Osteointegration of Cryopreserved Allograft Associated with Platelets-Rich Plasma, in Infected Bone Defects. Experimental Study
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Published:
Aug 10, 2013
Keywords:
Infected fractures, Allograft bone, Platelet-rich plasma.
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Abstract
BackgroundThe objective of this experimental work was to determine whether the addition of platelet-rich plasma influences the osseointegraton of cryopreserved allograft with antibiotics in infected fractures with bone loss, in long bones of rabbits.MethodsFour groups of 7 rabbits with generated infected fracture of the right femur. Milled allograft with local antibiotic was placed in the four groups; groups II and IV also received platelet-rich plasma. Rabbits in groups I and II were sacrificed at 30 days, and those of groups III and IV at 90 days. Histological and CT evaluation was performed.ResultsNine rabbits died during the study period. There were no statistically significant differences between groups. In group IV with platelet-rich plasma, bone formation was observed in three of the four samples, with noticeable areas of coupling between the receiver and the grafted tissue with consolidation in CT.ConclusionsIn our study, there was no correlation between the histological and tomographic findings. Although we found no statistically significant differences, the addition of platelet-rich plasma stimulated the generation of new tissue, and also decreased reabsorption of the grafted tissue according to the pathologic analysis. Besides increased bone formation and consolidation was detected in group IV (75%) treated with platelet-rich plasma, compared to group III (25%) without platelet-rich plasma bone allograft.
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Bruno, P. A., Bustos, D. G., Flores, J., Fernandez Savoy, I., Gutierrez, N., Rucheli, L. S., Jabif, A. J., & Allende, C. A. (2013). Osteointegration of Cryopreserved Allograft Associated with Platelets-Rich Plasma, in Infected Bone Defects. Experimental Study. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 78(2), 86-94. https://doi.org/10.15417/187
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Basic Research
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References
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13. Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of plateled-rich plasma and its applications in trauma and orthopaedic surgery. J Bone Joint Surg Br 2009;91:987-95.
14. Ranly D, Lohmann CH, Andreacchio D, Boyan BD, Schwartz Z. Platelet-Rich plasma inhibits demineralized bone matrixinduced
bone formation in nude mice. J Bone Joint Surg Am 2007;89:139-47.
15. Harris NL, Huffer WE, Von Stade E, Larson AI, Phinney S, Purnell ML. The effect of platelet-rich plasma on normal soft tissues in the rabbit. J Bone Joint Surg Am 2012;94:786-93.
16. Sasso RC, LeHuec JC, Shaffrey C. Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 2005;18(Suppl.):S77-81.
17. Fernyhough JC. Lumbar spine fusion: Comparing crushed, freeze-dried cortical allograft with autograft. Meeting International
Society for Study of the Lumbar Spine. Marseille, France, 1993.
18. Herron LD, Newman MH. The failure of ethylene oxide gas-sterilized freeze-dried bone graft for thoracic and lumbar spinal fusion. Spine 1989;14(5):496-500.
19. Zalavras CG, Marcus RE, Levin LS, Patzakis MJ. Management of open fractures and subsequent complications. J Bone Joint Surg 2007;89:884-95.
20. Hanssen A. Local antibiotic delivery vehicles in the treatment of musculoskeletal infection. Clin Orthop Relat Res 2005;437:91-6.
21. Chan YS, Ueng SW, Wang CJ, Lee SS, Chen CY, Shin CH. Antibiotic-impregnated autogenic cancellous bone grafting is an effective and safe method for the management of small infected tibial defects: a comparison study. J Trauma 2000;48(2):246-55.
2. Rio M, Gotter Campo G, Barrera Oro A, Sanatini Araujo E, Cabrini R. Reparación tendinosa con la utilización de plasma rico en plaquetas. Estudio experimental en conejos. Rev Asoc Argent Ortop Traumatol 2007;72(3):270-5.
3. Larrabe L. Plasma rico en plaquetas en cirugía de ortopedia y traumatología. Rev Argent Artroscopia 2007;14(2):145-51.
