Determination of the role of platelet rich fibrin in the process of regenerating the defect of the vertebral body (experimental study)

Kostiantin Popsuishapka, Nataliya Ashukina, Volodymyr Radchenko


In the process of developing methods for treating fractures of vertebral bodies, in particular in case of traumatic injury, it is necessary to understand the biology of the processes of formation and reorganization of the regenerate for the possibility of optimizing reparative osteogenesis.

Objective: to assess the effect of platelet rich fibrin on the healing of a defect in the vertebral body in experimental rabbits.

Methods: simulations were performed in 18 male rabbits aged 4–5 months with an average body weight (4 ± 0.5) kg. A hole defect (diameter and depth of3 mm) in the caudal apophysis of vertebral bodies L3, L4 was created. Defects in 9 rabbits of the experimental group were filled with platelet-rich fibrin, in control (9 animals) defect left unfilled and closed in both cases with a haemostatic «Fibrilar» film. Platelet rich fibrin was prepared by the method of D. M. Dohan Ehrenfest immediately before the operation. After 14 days, 1 and 3 months a histological study was carried out with morphometry of areas of regenerate tissues in the area of traumatic injury.

Results: after 14 days in the zone of defect in the vertebral bodies of the rabbits of the control group, granulation and connective tissues predominated. The relative area of the newly formed bone tissue in the defects of the rabbits of the test group was 2.16 times greater (p < 0.01) than in the control group. After 1 month it filled the entire territory of the defect and exceeded the control indicators by 1.2 times (p < 0.05), and in the defects of the vertebral bodies of the rabbits of the control group, the areas of the connective tissue were preserved. After 3 months in rabbits of both groups, the defect zone was filled with lamellar bone tissue.

Conclusions: the introduction of platelet rich fibrin into the perforated defect of the vertebral body of the rabbits promotes acceleration of bone formation 14 days and 1 month after injury.


traumatic fractures of vertebral bodies; platelet rich fibrin; bone regeneration; experiment


Aebi M, Arlet V, Webb J. AO spine manual principles and techniques. Vol. 1.Thieme, 2007. 663 р.

Aebi M, Arlet V, Webb J. AO spine manual principles and techniques. Vol. 2.Thieme, 2007. 837 р.

Popsuishapka K. Metaanalysis of treatment results in lower thoracic and lumbar spine burst fractures.Orthopaedics, Traumatology and Prosthetics. 2016:4(605); 134-42. doi: 10.15674/0030-598720164134-142 2016. (in Ukrainian)

GhiasiMS, Chen J, Vaziri A, Rodriguez EK,NazarianA. Bone fracture healing in mechanobiological modeling: A review of principles and methods.Bone Rep. 2017;6:87–100. doi: 10.1016/j.bonr.2017.03.002.

Sfeir C, Ho L, Doll BA, Azari K, Hollinger JO. Fracture repair. In: Bone regeneration and repair. Biology and clinical applications. Eds. LiebermanJR, FriedlaenderGE. Humana Press, 2005.pp. 21–44.

Popsuishapka O, Litvishko V, Ashukina N, Danishchuk Z. Peculiarities in the formation, structural-mechanical properties of a fibrin-blood clot and its importance for bone regeneration in fractures. Orthopaedics, Traumatology and Prosthetics. 2013;4:5–12.doi: 10.15674/0030-5987201345-12. (in Russian)

Popsuishapka O, Litvishko V, Ashukina N. Clinical and morphological stages of bone fragments fusion. Orthopaedics, Traumatology and Prosthetics. 2015;1:12–20. doi: 10.15674/0030-59872015112-20.(in Ukrainian)

Echeverri LF, Herrero MA, Lopez JM, Oleaga G. Early stages of bone fracture healing: formation of a fibrin-collagen scaffold in the fracture hematoma. Bull Math Biol. 2015;77(1):156–83. doi: 10.1007/s11538-014-0055-3.

Tomlinson RE, Silva MJ. Skeletal blood flow in bone repair and maintenance. Bone Research. 2013;4:311-22. doi: 10.4248/BR201304002.

Kobayashi M, Kawase T, Horimizu M, Okuda K, Wolff LF, Yoshie H. A proposed protocol for the standardized preparation of PRF membranes for clinical use. Biologicals. 2012;40: 323-29. doi: 10.1016/j.biologicals.2012.07.004.

