title: Repair of segmental load-bearing bone defect by autologous mesenchymal stem cells and plasma-derived fibrin impregnated ceramic block results in early recovery of limb function.
abstract: Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.
authors.affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.
authors.forename: Min Hwei
authors.initials: MH
authors.lastname: Ng
authors.affiliation: Department of Orthopaedics and Traumatology, Kuala Lumpur General Hospital, 50586 Kuala Lumpur, Malaysia.
authors.forename: Suryasmi
authors.initials: S
authors.lastname: Duski
authors.affiliation: Orthopaedic, Traumatology and Spinal Surgery Consultant Clinic, Johor Specialist Hospital, 80100 Johor Bahru, Malaysia.
authors.forename: Kok Keong
authors.initials: KK
authors.lastname: Tan
authors.affiliation: Materials Technology Group (MTEG), Industrial Technology Division (BTI), Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor, Malaysia.
authors.forename: Mohd Reusmaazran
authors.initials: MR
authors.lastname: Yusof
authors.affiliation: UKM Animal Resource Centre, Medical Faculty, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Kiat Cheong
authors.initials: KC
authors.lastname: Low
authors.affiliation: Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia.
authors.forename: Isa Mohamed
authors.initials: IM
authors.lastname: Rose
authors.affiliation: Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Kuala Lumpur, Malaysia.
authors.forename: Zahiah
authors.initials: Z
authors.lastname: Mohamed
authors.affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia ; Ear, Nose & Throat Consultant Clinic, Ampang Puteri Specialist Hospital, 68000 Ampang, Malaysia.
authors.forename: Aminuddin
authors.initials: A
authors.lastname: Bin Saim
authors.affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia ; Department of Physiology, Medical Faculty, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia.
authors.forename: Ruszymah Bt Hj
authors.initials: RB
authors.lastname: Idrus
mesh_terms: D000818:Animals; D001861:Bone Regeneration / Q000187:drug effects; D018786:Bone Substitutes; D002130:Calcium Phosphates / Q000008:administration & dosage*; D002516:Ceramics / Q000494:pharmacology; D005121:Extremities / Q000254:growth & development / Q000293:injuries / Q000503:physiopathology; D005260:Female; D006801:Humans; D059630:Mesenchymal Stem Cells / Q000737:chemistry*; D010012:Osteogenesis / Q000187:drug effects*; D053657:Platelet-Rich Plasma / Q000737:chemistry*; D011817:Rabbits; D023822:Tissue Engineering; D014945:Wound Healing / Q000187:drug effects
chemical_list: D018786:Bone Substitutes; D002130:Calcium Phosphates; C020243:calcium phosphate