Influence of unfractionated and low-molecular-weight heparin on bone healing: an animal model

Kock, H. J.; Werther, S.; Uhlenkott, H.; Taeger, G.

doi:10.1097/00005131-200301000-00018

Cited by 9 publications

(12 citation statements)

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“…27,28 In a rabbit femoral condyle defect model, a 6-week course of twice daily subcutaneous injection was associated with a reduction of new bone formation. 29 However, another similar study in a rabbit femoral condyle model showed no significant difference in bone regeneration using daily heparin injection (also for 6 weeks). 30 In our study, however, exposure to heparin occurs only at the time of bone marrow harvest and implantation, and the amount of heparin remaining in the scaffold at the time of implantation is low and should rapidly diffuse out of the implant site.…”

Section: Transplantation Of Marrow-derived Cells For Bone Regenerationmentioning

confidence: 94%

In VivoTransplantation of Autogenous Marrow-Derived Cells Following Rapid Intraoperative Magnetic Separation Based on Hyaluronan to Augment Bone Regeneration

Caralla

Joshi

Fleury

et al. 2013

Tissue Engineering Part A

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Section: Transplantation Of Marrow-derived Cells For Bone Regenerationmentioning

confidence: 94%

In VivoTransplantation of Autogenous Marrow-Derived Cells Following Rapid Intraoperative Magnetic Separation Based on Hyaluronan to Augment Bone Regeneration

Caralla

Joshi

Fleury

et al. 2013

Tissue Engineering Part A

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“…But according to some publications LMWH have negative effects on fracture healing as heparin (8,26,27). There some papers regarding the LMWH have no negative effects on fracture healing (9,27).…”

Section: Discussionmentioning

confidence: 99%

Fondapari̇nuksun Kirik İyi̇leşmesi̇ne Gerçekten Pozi̇ti̇f Etki̇si̇ Var Midir? Siçanlar Üzeri̇nde Yapilan Deneysel Bi̇r Çalişma

Mercan¹,

Aydın²,

Konya³

et al. 2017

Kocatepe Tıp Dergisi

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Antiembolik ajanlar ortopedi ve travmatoloji kliniklerinde özellikle artroplasti, tümör ve travma cerrahilerinde embolizm problemlerini azaltmak için rutin olarak kullanılmaktadır. Fondaparinuks'un kırık iyileşmesi üzerine etkisi belirsizdir. Bu çalışmanın amacı sıçan modeli kullanarak fondaparinuksun kırık iyileşmesi üzerine etkisinin incelenmesi ve enoksaparinin etkisi ile karşılaştırılmasıdır.GEREÇ VE YÖNTEM: 64 adet Wistar-Albino sekiz gruba randomize olarak ayrıldı. Genel anestezi altında sol femur kapalı standart kırıkları oluşturuldu. Kontrol grupları (A, B), heparin grupları (C, D), enoksaparin grupları (E, F), ve fondaparinuks grupları (G, H), sırasıyla izotonik NaCl (1cc/gün), heparin (1000 anti Xa IU/kg/gün), enoksaparin (100 anti Xa IU/kg/gün) ve fondaparinuks (0.2mg/kg/ gün) olacak şekilde 14 gün süre ile uygulandı. A, C, E, G gruplarındaki sıçanlar postoperatif 14. günün, B, D, F, H gruplarındakiler ise 28. günün sonunda sakrifiye edildiler. Tüm femurların radyolojik incelemesi standart ön-arka ve yan grafiler kullanılarak Goldberg sınıflamasına göre yapıldı. Histolojik inceleme ise Huo histolojik iyileşme sınıflamasına göre yapıldı. Bu çalışmanın istatiksel analizleri GraphPad Prisma V.3 paket programı kullanılarak yapıldı. Sonuçlarda anlamlılık p<0.05 düzeyi olarak belirlendi. BULGULAR: Radyolojik incelemede, ikinci ve dördüncü hafta sonundaki sonuçlar incelendiğinde, gruplar arasında istatiksel olarak anlamlı fark saptanmadı. Histolojik incelemede ise heparin almış olan H grubundaki iyileşme sonuçları diğer gruplarla karşılaştırıldığında istatiksel olarak anlamlı şekilde kötü olarak saptandı. Diğer gruplar arasında histolojik açıdan, heparin grubu hariç, istatiksel olarak anlamlı bir fark saptanmadı. Ayrıca histolojik ve radyolojik olarak fondaparinuks ve enoksaparin grupları arasında kırık iyileşmesi üzerine etkileri arasında istatiksel olarak anlamlı fark saptanmadı (p>0.05). SONUÇ:Çalışmamızda fondaparinuksun enoksaparin ile karşılaştırıldığında kırık iyileşmesi üzerine herhangi ekstra olumlu etkisini saptamadık. Fondaparinuks uygulamasının kırık iyileşmesi üzerine negatif bir etkisi saptanmamış olması nedeniyle travma vakalarında embolizm problemlerini önlemede kullanılabileceği kanaatindeyiz.

