Effects of chitosan scaffold along with royal jelly or bee venom in regeneration of critical sized radial bone defect in rat

The aim of this study was to compare the efficacy of honey bee venom (BV) and royal jelly (RJ) alongside chitosan scaffold (CS) in improving radius bone defect in rats. A total of 60 full thickness radial bone defects with a length of 5 mm were created in 60 male Wistar rats. Six healthy radial bones (3 rats) were also assigned as normal control for biomechanical studies. The defects were left empty (untreated group) or were filled by the autograft (autograft group), CS (CS group), CS alongside the BV solution (CS-BV group), and CS alongside the RJ solution (CS-RJ group). Healing of the bone defects were evaluated clinically and radiologically on days 0, 28, 42 and 56 after operation while the biomechanical testing and histopathological examination were performed on the 56th day after surgery. The autograft was more radiopaque than the untreated and CS groups at the 28th, 42nd and 56th postoperative days (P<0.05). The CS-BV and CS-RJ groups showed significantly higher radiographic outcomes than the untreated and CS groups at the 56th post-operative day (P<0.05). The density of osseous tissue (DOT) and the osteocytes and osteoblasts count of the CS-RJ and CS-BV groups were significantly higher than the CS and autograft groups (P<0.05). The biomechanical results of the CS-RJ group were significantly superior to the autograft, while the biomechanical properties of CS-BV group were not significantly different with the autograft group (P>0.05). The scaffolds in CS group were observable in the surgical site after 56 days. There was no significant difference in radiographs, DOT, cartilage tissue and fibrous tissue, and also biomechanical performances of the CS-BV and CS-RJ groups at the 42nd and 56th day after surgery. The untreated and CS groups showed weakest biomechanical results among all groups. It could be concluded that both treatment strategies in the CS-BV and CS-RJ groups were appropriate and useful in treating critical bone defects.