4. De Long WG Jr, Einhorn TA, Koval K, McKee M, Smith W, Sanders R. et al. Bone grafts and bone graft substitutes in orthopaedic trauma surgery. A critical analysis. J Bone Joint Surg Am 2007;89(3):649-58.
5. Aurori BF, Weierman RJ, Lowell HA, Nadel CI, Parsons JR. Pseudoarthrosis after spinal fusion for scoliosis: A comparison of autogenic and allogenic bone graft. Clin Orthop 1985;99:153-8.
6. Winkler H. Rationale for one stage exchange of infected hip replacement using uncemented implants and antibiotics impregnated
bone graft. Int J Med Sci 2009;6(5):247-52.
7. López Millán L, Aponte Tinao L, Farfalli G, Ayersa MA, Muscolo L. Reconstrucción de defectos segmentarios del fémur con aloinjerto óseo intercalar. Rev Asoc Argent Ortop Traumatol 2011;76(4):309-15.
8. Bagliardelli J, Díaz Gallardo P, Flores J, Bustos D, Bruno P, Allende C. Valor de la utilización de espaciadores de cemento y aloinjerto con antibiótico para reconstruir defectos óseos infectados. Estudio experimental en conejos. Rev Asoc Argent Ortop Traumatol 2011;76(2):133-40.
9. Kesteris U, Aspenberg P. Rinsing morcellised bone grafts with bisphosphonate solution prevents their resorption. J Bone Joint Surg Br 2006;88:993-6.
10. Allende C, Mangupli M, Bagliardelli J, Diaz P, Allende BT. Infected nonunions of long bones of the upper extremity: staged reconstruction using polimethylmethacrylate and bone graft impregnated with antibiotics. Chir Organi Mov 2009;93(3):137-42.
11. Cid Casteulani A. Enriquecimiento de injerto autólogo con concentrado de factores de crecimiento. Rev Asoc Argent Ortop
Traumatol 2007;72(4):373-81.
12. Radice FD, Yánez RD, Gutiérrez VB, Pinedo MB, Rosales J, Coda S. Uso de concentrado autólogo rico en factores de crecimiento en la reconstrucción del LCA. Rev Argent Artroscopia 2007;15(1):31-40.
13. Alsousou J, Thompson M, Hulley P, Noble A, Willett K. The biology of plateled-rich plasma and its applications in trauma and orthopaedic surgery. J Bone Joint Surg Br 2009;91:987-95.
14. Ranly D, Lohmann CH, Andreacchio D, Boyan BD, Schwartz Z. Platelet-Rich plasma inhibits demineralized bone matrixinduced
bone formation in nude mice. J Bone Joint Surg Am 2007;89:139-47.
15. Harris NL, Huffer WE, Von Stade E, Larson AI, Phinney S, Purnell ML. The effect of platelet-rich plasma on normal soft tissues in the rabbit. J Bone Joint Surg Am 2012;94:786-93.
16. Sasso RC, LeHuec JC, Shaffrey C. Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 2005;18(Suppl.):S77-81.
17. Fernyhough JC. Lumbar spine fusion: Comparing crushed, freeze-dried cortical allograft with autograft. Meeting International
Society for Study of the Lumbar Spine. Marseille, France, 1993.
18. Herron LD, Newman MH. The failure of ethylene oxide gas-sterilized freeze-dried bone graft for thoracic and lumbar spinal fusion. Spine 1989;14(5):496-500.
19. Zalavras CG, Marcus RE, Levin LS, Patzakis MJ. Management of open fractures and subsequent complications. J Bone Joint Surg 2007;89:884-95.
20. Hanssen A. Local antibiotic delivery vehicles in the treatment of musculoskeletal infection. Clin Orthop Relat Res 2005;437:91-6.
21. Chan YS, Ueng SW, Wang CJ, Lee SS, Chen CY, Shin CH. Antibiotic-impregnated autogenic cancellous bone grafting is an effective and safe method for the management of small infected tibial defects: a comparison study. J Trauma 2000;48(2):246-55.