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“…Animal studies have clearly demonstrated that hypocoagulation with warfarin, heparin and acetylsalicyclic acid impairs fracture healing [5][6][7]. However, the findings of in vivo animal studies of the effect of LMWHs on fracture healing remain contentious and no conclusive findings can be drawn from these studies [6,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…However, the findings of in vivo animal studies of the effect of LMWHs on fracture healing remain contentious and no conclusive findings can be drawn from these studies [6,8,9]. Nevertheless, in vitro studies on bone cells [10][11][12] and in vitro studies on bone metabolism [6,[13][14][15][16][17] demonstrate that LMWHs decrease bone formation and, therefore, could potentially delay fracture healing. Evidence exists that LMWHs reduce cancellous bone volume [15,17,19] in a dose-dependent manner [15] and reduce the biomechanical strength of bone [14,15].…”

Section: Discussionmentioning

confidence: 99%

The influence of low molecular weight heparin on the expression of osteogenic growth factors in human fracture healing

Sarahrudi

Kaiser

Thomas

et al. 2011

International Orthopaedics (SICOT)

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Purpose Anticoagulant therapy with low molecular weight heparins (LMWH) and mechanical compression is considered the gold standard for the prevention of thrombosis. However, evidence exists that LMWHs impair bone metabolism. The aim of this study was therefore to analyse alterations in the expression of M-CSF, VEGF and TGF-ß1 after treatment with enoxaparin in patients with long bone fracture to investigate the effect of LMWH on human fracture healing. Methods A total of 81 patients with long bone fractures were included in the study and divided into two groups. One group comprised patients who received enoxaparin and the other group, patients who did not receive enoxaparin postoperatively. Growth factor levels were analysed in patients' serum and different groups were retrospectively compared. Results M-CSF serum concentrations were found to be significantly higher only at 48 weeks after surgery in enoxaparin. Mean overall VEGF serum concentration was higher in patients with enoxaparin. TGF-β1 serum concentrations were higher at 48 weeks after surgery in patients with enoxaparin. Conclusion This is the first comparative systemic measurement of M-CSF, VEGF and TGF-ß1 serum levels in patients with and without enoxaparin after long bone fracture. Significant differences of the expression of the growth factors after enoxaparin therapy were only observed at week 48 after surgery for M-CSF and TGF-ß1.

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Influence of unfractionated and low-molecular-weight heparin on bone healing: an animal model

Cited by 9 publications

References 0 publications

In VivoTransplantation of Autogenous Marrow-Derived Cells Following Rapid Intraoperative Magnetic Separation Based on Hyaluronan to Augment Bone Regeneration

In VivoTransplantation of Autogenous Marrow-Derived Cells Following Rapid Intraoperative Magnetic Separation Based on Hyaluronan to Augment Bone Regeneration

Fondapari̇nuksun Kirik İyi̇leşmesi̇ne Gerçekten Pozi̇ti̇f Etki̇si̇ Var Midir? Siçanlar Üzeri̇nde Yapilan Deneysel Bi̇r Çalişma

The influence of low molecular weight heparin on the expression of osteogenic growth factors in human fracture healing

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