Allogeneic platelet gel with autologous cancellous bone graft for the treatment of a large bone defect.
OBJECTIVE
A 50-year-old type 2 diabetic male with a comminuted fracture of the tibia and delayed union after insufficient initial osteosynthesis with a resulting pseudoarthrosis was treated operatively by using a graft composed of platelet gel mixed with autologous cancellous bone. The essential idea of this therapy was to combine the healing capacities of platelet-derived growth factors and osteogenic stem cells and the modeling capacity of the gel. Due to a history of diabetes, allogeneic instead of autologous platelets were used.


METHODS
The allogeneic platelet concentrate was ABO- and RhD-matched, leukocyte-depleted, irradiated and activated by human thrombin. The defect of 45 ml was filled with the graft mixture and fixed with an external fixator.


RESULTS
Postoperative care was uneventful. After 6 months the graft was incorporated, the bone defect was fully bridged and full weight-bearing capacity was achieved. No side effects were observed and no platelet or HLA class I antibodies were detected.


CONCLUSIONS
This case report shows that the clinical use of allogeneic platelet-derived growth factors is feasible and that a prospective study is necessary to prove the effectiveness and reproducibility of this therapeutic approach.
Smrke
Dragica
D
Department of Surgical Infections, Clinical Centre, Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia.
Gubina
Borut
B
Domanoviç
Dragoslav
D
Rozman
Primoz
P
D016025:Bone Transplantation; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000628:therapy; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000628:therapy*