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Repair of segmental load-bearing bone defect by autologous mesenchymal stem cells and plasma-derived fibrin impregnated ceramic block results in early recovery of limb function.

Ng MH, Duski S, Tan KK, Yusof MR, Low KC, Rose IM, Mohamed Z, Bin Saim A, Idrus RB - Biomed Res Int (2014)

Bottom Line: Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0).Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%).Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa).

View Article: PubMed Central - PubMed

Affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.

ABSTRACT
Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.

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Gait pattern recorded with TechScan software. (a) Hopping pattern of a normal rabbit with even pressure on both hind limbs. (b) A near normal hopping pattern of a rabbit from TEB group at Day 90 after operation. (c) A distorted gait pattern of a rabbit from ALLO group showing unloading of the experimental limb (colour bars indicate pressure in PSI).
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fig3: Gait pattern recorded with TechScan software. (a) Hopping pattern of a normal rabbit with even pressure on both hind limbs. (b) A near normal hopping pattern of a rabbit from TEB group at Day 90 after operation. (c) A distorted gait pattern of a rabbit from ALLO group showing unloading of the experimental limb (colour bars indicate pressure in PSI).

Mentions: Example of a normal, near normal, and abnormal rabbit gait pattern is shown in Figure 3. At day 90, two out of the six rabbits in ALLO and MIC exhibited a normal gait pattern, while four out of six rabbits from TEB resumed a normal gait pattern. Most of the abnormal gait patterns were due to overbearing of weight and pressure on the nonoperated contralateral hind limb, nonloading or partial loading of the operated limb, or dragging of the operated limb. The restoration of normal gait pattern was taken as an indication for the restoration of function of the operated limb and the absence of implant complications.


Repair of segmental load-bearing bone defect by autologous mesenchymal stem cells and plasma-derived fibrin impregnated ceramic block results in early recovery of limb function.

Ng MH, Duski S, Tan KK, Yusof MR, Low KC, Rose IM, Mohamed Z, Bin Saim A, Idrus RB - Biomed Res Int (2014)

Gait pattern recorded with TechScan software. (a) Hopping pattern of a normal rabbit with even pressure on both hind limbs. (b) A near normal hopping pattern of a rabbit from TEB group at Day 90 after operation. (c) A distorted gait pattern of a rabbit from ALLO group showing unloading of the experimental limb (colour bars indicate pressure in PSI).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109366&req=5

fig3: Gait pattern recorded with TechScan software. (a) Hopping pattern of a normal rabbit with even pressure on both hind limbs. (b) A near normal hopping pattern of a rabbit from TEB group at Day 90 after operation. (c) A distorted gait pattern of a rabbit from ALLO group showing unloading of the experimental limb (colour bars indicate pressure in PSI).
Mentions: Example of a normal, near normal, and abnormal rabbit gait pattern is shown in Figure 3. At day 90, two out of the six rabbits in ALLO and MIC exhibited a normal gait pattern, while four out of six rabbits from TEB resumed a normal gait pattern. Most of the abnormal gait patterns were due to overbearing of weight and pressure on the nonoperated contralateral hind limb, nonloading or partial loading of the operated limb, or dragging of the operated limb. The restoration of normal gait pattern was taken as an indication for the restoration of function of the operated limb and the absence of implant complications.

Bottom Line: Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0).Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%).Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa).

View Article: PubMed Central - PubMed

Affiliation: Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia.

ABSTRACT
Calcium phosphate-based bone substitutes have not been used to repair load-bearing bone defects due to their weak mechanical property. In this study, we reevaluated the functional outcomes of combining ceramic block with osteogenic-induced mesenchymal stem cells and platelet-rich plasma (TEB) to repair critical-sized segmental tibial defect. Comparisons were made with fresh marrow-impregnated ceramic block (MIC) and partially demineralized allogeneic bone block (ALLO). Six New Zealand White female rabbits were used in each study group and three rabbits with no implants were used as negative controls. By Day 90, 4/6 rabbits in TEB group and 2/6 in ALLO and MIC groups resumed normal gait pattern. Union was achieved significantly faster in TEB group with a radiological score of 4.50 ± 0.78 versus ALLO (1.06 ± 0.32), MIC (1.28 ± 0.24), and negative controls (0). Histologically, TEB group scored the highest percentage of new bone (82% ± 5.1%) compared to ALLO (5% ± 2.5%) and MIC (26% ± 5.2%). Biomechanically, TEB-treated tibiae achieved the highest compressive strength (43.50 ± 12.72 MPa) compared to those treated with ALLO (15.15 ± 3.57 MPa) and MIC (23.28 ± 6.14 MPa). In conclusion, TEB can repair critical-sized segmental load-bearing bone defects and restore limb function.

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