Freeze-Dried Platelet-Rich Plasma Accelerates Bone Union with Adequate Rigidity in Posterolateral Lumbar Fusion Surgery Model in Rats
Yasuhiro Shiga, Sumihisa Orita, Go Kubota, Hiroto Kamoda, Masaomi Yamashita, Yusuke Matsuura, Kazuyo Yamauchi, Yawara Eguchi, Miyako Suzuki, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Kazuki Fujimoto, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Yasuchika Aoki, Tomoaki Toyone, Takeo Furuya, Masao Koda, Kazuhisa Takahashi, Seiji Ohtori, Yasuhiro Shiga, Sumihisa Orita, Go Kubota, Hiroto Kamoda, Masaomi Yamashita, Yusuke Matsuura, Kazuyo Yamauchi, Yawara Eguchi, Miyako Suzuki, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Kazuki Fujimoto, Koki Abe, Hirohito Kanamoto, Masahiro Inoue, Hideyuki Kinoshita, Yasuchika Aoki, Tomoaki Toyone, Takeo Furuya, Masao Koda, Kazuhisa Takahashi, Seiji Ohtori
Abstract
Fresh platelet-rich plasma (PRP) accelerates bone union in rat model. However, fresh PRP has a short half-life. We suggested freeze-dried PRP (FD-PRP) prepared in advance and investigated its efficacy in vivo. Spinal posterolateral fusion was performed on 8-week-old male Sprague-Dawley rats divided into six groups based on the graft materials (n = 10 per group): sham control, artificial bone (A hydroxyapatite-collagen composite) -alone, autologous bone, artificial bone + fresh-PRP, artificial bone + FD-PRP preserved 8 weeks, and artificial bone + human recombinant bone morphogenetic protein 2 (BMP) as a positive control. At 4 and 8 weeks after the surgery, we investigated their bone union-related characteristics including amount of bone formation, histological characteristics of trabecular bone at remodeling site, and biomechanical strength on 3-point bending. Comparable radiological bone union was confirmed at 4 weeks after surgery in 80% of the FD-PRP groups, which was earlier than in other groups (p < 0.05). Histologically, the trabecular bone had thinner and more branches in the FD-PRP. Moreover, the biomechanical strength was comparable to that of autologous bone. FD-PRP accelerated bone union at a rate comparable to that of fresh PRP and BMP by remodeling the bone with thinner, more tangled, and rigid trabecular bone.
Figures
References
- Fritzell P., Hagg O., Wessberg P. & Nordwall A. & Swedish Lumbar Spine Study, G. Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine (Phila Pa 1976) 27, 1131–1141 (2002).
- Madan S. S., Harley J. M. & Boeree N. R. Circumferential and posterolateral fusion for lumbar disc disease. Clin Orthop Relat Res, 114–123, doi: 10.1097/01.blo.0000059581.08469.77 (2003).
- Videbaek T. S. et al.. Circumferential fusion improves outcome in comparison with instrumented posterolateral fusion: long-term results of a randomized clinical trial. Spine (Phila Pa 1976) 31, 2875–2880, doi: 10.1097/01.brs.0000247793.99827.b7 (2006).
- Axelrad T. W., Kakar S. & Einhorn T. A. New technologies for the enhancement of skeletal repair. Injury 38 Suppl 1, S49–S62, doi: 10.1016/j.injury.2007.02.010 (2007).
- Anitua E., Andia I., Ardanza B., Nurden P. & Nurden A. T. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 91, 4–15, doi: 10.1160/TH03-07-0440 (2004).
- Crovetti G. et al.. Platelet gel for healing cutaneous chronic wounds. Transfus Apher Sci 30, 145–151, doi: 10.1016/j.transci.2004.01.004 (2004).
- Marx R. E. et al.. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85, 638–646 (1998).
- Li H. et al.. Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma. An experimental study on pigs. Eur Spine J 13, 354–358, doi: 10.1007/s00586-003-0647-3 (2004).
- Sethi P. M. et al.. Evaluation of autologous platelet concentrate for intertransverse process lumbar fusion. Am J Orthop (Belle Mead NJ) 37, E84–E90 (2008).
- Kamoda H. et al.. The effect of platelet-rich plasma on posterolateral lumbar fusion in a rat model. J Bone Joint Surg Am 95, 1109–1116, doi: 10.2106/JBJS.L.00320 (2013).
- Kamoda H. et al.. Platelet-rich plasma combined with hydroxyapatite for lumbar interbody fusion promoted bone formation and decreased an inflammatory pain neuropeptide in rats. Spine (Phila Pa 1976) 37, 1727–1733, doi: 10.1097/BRS.0b013e31825567b7 (2012).
