Osteogenic Ability of Free Periosteal Autografts in Tibial Fractures With Severe Soft Tissue Damage: An Experimental Study

Abstract

Our data suggest that orthotopically placed autologous nonvascularized periosteum retains its osteogenic potential in a poorly vascularized environment such as a tibial fracture with severe soft tissue damage. The effect is enhanced if the graft is in contact with intact periosteum. Histologically, callus formation after periosteal grafting resembles endochondral and intramembranous ossification.

Vascular Endothelial Growth Factor (VEGF) and Bone Morphogenetic Protein-4 (BMP-4) in Endochondral Ossification from Grafted Periosteum

“…Many studies have demonstrated that grafted periosteum has heterotopical osteogenecity, since Ollier first reported its osteogenic potentiality [13]. Recent histological investigations have revealed that grafted periosteum forms bone by endochondral ossification [12,14,16,17]. In the present study, we showed localization of VEGF and BMP-4 in endochondral ossification induced from grafted periosteum.…”

Periosteal pedicle graft for the treatment of gingival recession defects: a novel technique

“…Various research papers have been published explaining the osteogenic potential of human periosteal grafts. 7,[14][15][16] The use of periosteum as a barrier membrane for the treatment of periodontal defects was published by Lekovic et al in 1991 17 and again in 1998 by Lekovic et al 18 and Kwan et al 19 In their studies, they used connective tissue grafts obtained from the palate and covered the periodontal defect with donor tissue before suturing over the donor tissue with gingival flaps. This procedure produced results similar to improvements found with barrier membranes.…”

Elucidating Multiscale Periosteal Mechanobiology: A Key to Unlocking the Smart Properties and Regenerative Capacity of the Periosteum?

“…3,5,[77][78][79] Research has shown that net changes in periosteal strain during stance shift loading after surgery correlate to rapid de novo bone generation in critically sized defects. 13 Therefore, mechanical signaling at the tissue level may be responsible for the initiation of bone regeneration at the cellular level.…”

“…Although a number of studies have used native periosteum to heal critical size bone defects, 5,[77][78][79] alternatives are sought for the case when periosteum availability is limited. In many cases, native periosteum contains too few PDCs or has been damaged therefore limiting the tissue available for use.…”