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Osteogenic capacity of cultured human periosteal cells.

We developed a culture system of cells isolated from juvenile human periosteum. The culture consisted of epithelial-like and fibroblast-like cells. Both types of cells had intense alkaline phosphatase activity maintained in subculture. When these cells, loaded into diffusion chambers, were implanted subcutaneously in rats, cartilage tissue was mainly formed and bone was seen scantily. 1 alpha-OH-D3 and 1,25-(OH)2-D3 increased the alkaline phosphatase activity and proteoglycan synthesis in the periosteal cells. Calcitonin also stimulated the proteoglycan synthesis, but parathyroid hormone had no effect.

Alkaline Phosphatase↗

Two cases of periosteal chondroma.

One of our 2 cases of periosteal chondroma of the tibia recurred three times before definitive cure, and required extensive radiographic and histologic evaluation to avoid overinterpreting the malignancy. Our experience confirms that marginal excision should be employed.

Child↗

Tibial periosteal reactions in soldiers. A scintigraphic study of 29 cases of lower leg pain.

Twenty-two soldiers with tibial pain along the posteromedial tibial border (29 painful tibias) entered the study. The tibias were evaluated using radiographs and scintigraphs. Follow-up scintigraphs of 12 tibias were performed. The scintigraphic lesions were classified as Stages 0-V depending on the percentage of bone thickness involved. No attempts were made to differentiate between shin splints and stress fractures. Twenty-four symptomatic lesions and five asymptomatic lesions were found by scintigraphy. Radiographic changes were found in all the lesions classified as Stage III or higher, in some Stage II lesions, but never in Stages 0 and I lesions. Because intense scintigraphic uptake is seen in bone tumors, radiographs are needed to exclude this diagnosis. Radiographs were, however, not as sensitive as scintigraphs for differentiating the periosteal injuries seen in this study. The initial scintigraphs can be used to classify the lesions. Follow-up scintigraphs are not useful because they take months to return to normal. Consequently, the clinical symptoms and the level of pain should be the guidelines for treatment.

Adult↗

Periosteal stripping in achondroplastic children. Little effect on limb length in 10 cases.

We present a prospective study of the results of periosteal stripping and division in 10 achondroplastic children. A single limb (femur and tibia) was operated on and the change in actual length of each bone and the percentage change in growth compared to that of the non-operated limb was measured by scanogram. The mean absolute increase in growth was small, measuring 3 mm for the femur and 2 mm for the tibia. There was no measurable growth difference after 18 months. This method of increasing limb length in achondroplastic children prior to definitive and extensive lengthening procedures is not recommended.

Achondroplasia↗

Osteochondritis dissecans of the femoral condyle treated with periosteal transplantation. Poor outcome in 14 patients followed for 6-9 years.

We evaluated 14 consecutive periosteal transplantations to treat osteochondritis dissecans lesions of the femoral condyle. 1 year postoperatively, 9 knees were pain-free, but with 6-9 years follow-up, only 2 knees were pain-free. Formation of hyaline-like cartilage, assessed in 12 knees, was documented in 1 patients and assessed as possible in 1 more, but in 10 patients the tissue formed in the defects was not or probably not hyaline cartilage. 6 knees had developed arthrosis.

Adolescent↗

Repair of full-thickness cartilage defects in rabbit knees with free periosteal graft preincubated with transforming growth factor.

This study compared different concentrations of transforming growth factor-beta 1 (TGF-beta1) used for short-term preincubation in vitro of large periosteal explants to determine the effect of chondrogenesis and the fate of repair cartilage over time. Eighty-two rabbits were divided into four groups: group A, non-grafted; group B, non-incubated grafted; group C, 100 ng/mL recombinant human (rh) TGF-beta1 preincubated grafted; and group D, 20 ng/mL rhTGF-beta1 preincubated grafted. Rabbits from each group were sacrificed at intervals between 2 and 24 weeks. Histologic slides were stained with safranin O and were scored based on a subjective scoring system. Group A healed with non-cartilaginous material. Group B healed with hyaline cartilage-like material with progressive thinning of this regenerated layer; at 24 weeks, this layer was fibrous tissue. Group C enhanced repair with hyaline cartilage-like material but accelerated early degeneration and osteophyte formation; the cartilage became fibrous tissue at 24 weeks. Group D did not enhance cartilaginous repair. At 24 weeks, all groups had the same result. The 100 ng/mL rhTGF-beta1 preincubation in vitro with periosteum enhanced early osteochondral repair but did not show prolonged durability. Clinical application of this growth factor necessitates further study.

