Autologous platelet-rich plasma application for the optimization of bone tissue reparative regeneration in osteopenia

Authors

  • D. V. Ivchenko Zaporizhzhia State Medical University, Ukraine,
  • V. V. Miroshnikov Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2018.2.141333

Keywords:

platelet-rich plasma, bone regeneration, osteogenesis, bone remodeling, mineral metabolism, osteoporosis

Abstract

Objective: analysis of scientific literature on the effectiveness of using Plateled-Rich Plasma to optimize the treatment of compression fractures of vertebral bodies of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis.

All the methods of using Platelet-Rich Plasma, described in the literature, can be divided into several main groups. Platelet-Rich Plasma can be mixed with bone material; is applied to the lesion site before application of bone material; is applied over the bone material; used as a biological membrane.

Platelet-Rich Plasma contain fibrillar and cellular components and is able to act as a carrier of cells which are important for the regeneration of soft and bony tissues. It can strengthen the attachment of human osteoblasts to membranes and, as a consequence, induce osteogenesis. Many authors are the supporters of the stimulating effect of Platelet-Rich Plasma on reparative osteogenesis.

After injection of Platelet-Rich Plasma in the case of complicated fracture the following was observed: odema in the damaged tissues is less pronounced, there are less signs of acute and chronic inflammation, the phase of alteration is changing more quickly by regenerative-reparative processes. The natural clot contains fibrin, fibronectin and vitronectin, they are also called adhesion molecules necessary for cell migration, osteoconduction, epithelialization and osseointegration. Biological properties of Platelet-Rich Plasma are due not only to the presence of growth factors (TGF-β and PDGF), but without them it immediately induces the formation of a fibrin clot, followed by stimulation of cell adhesion and collagen synthesis.

Conclusion. Based on the published literature, a high potential of plasma therapy by Platelet-Rich Plasma for bone tissue regeneration is demonstrated. No adequate clinical studies on the effectiveness of Platelet-Rich Plasma therapy that would meet all modern criteria have yet been conducted. Therapy of Platelet-Rich Plasma is a promising branch in medicine and deserves further research in terms of new effective and safe method of application in medical practice.

 

References

Korzh, N. A., & Dedukh, N. V. (2006) Reparativnaya regeneraciya kosti: sovremennyj vzglyad na problemu. Stadii regeneracii [Orthopedics, traumatology and prosthetics]. Ortopediya, travmatologiya i protezirovanie, 1, 77–84. [in Russian].

Klimovickij, V. G., & Chernysh, V. Yu. (2011) Chastota zamedlennoj konsolidacii perelomov u postradavshikh raznykh vozrastnykh grupp i vliyanie na neyo osteotropnoj terapii [The frequency of delayed consolidation of fractures in affected individuals of different age groups and the impact of osteotropic therapy on it]. Travma, 12(3), 93–97. [in Russian].

Shteinle, A. V. (2010) Posttravmaticheskaya regeneraciya kostnoj tkani (chast' 2) [Posttraumatic regeneration of bone tissue (part 2)]. Sibirskij medicinskij zhurnal, 25(1), 114–118. [in Russian].

Kirilova, I. L., Fomichev, N. G., Podorozhnaya, V. T., & E'titejn, Yu. V. (2008) Sochetannoe ispol'zovanie osteoplastiki i obogashchennoj trombocitami plazmy v travmatologii i ortopedii (obzor literatury) [Combined use of osteoplasty and platelet-enriched plasma in traumatology and orthopedics (literature review)]. Travmatologiya i ortopediya Rossii, 3(49), 64–67. [in Russian].

Por, Y. C., Barceló, C. R., Salyer, K. E., Genecov, D. G., Troxel, K., Gendler, E., et al (2008) Bone generation in the reconstruction of a critical size calvarial defect in an experimental model. Ann. Acad. Med. Singapore, 36(11). 911–919.

Marunych, V. V., Ipatov, A. V., Korobkin, Yu. I., et al. (2012) Osnovni pokaznyky invalidnosti ta diialnosti medyko-sotsialnykh ekspertnykh komisii Ukrainy za 2011 rik [Main indicators of disability and activity of medical and social expert commissions of Ukraine for 2011] R.V. Bogatyreva (Ed). Dnipropetrovsk : Porohy. [in Ukrainian].

