Periosteum and fascia lata: Are they so different?

Abstract

Introduction: The human fascia lata (HFL) is used widely in reconstructive surgery in indications other than fracture repair. The goal of this study was to compare microscopic, molecular, and mechanical properties of HFL and periosteum (HP) from a bone tissue engineering perspective.Material and Methods: Cadaveric HP and HFL (N = 4 each) microscopic morphology was characterized using histology and immunohistochemistry (IHC), and the extracellular matrix (ECM) ultrastructure assessed by means of scanning electron microscopy (SEM). DNA, collagen, elastin, glycosaminoglycans, major histocompatibility complex Type 1, and bone morphogenetic protein (BMP) contents were quantified. HP (N = 6) and HFL (N = 11) were submitted to stretch tests.Results: Histology and IHC highlighted similarities (Type I collagen fibers and two-layer organization) but also differences (fiber thickness and compaction and cell type) between both tissues, as confirmed using SEM. The collagen content was statistically higher in HFL than HP (735 vs. 160.2 μg/mg dry weight, respectively, p < 0.0001). On the contrary, DNA content was lower in HFL than HP (404.75 vs. 1,102.2 μg/mg dry weight, respectively, p = 0.0032), as was the immunogenic potential (p = 0.0033). BMP-2 and BMP-7 contents did not differ between both tissues (p = 0.132 and p = 0.699, respectively). HFL supported a significantly higher tension stress than HP.Conclusion: HP and HFL display morphological differences, despite their similar molecular ECM components. The stronger stretching resistance of HFL can specifically be explained by its higher collagen content. However, HFL contains many fewer cells and is less immunogenic than HP, as latter is rich in periosteal stem cells. In conclusion, HFL is likely suitable to replace HP architecture to confer a guide for bone consolidation, with an absence of osteogenicity. This study could pave the way to a bio-engineered periosteum built from HFL.

Collagen molecular organization preservation in human fascia lata and periosteum after tissue engineering

“…HFL and HP were harvested from deceased donors (3 donors of average 86.81 ± 3.7 years) of the Human Anatomy Department of UCLouvain (Body donation service, IRB00008535, Brussels, Belgium) following the same procedure as previously described ( Manon et al, 2022 ) and were subjected to five chemical decellularization (D) protocols ( Table 1 ) performed under continuous agitation (N = 3 donors x 2 tissues x 5 protocols = 30 analyzes). The soap-based detergent protocols, D1 to D4, consisted of different combinations of Triton, Sodium dodecyl sulfate (SDS) and Deoxyribonuclease (DNase).…”

“…The DNA content was measured using the Quant-iT PicoGreen DNA assay kit (ThermoFisher, Waltham, MA, United States) just after being extracted using the DNeasy ® Blood & Tissue kit (Qiagen, Hilden, Germany). The very precise steps are previously described ( Manon et al, 2022 ; Manon et al, 2023 ). Samples were then stored at −80°C.…”

“…Decorin (DCN) content was evaluated using the enzyme-linked immunosorbent assay (ELISA). For this purpose, the protein extraction was performed as previously described ( Manon et al, 2022 ). Samples of each HFL and HP were weighted, cut and lysed with the buffer solution containing the radioimmunoprecipitation assay (RIPA, ThermoFisher Scientific, 89900), the protease inhibitor cocktail (Sigma-Aldrich, P8340-1 ML), and phosphatase inhibitors (PhosSTOP™, Roche, Basel, Switzerland).…”

“…Bone repair therefore remains a major concern for orthopedic surgeons ( Evans, Chang, and Knothe Tate, 2013 ; Delloye et al, 2014 ; Dalisson et al, 2021 ) which has led to the emergence of a series of alternative tissue engineering approaches in recent decades ( Chen et al, 2015 ; Lou et al, 2021 ; Manon et al, 2023 ). Among these, Manon et al recently showed the suitability of using human fascia lata matrices as a periosteal-like scaffold for bone regeneration, mainly through their collagen type I composition and appropriate mechanical properties ( Manon et al, 2022 ; Manon et al, 2023 ). The human fascia lata (HFL) is a dense connective tissue made up of three layers of collagen fiber bundles with little cellularity ( Pancheri et al, 2014 ; Blottner et al, 2019 ).…”

A New Osteogenic Membrane to Enhance Bone Healing: At the Crossroads between the Periosteum, the Induced Membrane, and the Diamond Concept

“…Nevertheless, to our knowledge, it has never yet been considered directly for CSBD treatment. This membrane was already compared with the human periosteum (HP) and has proven to be a good candidate to be used as an off-the-shelf membrane scaffold thanks to its wide shapeable surface, its mechanical resistance, and its easy harvesting [32]. However, the absence of osteogenic cells in HFL is critical and needs to be implemented by MSCs.…”