498 https://www.id-press.eu/mjms/index
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2020 Jun 20; 8(A):498-501.
https://doi.org/10.3889/oamjms.2020.3925
eISSN: 1857-9655
Category: A - Basic Sciences
Section: Immunology
The Role of Collagen Scaffold and Stromal Vascular Fraction on
Healing Process in Growth Plate Injury (SOX9 and Histological
Examination)
Panji Sananta
1,2
*, Mohamad Ibnu Imadudin
2
, I. Gede Made Oka Rahaditya
2
, Marvin Anthony Putera
2
, Sri Andarini
3
,
Umi Kalsum
4
, Respati Suryanto Dradjat
2
1
Doctoral Program of Medical Sciences, Faculty of Medicine, Universitas Brawijaya, Jalan Jaksa Agung Suprapto No. 2, Klojen,
Kota Malang, Jawa Timur 65112, Indonesia;
2
Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas
Brawijaya, Jalan Jaksa Agung Suprapto No. 2, Klojen, Kota Malang, Jawa Timur 65112, Indonesia;
3
Department of Public
Health, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran No. 2, Klojen, Kota Malang, Jawa Timur 65145, Indonesia;
4
Department of Pharmacology, Faculty of Medicine, Universitas Brawijaya, Jalan Veteran No. 2, Klojen, Kota Malang, Jawa
Timur 65145, Indonesia
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Abstract
BACKGROUND: Pediatric skeletal trauma presents a distinct approach to its treatment because of its unique auses
and possibility of its troublesome complications. One of its major complications is growth plate injury which may
disturb the longitudinal growth of child’s bone.
AIM: In this study, the author combined stromal vascular fraction (SVF) and collagen scaffold as biomaterial for future
treatment of physeal injury in skeletally immature patients using SOX9 and histological examination as a marker.
METHODS: The study was conducted experimentally on Rattus norvegicus growth plate based on Erickson study,
and the SVF was from R. norvegicus fat tissue with ZUK method. Histological examination was evaluated with 8
times magnifcation and SOX9 from the growth plate was measured with enzyme-linked immunosorbent assay.
RESULTS: Histological examination showed that the best result was obtained in SVF + collagen group judging by
the bony bridge diameter. The result was differed signifcantly from the positive control group with p < 0.05 in Tukey
test. The result from SOX9 level measurement shows that all of the treatment groups SOX9 level almost the same
as normal value (negative control group) and it is signifcantly differ from the positive control group with p < 0.05 in
Mann–Whitney U-test.
CONCLUSIONS: This study showed that the combination of collagen and SVF had a great effect on healing process
in growth plate injury.
Introduction
Injuries incurred by skeletally immature
patients are unique both in their causes and gravity
of their consequences. Physes, or growth plates, are
cartilaginous regions at the ends of children’s long
bones which act as primary sites of bone elongation.
Growth plate injury may result from trauma, infection,
metabolic abnormalities, or malignancy. The major
concern with growth plate injury is the damaged cartilage
in growth plate that could be replaced by bony repair
tissue, forming a “bony bridge.” Depending on the size
and location of the injury within the growth plate, the
bony bridge may cause asymmetric growth arrest with
subsequent angular deformity or complete cessation of
longitudinal growth. The latter is a devastating outcome
for children that have not yet reached their full height.
The current treatment involves surgical resection of the
bony bridge and replacement with an interpositional
material to preserve normal growth in the remaining
growth plate. Bony bridge reformation and additional
growth effects, however, remain major complications of
bar excision.
The current management, surgical or non-
surgical, has signifcant limitations and may result in
further morbidity in the form of additional surgeries,
further development of growth arrest, or progression of
angular limb deformities. As such, there is a dire need to
develop new treatment strategies for growth plate injury
that not only prevents bony bridge formation but also
leads to regeneration of healthy growth plate cartilage,
Edited by: Mirko Spiroski
Citation: Sananta P, Imadudin MI, Rahaditya IGMO,
Putera MA, Andarini S, Kalsum U, Dradjat RS. The
Role of Collagen Scaffold and Stromal Vascular
Fraction on Healing Process in Growth Plate Injury
(SOX9 and Histological Examination). Open Access
Maced J Med Sci. 2020 Jun 20; 8(A):498-501. https://doi.
org/10.3889/oamjms.2020.3925
Keywords: Collagen scaffold; Histological examination;
Physeal injury; SOX9; Stromal vascular fraction
*Correspondence: Panji Sananta, Doctoral Program
of Medical Sciences, Faculty of Medicine, Universitas
Brawijaya and Department of Orthopaedic and
Traumatology, Faculty of Medicine, Universitas Brawijaya,
Jalan Jaksa Agung Suprapto No. 2, Klojen, Kota Malang,
Jawa Timur 65112, Indonesia. Phone: +6282233600946.
E-mail: panjisananta@ub.ac.id
Received: 28-Oct-2019
Revised: 25-Mar-2020
Accepted: 29-Mar-2020
Copyright: © 2020 Panji Sananta, Mohamad Ibnu
Imadudin, I. Gede Made Oka Rahaditya, Marvin Anthony
Putera, Sri Andarini, Umi Kalsum, Respati Suryanto
Dradjat
Funding: This research did not receive any fnancial
support
Competing Interests: The authors have declared that no
competing interests exist
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)
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