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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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Related in: MedlinePlus

Histological sections from the middle segment of the implants three months after implantation (H&E). (a) Abundant new bones were found in TEB. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) while new compact bone (Nb) was found at the right periphery (40x). (b) Here, the peripheral bone appeared more mature with lamellar and osteon features (O) adjacent to the well-formed intramedullary canal filled with marrow element (Me) (100x). (c) Residual ceramic (Ce) was noted in MIC. Mineral deposits (Mi) (stained red) were seen around the ceramic (40x). (d) The section reveals new bones (Nb) that are undergoing mineralization amidst infiltrated marrow element (Me) (40x). (e) Significant fibrous tissues (Fb) were noted in ALLO. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) (40x). (f) An intact allograft bone (Allo) (100x).
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fig5: Histological sections from the middle segment of the implants three months after implantation (H&E). (a) Abundant new bones were found in TEB. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) while new compact bone (Nb) was found at the right periphery (40x). (b) Here, the peripheral bone appeared more mature with lamellar and osteon features (O) adjacent to the well-formed intramedullary canal filled with marrow element (Me) (100x). (c) Residual ceramic (Ce) was noted in MIC. Mineral deposits (Mi) (stained red) were seen around the ceramic (40x). (d) The section reveals new bones (Nb) that are undergoing mineralization amidst infiltrated marrow element (Me) (40x). (e) Significant fibrous tissues (Fb) were noted in ALLO. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) (40x). (f) An intact allograft bone (Allo) (100x).

Mentions: Figure 5 shows H&E stained sections of specimens taken from the middle segment of the implants three months after implantation. In TEB group, abundant new bone was found forming a trabecular network within the medullary cavity. Advance bone remodeling occurred in TEB group as evidenced by the presence of mature cortical bone at the periphery. The cortical bone was found along the entire gap of the bone defect bridging to the adjacent native bone. Intramedullary canal was maintained in which marrow elements flowed through. Almost the entire of the ceramic scaffold of the TEB had resorbed. Occasional scattered ceramic granules were noted. In the MIC group, substantial amount of the ceramic scaffolds remained. Mineral deposits were found accumulated around these degrading ceramic, and possibly the product of ceramic degradation was seen around the ceramic (Figure 5(c)). New bones found in MIC group appeared less mature. In ALLO group, significant fibrous tissues (Fb) were noted. Trabecular bone was actively being laid down next to these fibrous tissues. Most part of the allograft bone remained intact and devoid of any bone growth or remodeling activities. These bones were marked by empty lacunae with no resident cells (Figure 5(f)).


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)

Histological sections from the middle segment of the implants three months after implantation (H&E). (a) Abundant new bones were found in TEB. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) while new compact bone (Nb) was found at the right periphery (40x). (b) Here, the peripheral bone appeared more mature with lamellar and osteon features (O) adjacent to the well-formed intramedullary canal filled with marrow element (Me) (100x). (c) Residual ceramic (Ce) was noted in MIC. Mineral deposits (Mi) (stained red) were seen around the ceramic (40x). (d) The section reveals new bones (Nb) that are undergoing mineralization amidst infiltrated marrow element (Me) (40x). (e) Significant fibrous tissues (Fb) were noted in ALLO. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) (40x). (f) An intact allograft bone (Allo) (100x).
© Copyright Policy
Related In: Results  -  Collection

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

fig5: Histological sections from the middle segment of the implants three months after implantation (H&E). (a) Abundant new bones were found in TEB. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) while new compact bone (Nb) was found at the right periphery (40x). (b) Here, the peripheral bone appeared more mature with lamellar and osteon features (O) adjacent to the well-formed intramedullary canal filled with marrow element (Me) (100x). (c) Residual ceramic (Ce) was noted in MIC. Mineral deposits (Mi) (stained red) were seen around the ceramic (40x). (d) The section reveals new bones (Nb) that are undergoing mineralization amidst infiltrated marrow element (Me) (40x). (e) Significant fibrous tissues (Fb) were noted in ALLO. The section reveals new bones (Nb) forming a trabecular network amidst infiltrated cells (Ic) (40x). (f) An intact allograft bone (Allo) (100x).
Mentions: Figure 5 shows H&E stained sections of specimens taken from the middle segment of the implants three months after implantation. In TEB group, abundant new bone was found forming a trabecular network within the medullary cavity. Advance bone remodeling occurred in TEB group as evidenced by the presence of mature cortical bone at the periphery. The cortical bone was found along the entire gap of the bone defect bridging to the adjacent native bone. Intramedullary canal was maintained in which marrow elements flowed through. Almost the entire of the ceramic scaffold of the TEB had resorbed. Occasional scattered ceramic granules were noted. In the MIC group, substantial amount of the ceramic scaffolds remained. Mineral deposits were found accumulated around these degrading ceramic, and possibly the product of ceramic degradation was seen around the ceramic (Figure 5(c)). New bones found in MIC group appeared less mature. In ALLO group, significant fibrous tissues (Fb) were noted. Trabecular bone was actively being laid down next to these fibrous tissues. Most part of the allograft bone remained intact and devoid of any bone growth or remodeling activities. These bones were marked by empty lacunae with no resident cells (Figure 5(f)).

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.

Show MeSH
Related in: MedlinePlus