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PubMed2001

Regulation of endochondral cartilage growth in the developing avian limb: cooperative involvement of perichondrium and periosteum.

The perichondrium and periosteum have recently been suggested to be involved in the regulation of limb growth, serving as potential sources of signaling molecules that are involved in chondrocyte proliferation, maturation, and hypertrophy. Previously, we observed that removal of the perichondrium and periosteum from tibiotarsi in organ culture resulted in an overall increase in longitudinal cartilage growth, suggesting negative regulation originating from these tissues. To determine if the perichondrium and periosteum regulate growth through the production of diffusible factors, we have tested various conditioned media from these tissues for the ability to modify cartilage growth in tibiotarsal organ cultures from which these tissues have been removed. Both negative and positive regulatory activities were detected. Negative regulation was observed with conditioned medium from (1) cell cultures of the region bordering both the perichondrium and the periosteum, (2) co-cultures of perichondrial and periosteal cells, and (3) a mixture of conditioned media from perichondrial cell cultures and periosteal cell cultures. The requirement for regulatory factors from both the perichondrium and periosteum suggests a novel mechanism of regulation. Positive regulation was observed with conditioned media from several cell types, with the most potent activity being from articular perichondrial cells and hypertrophic chondrocytes.

Animals↗
PubMed2003

[Integration of periosteum covered autogenous bone grafts with and without autologous chondrocytes. An animal experiment using the Göttinger minipig].

Autologous osteochondral transplantation has the major disadvantage of significant damage to a healthy joint surface at the donor site. The purpose of this study was to examine the effect of autogenous chondrocytes injected into the periosteum of autologous bone grafts in order to provide an alternative method for cartilage repair. A total of 22 Göttinger minipigs were operated twice on both knees. The first operation served for cartilage biopsy for the chondrocyte culture. During the second operation an osteochondral defect was created in the medial facet of the trochlear groove. The defect was treated differently with an autologous cortico-cancellous bone cylinder,harvested from the proximal tibia.Group A: untreated defect (control);B: bone-graft;C: bone-graft covered with periosteum; D: bone-graft with periosteum and injected autologous chondrocytes. The animals were killed after 6, 12, 26 and 52 weeks. The regenerated areas were evaluated macroscopically, tested biomechanically (long-term specimens; indentation-test) and a histological, blind evaluation was carried out according to a semi-quantitative scoring system. The periosteum covered bone cylinders in Groups C and D showed good repair of the bone and cartilage defect. The repaired tissue consisted predominantly of fibrocartilage with the partial formation of hyalin like tissue. The regenerated areas were integrated with the adjacent cartilage and were biomechanically superior when compared with the other groups. The additional injection of chondrocytes did not produce significantly better results. Our findings suggest that the transplantation of periosteum-covered bone cylinders may provide an alternative method for treating chondral and osteochondral defects and can be recommended for filling large donor site defects in joint surgery. The additional transplantation of chondrocytes does not seem to be justified.

Animals↗
PubMed2004

Arthroscopic anterior cruciate ligament reconstruction with periosteum-enveloping hamstring tendon graft.

Tendon-bone incorporation of a tendon graft within the bone tunnel is of priority concern when using for anterior cruciate ligament (ACL) reconstruction. Superior healing process and stronger healing strength can be achieved when periosteum is sutured on the tendon inserted into a bone tunnel. We applied this idea to ACL reconstruction for enhancing tendon graft-bone tunnel healing. This is a prospective clinical outcome study with this surgical technique at minimal 2 years follow-up. Periosteum-enveloping hamstring tendon graft has been used in 68 patients. Data from 62 patients who had been followed up completely were analyzed. All patients suffered from a grade 3 or higher grade of Lachman and anterior drawer test with a positive pivot-shift test. Clinical assessments included the Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, KT-1000 instrumented testing, thigh muscle assessment, and radiographic evaluation. The median Lysholm knee score was 59 (40-70) and 94 (60-100) points (P<0.01) before and after surgery. After reconstruction, 81% of patients were able to return to moderate or strenuous activity. Four (6%) patients were found to exhibit grade 2 or more ligament laxity. Complete range of motion could be achieved in 86% of patients. Three patients (5%) had positive pivot shift. Finally, 92% of patients were assessed as normal or nearly normal rating by IKDC guideline. Bone tunnels enlargement of more than 1 mm was identified in 5% of femoral tunnels and 6% of tibial tunnels. The study shows that a satisfactory result can be achieved with the periosteum-enveloping hamstring tendon graft in ACL reconstruction. Periosteum can be easily harvested at the proximal tibia from a routine incision for hamstring tendon harvesting. Besides the potential for improving tendon-bone healing, enveloped periosteum may help to seal the intra-articular tunnel opening in the early postoperative period, and thus avoid synovial fluid reflux into the tunnel. Bone tunnel enlargement could be reduced.

