Effect of N-acetylcysteine on fracture healing in rat femoral diaphysis: A histopathological, radiological, and biomechanical analysis
Burak Yildirim1
, Cemil Erturk2, Halil Buyukdogan3, Tahir Burak Saritas4, Nilsen Yildirim Erdogan5, Fatih Ertem6
1Department of Orthopedics and Traumatology, Kırklareli Training and Research Hospital, Kırklareli, Türkiye
2Department of Orthopedics and Traumatology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
3Department of Orthopedics and Traumatology, Beykent University Hospital, İstanbul, Türkiye
4Department of Orthopedics and Traumatology, Tuzla State Hospital, İstanbul, Türkiye
5Department of Pathology, Health Sciences University, Bağcılar Training and Research Hospital, İstanbul, Türkiye
6Department of Biomechanics, Dokuz Eylül University Institute of Health Sciences, İzmir, Türkiye
Keywords: Bone healing, N-acetyl cysteine, open fracture, reactive oxygen species.
Abstract
Objectives: The aim of this study was to examine the effect of N-acetylcysteine (NAC), which has antioxidant properties, on healing in a rat femoral diaphysis fracture model.
Materials and methods: Twenty-four male Wistar-Hannover rats were randomly divided into two groups: experimental (n=12) and control groups (n=12). An open femur fracture model (osteotomy) was applied to the right femora of both groups. Fixation was performed with Kirschner wire. While intraperitoneal NAC treatment was given to the experimental group for 21 days after surgery, an equal volume of intraperitoneal saline injection was administered to the control group. At the end of this period, the femurs obtained from the sacrificed animals were examined histopathologically, radiologically, and biomechanically. Huo scoring was used for histopathological examination. The samples were examined radiologically according to the Radiographic Union Scale in Tibial Fractures (RUST) scoring system. The threepoint bending test was used for the biomechanical examination.
Results: According to the third-week results, NAC could histopathologically contribute positively to fracture healing in rats (p=0.003 and p<0.05, respectively). Considering radiological and biomechanical parameters, no significant difference was observed between the groups in terms of healing (p>0.05). However, a positive significant correlation (67.7%) was found between histopathological results and radiological findings (p=0.016 and p<0.05, respectively).
Conclusion: Our study results indicate that NAC may have a histopathologically positive effect on the healing process in rat traumatic fractures. Based on these findings, NAC preparations may be used as a supportive agent in the treatment of fractures. Further clinical studies are needed.
Citation: Yildirim B, Erturk C, Buyukdogan H, Saritas TB, Yildirim Erdogan N, Ertem F. Effect of N-acetylcysteine on fracture healing in rat femoral diaphysis: A histopathological, radiological, and biomechanical analysis. Jt Dis Relat Surg 2025;36(2):1-10. doi: 10.52312/jdrs.2025.1975.