Abstract
Bone regeneration remains one of the major clinical needs in orthopedics, and advanced and alternative strategies involving bone substitutes, cells, and growth factors (GFs) are mandatory. The purpose of this study was to evaluate whether the association of autologous bone marrow mesenchymal stem cells (BMSC), isolated by ‘one-step surgical procedure’, and activated platelet rich plasma (PRP) improves osseointegration and bone formation of a hydroxyapatite-coated titanium (Ti-HA) implant, already in clinical use, in a rabbit cancellous defect. The GFs present in plasma, in inactivated and activated PRP were also tested. At 2 weeks, histology and histomorphometry highlighted increased bone-to-implant contact (BIC) in Ti-HA combined with BMSC and PRP in comparison to Ti-HA alone and Ti-HA + PRP. The combined effect of BMSC and PRP peaked at 4 weeks where the BIC value was higher than all other treatments. At both experimental times, newly formed bone (Trabecular Bone Volume, BV/TV) in all tested treatments showed increased values in comparison to Ti-HA alone. At 4 weeks Ti-HA + PRP + BMSC showed the highest BV/TV and the highest osteoblasts number; additionally, a higher osteoid surface and bone formation rate were found in Ti-HA + BMSC + PRP than in all other treatments. Finally, the analyses of GFs revealed higher values in the activated PRP in comparison to plasma and to non-activated PRP. The study suggests that the combination of autologous activated PRP, as a carrier for BMSCs, is a promising regenerative strategy for bone formation, osseointegration, and mineralization of bone implants.
Highlights
The purpose of this study was to evaluate whether the association of autologous bone marrow mesenchymal stem cells (BMSC), isolated by ‘one-step surgical procedure’, and activated platelet rich plasma (PRP) improves osseointegration and bone formation of a hydroxyapatite-coated titanium (Ti-HA) implant, already in clinical use, in a rabbit cancellous defect
The purpose of this study was to evaluate whether the association of autologous BMSCs and activated PRP improves the pattern of early osseointegration and bone formation of a hydroxyapatite-coated titanium (Ti-HA) implant, an implant already of clinical use, in an in vivo animal model
Several strategies have been developed based on the dogma that the efficiency and efficacy of any successful bone implants commonly can be ascribed to one or more of three properties: osteogenic cells, osteoconduction, and osteoinduction [57]
Summary
Biological osseointegration is a long and complex process that involves several processes implicated in bone healing around implants [3] This last in turn involves cellular and extracellular biological events that take place at the bone-implant interface [3]. This cascade of biological events is controlled by growth factors and differentiation factors released by the hematopoietic cells activated at the bone–implant interface [4]. Alteration of these biological processes leads to late bone healing and poor osseointegration at the bone–implant interface which can affect the implant stability and increase the risk of aseptic loosening [3]. As no specific strategy can effectively satisfy all the clinical needs for bone healing, the idea of supplying different critical elements for tissue regeneration, such as osteoconductive matrix, osteogenic cells, and growth factors, has been suggested by numerous researchers and clinicians
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