Effect of Human Amniotic Fluid and Membrane on Fracture Healing on Rat Fracture Model

Abstract

Purpose: Human amniotic fluid contains several growth factors and hyaluronic acid. It has positive effect in healing the tendon, nerve and bone injuries. Human amniotic membrane has positive effects on tendon, nerve healing and is also used for skin healing in burns and complex wounds. We hypothesized that human amniotic fluid and human amniotic membrane have positive stimulating effects on fracture healing.\xa0\xa0The aim of this study is to investigate the effects of human amniotic fluid and human amniotic membrane on bone healing in rat tibial bone fracture model.\xa0 Materials and Methods: A 72 open fracture model was created for both tibial bones of 36 male Wistar rats. They were divided into three groups. Group-1 was the control group. In Group-2, human amniotic fluid which was taken from amniocentesis of seronegative pregnants in their second trimester was injected to the fracture site. In group-3, human amniotic membrane which was taken from normal seronegative term pregnants after their caesarean sections was wrapped around fracture site and then human amniotic fluid was injected to the fracture site. Radiological fracture union patterns and histopathological evaluations with Modified Lane-Sandhu classification were performed with Modified Lane-Sandhu classification at the end of third and sixth weeks. Results: At third week, Group-2 and Group-3 had better histopathological results than Group-1. At sixth week, Group-2 had significantly better results than Group-1. Group-3 had also better results than Group-1 although there was no statistical significance. At third and sixth weeks, histopathological scores of Group-2 were significantly better than Group-3(p=0.021, p=0.019).\xa0\xa0 Conclusion: Our data suggested that human amniotic fluid had positive effect while human amniotic membrane had no positive effect on bone healing. With its low immunity and easy delivery, human amniotic membrane can also be used to stimulate bone healing in combination with human amniotic fluid with different application techniques.