The effect of bone marrow mesenchymal stem cell and nano‑hydroxyapatite/collagen I/poly‑L‑lactic acid scaffold implantation on the treatment of avascular necrosis of the femoral head in rabbits

Wang,Le; Xu,Leixin; Peng,Changliang; Teng,Guoxin; Wang,Yu; Xie,Xiaoshuai; Wu,Dongjin

doi:10.3892/etm.2019.7800

The effect of bone marrow mesenchymal stem cell and nano‑hydroxyapatite/collagen I/poly‑L‑lactic acid scaffold implantation on the treatment of avascular necrosis of the femoral head in rabbits

Authors:
- Le Wang
- Leixin Xu
- Changliang Peng
- Guoxin Teng
- Yu Wang
- Xiaoshuai Xie
- Dongjin Wu
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Affiliations: Department of Spinal Surgery, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China, Department of Orthopedics, The Fourth People's Hospital, Heze, Shandong 274100, P.R. China, Department of Pathology, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China, Department of Radiology, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, Shandong 250012, P.R. China, Department of Kidney Transplantation, Second Hospital of Shandong University, Jinan, Shandong 250033, P.R. China
Published online on: July 23, 2019 https://doi.org/10.3892/etm.2019.7800
Pages: 2021-2028
Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

For avascular necrosis of the femoral head (ANFH), repair and regeneration are difficult because of the edema and high pressure caused by continuous ischemia and hypoxia. Core decompression (CD) is a classic method for treating early ANFH before the collapse of the femoral head; however, its effect is still controversial. To improve the therapeutic effect of CD on ANFH, a novel tissue‑engineered bone (TEB) was constructed by combining bone marrow mesenchymal stem cells (BMSCs) with nano‑hydroxyapatite/collagen I/poly‑L‑lactic acid (nHAC/PLA) scaffolds and implanting the TEB into the bone tunnel of CD. Cell attachment was observed by scanning electron microscopy and hematoxylin and eosin staining. The authors' previous studies confirmed that nHAC/PLA is an excellent scaffold material with favorable biocompatibility and no cytotoxicity. A total of 24 New Zealand rabbits with ANFH were randomly divided into three groups, as follows: Group A (n=8), pure CD; group B (n=8), CD+nHAC/PLA; and group C (n=8), CD+BMSCs‑nHAC/PLA. The favorable effect of BMSCs‑nHAC/PLA on angiogenesis and bone formation in necrotic areas was further evaluated via radiographic and histological analyses. Computerized tomography (CT) scanning and H&E staining showed more capillaries and new osteoid tissue in group C compared with in groups B and A. Micro‑CT showed that the new bone coverage rate and implanted material degradation degree were each increased in group C compared with in group B. These results indicate that BMSCs‑nHAC/PLA scaffolds may improve the curative effect of CD and provide a strategy for treating ANFH.

