Abstract:

The current study was designed to study the effects of the amniotic
membrane accompanied by platelet-rich plasma on fracture healing in
dogs. Thirty dogs were used in this study. A complete transvers fracture
was created in the middle of the tibia's diaphysis of all experimental
animals, then they were divided into three equal groups as follows: the
first group Amniotic Membrane, in which the acellular amniotic
membrane was wrapped around the fracture line, then bone segments
were immobilized by the bone plate and screws. The second group
(Amniotic Membrane + platelet-rich plasma), in which the fracture site
was wrapped with the acellular amniotic membrane and then autologous
platelet-rich plasma was placed on the amniotic membrane as well as
injected into the fracture site and then bone segments were immobilized
by the bone plate and screws. While the third group (control) bone
segments were immobilized with the bone plate and screws and left
without treatment. The experiment was extended to 8 weeks. All animals
were subjected to clinical, radiographic, biomechanical, and
histopathological examinations.

Clinical observations showed that the lameness completely

disappeared in (Amniotic Membrane + platelet-rich plasma) group after
the fourth week and to a lesser extent in (Amniotic Membrane) group,
while still being present in the control group. Radiological results showed
the presence of complete calcification in the fracture line with a periosteal
reaction after the eighth week in the (Amniotic Membrane + platelet-rich
plasma) group, while the fracture line is still clearly defined with no clear
interaction with the surrounding tissues in the (Amniotic Membrane)
group, whereas the fracture line is still present after the eighth week in the
control group.

I
 The results of examining bone hardness by using the Universal
Testing Machine, showed that the (Amniotic Membrane + platelet-rich
plasma) group needed greater fracture strength compared with the
(Amniotic Membrane) group and the control group. Histological
examination revealed that the (Amniotic Membrane + platelet-rich
plasma) group showed superior results compared to the other groups in
the study, while the (Amniotic Membrane) group showed areas of
trabecular bone growth at the site of the operation with the presence of
the remaining sites of mixed fibrous tissue, whereas in the control group
there were still huge fibrous tissues with inflammatory foci and the
absence of cartilage. The registration results showed that 20% of the
healing site contained inflammation in the control group, 10% in the
(Amniotic Membrane) group, and 0% in the (Amniotic Membrane
+Platelate Rich Plasma) group.

Conclusion: The results showed that implementation of an acellular

amniotic membrane accompanied with autologous platelet rich plasma
directly on the fracture site had beneficial effects for bone healing based
on clinical, radiological, biomechanical, and histopathological
assessments.

II