Dong LQ, Yin H, Wang CX, Hu WF. Effect of the timing of surgery on the fracture healing process and the expression levels of vascular endothelial growth factor and bone morphogenetic protein-2. ExpTher Med. 2014;8(2):595-9. doi: 10.3892/etm.2014.1735.

Grigoryev V, Popsuishapka O, Ashukina N, Galkin F. Localization of vascular endothelial growth factor and transforming growth factor-β in tissues in perifractural zone after fractures of long bones of limbs in humans. Orthopaedics, Traumatology and Prosthetics. 2017;2:62-9. doi: 10.15674/0030-59872017262-69.(in Ukrainian)

Sarahrudi K, Thomas A, Mousavi M, Kaiser G, Köttstorfer J, Kecht M, Hajdu S, Aharinejad S. Elevated transforming growth factor-beta 1 (TGF-β1) levels in human fracture healing. Injury. 2011;42(8);833-7. doi: 10.1016/j.injury.2011.03.055.

Roukis TS, Zgonis T, Tiernan B. Autologous platelet-rich plasma for wound and osseous healing: a review of the literature and commercially available products. Adv Ther. 2006;23(2):218-37.

Tarantino R, Donnarumma P, Mancarella C, Rullo M, Ferrazza G, Barrella G, Martini S, Delfini R. Posterolateral arthrodesis in lumbar spine surgery using autologous platelet-rich plasma and cancellous bone substitute: an osteoinductive and osteoconductive effect. Global Spine J. 2014;4(3):137-42. doi: 10.1055/s-0034-1376157.

Bastami F, Khojasteh A. Use of leukocyte-and platelet-rich fibrin for bone regeneration: a systematic review. Regeneration, Reconstruction & Restoration. 2016;1(2):47–68. doi: 10.7508/rrr.2016.02.001.

Landi A, Tarantino R, Marotta N, Ruggeri AG, Domenicucci M, Giudice L, Martini S, Rastelli M, Ferrazza G, De Luca N, Tomei G, Delfini R. The use of platelet gel in postero-lateral fusion: preliminary results in a series of 14 cases. Eur Spine J. 2011;20 Suppl 1:S61-7. doi: 10.1007/s00586-011-1760-3.

European Convention for the protection of vertebrate animals used for experimental and other scientific purposes. Strasbourg, March 18, 1986..

On the Protection of Animals from Cruel Treatment: Law of Ukraine No. 3447-IV dated February 21, 2006. Available from:

Dohan Ehrenfest DM, Andia I, Zumstein MA, Zhang CQ, Pinto NR, Bielecki T. Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J. 2014;4(1):3–9. doi: 10.11138/mltj/2014.4.1.0013.

Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G. Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors. 2009;27:63-9. doi: 10.1080/08977190802636713.

Sarkisov DS, Perov JL. Microscopic techniques. Moskow: Medicine, 1996. 542 p. (in Russian).

Avtandilov GG. Medical morphometry. Moscow: Medicine, 1990. 384 p.(in Russian)

Lavrishcheva GI, Onoprienko GA. Morphological and clinical aspects of reparative regeneration of supporting organs. Moscow: Medicine, 1996. 208 p.(in Russian)

Masuki H, Okudera T, Watanebe T, Suzuki M, Nishiyama K, Okudera H, Nakata K, Uematsu K, Su CY, KawaseT. Growth factor and pro-inflammatory cytokine contents in platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), advanced platelet-rich fibrin (A-PRF), and concentrated growth factors (CGF). Int J Implant Dent. 2016 Dec;2(1):19. doi10.1186/s40729-016-0052-4.

Dulgeroglu TC, Metineren H. Evaluation of the effect of platelet-rich fibrin on long bone healing: an experimental rat model. Orthopedics. 2017;40(3):e479-84. doi: 10.3928/01477447-20170308-02.

Radchenko V, Palkin A, Kolesnichenko V. Radiological assessment of experimental mono-segmental posterior-lateral lumbar fusion using autologous platelet rich fibrin. Ortopaedics, Traumatology and Prosthetics. 2017;(2):45–51. doi: (in Russian)

Singh A, Kohli M, Gupta N. Platelet rich fibrin: a novel approach for bone regeneration. J Maxillofac Oral Surg. 2012;11(4):430-4. doi: 10.1007/s12663-012-0351-0.



  • There are currently no refbacks.

Copyright (c) 2017 Kostiantin Popsuishapka, Nataliya Ashukina, Volodymyr Radchenko

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.