Healing potentials of polymethylmethacrylate bone cement combined with platelet gel in the critical-sized radial bone defect of rats.

Ahmad Oryan,Soodeh Alidadi,Amin Bigham-Sadegh,Ali Moshiri,Masaya Yamamoto

doi:10.1371/journal.pone.0194751

Ahmad Oryan, Soodeh Alidadi + Show 3 more

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https://doi.org/10.1371/journal.pone.0194751

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Abstract

Polymethylmethacrylate (PMMA) is the most commonly used filler material that lacks biological properties and osteoconductivity or osteoinductivity. Platelet gel (PG) is a typical source of growth factors, cytokines and molecules efficient for bone formation and remodeling. The aim of this study was to evaluate bone healing and regeneration of bone defect in rat model by combining PMMA with PG. A total of 50 defects were created in the diaphysis of the radii of 25 male Sprague-Dawley rats. These defects were randomly divided into five groups (n = 10 defects for each group) and treated by autograft, plain PMMA, PG and PMMA-PG or left untreated. The rats were examined clinically and radiologically during the experiment and also after euthanasia at the 8th post-operative week, the healed defects were evaluated by gross morphology, histopathology, histomorphometry, computed tomography, scanning electron microscopy and biomechanical testing. PG could function as efficiently as autograft in promoting bone healing of the radial bones. Additionally, bone formation, and densities of cartilaginous and osseous tissues in the defects treated with autograft, PG and PMMA-PG were more satisfactory than the untreated and PMMA treated defects. Compared with the PMMA-PG implant, more PMMA residuals remained in the defect area and induced more intense inflammatory reaction. In conclusion, addition of PG could improve the bone regenerative properties of PMMA bone cement compared with PMMA alone in vivo. Therefore, the PG-PMMA can be proposed as a promising option to increase regenerative potential of PMMA, particularly when it is used as fixator, filler or adhesive in the dentistry, neurosurgery and bone tissue engineering applications.

Highlights

Treatment of large bone defects remains as a major challenge in the field of orthopedics and regenerative medicine
The SEM micrographs of the PMMA bone cement and PMMA-Platelet gel (PG) scaffold showed that the pure PMMA was less rough and porous than the PMMA-PG scaffold, so that platelets were observed in some parts of the scaffold (Fig 1)
These signs rapidly reduced toward the normal status in the defects treated with PG, PMMA-PG and autograft, so that they appeared almost normal at the 3rd post-operative week

Summary

Introduction

Treatment of large bone defects remains as a major challenge in the field of orthopedics and regenerative medicine. Among many potential bone cement materials, acrylic bone cement or polymethylmethacrylate (PMMA) has been used in the orthopedic procedures [2, 3]. This polymer has been proposed to be suitable in fixation of prosthetic implants and repair of vertebral fractures or vertebroplasty [4,5,6,7]. Other applications of PMMA in the orthopedic field include arthroplasty, remodeling of osteoporotic bones, hip endoprosthesis, hip replacement, and cranioplasty [4, 5]. PMMA can conform to the shape of its surrounding tissue, form mechanical bonds with implants and provide mechanical support [2]

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