Synergistic effects of HBO and PRP improve bone regeneration with autologous bone grafting.
Bone defects remain a challenge for patients and orthopaedic surgeons. Autologous transfer of cancellous bone grafts remains the standard of care. However, in recent years various osteoinductive substitute materials, such as platelet rich plasma (PRP) and hyperbaric oxygen therapy (HBO) have been shown to improve bone healing. This study evaluates the effects of a combined application of PRP and HBO with autologous bone grafting in an animal model. In 48 New Zealand White rabbits bone defects at the radius were filled with autologous bone harvested at the iliac crest. This was combined with application of autologous PRP and/or HBO treatment for the duration of this study. After 3 and 6 weeks histomorphometric, immunohistochemical and radiologic evaluations were performed. All animals tolerated the treatment well. Improved bone regeneration was shown in all groups at 6 weeks compared to 3 weeks. Additional application of PRP and HBO resulted in an increase in new bone formation and increased neovascularization at 3 and 6 weeks. There was no statistical significant difference between PRP and HBO application in these regards. A combinatory use of PRP and HBO resulted in an increased bone regeneration and neovascularization compared to all other groups. This study provides evidence for an improvement of bone regeneration with the combinatory application of PRP and HBO to autologous cancellous bone grafts in a model of weight bearing bone defects in rabbits. Also synergistic effects of these two measures on angiogenesis were evident.
Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Johannes
J
Schneppendahl
Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany. Electronic address: pascal.jungbluth@med.uni-duesseldorf.de.
Pascal
P
Jungbluth
Heinrich Heine University Hospital Duesseldorf, Animal Research Institute, Moorenstr. 5, 40225 Duesseldorf, Germany.
Martin
M
Sager
Heinrich Heine University Hospital Duesseldorf, Animal Research Institute, Moorenstr. 5, 40225 Duesseldorf, Germany.
Laurentiu
L
Benga
University Hospital Muenster, Department for Vascular and Endovascular Surgery, Waldeyerstraße 30, 48149 Münster, Germany.
Monika
M
Herten
Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Armin
A
Scholz
Department of Orthopaedic, Trauma, and Hand Surgery, Klinikum Darmstadt, Grafenstraße 9, 64283 Darmstadt, Germany.
Michael
M
Wild
Department of Trauma, Orthopaedic, and Hand Surgery, Vivantes Klinikum am Urban, Dieffenbachstraße 1, 10967 Berlin, Germany.
Mohssen
M
Hakimi
Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Joachim
J
Windolf
Heinrich Heine University Hospital Düsseldorf, Department of Trauma and Hand Surgery, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Jan-Peter
JP
Grassmann
D000818:Animals; D001861:Bone Regeneration / Q000502:physiology*; D018786:Bone Substitutes / Q000494:pharmacology*; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology*; D004195:Disease Models, Animal; D017102:Fracture Healing / Q000502:physiology*; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007085:Ilium / Q000637:transplantation*; D053657:Platelet-Rich Plasma; D011817:Rabbits; D011885:Radius Fractures / Q000473:pathology*; D014182:Transplantation, Autologous
D018786:Bone Substitutes
Autologous bone grafting; Bone healing; Bone regeneration; HBO; Hyperbaric oxygen therapy; Non-union; PRP; Platelet rich plasma