Birhan Oktaş1, Meriç Çırpar1, Elif Şanlı2, İbrahim Deniz Canbeyli1, Önder Bozdoğan3

1Department of Orthopedics and Traumatology, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
2Department of Plastic, Reconstructive and Esthetic Surgery, Kırıkkale University Faculty of Medicine, Kırıkkale, Turkey
3Department of Pathology, Ministery of Health Gülhane Training and Research Hospital, Ankara, Turkey

Keywords: Fracture healing, osteogenesis, periosteum, platelet-rich plasma

Abstract

Objectives: This study aims to investigate whether plasma-rich plasma (PRP) enhances the osteogenic potential of periosteal grafts used to repair bone defects and maintains both histologically and biomechanically more durable bone tissue.

Materials and methods: A standard bone defect was formed to the left femurs of 54 Sprague-Dawley rats and three groups were formed. In the first group (n=18), no periosteal repair was done for bone defect. In the second group (n=18), periosteal graft tissue was sutured to cover the defect entirely. In the third group (n=18), before periosteal repair, a 1 mL of PRP fibrin was applied into the bone defect. All femoral specimens were compared histologically at four and six weeks and biomechanically by three-point bending test at six weeks after treatment.

Results: In the PRP applied group, healing of the bone defect at four weeks was significantly better than the other groups in terms of histological new bone formation (p<0.05). At six weeks, new bone formation in both of the periosteum preserved groups was superior to the first group (p<0.05, for both). There was no statistically significant difference between the second and third groups at the end of the sixth week in the biomechanical analysis, although both groups were significantly stronger than the first group (p<0.05).

Conclusion: Stimulation of the periosteum with PRP application causes early osteogenic differentiation of precursor cells. Although, at biomechanical basis, PRP application does not create any significant difference, in the recovery of the bone defects at very early period, application of PRP may play a role to accelerate fracture healing and to decrease nonunions.