Abstract

Background & Objective:This study aimed to investigate the effect of decellularized allogeneic bone graft enriched by periosteal stem cells (PSCs) and growth factors on the bone repair process in a rabbit model, which could be used in many orthopedic procedures.Methods:In this experimental study, a critical size defect (CSD) (10 mm) was created in the radial diaphysis of 40 rabbits. In group A, the defect was left intact with no medical intervention. In group B, the defect was filled by a decellularized bone graft. In group C, the defect was implanted by a decellularized bone graft enriched with platelet growth factors. In group D, the defect was treated by a decellularized bone graft seeded by periosteal mesenchymal stem cells (MSCs). Also, in group E, the defect was filled by a decellularized bone graft enriched with platelet growth factors and periosteal MSCs. Radiological evaluation was done on the first day and then in the second, fourth, and eighth weeks after the operation. The specimens were harvested on the 28th and 56th postoperative days and evaluated for histopathological criteria.Results:The radiologic and microscopic analysis of the healing process in bone defects of the treated groups (C, D, and E) revealed more advanced repair criteria than those of groups A and B significantly (P<0.05).Conclusion:Based on this study, it appears that implantation of concentrated PSCs in combination with growth factors and allogeneic cortical bone graft is an effective therapy for the repair of large bone defects.

Highlights

  • Bone grafting is used for the treatment of several conditions that represent a great global burden, including critical size bone defects caused by trauma, tumor excision or chronic osteomyelitis, and nonunion and delayed union

  • Background & Objective: This study aimed to investigate the effect of decellularized allogeneic bone graft enriched by periosteal stem cells (PSCs) and growth factors on the bone repair process in a rabbit model, which could be used in many orthopedic procedures

  • In group E, the defect was filled by a decellularized bone graft enriched with platelet growth factors and periosteal mesenchymal stem cells (MSCs)

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Summary

Introduction

Bone grafting is used for the treatment of several conditions that represent a great global burden, including critical size bone defects caused by trauma, tumor excision or chronic osteomyelitis, and nonunion and delayed union. A nonunion fracture is known as a fracture that fails to heal and stops the process of fracture healing, in which the fracture gap fills with persistent fibrous tissue, woven bone, and cartilage. In this regard, nonunion fractures are divided into two categories of hypertrophic nonunion and atrophic nonunion [2, 3]. Operative intervention is necessary to promote fracture union, and the current gold standard treatment is autografts [9]. They have optimal osteoconductive, osteoinductive, and osteogenic properties. This study aimed to investigate the effect of decellularized allogeneic bone graft enriched by periosteal stem cells (PSCs) and growth factors on the bone repair process in a rabbit model, which could be used in many orthopedic procedures

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