Ahmet Yurteri1, Ahmet Yildirim2, Zeliha Esin Çelik3, Hüsamettin Vatansev4, Mehmet Sedat Durmaz5

1Department of Orthopedics and Traumatology, Konya City Hospital, Konya, Türkiye
2Department of Orthopedics and Traumatology, Medova Hospital, Konya, Türkiye
3Department of Medical Pathology, Selçuk University Faculty of Medicine, Konya, Türkiye
4Department of Medical Biochemistry, Selçuk University Faculty of Medicine, Konya, Türkiye
5Department of Radiology, Selçuk University Faculty of Medicine, Konya, Türkiye

Keywords: Bone healing, fracture union, open fracture, quercetin, rat.


Objectives: This study aims to evaluate the effect of quercetin on fracture healing in an open fracture model in rats.

Materials and methods: A total of 80 Wistar-Albino male rats were used in this study. The rats were divided into 10 groups. Daily oral treatment of 100 mg/kg of quercetin dissolved in corn oil were given to four groups, whereas the other four group of control rats were treated with corn oil only. Histopathological and radiological examinations of fracture healing were performed at the end of Weeks 2 and 4 in these rats, while biomechanical and biochemical examinations were performed at the end of Weeks 4 and 6, since harder callus was required. Among the rats in the last two group that were not subjected to the open fracture model, one group was given only quercetin for three weeks and the other for six weeks, and the biochemical markers in the blood were compared between these two groups. Computed tomography images were taken for radiological evaluation. The modified Lane and Sandhu scoring system was used for histological evaluation. The 3-point bending test was performed for biomechanical evaluation. For biochemical evaluation, plasma alkaline phosphatase (ALP), acid phosphatase (AP), total antioxidant status (TAS) and total oxidant status (TOS) levels were measured.

Results: Radiologically, there was no significant difference between the early-stage results of quercetin and control groups (p=0.247), while quercetin caused a significant increase in callus tissue in terms of latestage results (p=0.012). Histopathologically, there was no significant difference in the early stage (p=0.584); however, in the late stage, a borderline significant increase was observed in the quercetin group compared to the control group (p=0.091). Biomechanical analysis showed that quercetin significantly increased the fracture strength in the healing bone both in the early period (p=0.036) and in the late period (p=0.027). Among biochemical markers, TOS and AP were found to be significantly decreased in the quercetin group. In the non-operated and quercetin given groups, TAS levels was significantly higher (p=0.001) and AP levels were borderline significantly lower at the end of Week 6 (p=0.063).

Conclusion: Quercetin did not have a significant effect on bone healing in the early period, but significantly promoted bone healing in the late period in rats. We recommend the use of quercetin, a strong antioxidant, in cases with high oxidative stress and conditions such as diabetes, smoking, and malnutrition which may inhibit fracture union, although further clinical studies are needed to confirm these findings.

Citation: Yurteri A, Yıldırım A, Esin Çelik Z, Vatansev H, Durmaz MS. The effect of quercetin on bone healing in an experimental rat model. Jt Dis Relat Surg 2023;34(2):365-373. doi: 10.52312/ jdrs.2023.870.

Ethics Committee Approval

The study protocol was approved by the Selçuk University Experimental Medicine Application and Research Center Animal Experiments Ethics Committee (date: 27.03.2020, no: 2020-16).

Author Contributions

Conceptualization, methodology,software, data curation, writing, original draft: A.Y.; Methodology, project administration: A.Y.; Histopathological analysis: Z.E.Ç.; Biochemical analysis: H.V.; Radiological analysis: M.S.D.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.