Research Article

Investigation into the effect of epidermal growth factor and hyaluronic acid on fracture healing in a rat femoral fracture model

Volume 57 · Issue 5 · January 2023 Publish Date: October 27, 2023
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Barış Can Kuzuca
Department Orthopaedics and Traumatology, Çerkezköy State Hospital, Tekirdağ, Turkey
Mahmut Nedim Doral
Department Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey
Laura Mangiavini
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Ersin Sapmaz
Department Thoracic Surgery, Medical Sciences University, Gülhane Training and Research Hospital, Ankara, Turkey
Nicola Maffulli
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi, Italy
Murat Koken
Department Orthopaedics and Traumatology, Medical Park Hospital, Antalya, Turkey
Kuzuca, B. C., Nedim Doral, M., Mangiavini, L., Sapmaz, E., Maffulli, N., & Koken, M. (2023). Investigation into the effect of epidermal growth factor and hyaluronic acid on fracture healing in a rat femoral fracture model. Acta Orthopaedica Et Traumatologica Turcica, 57(5), 229–236. https://doi.org/10.5152/j.aott.2023.22163
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Abstract

Objective: This study aimed to investigate the role of an exogenous Epidermal Growth Factor and a hyaluronic acid-based scaffold on fracture healing in a rat femoral fracture model

Methods: Forty-eight male Wistar-Albino rats, each weighing a mean 392 grams (range= 350-450 grams) and aged 8.2 months (6-9 months), were used for this experimental study. All surgical procedures were performed on the left femur by a single surgeon. An open femoral fracture was created in all rats. The animals were randomly divided into one of the four groups: Control (12), EGF (12), HA (12) and Combined (12). In the 4th and sixth weeks, samples were processed and analyzed using biomechanical and histological methods.

Results: Fracture healing was significantly improved in the Combined group compared to the control one, EGF and HA groups in all parameters at both experimental time points. At the fourth and sixth weeks after surgery, fracture healing in the EGF and HA groups was significantly increased at histological evaluation compared to controls. In addition, compared with EGF, HA and Control groups, a significant difference in callus tissue was detected in the Combined group at 4 and 6-week time points in biomechanical features.

Conclusion: This study has shown that combining local EGF and HA scaffold accelerates bone healing and strengthens the bony callus histologically and biomechanically. Using EGF-HA combined scaffolds may represent a possible future strategy in trauma surgery.

Level of Evidence: N/A.

Cite this article as: Kuzuca BC, Doral MN, Mangiavini L, Sapmaz E, Maffulli N, Koken M. Investigation into the effect of epidermal growth factor and hyaluronic acid on fracture healing in a rat femoral fracture model. Acta Orthop Traumatol Turc., 2023;57(5):229-236.

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Article Info
Published In
Journal Acta Orthopaedica et Traumatologica Turcica
Volume / Issue Volume 57 · Issue 5 · January 2023
Pages 229-236
History
Published Online October 27, 2023
Copyright
Affiliations
1
Barış Can Kuzuca
Department Orthopaedics and Traumatology, Çerkezköy State Hospital, Tekirdağ, Turkey
2
Mahmut Nedim Doral
Department Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey
3
Laura Mangiavini
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
4
Ersin Sapmaz
Department Thoracic Surgery, Medical Sciences University, Gülhane Training and Research Hospital, Ankara, Turkey
5
Nicola Maffulli
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi, Italy
6
Murat Koken
Department Orthopaedics and Traumatology, Medical Park Hospital, Antalya, Turkey
Cite this Article
Kuzuca, B. C., Nedim Doral, M., Mangiavini, L., Sapmaz, E., Maffulli, N., & Koken, M. (2023). Investigation into the effect of epidermal growth factor and hyaluronic acid on fracture healing in a rat femoral fracture model. Acta Orthopaedica Et Traumatologica Turcica, 57(5), 229–236. https://doi.org/10.5152/j.aott.2023.22163
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