The Combined Use of Platelet-Rich Plasma Clot Releasate and Allogeneic Human Umbilical Cord Mesenchymal Stem Cells Rescue Glucocorticoid-Induced Osteonecrosis of the Femoral Head

Figure 6

Effects of PRCR, UC-MSCs, and PRCR + UC-MSCs on bone tissue protection and necrosis restoration in the ONFH rat model. (a) Visualized intra-articular injection using ultrasonic guidance, the white arrows indicated the needle pathway. (b, c) Representative micro-CT images of femoral heads (coronal, transverse, and sagittal images) from different treatment groups followed by quantitative analysis. The PRCR, UC-MSC, and PRCR + UC-MSC treatments improved the microstructural parameters changes and bone loss compared to the MPS group (). (d) Hematoxylin and Eosin (HE) staining of femoral heads from different groups. (e) Immunohistochemical staining of RUNX2, ALP, and VEGF of different groups followed by quantitative analysis. The treatment groups significantly promoted the expression of RUNX2, ALP, and VEGF compared to the MPS group (). (f) Representative tartrate-resistant acid phosphatase (TRAP) staining images showing the distributions of osteoclasts in the femoral heads from different groups, followed by quantitative analysis. The black arrows indicate the osteoclasts. The number of TRAP-positive cells in the treatment groups was significantly lower compared to the MPS group (). (g) Representative TUNEL staining images of femoral heads from different groups, followed by quantitative analysis. The apoptotic cell numbers in the treatment groups were significantly decreased compared to the MPS group () ( for each group. ^#Comparisons between the DEX group and other groups, ; Comparisons between the two groups, ). Tb.Th: trabecular thickness; Tb.Sp: trabecular separation; BV/TV: bone volume per tissue volume; Tb.N: trabecular number; PRCR: platelet-rich plasma clot releasate; UC-MSCs: umbilical cord mesenchymal stem cells; DEX: dexamethasone; TUNEL: terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate (dUTP) nick-end labeling; VEGF: vascular endothelial growth factor; ALP: alkaline phosphatase; MPS: methylprednisolone.

(a)

(b)

(c)

(d)

(e)

(f)

(g)