The influence of oral L-arginine on fracture healing: an animal study.
BACKGROUND
The known biological activities of nitric oxide suggest a role in bone healing. We hypothesized that L-arginine, a source of nitric oxide, expedites the healing process of stabilized diaphyseal defects.


METHODS
Prospective blinded animal study.


METHODS
Using a guinea-pig model, a 7 mm diaphyseal and periosteal defect was produced in the right femur and splinted intramedullary with a 1.4 mm K-wire. The guinea pigs (n = 44) were treated orally in three parallel groups: two treatment groups received high doses of L-arginine (one group for 2 weeks and the other for 4 weeks) and a control group received vehicle only. After four weeks, all animals were killed and both femora explanted. Radiological, histological, histomorphometric and mechanical evaluation was performed blinded.


RESULTS
Radiographs showed significantly more healing in the treatment groups (2 weeks, 10/15; 4 weeks, 11/15) than in the control group (3/14). The mechanical energy necessary for femur failure was significantly higher in the 4-week treatment group than in the control group (P < 0.05). Histology and histomorphometry showed significantly increased coverage of nonvascularized bone fragments with newly formed bone in the treatment groups (P < or = 0.05). The contralateral uninjured femora did not show significant differences between groups.


CONCLUSIONS
Oral L-arginine expedites healing in stabilized diaphyseal defects in guinea pigs without detrimentally affecting uninjured counterparts.
Kdolsky
Richard K
RK
Department of Traumatology, University of Vienna Medical School, Vienna, Austria. richard.kdolsky@meduniwien.ac.at
Mohr
Wolfgang
W
Savidis-Dacho
Helga
H
Beer
Rudolf
R
Puig
Stefan
S
Reihsner
Roland
R
Tangl
Stefan
S
Donath
Karl
K
D000284:Administration, Oral; D000818:Animals; D002113:Calcification, Physiologic / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004548:Elasticity; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D017102:Fracture Healing / Q000187:drug effects / Q000502:physiology*; D006168:Guinea Pigs; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D016037:Single-Blind Method; D013314:Stress, Mechanical; D016896:Treatment Outcome; D016474:Weight-Bearing