Grigorovsky, V. V., Khyzhnyak, M. V., Vasilyeva, I. G., Shuba, I. N., & Gafiychuk, Yu. G. (2013) Vliyanie kulʹtivirovannykh autogennykh kletok studenistogo yadra na strukturu mezhpozvonkovykh diskov khvostovykh segmentov pri modelirovanii osteokhondroza u krys [The influence of cultivated autogenous nucleus pulposus cells on structure of intervertebral discs of caudal spine at osteochondrosis model in rats]. Ukrainskyi neirokhirurhichnyi zhurnal, 2, 28–34. [in Russian].

Klimovitsky, V. G., Kanziuba, M. A., Kanziuba, A. I., & Кhachatryan, S. S. (2013) Osobennosti osteosinteza perelomov shejki bedrennoj kosti v molodom vozraste [Features of Osteosyntesis of Femoral Neck Fracture in young Adults]. Litopys travmatolohii ta ortopedii, 3–4, 58–60. [in Russian].

Hee, H. T., Majd, M. E., Holt, R. T., & Myers, L. (2003) Do autologous growth factors enhance transforaminal lumbar interbody fusion? Eur Spine J., 12(4), 400–407. doi: 10.1007/s00586-003-0548-5.

Berchenko, G. N., Kesyan, G. A., & Mikelaishvili, D. S. (2010) Primenenie biokompozitnogo nanostrukturnogo preparata kollapan y obogashchennoj trambocitami autoplazmy v inzhiniringe kostnoj tkani [Application of biocomposite nanostructural preparation collapine and autoplastic enriched trombocytes in bone engineering]. Travma, 11(1), 7–14. [in Russian].

Badr, M., Coulthard, P., Alissa, R., & Oliver, R. (2010) The efficacy of platelet­rich plasma in grafted maxil lae. A randomised clinical trial. European Journal Oral Implantology, 3(3), 233–244.

Chen, L., Yang, X., Huang, G., Song, D., Ye, X. S., Xu, H., & Li, W. (2013) Platelet-rich plasma promotes healing of osteoporotic fractures. Orthopedics, 36(6), 687–694. doi: 10.3928/01477447-20130523-10.

Zubenko, A. H. (2011) Optymizatsiia perebihu reparatyvnoho osteohenezu pry perelomakh velykohomilkovoi kistky (eksperymentalno-klinichne doslidzhennia) (Avtoref. dis…kand. med. nauk). [Optimization of the course of reparative osteogenesis in fractures of the tibia (experimental and clinical study)]. (Extended abstract of candidate’s thesis). Kyiv [in Ukrainian].

Pavlenko, K. V. (2016) Vliyanie e'ndogennykh i e'kzogennykh stimulyatorov rosta na mekhanizmy reparativnoj regeneracii kostnoj tkani (Dis…kand. med. nauk). [Influence of endogenous and exogenous growth stimulants on mechanisms of reparative regeneration of bone tissue. Dr. med. sci. diss.]. Odessa. [in Russian].

Uggeri, J., Belletti, S., Guizzardi, S., Poli, T., Cantarelli, S., Scandroglio, R., & Gatti, R. (2007) Dose-dependent effects of platelet gel releasate on activities of human osteoblasts. J. Periodontol, 78(10), 1985–1991. doi: 10.1902/jop.2007.070116.

Chang, T., Liu, Q., Marino, V., & Bartold, P. M. (2007) Attachment of periodontal fibroblasts to barrier membranes coated with platelet-rich plasma. Aust. Dent. J., 52(3), 227–233.

Simman, R., Hoffmann, A., Bohinc, R. J., Peterson, W. C., & Russ, A. J. (2008) Role of platelet-rich plasma in acceleration of bone fracture healing. Ann Plast Surg., 61(3), 337–344. doi: 10.1097/SAP.0b013e318157a185.

Stanton, T. (2012) High-concentrate PRP Promotes Healing in Long-Bone Nonunions Retrieved from http://www.aaos.org/News/The_Daily_Edition_of_AAOS Now/2012/.

