Evaluation of adipose-derived stem cells (ASCS) exosome implantation and platelet-rich fibrin (PRF) on critical long bone defects in Sprague-Dawley rats

Eur J Orthop Surg Traumatol. 2024 Jul;34(5):2805-2810. doi: 10.1007/s00590-024-03964-0. Epub 2024 May 23.

Abstract

Introduction: This study aimed to assess the efficacy of adipose-derived mesenchymal stem cell exosomes (ASCs exosome) and platelet-rich fibrin (PRF) in treating critical long bone defects in Sprague-Dawley rats. Critical long bone defects, defined as exceeding 2 cm or 50% of the bone diameter, often pose a healing challenge. While autologous bone grafts have been considered, they have shown unreliable results and donor-site complications, necessitating alternative treatments.

Methods: The research followed a quasi-experimental post-test only control group design involving 30 male Sprague-Dawley rats. The rats were divided into five groups and subjected to femur bone defect creation, internally fixed with a 1.4 mm K-wire, and treated with various combinations of hydroxyapatite (HA), bone graft (BG), ASCs exosome, and PRF. Histomorphometry and BMP-2 gene expression analysis were performed to evaluate bone healing.

Results and discussion: The results indicated that the group treated with HA + BG + ASCs exosome (group IV) exhibited the highest BMP-2 gene expression, while group III (HA + BG + ASCs exosome + PRF) had the highest chordin level. Overall, groups receiving ASCs exosome or PRF intervention showed elevated BMP-2 expression compared to the control group. The use of ASCs exosome and PRF showed comparable outcomes compared to bone graft administration in terms of histomorphometry analysis.

Conclusion: The administration of adipose tissue derived mesenchymal stem cells and PRF has a comparable outcome with the use of bone graft in terms of osseus area and expression of BMP-2 in critical bone defect.

Keywords: Adipose-derived stem cells (ASCs) exosome; Critical long bone defect; Platelet-rich fibrin (PRF); Sprague-Dawley.

MeSH terms

  • Adipose Tissue / cytology
  • Animals
  • Bone Morphogenetic Protein 2 / metabolism
  • Bone Regeneration / drug effects
  • Bone Transplantation / methods
  • Durapatite
  • Exosomes* / metabolism
  • Exosomes* / transplantation
  • Femur / injuries
  • Male
  • Mesenchymal Stem Cell Transplantation / methods
  • Mesenchymal Stem Cells / metabolism
  • Platelet-Rich Fibrin*
  • Rats
  • Rats, Sprague-Dawley*

Substances

  • Bone Morphogenetic Protein 2
  • Durapatite