Comparative biochemical analysis of platelet-rich plasma-chitosan and platelet-rich fibrin-chitosan for treating tibial bone defects in rabbits

Abstract

Background and Aim: Fracture healing can cause serious complications, both preoperatively and postoperatively, including malunion or non-union. Biomaterials can enhance the fracture healing process. This study aimed to compare platelet-rich plasma (PRP)-chitosan and platelet-rich fibrin (PRF)-chitosan on the basis of biochemical parameters for fracture treatment in rabbits. Materials and Methods: This study involved 12 clinically healthy rabbits. After preparing PRP and PRF, a 3-mm bone defect was created in the tibia of each rabbit. The animals were divided randomly into two groups (A and B). Group A received PRP-Chitosan, and Group B received PRF-Chitosan. Bone healing was assessed using biochemical parameters (calcium [Ca], phosphorus [P], serum alkaline phosphatase [ALP], and osteocalcin [Ocn]) at 2-, 4-, 6-, and 8-week postoperatively. The data were compared using repeated-measures analysis of variance (p < 0.05) with Statistical Package for the Social Sciences statistical software. Results: Group-wise comparison showed no significant differences (p > 0.05) between the groups, except for ALP levels, which were significantly higher in Group B than in Group A (p < 0.05). In the week-wise comparison, there was a significant difference between both groups, as Ca and ALP levels showed significant differences at all weeks postoperatively, whereas Ocn showed a significant difference at 2- and 4-week postoperatively (p < 0.05). However, there was no difference in P levels between the groups at any post-operative week (p > 0.05). Conclusion: Both combinations enhanced bone regeneration. However, PRF-Chitosan is a better combination for bone repair than PRP-Chitosan. There were some limitations of this study, such as a small sample size, only male rabbits were used, and a lack of mechanical testing; these limitations should be addressed in future studies. The insights gained from the present study may open a new approach to the use of a combination of biomaterials for bone healing, which should be further investigated clinically and in other animal models as a future scope. Keywords: chitosan, fractures, platelet-rich plasma, platelet-rich fibrin, rabbits, tibia.