Evaluation of Bone Regeneration Following Combination Therapy with Platelet-Rich Plasma and Chitosan/Hydroxyapatite

Background. Increasing attention has been paid to platelet-rich plasma (PRP) as an adjunct to aid bone healing. Combining bone graft substitutes with PRP is a promising approach to reduce the reliance on autografts. The aim of this study was to evaluate the combination of PRP with a chitosan/hydroxyapatite (CS/HA) scaffold to promote bone regeneration in a rabbit model. Methods. Sixteen adult rabbits were included in this randomized, prospective study. Bone defects measuring 10x5 mm(2) were created in the middle shaft of the radius. The defects were treated with void, PRP, artificial bone substitute (CS/HA) and PRP + CS/HA. The animals were sacrificed at 12 weeks. Bone regeneration was assessed by radiographical, histological and immunohistochemical (COL I and OC) analyses. Results. The platelet concentration of the PRP was 4.45-fold higher than that of the peripheral whole blood. Twelve weeks after surgery, the PRP + CS/HA group showed much more bone formation than the other groups on the basis of the radiological, histological and gross findings. However, the immunohistochemical analyses indicated no significant difference among the groups. Conclusions. The PRP and the CS/HA and PRP + CS/HA scaffolds showed osteogenic regeneration in the rabbit radius defect model. The study demonstrated a synergistic enhancing effect between the PRP and the CS/HA scaffold.