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

Nucki Nursjamsi Hidajat, Dicky Mulyadi, M. Rizal Chaidir, Taufan Herwindo Dewangga

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.

 


Keywords


Bone graft, defect fracture, platelet rich fibrin

Full Text:

PDF

References


Kanthan SR, Kavitha G, Addi S, Choon DSK, Kamarul T. Platelet-rich plasma (PRP) enhances bone healing in non-united critical-sized defects: A preliminary study involving rabbit models. International Journal Care Injured. 2011;42(4):782–789.

Mills LA, Simpson AHRW. The relative incidence of fracture non-union in the Scottish population (5.17 million): a 5-year epidemiological study. BMJ Open. 2013;3(3):1-6.

Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res. 1990;250:81–104

Hasler cc, Krieg AH. Current Concept of Leg Lenghtening. Journal Child Orthop. 2012;6:89-104

Kazemi D, Fakhrjou A, Dizaji VM, Alishahi MK. Effect of Autolog Platelet Rich Fibrin on the Healing of Experimental Articular Cartilage Defect of the Knee in an Anilam Model. Biomed Research International. 2014; 2014:486436

Bagi CM, Berryman E, Moalli MR. Comparative Bone Anatomy of Commonly Used Laboratory Animals: Implications for Drug Discovery. Comp Med. 2011;61(1):76-85

Utoledo. Cited 2011 Juny 25th. Guidelines For Blood Collection: Rodents And Rabbits. Accesed on 2017 September 13th, available from https://www.utoledo.edu/Guideline-for-Blood-Collection-Rodents-and-Rabbits.pdf

Dohan Ehrenfest, D. M., Bielecki, T., et al. Do the Fibrin Architecture and Leukocyte Content Influence the Growth Factor Release of Platelet Concentrates? An Evidence-based Answer Comparing a Pure Platelet-Rich Plasma (P-PRP) Gel and a Leukocyte- and Platelet-Rich Fibrin (L-PRF). Curr Pharma Biotechno. 2012;13(7):1145-1152

Salkeld SL, Patron LP, Barrack RL, Cook SD. The effect of osteogenic protein-1 on the healing of segmental bone defects treated with autograft or allograft bone. Journal of Bone and Joint Surgery – American Volume. 2001;83(6):803–16.

Leteve M, Passuti N. Current Concepts in Bone Graft Substitutes. New Journal of Glass and Ceramics. 2018;8(1):39-54

Pripatnanont P, Nuntanaranont T, Vongvatcharanon S, et al. The primacy of platelet rich fibrin on bone regeneration of various grafts in rabbit’s calvarial defect. Journal of Cranio-Maxillo-Facial Surgery. 2013;41(8):191-200.

Floerkemeier T, Witte F, Nellesen J, Thorey F, Windhagen H, Wellmann M. Repetitive Recombinant Human Bone Morphogenetic Protein 2 Injection Improve the Callus Microarchitecture and Mechanical Stiffness in a Sheep Model of Distraction Osteogenesis. Orthopaedic Reviews. 2012;4(13):59-62.

Miller MD, Thompson SR, Hart J. Review of orthopaedics. 6th Ed. Philadelphia: Elsevier; 2012. p.1-5

Venkataraman N, Bansal S, Bansal P, Narayan S. Dynamic of Bone Graft Healing Around Implants. Journal of the International Clinical DentalResearch Organization. 2015;7:40-7

Pluemsakunthai W, Kuroda S, Shimokawa H, Kasugai S. A Basic Analysis of Platelet-Rich Fibrin: Distribution and Release of Platelet-Derived Growth Factor-BB. Original Article. 2013; 33(3):164-167.

He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. 2009. Beijing, China. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):707-713

Faot F, Deprez S, Vandamme K, Camargos GV, Pinto N, Wouters J, et al. The Effect of L-PRF Membranes on Bone Healing in Rabbit Tibiae Bone Defect: Micro-CT and Biomarker Results. Scientific Reports. 2017;7(1):2-8.




DOI: https://doi.org/10.15850/amj.v7n4.1960



 This Journal indexed by

                         

Creative Commons License
AMJ is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats