Bone regeneration in a rabbit critical-sized skull defect using autologous adipose-derived cells

Repair of substantial cranial defects in adults and children may be compromised due to limitations in donor bone stocks for autologous grafts. We evaluated the capability of autologous adipose-derived mesenchymal cells (ADCs) in combination with polylactic acid (PLA) scaffolds to regenerate bone in a critical-sized skull defect. Thirty adult New Zealand White rabbits were divided into six groups of five animals each: (1) PLA alone (control), (2) fibronectin-coated PLA, (3) PLA with ADCs, (4) fibronectin-coated PLA with ADCs, (5) PLA with osteogenically induced ADCs (osADCs), and (6) fibronectin-coated PLA with osADCs. All the animals were humanely killed after 6 weeks. X-ray, histology, and histomorphometric analysis were performed to evaluate the new bone formation inside the PLA scaffold. Radiographically and histomorphometrically, the groups in which the PLA was not fibronectin coated showed no bone formation in contrast to the fibronectin-coated groups (Gp1 vs. Gp2, p < 0.0005); the group treated with osteo-induced ADCs and fibronectin (Gp6) showed significantly more bone formation than the group treated with undifferentiated ADCs (Gp4) and the group treated without cells (Gp5, p < 0.0005, in both cases). These data indicate that the surface treatment with fibronectin promotes bone formation within the scaffold, and that autologous, osteo-induced adipose-derived cells enhance bone formation if seeded into a fibronectin-treated PLA scaffold.