Aim: Mesenchymal stem cells (MSCs) are an excellent potential source of cells for bone tissue engineering due to their excellent renewal ability and osteogenic differentiation capabilities. This study was designed to evaluate the bone formation properties of a demineralized cancellous bone scaffold seeded with MSCs, with or without periosteum, in a critical size bone defect model in rabbits. Methods: Rabbit culture-expanded bone marrow (BM)-MSCs were seeded onto a human demineralized cancellous bone (HDCB) scaffold. Bone defects measuring 15 mm in length were created in each radius. A total of 56 bone defects in 28 rabbits were randomly assigned to one of the 4 groups for scaffold implantation: Group 1: HDCB graft only; Group 2: periosteum-wrapped HDCB graft; Group 3: HDCB graft seeded with BM-MSCs and Group 4: periosteum-wrapped HDCB graft seeded with BM-MSCs. All rabbits were sacrificed 12 weeks after surgery for gross observation, radiological assessment, histological analyses and biomechanical measurements. Results: New bone (NB) formation and bone healing were successfully achieved, both radiologically and histologically, on demineralized cancellous bone graft seeded with BM-MSCs. Results were improved when BM-MSCs were associated with periosteum. Conclusion: This study demonstrates that repair of bone defects in a rabbit model can be achieved through bone grafting using BM-MSCs, implanted on a demineralized cancellous bone scaffold. The formation of NB was optimized when combined with the preservation of periosteum at the site of injury.

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Aim: The anatomical study and clinical application for the vascularized corticoperiosteal fl ap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous fl ap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA) was found in 33 of 40 cases (82.5%). The superomedial genicular artery (SGA) was present in 10 cases (25%). All 33 cases (100%) of the DGA had articular branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches of the DGA were present in 25 cases (62.5%) and 26 cases (70.3%), respectively. Conclusion: The current study demonstrates that the size and length of the vessels to the medial femoral condyle are suffi cient for a vascularized bone fl ap. A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous fl ap from the medial femoral condyle, because of the considerable anatomical variations in different branches of the DGA.