Adolescent↗
PubMed1988

Calcitonin gene-related peptide-immunoreactive nerve fibers in mandibular periosteum of rat: evidence for primary afferent origin.

Peptidergic neurons may play a role in the local regulation of bone mineralization. The neuropeptide vasoactive intestinal peptide (VIP) increases bone resorption in vitro, while calcitonin gene-related peptide (CGRP) has been shown to inhibit bone resorption in vitro. We have previously reported that sympathetic nerves with VIP-immunoreactivity innervate bone and periosteum. In the present study we sought to determine if CGRP fibers, like VIP fibers, exist in periosteum and what their origin might be. In whole-mount preparations of mandibular periosteum from rat, CGRP- and VIP-immunoreactive (IR) nerve fibers were present as networks within the periosteum. In preparations using two-color immunofluorescence, most CGRP-IR fibers were also immunoreactive for substance P (SP). In rats in which the subperiosteal space subjacent to the mandibular molars was injected with Fast blue or Fluoro-gold, retrogradely labeled cells were seen in ipsilateral trigeminal ganglia, superior cervical ganglia, and nodose ganglia. Individual cells labeled with both CGRP immunoreactivity and retrograde tracer were seen only in the mandibular portion of the trigeminal ganglion. These data suggest that CGRP-IR nerve fibers in periosteum may be of primary afferent origin. Given the reported effects of CGRP on bone mineralization, the present results suggest that primary afferent nerves containing CGRP and SP, as well as sympathetic nerves containing VIP, may play a role in focal bone remodeling.

Afferent Pathways↗
PubMed2001

The chondrogenic potential of periosteum decreases with age.

Periosteum contains undifferentiated mesenchymal stem cells that possess the potential for chondrogenesis during cartilage repair and in fracture healing. With aging, the chondrogenic potential of periosteum declines significantly. An organ-culture model was used to investigate the relationship between the chondrogenic potential of periosteum and aging. A total of 736 periosteal explants from the proximal medial tibiae of 82 rabbits, aged 2 weeks to 2 years, were cultured in agarose suspension conditions conductive for chondrogenesis. and analyzed using histomorphometry, collagen typing, wet weight measurement, 3H-thymidine and 35S-sulfate uptake, autoradiography, and PCNA immunostaining. The rabbits were skeletally mature by 6 months and stopped increasing in weight by 12 months. Chondrogenesis declined significantly with age (P < 0.0001) and was maximal in the 1.5-2 month-old rabbits. Explants from the 6 month-old rabbits formed 50% less cartilage. and by 12 months chondrogenesis reached a steady state minimal level. In parallel with this decrease in chondrogenic potential similar decreases were measured in 3H-thymidine uptake (P < 0.0001). 35S-sulfate uptake (P = 0.0117), as well as the thickness (P < 0.0001) and the total number of cells in the cambium layer of the periosteum (P < 0.0001). Autoradiography with 3H-thymidine and PCNA immunostaining confirmed the measured decrease in proliferative activity in the cambium layer where the chondrocyte precursors reside, although the percentage of proliferating cells did not change significantly with age. The most dramatic change was the marked decrease (87%) in the thickness and total cell number in the cambium layer of the perisoteum between the 2 and 12 month-old rabbits (P < 0.05). These data confirm a decline in the chondrogenic potential of periosteum with aging. Thus, one possibility for improving cartilage formation by periosteal transplantation after skeletal maturity would be to stimulate an increase in the total number of cells in the chondrocyte precursor pool early during chondrogenesis.