Civinini, R., Macera, A., Nistri, L., Redl, B., Innocenti, M. (2011) The use of autologous blood-derived growth factors in bone regeneration. Innocenti Clin. Cases Miner. Bone Metab, 8(1), 25–31.

Zhao, Y., & Zhai, W. (2010) Research progress of platelet­rich plasma in promoting bone regeneration and repairing. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 24(8), 1004–1008.

de Vos, R. J., Weir, A., van Schie, H. T., Bierma-Zeinstra, S. M., Verhaar, J. A., Weinans, H., & Tol, J. L. (2010) Platelet­rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA, 303(2), 144–149. doi: 10.1001/jama.2009.1986.

Buryanov, O. A., Omelchenko, T. N., Yarmolyuk, Y. А., & Vakulich, M. V. (2017) Regeneraciya kosti pri ispolʹzovanii autogennoj kostnoj tkani i fibrina, obogashchennogo trombocitami [Bone regeneration using autogenous bone and platelet-rich fibrin]. Visnyk problem biolohii i medytsyny, 1(135), 96–99. [in Russian].

Schwartz-Arad, D., Levin, L., & Aba, M. (2007) The use of platelet rich plasma (PRP) and platelet rich fibrin (PRP) extracts in dental implantology and oral surgery. Refuat Hapeh Vehashinayim, 24(1), 51–55, 84.

Schaaf, H., Streckbein, P., Lendeckel, S., Heidinger, K., Görtz, B., Bein, G., et al. (2008) Topical use of platelet-rich plasma to influence bone volume in maxillary augmentation: a prospective randomized trial. Vox Sang, 94(1), 64–69. doi: 10.1111/j.1423-0410.2007.00997.x.

Dozza, B., Lesci, I. G., Duchi, S., Della Bella, E., Martini, L.,

Salamanna, F., et al. (2017) When size matters: differences in demineralized bone matrix particles affect collagen structure, mesenchymal stem cell behavior, and osteogenic potential. Biomed Mater Res A, 105(4), 1019–1033. doi: 10.1002/jbm.a.35975.

Viny, A. D., Ott, C. J., Spitzer, B., Rivas, M., Meydan, C., Papalexi, E., et al. (2015) Dose-dependent role of the cohesin complex in normal and malignant hematopoiesis. RL.J Exp Med., 212(11), 1819–32. doi: 10.1084/jem.20151317.

Tao, H., Lin, Y., Zhang, G., Gu, R., & Chen, B. (2016) Experimental observation of human bone marrow mesenchymal stem cell transplantation into rabbit intervertebral discs. B.Biomed Rep., 5(3), 357–360. doi: 10.3892/br.2016.731.

Lai, Y., Cao, H., Wang, X., Chen, S., Zhang, M., Wang, N., et al. (2018) Porous composite scaffold incorporating osteogenic phytomolecule icariin for promoting skeletal regeneration in challenging osteonecrotic bone in rabbits. Biomaterials, 153, 1–13. doi: 10.1016/j.biomaterials.2017.10.025.

Lowery, J. W., & Rosen, V. (2017) Bone Morphogenetic Protein-Based Therapeutic Approaches. Cold Spring Harb Perspect Biol., pii: a022327. doi: 10.1101/cshperspect.a022327.

Perut, F., Dallari, D., Rani, N., Baldini, N., & Granchi, D. (2016) Cell-based Assay System for Predicting Bone Regeneration in Patient Affected by Aseptic Nonunion and Treated with Platelet Rich Fibrin. Curr Pharm Biotechnol., 17(12), 1079–1088.

Osawa, Y., Matsushita, M., Hasegawa, S., Esaki, R., Fujio, M., Ohkawara, B., et al. (2017) Activated FGFR3 promotes bone formation via accelerating endochondral ossification in mouse model of distraction osteogenesis. Bone, 105, 42–49. doi: 10.1016/j.bone.2017.05.016.

Mebarki, M., Coquelin, L., Layrolle, P., Battaglia, S., Tossou, M., Hernigou, P., et al. (2017) Enhanced human bone marrow mesenchymal stromal cell adhesion on scaffolds promotes cell survival and bone formation. Acta Biomater., 59, 94–107. doi: 10.1016/j.actbio.2017.06.018.

