Effect Of Medullary Core Decompression And Platelet-rich Plasma On Steroid-induced Osteonecrosis Of The Femoral Head In Rabbits

Objective: In this study,we established a model of steroid-induced femoral head necrosis in rabbits and treated the model with core decompression combined with Platelet-rich plasma(PRP).We observed the imaging and pathological changes,cell apoptosis,oxidative stress reaction of related enzymes in serum,and expression of related proteins in femoral head tissue of steroid-induced femoral head necrosis in rabbits.To observe the effect of femoral head core decompression combined with PRP on steroid-induced femoral head necrosis in rabbits,and to explore the application value of PRP in the treatment of femoral head necrosis.Methods: 40 New Zealand rabbits were randomly divided into normal group,model group,control group and PRP group with 10 rabbits in each group.Animal models of steroid-induced femoral head necrosis in rabbits were established in sterile environment in model group,control group and PRP group.After 4 weeks of modeling,imaging identification was carried out and 0.4ml3% of 3% PRP was injected into PRP group after core decompression.The control group only received core decompression treatment,while the blank control group and model group were normally fed.After 14 weeks,the imaging manifestations of femoral head of rabbits in each group were observed,and the experimental animals were executed.HE staining was used to observe the histopathological manifestations and lacuna vacancy rate of bone in medullary cavity of femoral head of animals in each group,and the activity of oxidative stress mold index in serum of rabbits in each group was detected.TUNEL was used to detect the apoptosis of femoral head tissue cells,immunofluorescence was used to detect the distribution of Keap1 and HO-1 in femoral head tissue,and Western Blot was used to detect the expression of Keap1,Nrf2 and HO-1 proteins in femoral head tissue.Approval was obtained from the Animal Ethics Committee of the Affiliated Hospital of Qinghai University,approval No.qhdx-201908347.Results: Compared with the normal group,MRI showed that the bone trabecula in the model group became thinner and the structure was disordered after 14 weeks of experiment.Compared with the model group,the control group was improved,the trabecular bone structure was recovered to a certain extent,and the empty bone lacunae were reduced(P < 0.05).compared with the control group,the PRP group was further improved,the trabecular bone structure was more perfect,and the empty bone lacunae were further reduced(P < 0.05),with no significant difference(P >0.05).The serum-related enzymes in the model group were significantly lower than those in the normal group(P<0.05),while those in the control group were slightly higher than those in the model group,but the difference was not statistically significant(P>0.05).the serum-related enzymes in PRP group were significantly higher than those in the model group and normal group(P<0.05).The expression of Keap1 protein in the femoral head tissue of the model group was significantly lower than that of the normal group(P<0.05),and the expression of Nrf2 and HO-1 protein was significantly higher than that of the normal group(P<0.05).the expression of Keap1,Nrf2 and HO-1 protein in the femoral head tissue of the control group was not significantly different from that of the model group(P>0.05).the expression of Keap1 protein in the femoral head tissue of the PRP group was lower than that of the model group and the control group(P<0.05),and the expression of Nrf2 and HO-1 was significantly higher than that of the model group and the control group(P<0.05).The results suggest that core decompression combined with platelet-rich plasma can significantly improve the cell regeneration and bone trabecula after steroid-induced femoral head necrosis in rabbits,effectively inhibit oxidative stress kinase reaction in the process of steroid-induced femoral head necrosis in rabbits,significantly affect the changes of related proteins in bone tissues,and have reference application value for the treatment of human femoral head necrosis.