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1	Moya-Angeler J, Gianakos AL, Villa JC, Ni A and Lane JM: Current concepts on osteonecrosis of the femoral head. World J Orthop. 6:590–601. 2015. View Article : Google Scholar : PubMed/NCBI
2	van der Jagt D, Mokete L, Pietrzak J, Zalavras CG and Lieberman JR: Osteonecrosis of the femoral head: Evaluation and treatment. J Am Acad Orthop Surg. 23:69–70. 2015. View Article : Google Scholar : PubMed/NCBI
3	Mont MA, Jones LC and Hungerford DS: Nontraumatic osteonecrosis of the femoral head: Ten years later. J Bone Joint Surg Am. 88:1117–1132. 2006. View Article : Google Scholar : PubMed/NCBI
4	Ficat RP: Treatment of avascular necrosis of the femoral head. Hip. 279–295. 1983.PubMed/NCBI
5	Zhao DW, Yu M, Hu K, Wang W, Yang L, Wang BJ, Gao XH, Guo YM, Xu YQ and Wei YS: Prevalence of nontraumatic osteonecrosis of the femoral head and its associated risk factors in the Chinese population: Results from a nationally representative survey. Chin Med J (Eng). 128:2843–2850. 2015. View Article : Google Scholar
6	Larson E, Jones LC, Goodman SB, Koo KH and Cui Q: Early-stage osteonecrosis of the femoral head: Where are we and where are we going in year 2018? Int Orthop. 42:1723–1728. 2018. View Article : Google Scholar : PubMed/NCBI
7	Sultan AA, Khlopas A, Surace P, Samuel LT, Faour M, Sodhi N, Krebs VE, Stearns KL, Molloy RM and Mont MA: The use of non-vascularized bone grafts to treat osteonecrosis of the femoral head: Indications, techniques, and outcomes. Int Orthop. 43:1315–1320. 2019. View Article : Google Scholar : PubMed/NCBI
8	Wang Y, Kim UJ, Blasioli DJ, Kim HJ and Kaplan DL: In vitro cartilage tissue engineering with 3D porous aqueous-derived silk scaffolds and mesenchymal stem cells. Biomaterials. 26:7082–7094. 2005. View Article : Google Scholar : PubMed/NCBI
9	Fan L, Zhang C, Yu Z, Shi Z, Dang X and Wang K: Transplantation of hypoxia preconditioned bone marrow mesenchymal stem cells enhances angiogenesis and osteogenesis in rabbit femoral head osteonecrosis. Bone. 81:544–553. 2015. View Article : Google Scholar : PubMed/NCBI
10	Li D, Xie X, Yang Z, Wang C, Wei Z and Kang P: Enhanced bone defect repairing effects in glucocorticoid-induced osteonecrosis of the femoral head using a porous nano-lithium-hydroxyapatite/gelatin microsphere/erythropoietin composite scaffold. Biomater Sci. 6:519–537. 2018. View Article : Google Scholar : PubMed/NCBI
11	Lai Y, Cao H, Wang X, Chen S, Zhang M, Wang N, Yao Z, Dai Y, Xie X, Zhang P, et al: Porous composite scaffold incorporating osteogenic phytomolecule icariin for promoting skeletal regeneration in challenging osteonecrotic bone in rabbits. Biomaterials. 153:1–13. 2018. View Article : Google Scholar : PubMed/NCBI
12	Wu S, Xiao Z, Song J, Li M and Li W: Evaluation of BMP-2 enhances the osteoblast differentiation of human amnion mesenchymal stem cells seeded on nano-hydroxyapatite/Collagen/Poly(l-Lactide). Int J Mol Sci. 19(pii): E21712018. View Article : Google Scholar : PubMed/NCBI
13	Wu DJ, Hao AH, Zhang C, Cui FZ, Wang XW, Gao CZ, Zhou CJ, Liu JL, Qiao Y and Ma SZ: Promoting of angiogenesis and osteogenesis in radial critical bone defect regions of rabbits with nano-hydroxyapatite/collagen/PLA scaffolds plus endothelial progenitor cells. Zhonghua Yi Xue Za Zhi. 92:1630–1634. 2012.(In Chinese). PubMed/NCBI
14	Rajagopal M, Balch Samora J and Ellis TJ: Efficacy of core decompression as treatment for osteonecrosis of the hip: A systematic review. Hip Int. 22:489–493. 2012. View Article : Google Scholar : PubMed/NCBI
15	He Z: The Guide for the Care and Use of Laboratory Animals. China Science Press; Washington: 2016
16	Xie X, Du X, Li K, Chen Y, Guan Y, Zhao X, Niu G, Luan Y, Zhang D, Sun C, et al: Construction of engineered corpus cavernosum with primary mesenchymal stem cells in vitro. Sci Rep. 7:180532017. View Article : Google Scholar : PubMed/NCBI
17	Wang X, Xing H, Zhang G, Wu X, Zou X, Feng L, Wang D, Li M, Zhao J, Du J, et al: Restoration of a critical mandibular bone defect using human alveolar bone-derived stem cells and porous nano-HA/Collagen/PLA scaffold. Stem Cells Int. 2016:87416412016. View Article : Google Scholar : PubMed/NCBI
18	E LL, Xu WH, Feng L, Liu Y, Cai DQ, Wen N and Zheng WJ: Estrogen enhances the bone regeneration potential of periodontal ligament stem cells derived from osteoporotic rats and seeded on nano-hydroxyapatite/collagen/poly(L-lactide). Int J Mol Med. 37:1475–1486. 2016. View Article : Google Scholar : PubMed/NCBI
19	O'Brien FJ: Biomaterials & scaffolds for tissue engineering. Materials Today. 14:88–95. 2011. View Article : Google Scholar
20	Kihara T, Hirose M, Oshima A and Ohgushi H: Exogenous type I collagen facilitates osteogenic differentiation and acts as a substrate for mineralization of rat marrow mesenchymal stem cells in vitro. Biochem Biophys Res Commun. 341:1029–1035. 2006. View Article : Google Scholar : PubMed/NCBI
21	Zhang C, Hu YY, Cui FZ, Zhang SM and Ruan DK: A study on a tissue-engineered bone using rhBMP-2 induced periosteal cells with a porous nano-hydroxyapatite/collagen/poly(L-lactic acid) scaffold. Biomed Mater. 1:56–62. 2006. View Article : Google Scholar : PubMed/NCBI
22	Griffith LG and Naughton G: Tissue engineering-current challenges and expanding opportunities. Science. 295:1009–1014. 2002. View Article : Google Scholar : PubMed/NCBI
23	Zhang HX, Zhang XP, Xiao GY, Hou Y, Cheng L, Si M, Wang SS, Li YH and Nie L: In vitro and in vivo evaluation of calcium phosphate composite scaffolds containing BMP-VEGF loaded PLGA microspheres for the treatment of avascular necrosis of the femoral head. Mater Sci Eng C Mater Biol Appl. 60:298–307. 2016. View Article : Google Scholar : PubMed/NCBI
24	Fu Q, Tang NN, Zhang Q, Liu Y, Peng JC, Fang N, Yu LM, Liu JW and Zhang T: Preclinical study of cell therapy for osteonecrosis of the femoral head with allogenic peripheral blood-derived mesenchymal stem cells. Yonsei Med J. 57:1006–115. 2016. View Article : Google Scholar : PubMed/NCBI
25	Zhang YG, Wang X, Yang Z, Zhang H, Liu M, Qiu Y and Guo X: The therapeutic effect of negative pressure in treating femoral head necrosis in rabbits. PLoS One. 8:e557452013. View Article : Google Scholar : PubMed/NCBI