Evaluation of the effects of the combination of autologous mesenchymal stem cells and platelet-rich plasma on structural
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Evaluation of the effects of the combination of autologous mesenchymal stem cells and platelet-rich plasma on structural bone allograft healing Chang-Goo Park . Min Wook Joo . Jinyoung Jeong . Yong-Koo Kang . Da-Reum Lee
Received: 6 October 2016 / Accepted: 14 February 2017 Ó Springer Science+Business Media Dordrecht 2017
Abstract In this study, we evaluated the efficacy of the combination of autologous mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) for enhancing structural allogenic bone graft healing in rabbits. For these experiments segmental bone defects (1.5–2 cm) were generated on femoral diaphysis of New Zealand white rabbits and reconstructed via structural allogenic bone grafting and additional intramedullary nail fixation. The structural allografts were subsequently wrapped with Gelfoam containing autologous MSCs and PRP, or PRP alone (control). Grafted periosteal tissues were harvested at 4, 8, and 12 weeks post-implantation and subjected to plain radiographic and, histological, as well as real-time quantitative reverse transcription-PCR analysis of bone morphogenic protein (BMP)-2, BMP-4, BMP-7, receptor activator of nuclear factor-kappa B ligand (RANKL), and vascular endothelial growth factor (VEGF) expression.
Compared to those in the control group, the animals in the experimental group exhibited significantly higher Taira radiographic scores at 4 and 12 weeks after surgery, as well as callus formation. Likewise, these animals exhibited increases in BMP-4 production at 4 weeks, RANKL production at 4 and 12 weeks, and BMP-2, BMP-7, and VEGF production at 4, 8, and 12 weeks. Together, these data suggest that the administration of autologous MSCs and PRP resulted in enhanced healing of structural allogenic bone grafts compared to PRP alone. As such, this combination might comprise an ideal therapy for improving the clinical outcomes of structural allografts. Keywords Mesenchymal stem cell Platelet-rich plasma Bone regeneration Allografts
Introduction C.-G. Park Department of Orthopaedic Surgery, Wooshinhyang Hospital, Seoul, Republic of Korea M. W. Joo J. Jeong Y.-K. Kang (&) Department of Orthopaedic Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggido, Seoul 16247, Republic of Korea e-mail: [email protected] D.-R. Lee Research Institute of Medical Science, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Surgeries for musculoskeletal tumor removal, trauma and infection, and revisional arthroplasty can result in the development of large segmental bone defect, which require the administration of bone substitutes, such as autologous and allogenic bone grafts, or biosynthetic materials for repair. Indeed, there has been a continued increase in the number of bone grafts performed to repair defects associated with orthopedic reconstruction surgeries, with approximately one million bone grafts being performed in the United States alone during
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