy.,Department of Biomedical & Neuromotor Sciences, University of Bologna, Bologna, 40136, Italy
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