2022, Vol. 26 ›› Issue (30): 4812-4818

Implantation of bone marrow mesenchymal stem cells-loaded platelet-rich plasma combined with extracorporeal shock wave in the repair of bone defects

Huang Gao, Xu Jun, Chen Wenge   

Abstract: BACKGROUND: Segmental bone defects are prone to non-unions, and its treatment is a formidable clinical challenge. Additionally, the aging population and prevalence of osteoporosis-related fractures make it urgent to further explore a novel strategy to induce osteogenesis in this special population with limited bone generation ability.
OBJECTIVE: To evaluate the novel strategy of bone marrow mesenchymal stem cells-loaded platelet-rich plasma combined with extracorporeal shock wave in reconstruction of segmental bone defects in osteoporosis.  
METHODS: The bone marrow mesenchymal stem cells pretreated by extracorporeal shock wave were co-cultured with platelet-rich plasma and the cell biocompatibility was tested by CCK-8 and live-death staining. Osteogenic differentiation of bone marrow mesenchymal stem cells was detected by alkaline phosphatase staining, alizarin red staining, and RT-PCR detection. New-Zealand rabbit models of osteoporosis were established and segmental bone defects of the radius were prepared. The combined treatment strategy of bone marrow mesenchymal stem cells-loaded platelet-rich plasma implantation and extracorporeal shock wave was used. The bone regeneration of radius samples was analyzed by Micro-CT and histological evaluation.
RESULTS AND CONCLUSION: (1) In vitro, platelet-rich plasma combined with extracorporeal shock wave significantly promoted bone marrow mesenchymal stem cells proliferation and migration, as well as induced osteogenic differentiation of bone marrow mesenchymal stem cells by up-regulating the deposition of calcium nodule, and expression of alkaline phosphatase, runt-related transcription factor-2 (Runx-2) and osteocalcin. (2) In vivo, Micro-CT analysis and histological evaluation indicated this combination strategy of bone marrow mesenchymal stem cells-loaded platelet-rich plasma implantation combined with   extracorporeal shock wave significantly enhanced bone regeneration in osteoporotic segmental bone defects. (3) The results indicated that this novel strategy of bone marrow mesenchymal stem cells-loaded platelet-rich plasma implantation combined with extracorporeal shock wave could improve the poor osteogenic microenvironment associated with osteoporosis and show the potential for enhancing healing in segmental bone defects with osteoporosis.
Key words: bone marrow mesenchymal stem cells, platelet-rich plasma, extracorporeal shock wave, implantation, osteoporosis, bone defect, bone regeneration