Animals↗

Periosteal osteosarcoma in the long head of the triceps in a dog.

A 2.5-year-old Labrador retriever was evaluated for forelimb lameness. Fine-needle aspirates of a mass in the proximal brachium were suggestive of a mesenchymal tumor. The dog was euthanized and necropsied. Radiographic evaluation and gross and histopathological findings provided a diagnosis of periosteal osteosarcoma in the long head of the triceps.

Animals↗

Bone formation with free periosteal grafts in reconstruction of congenital maxillary clefts.

In a series of 23 patients free grafts of tibial periosteum have been used in the reconstrlction of 26 congenital maxillary clefts. In 23 (88.5%) of these clefts, rapid bone formation occurred at the transplantation site overbridging the bone defect in 20 (77%) of the clefts. The permanent value of these bone bridges has not yet been solved. Nevertheless, this operation has demonstrated the strong osteogenic capacity of free periosteal grafts suggesting their use also in other fields, where bony fusion or reconstruction of other defects is needed.

Cleft Lip↗

[High tibial osteotomy combined with autogenous periosteal graft for osteoarthritis of knee].

The osteoarthritis of knee is a common disorder but no always to be treated satisfactorily. Between 1988 and 1992, the method, a high tibial osteotomy to correct the genu varum combined with autogenous periosteal or perichondrial graft to deal with the chondromalacia patella was used. Thirty-two patients (51 knees) were treated by this method and the patients were followed up for an average of 5.1 years. The excellent and good results were obtained in 90.2%. This method was obviously better than any other simple high tibial osteotomy. Therefore, this method was considered to be effective for treatment of osteoarthritis of knee with varum deformity and chondromalcia patella.

Female↗

[Periostal interposition in epiphysiolysis, diagnosed by ultrasound].

Musculoskeletal ultrasound is a rapidly expanding diagnostic field. High frequency transducers with high spacial resolution make it possible to demonstrate superficial soft tissue structures such as tendons, muscles, ligaments and even, under certain circumstances, fractures and periosteum. A case is presented where ultrasound clearly visualised periostal interposition in a distal tibial epiphysiolysis in an eight year-old boy, and some aspects of ultrasound in musculo-skeletal imaging are discussed.

Child↗

[Intradural reconstructive surgery of anterior fossa dural lesions using pedunculated periosteal flaps].

The cranio-cerebral injury could result in cerebro-spinal fluid fistula with serious consequences in form of meningitis. In a number of cases a surgical procedure is needed, however in spite of established standards the controversies are still present concerning approach and reconstruction technique. The author presents his own experience in duroplastic operations with intradural use of pedunculated periostal allograft flaps.

Adult↗

[Correction of blepharophimosis with a temporal periosteal flap].

OBJECTIVE: To Provide a dependable and effective method for the treatment of blepharophimpsos. METHODS: In Blaskovics canthoplasty, a periosteum flap raised from the lateral orbit margin was turned over and fixed to the end of superiou tarsur. The operation was performed on 11 patients (13 lids), with blepharophimosis. Of whom 8 patients (8 lids) were serious blepharophimosis associated with cryptophthalmus or hollow socket; 3 patients (5 lids) were moderate. The epicanthus in 3 cases (4 lids) was corrected by Spaeth's technique. RESULTS: The follow-up period was 10.5 months in average. 10 lids of blepharophimosis were cured; 2 were improved significantly and 1 improved. No severe complications were found. CONCLUSIONS: The periosteal flap acts not only as a palpebral supporting tissue but also forms lateral ligament. The corrective effects of this method for blepharophimosis are fairly good.

