In Park, Saerom Jeong, Jihoon Ryu
Joint Diseases and Related Surgery - 2026;37(2):372-380
Severe defect of long bone is a major clinical concern in fracture patients with high-energy trauma. Successful fracture site union requires bone defect restoration, which could be achieved through various treatment options, including autogenic or allogenic bone grafts. Autogenic bone grafts, typically harvested from the iliac bone, is known to exhibit superior osteogenic potential compared to allogenic grafts. However, their clinical use may be limited by donor site morbidity and restricted amount availability. Therefore, there remains a persistent need for alternative bone graft strategies that retain the superior osteogenic potential of autografts while avoiding donor site morbidity and limitations in graft availability. Platelet-rich plasma (PRP) contains various growth factors, including platelet-derived growth factor, transforming growth factor beta-1, and vascular endothelial growth factor, which contribute to tendon and bone healing through multidirectional effects. Despite its potential benefits, limited studies have explored the clinical application of PRP in bone defect treatment. This is primarily due to the fluid nature of PRP, which makes it challenging to retain at the bone defect site in clinical practice. To address this limitation, PRP can be fibrinized into platelet-rich fibrin (PRF), which is already used clinically for bone defects, particularly in dental surgery. However, there are few studies in the literature to investigating the osteogenic effect of PRF on the bone defect of long bone in orthopedic surgery. In the light of these data, in the present study, we hypothesized that the PRF graft with periosteal repair would result in superior new bone formation on a bone defect of long bone in rabbits, as assessed by histological and radiological examinations, compared to periosteal repair alone. We, therefore, aimed to evaluate the osteogenic effect of PRF grafting with periosteal repair on a bone defect of long bone in rabbits, compared to a control group that underwent periosteal repair alone.
