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Review
. 2008 Aug;466(8):1777-87.
doi: 10.1007/s11999-008-0312-6. Epub 2008 May 29.

A perspective: engineering periosteum for structural bone graft healing

Xinping Zhang  1 , Hani A Awad, Regis J O'Keefe, Robert E Guldberg, Edward M Schwarz
Affiliations
Review

A perspective: engineering periosteum for structural bone graft healing

Xinping Zhang et al. Clin Orthop Relat Res. 2008 Aug.

Abstract

Autograft is superior to both allograft and synthetic bone graft in repair of large structural bone defect largely due to the presence of multipotent mesenchymal stem cells in periosteum. Recent studies have provided further evidence that activation, expansion and differentiation of the donor periosteal progenitor cells are essential for the initiation of osteogenesis and angiogenesis of donor bone graft healing. The formation of donor cell-derived periosteal callus enables efficient host-dependent graft repair and remodeling at the later stage of healing. Removal of periosteum from bone autograft markedly impairs healing whereas engraftment of multipotent mesenchymal stem cells on bone allograft improves healing and graft incorporation. These studies provide rationale for fabrication of a biomimetic periosteum substitute that could fit bone of any size and shape for enhanced allograft healing and repair. The success of such an approach will depend on further understanding of the molecular signals that control inflammation, cellular recruitment as well as mesenchymal stem cell differentiation and expansion during the early phase of the repair process. It will also depend on multidisciplinary collaborations between biologists, material scientists and bioengineers to address issues of material selection and modification, biological and biomechanical parameters for functional evaluation of bone allograft healing.

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Figures

Fig. 1A–C
Fig. 1A–C
Live donor isografts from R26A mice were transplanted into wild type β-gal negative mouse femurs. (A) H&E/alcian blue staining (original magnification at 4X) demonstrates live Rosa 26 isograft in a wild type donor produces robust endochondral and intramembranous bone formation at the cortical bone junction. Host side and graft side at the junctions are marked as * (host) and # (graft). (B) X-gal staining of adjacent sections demonstrates the majority of cartilage and bone overlying the donor graft stained positive for β-gal (blue), indicating donor origin. (C) Magnified images (20X) of the boxed region in B demonstrated nearly all the osteocytes (arrow) in newly formed bone overlying donor bone graft stained β-gal positive (blue), indicating donor origin. (A1–A5) Photomicrographs (original magnification 20X) of X-Gal-stained sections show the progression of donor periosteal progenitor cells (blue) through the endochondral bone formation from Day 1 to Day 10. (B1–B5) X-Gal (blue) and alkaline phosphatase (AP) (red) double staining demonstrate the differentiation of β-gal-positive cells from Day 1 to Day 10.
See this image and copyright information in PMC

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