- Forriol F. et al.. Platelet-rich plasma, rhOP-1 (rhBMP-7) and frozen rib allograft for the reconstruction of bony mandibular defects in sheep. A pilot experimental study. Injury 40 Suppl 3, S44–S49, doi: 10.1016/S0020-1383(09)70011-7 (2009).
- Hee H. T., Majd M. E., Holt R. T. & Myers L. Do autologous growth factors enhance transforaminal lumbar interbody fusion? Eur Spine J 12, 400–407, doi: 10.1007/s00586-003-0548-5 (2003).
- Jenis L. G., Banco R. J. & Kwon B. A prospective study of Autologous Growth Factors (AGF) in lumbar interbody fusion. Spine J 6, 14–20, doi: 10.1016/j.spinee.2005.08.014 (2006).
- Lowery G. L., Kulkarni S. & Pennisi A. E. Use of autologous growth factors in lumbar spinal fusion. Bone 25, 47S–50S (1999).
- McCarrel T. & Fortier L. Temporal growth factor release from platelet-rich plasma, trehalose lyophilized platelets, and bone marrow aspirate and their effect on tendon and ligament gene expression. J Orthop Res 27, 1033–1042, doi: 10.1002/jor.20853 (2009).
- Pietramaggiori G., Kaipainen A., Czeczuga J. M., Wagner C. T. & Orgill D. P. Freeze-dried platelet-rich plasma shows beneficial healing properties in chronic wounds. Wound Repair Regen 14, 573–580, doi: 10.1111/j.1743-6109.2006.00164.x (2006).
- Pan L. et al.. Growth Factor Release from Lyophilized Porcine Platelet-Rich Plasma: Quantitative Analysis and Implications for Clinical Applications. Aesthetic Plast Surg 40, 157–163, doi: 10.1007/s00266-015-0580-y (2016).
- Markou N. et al.. Treatment of periodontal endosseous defects with platelet-rich plasma alone or in combination with demineralized freeze-dried bone allograft: a comparative clinical trial. J Periodontol 80, 1911–1919, doi: 10.1902/jop.2009.090216 (2009).
- Arosarena O. & Collins W. Comparison of BMP-2 and -4 for rat mandibular bone regeneration at various doses. Orthod Craniofac Res 8, 267–276, doi: 10.1111/j.1601-6343.2005.00349.x (2005).
- Bae H. W. et al.. Bone marrow enhances the performance of rhBMP-2 in spinal fusion: a rodent model. J Bone Joint Surg Am 95, 338–347, doi: 10.2106/JBJS.K.01118 (2013).
- Bosemark P., Isaksson H. & Tagil M. Influence of systemic bisphosphonate treatment on mechanical properties of BMP-induced calluses in a rat fracture model: comparison of three-point bending and twisting test. J Orthop Res 32, 721–726, doi: 10.1002/jor.22599 (2014).
- Eppley B. L., Woodell J. E. & Higgins J. Platelet quantification and growth factor analysis from platelet-rich plasma: implications for wound healing. Plast Reconstr Surg 114, 1502–1508 (2004).
- Okuda K. et al.. Platelet-rich plasma contains high levels of platelet-derived growth factor and transforming growth factor-beta and modulates the proliferation of periodontally related cells in vitro. J Periodontol 74, 849–857, doi: 10.1902/jop.2003.74.6.849 (2003).
- Weibrich G., Kleis W. K., Hafner G. & Hitzler W. E. Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count. J Craniomaxillofac Surg 30, 97–102, doi: 10.1054/jcms.2002.0285 (2002).
- Seeman E. Bone quality: the material and structural basis of bone strength. J Bone Miner Metab 26, 1–8, doi: 10.1007/s00774-007-0793-5 (2008).
- Bono C. M. & Wetzel F. T. & North American Spine Society Executive Committee, e. b. t. N. A. S. S. S. o. B. Black, white, or gray: how different (or similar) are YODA and the The Spine Journal reviews of BMP-2? Spine J 13, 1001–1005, doi: 10.1016/j.spinee.2013.07.030 (2013).
- Glassman S. D., Gum J. L., Crawford C. H. 3rd, Shields C. B. & Carreon L. Y. Complications with recombinant human bone morphogenetic protein-2 in posterolateral spine fusion associated with a dural tear. Spine J 11, 522–526, doi: 10.1016/j.spinee.2010.05.016 (2011).
- Mannion R. J., Nowitzke A. M. & Wood M. J. Promoting fusion in minimally invasive lumbar interbody stabilization with low-dose bone morphogenic protein-2--but what is the cost? Spine J 11, 527–533, doi: 10.1016/j.spinee.2010.07.005 (2011).
- Oryan A., Moshiri A. & Meimandi-Parizi A. Role of embedded pure xenogenous bovine platelet gel on experimental tendon healing, modelling and remodelling. BioDrugs 28, 537–556, doi: 10.1007/s40259-014-0107-0 (2014).
Source: PubMed