Abstract
Aim: Tissue injury leads to platelets migration and release of growth factors (GF): Platelet-Derived GF (PDGF) and Transforming GF-beta (TGF-b) that are particularly important for the bone repair process. The purpose of our study is to evaluate the new bone formation with the use of AGF-bone graft combination and to estimate the concentrations of PDGF-AB and TGF-b2 during the procedure.
Methods: AGF-bone graft combination was used in 34 patients with long bone defects (24) and spinal fusion (10). TGF-b2 and PDGF-AB concentrations were assessed in samples from blood. Aliquots were taken at each stage of AGF preparation (whole blood, buffy coat, AGF, wound drain) and analyzed for TGF-b2, PDGF-AB concentration and platelet counts. ELISA was performed to quantify concentrations of active PDGF-AB and TGF-b2. Postoperative evaluation was clinical and radiological (radiographs, tomograms, QCT).
Results: Mean follow up time was 9 months. Signs of bone union were apparent in radiographs 3–6 months after the index procedure. Average platelet count increased from 212x106 cells/ml to 680x106 cells/ml (buffy coat) and to 1280x106 cells/ml (AGF concentrate), resulting in a 604% increase. A 480% increase of PDGF-AB levels and a 320% increase of TGF-b2 levels in AGF concentrate comparing to whole blood levels was determined. TGF-b2 and PDGF-AB levels were also detected in samples collected from the wound drains, in increased levels comparing to the AGF concentrates.
Conclusions: In all cases the clinical results were very encouraging with augmented osteogenesis, whereas the laboratory results (increased values of TGF-b2 and PDGF-AB in subsequent stages of the procedure) practically predicted the clinical success.
The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.
