Comparision of fracture healing from periosteum and bone marrow derived stem cells experimentally

The incidence of post-traumatic fractures is around 10-15%(1). This rate may increase in elderly patients due to osteoporosis and poor bone quality. There are various methods for stabilization of the fracture. The aim here is to heal the fracture and enable the patient to continue daily life as early as possible. Sometimes there may be problems with the union of the fracture. Especially infection, loss of fracture stability, delayed union or nonunion increase the cost and decrease the quality of life. Many methods have been used for these situations. Autografts, allografts and other external fixators have been used. In bone tissue engineering, which is one of these areas; studies on fracture union continue increasingly. The effects of stem cell studies and scaffolds on fracture healing are evaluated. Tissue scaffolds have been shown to increase osteoblastic and osteoconductive effects in fracture healing. The use of stem cells obtained from adipose tissue has increased in studies. However, other sources such as bone marrow, periosteum, dental pulp, umbilical cord are also used to obtain stem cells. In particular, the transformation of stem cells obtained from bone marrow and periosteum into osteoblastic cells can get higher quality structure. The differentiation capacity of stem cells originating from the bone marrow and periosteum got in a standard and sterile environment is provided with appropriate media. When constructing scaffolds, bioactivity, biocompatibility and biodegradability are the three main characteristics of the biomaterials used. HAp, which we used for tissue scaffolding in our study, has an extremely effective role in the differentiation, proliferation and biocompatibility of osteoblasts. Carboxymethyl chitosan used in tissue scaffolding is a natural polymer that increases the osteoconductive effect. By carboxymethylation of chitosan, its water solubility is increased and thus it can be processed more easily. In this way, mechanical stabilization is increased. Luffa cylindrica (LC) plant, known as loofah or sponge gourd, comes from the Cucurbitaceae family and its fruit has a thick peel. This fruit has seeds inside and has a versatile fiber array with a natural mat. Its main composition can be considered as 60% cellulose, 30% hemicellulose and 10% lignin. At the same time, its porous structure, non-toxicity and low cost are considered as a reliable and usable matrix part. Our study aimed to compare the fracture healing of tissue scaffolds with loofah + CMCht + HAp used together with stem cells obtained from bone marrow and periosteum in rat models. At the same time, the contribution of the empty tissue scaffold to fracture healing was evaluated. In the different groups we created, the quality of the bone formed in the fracture area was evaluated by imaging methods such as radiological graphy and micro-CT. Fracture healing of the groups was evaluated separately by performing histological staining and biomechanical measurement analysis.