Platelet rich plasma gel combined with core decompression for repair of aseptic necrosis of the femoral head in a rabbit

doi:10.3969/j.issn.2095-4344.2014.27.019

Abstract

Abstract:

BACKGROUND: Recent studies have shown that platelet rich plasma has strong osteogenic ability and it has been widely used in the field of department of orthopedics and department of stomatology, but experimental study on avascular necrosis of the femoral head has been not reported.
OBJECTIVE: To observe the effect of platelet rich plasma gel combined with marrow core decompression in the repair of aseptic necrosis of rabbit femoral head.
METHODS: A total of 25 New Zealand white rabbits were obtained. Without dislocation of the hip joint, aseptic necrosis model was established by using liquid nitrogen cryotherapy on bilateral femoral head of rabbits. At 2 weeks after model establishment, rabbit models were randomly assigned. Model group with nine rabbits did not receive any treatment. Core decompression group with eight rabbits underwent core decompression treatment. Combination group with eight rabbits underwent core decompression combined with platelet rich plasma gel treatment. At 8 weeks after model induction, tissue sections of femoral head specimens were collected and subjected to MRI and hematoxylin-eosin staining.
RESULTS AND CONCLUSION: (1) MRI examination: The model group showed low signal area of different forms in femoral head fat high signal, exhibited annular, ribbon and focal shapes. No evident changes in osteogenesis, no apparent minification of the defect cavity were detected at defect site in the core decompression group, showing long T1 and T2 signals. Defect cavity disappeared, and new bone of short T1 and T2 signals filled in the combination group. (2) Hematoxylin-eosin staining: Articular cartilage defect and repair existed in the model group, showing osteoarthritis-like changes. Empty bone lacuna of bone trabecula, hematopoietic cell and adipocyte necrosis in bone marrow were detected in the core decompression group. Empty bone lacuna of bone trabecula, focal necrosis scattered in bone marrow were visible in the combination group. Results suggested that the outcomes of platelet rich plasma gel combined with core decompression were better than core decompression alone in treatment of rabbit models of femoral head necrosis.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: decompression, surgical, platelet-rich plasma, gels

CLC Number:

R318

Cui Yong, Fang Guo-zheng, Kaisaierjiang•Aihemaiti. Platelet rich plasma gel combined with core decompression for repair of aseptic necrosis of the femoral head in a rabbit[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(27): 4383-4388.

Figures/Tables 3

2.1 动物一般情况观察建模过程中3只兔因腹泻死亡，余25只动物未发生髋关节脱位，造模后二三周伤口缝线自行脱落，伤口Ⅰ期愈合。模型组：造模后第1周食欲尚可，体质量未见明显改变，无跛行步态，第2周体质量增长速度缓慢，活动量较前减少，无跛行步态，第4周所有动物未出现跛行，从第6周开始体质量无明显增长，未出现跛行，两侧髋关节外旋外展出现明显抵抗。第8周，7只体质量减轻，毛发无色泽，所有兔均有不同程度跛行。髓芯减压组：行髓芯减压1周后所有实验动物饮食正常，活动较少，将两侧髋关节外旋外展时伴有抵抗，2周后所有动物均恢复正常活动，饮食正常，其中有4只两侧髋关节外旋外展时无明显抵抗。4周后所有动物正常活动，无明显跛行，髋关节外旋外展时无明显抵抗。联合组：髓芯减压注入富血小板血浆后1周所有实验动物饮食、活动正常，将两侧髋关节外旋外展时伴有抵抗，2周后所有动物恢复正常活动，无跛行，其中有6只两侧髋关节外旋外展时无明显抵抗。4周后所有动物正常活动，无跛行，髋关节外旋外展时无明显抵抗。 2.2 MRI观察模型组造模后4周表现为坏死区低信号围绕的信号不均坏死区，8周时表现为股骨头脂肪高信号中出现不同形态的低信号区，呈环形、带状和灶状。髓芯减压组造模后4周，减压缺损区无明显成骨改变，缺损腔无明显缩小，以长T1、T2信号为主，8周时缺损腔仍为长T1、T2信号。联合组造模后4周有较明显的成骨，表现为长T1短T2信号，缺损腔缩小；8周时缺损腔消失，可见到被短T1、T2的大量新生骨所充填。 2.3 股骨头标本大体及组织学观察模型组股骨头标本外形变扁，冷冻关节软骨表面苍白粗糙不平，剥脱严重，关节软骨下有骨暴露，大量骨小梁断裂，对应冷冻处下方骺板模糊，髓腔周围有死骨，并可见新骨生长，并有2只失去其圆形轮廓，间隙变窄，呈现骨性关节炎样改变(图1A)；苏木精-伊红染色显示冷冻关节的关节软骨缺损与修复同时存在，骨小梁断裂，排列紊乱，骨小梁骨折和吸收同时存在，骨陷窝空虚，出现大量的新生类骨质，骨髓内大面积造血细胞和脂肪细胞坏死，坏死周围可见炎细胞浸润及纤维组织增生，间隙变窄，呈现骨性关节炎样改变(图2A)。髓芯减压组冷冻股骨头标本外形大体正常，关节软骨薄且苍白，未见明显软骨剥脱或股骨头塌陷(图1B)；苏木精-伊红染色表现为骨小梁空骨陷窝，骨髓内造血细胞和脂肪细胞坏死(图2B)。联合组冷冻股骨头标本外形大体正常，关节软骨表面略苍白，表面平整，无明显软骨剥脱及股骨头塌陷(图1C)；苏木精-伊红染色表现骨小梁空骨陷窝，骨髓散在灶状坏死(图2C)。各组股骨头坏死率见表1。 "

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