Age Factors↗
PubMed2001

Prefabricated bone graft induced from grafted periosteum for the repair of jaw defects: an experimental study in rabbits.

PURPOSE: The purpose of the study was to determine whether a prefabricated graft of new bone induced from periosteum grafted into muscle was an effective material for the repair of jaw defects. MATERIAL AND METHODS: Artificial mandibular jaw defects in young Japanese rabbits were covered either with free grafted periosteum (n = 5) or a prefabricated graft of newly formed bone induced from periosteum, which was first grafted into the floor of the mouth, and placed as a revascularized muscle-pedicled bone flap (n = 5). Bone formation in jaw defects was examined radiographically and histologically 28 days after grafting into defects. RESULTS: Bone formation was confirmed radiographically and histologically in both groups. However, the free grafted periosteum formed thin bone and fibrous tissue existed between the new and the original bone. In contrast, more active bone formation was observed with the prefabricated graft. This grafted new bone developed further and fused to the mandible. Blood vessels surrounding the new bone were observed histologically. CONCLUSION: These experimental findings suggested that prefabricated bone grafts induced from periosteum grafts are potentially useful for correction of jaw defects.

Animals↗
PubMed1994

In the absence of periosteum, transplanted fetal and neonatal rat coronal sutures resist osseous obliteration.

Normal craniofacial development depends on expansion of the cranial vault by growth at the sutures. Inappropriate development of the sutures leads to global disruption of patterns of craniofacial growth. Tissue interactions between dura mater and suture matrix play a critical role in the phenotypic maintenance of cranial sutures. However, the function of the periosteum in this process remains under-reported and controversial. To examine the contribution of periosteum in maintaining the patency of coronal sutures, fetal and neonatal rat coronal sutures were transplanted to surgically created defects in adult rat host parietal bones. These sutures were examined for their ability to persist in the host milieu in the presence and absence of both donor and host periosteum. This study established that removal of both host and transplant periosteum, unlike removal of dura mater, did not lead to obliteration of either fetal or neonatal sutures. Thus, periosteum and dura mater are nonequivalent tissues with respect to influence on suture patency.

Animals↗
PubMed2000

Effect of interposed periosteum in an animal physeal fracture model.

To study the effect of interposed periosteum on physeal fracture healing, 52 skeletally immature female Harlan Sprague-Dawley rats, 4 to 5 weeks of age, were randomized to one of three cohort groups. All animals underwent surgical dissection of the left proximal medial tibia; dissection consisted of superficial exposure and incision of a standard periosteal flap. Animals in Group I (fracture alone) underwent physeal fracture; those in Group II (fracture and periosteum) underwent physeal fracture with interposition of periosteum in the fracture site, and those in Group III (positive control) underwent physeal fracture, excision of 1/2 of the growth plate, and interposition of periosteum in the defect. After histologic examination of serial sections, fracture alone resulted in physeal injury frequently associated with small bar formation without a reduction in leg length. With the addition of interposition of periosteum into the fracture site, a small, but statistically significant, increase in leg length discrepancy frequently associated with small histologic bar formation occurred when compared with fracture alone.

Animals↗
PubMed2005

Osteogenic potential of primed periosteum graft in the rat calvarial model.

Repair of bone defects remains a major concern in plastic and maxillofacial surgery. Based on modern concepts of tissue engineering, periosteum has gained attention as a suitable osteogenic material. We tested the hypothesis that surgically released and immediately repositioned periosteum would exhibit high osteogenic capacity upon grafting in a rat calvarial defect. Seven days after periosteum was released from the tibia and immediately repositioned, the "primed periosteum graft" (PPG; n = 15) was placed into a critical-sized defect of rat calvaria and the process of bone formation was evaluated histologically, immunohistologically, and radiographically at 7, 14, and 21 days after grafting. Findings were compared with a nonprimed periosteal graft (NPG; n = 15). Endochondral ossification was observed in both the PPG and NPG. The PPG showed higher expression of proliferative cell nuclear antigen, bone morphogenetic protein, and vascular endothelial growth factor than the NPG. Three-dimensional radiographic examination revealed significantly increased bone formation in the PPG than in the NPG (P < 0.01). These findings suggested that surgical stimulation of the periosteum enhanced the osteogenic potential of periosteal cells. This method may be suitable for the clinical repair of bone defects.

