Application of a Periosteum-bone Allograft for Healing of Segmental Bone Defects
Whole bone allografts or autografts are commonly applied surgically to repair approximately 2.2 million segmental bone defects annually caused by trauma or bone tumor resection worldwide.[1] However, about 15-40% of these cases result in unsuccessful healing because of a persistent gap or nonunion between the graft and the original bone.[2] Under such circumstances, the Landis Laboratory is now trying to use periosteum as a `tissue bridge’ to create a viable junction or union between an allograft and the host bone. It has been proposed that periosteal cells enhance formation of tissue-engineered bone better than cells of bone marrow alone, and methods for obtaining such cells have been demonstrated in previous research by the Landis group.[3] The overall objective of this study is to determine if human periosteum, wrapped around a scaffold of allograft bone from human cadavers, will induce new bone formation in segmental bone defects. The complete tissue-engineering process included fabrication of periosteum/allograft bone constructs, cultivation in vitro of the constructs, implantation of the constructs in nude mice serving as bioreactors in vivo, constructs harvest, histological assessment, µCT scanning and gene expression analysis. The allograft bone and periosteum were obtained from human cadaveric donors and the bone was sterilized by autoclaving. Periosteum was dissected from the donor tissues. Preliminary results show that the use of periosteum is promising for improving healing of segmental bone defects through an increase of new, autogenous bone growth into cortical allografts. The tissue-engineering approach here has potential to promote healing at other non-union sites including fractures and defects complicated by osteomyelitis and other debilitating bone pathologies.
Biomedical Engineering, Biomedical Research, Periosteum, tissue engineering, human allograft
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