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Efficacy of platelets in bone healing: A systematic review on animal studies

机译：血小板在骨愈合中的疗效：动物研究的系统综述

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In presence of large bone defects, delayed bone union, non-union, fractures, and implant surgery, bone reconstruction may be necessary. Different strategies have been employed to enhance bone healing among which the use of autologous platelet concentrates. Due to the high content of platelets and platelet-derived bioactive molecules (e.g., growth factors, antimicrobial peptides), they are promising candidates to increase bone healing. However, a high heterogeneity of both preclinical and clinical studies resulted in contrasting results. Aim of the present systematic review was to evaluate the efficacy of platelet concentrates in animal models of bone regeneration, considering the possible factors which might affect the outcome. An electronic search was performed on MEDLINE and SCOPUS databases. Animal studies with a minimum follow up of 2 weeks and a sample size of five subjects per group, using platelet concentrates for bone regeneration, were included. Articles underwent risk of bias assessment and further quality evaluation was done. Sixty studies performed on six animal species (rat, rabbit, dog, sheep, goat, and mini-pig) were included. The present part of the review considers only studies performed on rats and rabbits (35 articles). The majority of the studies were considered at medium risk of bias. Animal species, healthy models, platelet, growth factors and leukocytes concentration, and type of bone defect seemed to influence the efficacy of platelet concentrates in bone healing. However, final conclusions were not be drawn, since only few included studies evaluated leukocyte, growth factor content, or presence of other bioactive molecules in platelet concentrates. Further studies with a standardized protocol including characterization of the final products will provide useful information for clinical application of platelet concentrates in bone surgery.
机译：在存在大面积骨缺损、骨延迟愈合、骨不愈合、骨折和植入手术的情况下，可能需要进行骨重建。不同的策略被用来促进骨愈合，其中包括使用自体血小板浓缩物。由于血小板和血小板衍生的生物活性分子（如生长因子、抗菌肽）含量高，它们有望促进骨愈合。然而，临床前和临床研究的高度异质性导致了对比结果。本系统综述的目的是评估血小板浓缩物在骨再生动物模型中的疗效，并考虑可能影响结果的因素。在MEDLINE和SCOPUS数据库上进行了电子搜索。包括至少随访2周、每组样本量为5名受试者、使用血小板浓缩物进行骨再生的动物研究。文章进行了偏倚风险评估，并进行了进一步的质量评估。包括对六种动物（大鼠、兔子、狗、绵羊、山羊和小型猪）进行的60项研究。本综述的当前部分仅考虑在大鼠和兔子身上进行的研究（35篇文章）。大多数研究被认为存在中度偏倚风险。动物种类、健康模型、血小板、生长因子和白细胞浓度以及骨缺损类型似乎会影响血小板浓缩物在骨愈合中的效果。然而，由于只有少数研究评估了白细胞、生长因子含量或血小板浓缩物中是否存在其他生物活性分子，因此没有得出最终结论。进一步的标准化方案研究，包括最终产品的表征，将为血小板浓缩物在骨外科的临床应用提供有用的信息。

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