Animals↗
PubMed1995

Periosteum in regeneration of palatal defects.

The influence of the periosteum on the regeneration of palatal bone was investigated in this study. Eighty, 8-week-old, purebred beagle dogs were assigned randomly to four groups: (1) unoperated dogs as a group control; dogs in which the mid-third of the palate was surgically removed and (2) left unrepaired (unrepaired controls); (3) repaired with mucosal flaps; (4) repaired with mucoperiosteal flaps. Five animals from each group were killed at 4, 6, 8, and 12 weeks after surgery and coronal sections examined under light microscopy. Among the animals with complete soft tissue healing, 8 of 12 dogs from Group 2, 11 of 20 from Group 3, and 10 of 19 from Group 4 showed complete bone regeneration. No significant differences were found overall in bone thickness and bone density measurements between Group 3 and Group 4. Histologically, a well-differentiated periosteum was present on the maxilla at 4 weeks, even in animals in which the periosteum had not been preserved in the original flap. These results suggest that maintaining the periosteum at surgical closure does not influence bone regeneration in beagles up to 12 weeks of age. We suggest that osteoprogenitor cells, migrating from the undisturbed local periosteum adjacent to the defect, were responsible for the new bone growth in our study.

Analysis of Variance↗
PubMed1978

Osteogenic capacity of periosteal grafts. A qualitative and quantitative study of membranous and tubular bone periosteum in young rabbits.

A standardized model, permitting only periosteal bone formation, has been applied for qualitative and quantitative studies on the osteogeneses from periosteal grafts. The periosteum from the tibia was grafted to the skull and vice versa. The investigation also included the study of periosteal bone formation combined with other osteogenic factors. A total of 78 operations were performed on the tibias and skulls of 43 growing rabbits. For qualitative studies ordinary histological methods were used. Tibial periosteal grafts to skull defects started bone formation already after 2 weeks and, via a very small amount of woven bone, compact bone and bone marrow was formed after 8-10 weeks. Combined epidural and subperiosteal bone formation gave a calvarial bone. Skull periosteal grafts to tibial defects started bone formation somewhat later, but, after more woven bone as an intermediate stage, the defect had healed with thick compact bone and bone marrow after about the same period. For quantitative studies the newly formed periosteal bone was removed, dry-weighted and ashed. The ashes were dissolved in HCl for spectrophotometric determination of total Ca content, which was used as a quantitative measure of bone amount. Tibial periosteum grafted to a calvarial defect halved its bone forming capacity but compared to the in situ skull periosteal potential, the capacity was tripled. This meant that the defect was completely healed. Calvarial periosteum was much less potent than was the tibial periosteum, when both were grafted to skull defects. However, when transplanted to a long bone defect the former increased its bone forming capacity 5 times compared to its original one as an in situ flap. Environmental functional demands seem to influence the type of bone formation and the final structure of the new bone. On the other hand, there are differences between long and membranous bone periosteum regarding the amount of bone formed.

Animals↗
PubMed1998

[Repair of large articular cartilage defect of hip with allograft of skull periosteum].

It is very difficult to repair large articular cartilage defect of the hip. From May 1990 to April 1994, 47 hips in 42 patients of large articuler cartilage defects were repaired by allograft of skull periosteum. Among them, 14 cases, whose femoral heads were grade. IV necrosis, were given deep iliac circumflex artery pedicled iliac bone graft simultaneously. The skull periosteum had been treated by low tempreturel (-40 degrees C) before and kept in Nitrogen (-196 degrees C) till use. During the operation, the skull periosteum was sutured tightly to the femoral head and sticked to the accetabulum by medical ZT glue. Thirty eight hips in 34 patients were followed up for 2-6 years with an average of 3.4 years. According to the hip postoperative criteria of Wu Zhi-kang, 25 cases were excellent, 5 cases very good, 3 cases good and 1 case fair. The mean score increased from 6.4 before operation to 15.8 after operation. The results showed, in compare with autograft of periosteum for biological resurface of large articular defect, this method is free of donor-site morbidity. Skull periosteum allograft was effective for the treatment of large articular cartilage defects in hip.