Kawase, T., Okuda, K., Saito, Y., & Yoshie, H. (2005) In vitro evidence that the biological effects of platelet-rich plasma on periodontal ligament cells is not mediated solely by constituent transforming-growth factor-beta or platelet-derived growth factor. J. Periodontol., 76(5), 760–767. doi: 10.1902/jop.2005.76.5.760.

Akeda, K., An, H. S., Okuma, M., Attawia, M., Miyamoto, K., Thonar, E. J., et al. (2006) Platelet-rich plasma stimulates porcine articular chondrocyte proliferation and matrix biosynthesis. Osteoarthritis Cartilage., 14(12), 1272–1280. doi: 10.1016/j.joca.2006.05.008.

Brekhov, V. L. (2007) Khirurgicheskoe lechenie bol'nykh s defektami kostnoj i khryashchevoj tkanej s primeneniem bogatoj trombocitami autoplazmy (Avtoref. dis…kand. med. nauk). [Surgical treatment of patients with defects of bone and cartilaginous tissues using a platelet-rich autoplasm]. (Extended abstract of candidate’s thesis). Kursk. [in Russian].

Keceli, H. G., Sengun, D., Berberoğlu, A., & Karabulut, E. (2008) Use of platelet gel with connective tissue grafts for root coverage: a randomized-controlled trial. J. Clin. Periodontol., 35(3), 255–262. doi: 10.1111/j.1600-051X.2007.01181.x.

Hatakeyama, M., Beletti, M. E., Zanetta-Barbosa, D., & Dechichi, P. (2008) Radiographic and histomorphometric analysis of bone healing using autogenous graft associated with platelet-rich plasma obtained by 2 different methods. Oral Surg., Oral Med., Oral Pathol., Oral Radiol. Endod., 105(1), el3–el8. doi: 10.1016/j.tripleo.2007.07.033.

Moojen, D. J., Everts, P. A., Schure, R. M., Overdevest, E. P., van Zundert, A., Knape, J. T., et al. (2007) Antimicrobial activity of platelet-leukocyte gel against Staphylococcus aureus. J. Orthop. Res., 26(3), 404–10. doi: 10.1002/jor.20519.

Bielecki, T. M., Gazdzik, T. S., Arendt, J., Szczepanski, T., Król, W., & Wielkoszynski, T. (2007) Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances (in vitro study). J. Bone Jt Surgery., 89(3), 417–420. doi: 10.1302/0301-620X.89B3.18491.

Samodaj, V. G. (2007) Ispol'zovanie bogatoj trombocitami autoplazmy v lechenii psevdoartrozov i inficirovannykh defektov kostnoj tkani [Use of platelet-rich autoplasma in the treatment of pseudoarthrosis and infected bone tissue defects]. Aktual'nye voprosy tkanevoj i kletochnoj transplantologii Proceedings of the III All-Russian Symposium with international participation. (P. 148–150). Moscow. [in Russian].

Pavlenko, K. V., Nasibullin, B. A., Uvarova, Ye. B., & Gozhenko, A. I. (2015) Structural and functional features of reparative osteogenesis under the influence of natural healing factors. Journal of Education, Health and Sport., 5(3), 279–288. doi: 10.5281/zenodo. 16453.

Kholodkova, O. L., Tsyurupa, O. V., & Badyin, I. Yu. (2015) Porivnialna kharakterystyka patolohichnykh zmin u mizhkhrebtsevykh dyskakh khvostovykh sehmentiv shchuriv za umov modeliuvannia postiinoi asymetrychnoi kompresii-dystenzii ta pislia korektsii zbahachenoiu trombotsytamy plazmoiu [Comparative characteristics of the pathological changes in the intervertebral discs at the condition of constant asymmetric compression-distension modeling and after the platelet-rich plasma correction]. Zdobutky klinichnoi i eksperymentalnoi medytsyny, 4, 66–68. [in Ukrainian].

Kholodkova, O. L., & Horchah, D. M. (2013) Mozhlyvosti vykorystannia zbahachenoi trombotsytamy plazmy pry eksperymentalnii terapii toksychnoho urazhennia pechinky [The possibilities of platelet-rich plasma usage in experimental treatment of toxic affection of the liver]. Ukrainskyi morfolohichnyi almanakh, 11(3), 63–65. [in Ukrainian].

