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Joint Diseases and
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Original Article · Open access

Fracture healing potential of tetracalcium phosphate: An experimental study in a rat femur standardized diaphyseal osteotomy with open approach

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Bilal Karabak

Department of Orthopedics and Traumatology, Erzurum City Hospital, Erzurum, Türkiye

ORCID: 0000-0003-3134-8731

Yusuf Sait Durak

Department of Orthopedics and Traumatology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye

ORCID: 0000-0002-5438-5394

Orhan Karsan

Department of Orthopedics and Traumatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye

ORCID: 0000-0002-5395-1497

Kutsi Tuncer

Department of Orthopedics and Traumatology, Altınbaş University, Medical Park Bahçelievler Hospital, İstanbul, Türkiye

ORCID: 0000-0002-7544-2554

Cemil Bayram

Department of Pharmacology and Toxicology, Atatürk University Faculty of Veterinary Medicine, Erzurum, Türkiye

ORCID: 0000-0001-8940-8560

Selma Sezen

Department of Pharmacology, Ağrı İbrahim Çeçen University Faculty of Medicine, Ağrı, Türkiye

ORCID: 0000-0001-6575-6149

Ufuk Okkay

Department of Pharmacology, Atatürk University Faculty of Medicine, Erzurum, Türkiye

ORCID: 0000-0002-2871-0712

Abstract

Objectives: This study aims to evaluate the impact of tetracalcium phosphate (TTCP) applied directly to the fracture line in a rat femur fracture model.

Materials and methods: Thirty-three male Sprague-Dawley rats weighing 350 to 400 g were randomly and equally divided into three groups: normal control (NC), fracture control (PC), and TTCP treatment group. Standardized femur fractures were created in the PC and TTCP groups and fixed using intramedullary Kirschner wires. In the TTCP group, TTCP dissolved in distilled water was applied directly to the fracture line. All rats were sacrificed on postoperative Day 28. Radiological, histopathological, and biochemical analyses were performed to assess fracture healing.

Results: Radiological scoring revealed significantly higher fracture healing in the TTCP group compared to the PC group on Days 14 and 28 (p<0.05). Histopathological analyses showed reduced inflammation and fibrosis, and increased chondrocyte activity and neovascularization in the TTCP group. On Day 28, serum tumor necrosis factor-alpha (TNF-α) levels were significantly higher in the PC group compared to TTCP and NC, while TTCP values were comparable to NC. No adverse tissue reactions were observed in any group.

Conclusion: The TTCP enhances fracture healing when applied directly to the fracture line, without causing soft tissue irritation or histologically detectable adverse reactions. Its biological activity and ease of application suggest that TTCP may be a promising adjunct in the treatment of complex fractures.

Declarations

Author Contributions

Idea/concept, B.K., K.T.; Design, writing the article, references and fundings: B.K.; Control/supervision, critical review: B.K., O.K.; Data collection and/or processing: B.K., S.S.; Analysis and/or interpretation: B.K., C.B.; Literature review: B.K., Y.S.D.; Materials: B.K., U.O.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Acknowledgments

The authors would like to thank Atatürk University Scientific Research Projects Unit for their valuable support (Project code: TTU-2022-10243). The knowledge and technical support provided during this research were greatly appreciated.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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