Adolescent↗
PubMed2000

Developmental changes in the transmitter properties of sympathetic neurons that innervate the periosteum.

During the development of sweat gland innervation, interactions with the target tissue induce a change from noradrenergic to cholinergic and peptidergic properties. To determine whether the change in neurotransmitter properties that occurs in the sweat gland innervation occurs more generally in sympathetic neurons, we identified a new target of cholinergic sympathetic neurons in rat, the periosteum, which is the connective tissue covering of bone, and characterized the development of periosteal innervation of the sternum. During development, sympathetic axons grow from thoracic sympathetic ganglia along rib periosteum to reach the sternum. All sympathetic axons displayed catecholaminergic properties when they reached the sternum, but these properties subsequently disappeared. Many axons lacked detectable immunoreactivities for vesicular acetylcholine transporter and vasoactive intestinal peptide when they reached the sternum and acquired them after arrival. To determine whether periosteum could direct changes in the neurotransmitter properties of sympathetic neurons that innervate it, we transplanted periosteum to the hairy skin, a noradrenergic sympathetic target. We found that the sympathetic innervation of the transplant underwent a noradrenergic to cholinergic and peptidergic change. These results suggest that periosteum, in addition to sweat glands, regulates the neurotransmitter properties of the sympathetic neurons that innervate it.

Animals↗
PubMed1998

[Influence of stripping periosteum on bone formation in guided tissue regeneration].

OBJECTIVE: To analyze the role of periosteum in guided bone regeneration by means of undecalcified sections and X-ray films. METHOD: 10 mm long segmental defects were created in the diaphyses of both radii in 24 New Zealand rabbits. The defect on the control side was covered with a silicone membrane shaped as a tube. On the experimental side, 10 mm periosteum of both sides of the defect was stripped and the defect was covered with a silicone tube. The animals were killed at the 3rd day and the 1st, 2nd, 3rd, 4th, 6th, 10th, 12th weeks. Samples were treated for radiologic and histologic examinations. RESULT: (1) periosteal stripping exerts no effect on callus formation in or out of the tube. (2) osteoblasts in the cambium layer of the periosteum come from bone surface, endosteum or the Haversian envelopes. (3) the tissue in the two layers of the periosteum has different origins, the fibrous layer comes from soft tissue and osteoblasts in the cambium from bone surface or Haversian envelopes. CONCLUSION: Stripping periosteum has no influence on bone formation in guided tissue regeneration.

Animals↗
PubMedDate not supplied

Physeal fractures, part II: fate of interposed periosteum in a physeal fracture.

This study describes the histologic features of periosteum interposed into a physeal fracture of the rat proximal tibia. Periosteum was introduced into a physeal fracture in two groups of animals: those with an intact physis after fracture, and those with the medial half of the physis surgically ablated. Specimens of the proximal tibia underwent histologic analysis at 2, 4, 6, 10, and 21 days after fracture to determine the histologic features of interposed periosteum in a physeal fracture. In animals with an intact physis, interposed periosteum underwent one of two fates: it was degraded by giant cells in the fracture plane, which allowed cellular infiltration, or if the periosteum was closely surrounded by physeal cartilage, the physis grew around it and appeared to force it toward the metaphysis. In animals whose physis received surgical ablation, physeal bar formation was always present, with poor organization of the remaining lateral growth plate. Histologic evidence from this study also underscores the fact that physeal bar formation occurs from the migration of osteoblasts and osteoclasts along vertical septa.

Animals↗
PubMed2003

[Treatment of large bone defect of radius with vascularized tubulate periosteum graft and bone filling material in rabbits].