Adolescent↗

Spinal fusion with free periosteal grafts and its effect on vertebral growth in yound rabbits.

The effect of early fusion on growth of the spine has been studied in rabbits. Free periosteal grafts from the tibia were transplanted either posteriorly between the spinous and articular processes or postero-laterally between the articular and transverse processes. Sound bony fusion was achieved in both the thoracic and the lumbar spine. Spinal fusion caused local narrowing and wedging of the intervertebral spaces, followed by retardation of growth and wedging of the vertebrae. A progressive structural scoliosis developed after unilateral postero-lateral fusion and a lordosis developed after posterior fusion.

Animals↗

In vivo osteogenic properties of the composite of periosteal-derived osteoblast and collagen- coated true bone ceramics.

OBJECTIVE: To contrive new ways for repairing bone defects on the basis of the observation of the osteogenic properties of implanted composite made from periosteal-derived osteoblasts (POB) and true bone ceramics (TBC) coated with collagen (TBCc). METHODS: Bovine cancellous bone was calcined and coated with collagen before being mixed with cultured rabbit osteoblast suspension to prepare the composite, which was respectively implanted subcutaneously on the right of the back of BALB/c nude mice and in the muscle pouches in similar sites of rabbits. The control was established by implantation of TBCc in the contralateral sites corresponding to the former implants in both of animals. Samples were obtained from the implant sites 4 weeks later in mice and 8 weeks later in rabbits respectively, and light and electron microscopic observation was performed routinely. RESULTS: A large number of osteoblasts were seen to grow and proliferate within the TBCc-POB composite where cartilage and bone tissues also generated, which was no observed in the control group. CONCLUSION: The osteoblasts in the implanted TBCc-POB composite can survive and develop into cartilage and bone tissues.

Animals↗

[With periosteal "sandwich" suturing and repairing septonasal perforation by nasal columella degloving].

OBJECTIVE: To recommend a new type of repairing septonasal peforation. METHOD: After a seagull's incision is made around the internal edges of anterior nares and the root of nasal columella, the mucoperiost of nasal septum and nasal bottom is widely dissected through the nasal columella degloving pathway. Then, relaxative incisions are made in bilateral mucoperiost at different directions and bilateral peforations are relaxative sutured at different levels respectively. Meanwhile, an autograft of tibil periost is fixed into nasal septum by the "sandwich" technique. Finally, both nasal cavities are carefully packed. RESULTS: Three cases of septonasal perforation were successfully repaired and have been followed up for 1-2 years respectivelly with no recurrence. CONCLUSION: The characteristics of this operation are: style rather fashionable, pathway rather wide, mucoperiost rather relaxed, suture rather firm and failing rather few.

Adult↗

[Experimental study on rabbit periosteal osteoblasts and renal vascular endothelial cells indirect co-culture in vitro].

OBJECTIVE: To determine an optimal co-culture ratio of the rabbit periosteal osteoblasts (RPOB) and rabbit renal vascular endothelial cells(RRVEC) without direct contact for future study of bone tissue engineering. METHODS: RPOB and RRVEC in the ratios of 1:0(control group), 2:1(group 1), 1:1(group 2) and 1:2(group 3) were co-cultured by six well plates and cell inserts. Four days later, the proliferation of RPOB and RRVEC were examined through cell count. Differentiated cell function was assessed by alkaline phosphatase (ALP) activity assay and 3H proline incorporation assay. RESULTS: When RPOB and RRVEC were indirectly co-cultured, the proliferation of RPOB and 3H proline incorporation was higher in group 1 than in the other experimental groups and control group (P < 0.05). ALP activity of RPOB was higher in group 1 than in control group and group 3 (P < 0.05), but there was no significant difference between group 1 and group 2 (P > 0.05). CONCLUSION: These results suggest that RPOB and RRVEC co-cultured in a ratio of 2:1 is optimal for future study of bone tissue engineering.

Alkaline Phosphatase↗