The Effects Of De Novo Bone Formation Using Autologous Leucocyte And Platelet-rich Fibrin With Bone Marrow Mesenchymal Stem Cells In Avascular Necrosis Of Femoral Head In Rabbits

Objective In the early stage and from the perspective of the world point of view especially in china or in foreign there have been a lot of methods to treat the avascular necrosis of femoral head.we often use the non-surgical technique and surgical technique to treat this disease.but the prognosis is allways different and variable.the outcome is always unsatisfactory and it is difficult to convert failed case to a total hip replacement.leucocyte and platelet-rich fibrin(L-PRF)is a new generation of the Blood concentrates.which has three-dimensional architecture to provide the biologic matrix,and it will release a number of growth factors that will healing and resist the infection,then combined with use of bone marrow mesenchymal stem cells(BMSCs),the De Novo bone formation will be highly significant,we need to research the efficacy of the De Novo bone formation and Vascular regeneration by using leucocyte-and platelet-rich fibrin and bone marrow stromal cells after we do the operation of core decompression in rabbits which have suffered avascular necrosis of femoral head disease.Methods Twenty-four New Zealand white rabbits(4-6 months old,both genders,weighing 2.0-3.0kg)were used for the establishment of bilateral avascular necrosis of femoral head defect models and divided into 4 groups(n=6).BMSCs were isolated from the bone marrow of iliac crest,cultured and identified.L-PRF was prepared by the blood which will extracted from the heart of the rabbit.core decompression only(Group A),core decompression followed by implantation of L-PRF(Group B),core decompression followed by implantation of cultured BMSCs(Group C),core decompression followed by implantation of cultured BMSCs and L-PRF(Group D)were performed in 4 groups.To evaluate bone formation and remodeling of the defects,X-ray photography was taken at 4,8 and 12 weeks postoperatively.The modified Lane-Sandhu scoring system was used to evaluate the bone formation.Two rabbits were sacrificed at 4,8,12 weeks after orperation to harvested the specimens for histological observation,new blood vessel count and new bone area ratio.Results We investigated the process of de novo bone formation on images of radiology and histology.the results of Lane and Sandhu X-ray photography scoring,new blood vessel count and new bone area ratio showed the differences that groups C and D were significantly better than groups A and B,group D was significantly better than group C and group B was significant better than group A(P<0.05).Conclusion Our research indicate that core decompression associated with BMSCs and L-PRF is capable of stimulating bone regeneration more effectively than isolated core decompression or in association with BMSCs or L-PRF alone in a preclinical femoral head osteonecrosis model in rabbits.These findings demonstrate that L-PRF can promote osteogenic differentiation and de novo bone formation of BMSCs in treating avascular necrosis of femoral head in rabbits,and core decompression associated with BMSCs and L-PRF is an effective and feasible method for treating early osteonecrosis.