OBJECTIVE: To study the treatment efficacy of vascularized periosteum graft and bone filling material for long bone defect. METHODS: Forty young and forty adult rabbits were divided into four groups respectively according to the bone filling materials. A 3 cm long segment was removed from the middle part of the rabbit radius to make a bone defect model. The periosteum was reserved and restored to set up a vascularized tubulate periosteum graft. On the left side, autogenous bone graft, decalcified allograft, tricalcium phosphate, and hydroxyapatite were used to fill in the bone defect respectively; on the right side, no bone filling material was used as controls. The repairing effect of bone defect was evaluated by roentogenography, biomechanical, and histological methods. RESULTS: In young rabbits, bone defects on both sides healed in the 6th week after operation. The bending strength of radius in the tricalcium phosphate group and in the hydroxyapatite group were lower in the 12th week and there was significant difference when compared with autogenous bone graft group, decalcified allograft group and control group (P < 0.05). The repairing mechanism included intramembranous and endochondral ossification, and intramembranous ossification was prevalent. In the adult rabbits, the repairing rates of bone defect were 50% in the autogenous bone graft group, 40% in the decalcified allograft group, 30% in the tricalcium phosphate group and in the hydroxyapatite group and 42.5% in the control group, respectively. CONCLUSION: In young rabbits, large bone defect can be repaired with vascularized tubulate periosteum graft with or without the combining use of bone filling materials. The bone filling material which will be substituted slowly is disadvantageous to the recovery of bone strength. In adult rabbits, vascularized tubulate periosteum graft combined with bone filling materials can not repair the large bone defect effectively.

Animals↗
PubMed2004

Segmental distribution and morphometric features of primary sensory neurons projecting to the tibial periosteum in the rat.

Previous reports have demonstrated very rich innervation pattern in the periosteum. Most of the periosteal fibers were found to be sensory in nature. The aim of this study was to identify the primary sensory neurons that innervate the tibial periosteum in the adult rat and to describe the morphometric features of their perikarya. To this end, an axonal fluorescent carbocyanine tracer, DiI, was injected into the periosteum on the medial surface of the tibia. The perikarya of the sensory fibers were traced back in the dorsal root ganglia (DRG) L1-L6 by means of fluorescent microscopy on cryosections. DiI-containing neurons were counted in each section and their segmental distribution was determined. Using PC-assisted image analysis system, the size and shape of the traced perikarya were analyzed. DiI-labeled sensory neurons innervating the periosteum of the tibia were located in the DRG ipsilateral to the injection site, with the highest distribution in L3 and L4 (57% and 23%, respectively). The majority of the traced neurons were of small size (area < 850 microm2), which is consistent with the size distribution of CGRP- and SP-containing cells, regarded as primary sensory neurons responsible for perception of pain and temperature. A small proportion of labeled cells had large perikarya and probably supplied corpuscular sense receptors observed in the periosteum. No differences were found in the shape distribution of neurons belonging to different size classes.

Animals↗
PubMed1989

[Localization and invasion of the femur in the rat by a soft tissue tumor induced by pellets made of hydroxypropylcellulose mixed with 20-methylcholanthrene: special reference to effects of the periosteum].

Pellets made of a carcinogenic substance, methylcholanthrene admixed with a high molecular substance, hydroxypropycellulose were implanted into the thigh of 90 Wistar white female rats of 5 weeks of age (3 groups, 30 rats each). Ten control rats did not receive the pellets. In group 1, the pellets were placed at the window made at the cortex of the right femur; in group 2, into the space between the cortex and the periosteum; in group 3, into the pouch created outside of the periosteum. Twenty weeks after implantation, spindle cell sarcoma developed in 28 rats of group 1, 27 of group 2, and 21 of group 3. Tumor invasions into the bone marrow of the femur were seen in 14 rats in group 1 (46.7%), 5 in group 2 (18.5%). In group 3, however, tumor invasion was not observed. There were significant differences in the frequency of tumor invasion between group 1 and 2 (p less than 0.01) as well as between group 2 and 3 (p less than 0.05). At implant sites, group 2 showed thinning out of periosteum, while group 3 exhibited thickening of both cortex and periosteum. This experimental results suggested that periosteum provides an important barrier in the bone against tumor invasion.

Animals↗