Lazishvili, G. D., Egiazaryan, К. A., Akhpashev, A. A., Danilov, M. A., Strakhov, M. A., & Gaev T. G. (2016) Klinicheskaya eʹffektivnost' primeneniya obogashchennoj trombocitami plazmy v lechenii osteoartroza kolennogo sustava [Study of the platelet-rich plasma clinical efficacy in the treatment of knee osteoarthritis]. Klinicheskaya praktika, 3, 54–60. [in Russian].

Lazishvili, G. D., Kuzin, V. V., Gordienko, D. I., Strakhov, М. А., Doshlova, D. V., Shpak, М. А., et al. (2016) Biotekhnologii v lechenii lokal'nykh khryashchevykh i kostno-khryashchevykh defektov myshchelkov bedrennoj kosti [Biotechnologies in treatment of focal cartilage and bone defects of the knee]. Kafedra travmatologii i ortopedii, 1(17), 40–44. [in Russian].

Lazishvili, G. D., Kuzin, V. V., Gordienko, D. I., Strakhov, M. A., Doshlova, D. V., Danilov, M. A., et al. (2016) Khirurgicheskaya korrekciya lokal'nykh defektov gialinovogo khryashcha kolennogo sustava, proshloe i nastoyashchee [Surgical correction of local chondral and osteochondral defects of the knee. Past and present]. Khirurgicheskaya praktika, 1, 46–52. [in Russian].

Tryfanenko, S. I., Prodan, M. P., & Kuzniak, N. B. (2012) Efektyvnist zastosuvannia zbahachenoi trombotsytamy plazmy dlia optymizatsii reparatsiinoho osteohenezu pry perelomakh nyzhnoi shchelepy z uskladnenym klinichnym perebihom [Efficacy of using thrombocyte concentrated plasma administration for optimization of reparative osteogenesis in case of mandibular fractures with a complicated clinical course]. Bukovynskyi medychnyi visnyk, 16, 4(64), 162–164. [in Ukrainian].

Popsuishapka, A. K., Litvishko, A. V., Grigoryev, V. V., Ashukina, N. A. (2014) Lecheniye nesrashcheniya otlomkov kosti posle diafizarnogo pereloma [Treatment of bone fragments nonunion after dyaphiseal fracture]. Ortopediya, travmatologiya i protezirovanie, 1, 34–41. [in Russian].

Borzykh, А. V., Solovyov, I. A., Pogorilyak, A. I., Kravchenko, A. V., & Kovalchuk, D. U. (2013) Rezul'taty lecheniya lozhnykh sustavov lad'evidnoj kosti kisti s primeneniem plazmy obogashchennoj trombocitami [Regional Clinical Traumatology hospital, Donetsk, Ukraine Trearment Results of Nonunion of Scaphoid Bone with Platelet Rich Plasma]. Litopys travmatolohii ta ortopedii, 3–4(27–28), 9–11. [in Russian].

Kulytska, O. V. (2015) Osoblyvosti likuvannia perelomiv pidboridnoho viddilu nyzhnoi shchelepy [Features of treatment of fractures of the chest section of the mandible]. Visnyk naukovykh doslidzhen, 4, 68–70. doi: 10.11603/1681-276Х.2015.4.5648. [in Ukrainian].

Glukhov, A. A., Mikulich, E. V., & Alexeeva, N. T. (2013) Kliniko‐laboratornaya ocenka ispolʹzovaniya obogashchennoj trombocitami plazmy i strujnoj sanacii v lechenii khronicheskogo eʹksperymentalʹnogo osteomielita [Clinical and laboratory evaluation of the use of platelet-rich plasma and jet sanation in treatment of chronic experimental osteomyelitis]. Vestnik novykh medicinskikh tekhnologsj, 20(2), 108–112. [in Russian].

How to Cite

1.
Ivchenko DV, Miroshnikov VV. Autologous platelet-rich plasma application for the optimization of bone tissue reparative regeneration in osteopenia. Pathologia [Internet]. 2018Sep.12 [cited 2024Dec.24];(2). Available from: http://pat.zsmu.edu.ua/article/view/141333

Issue

Section

Review