Comparative study between tissue-engineered periosteum and structural allograft in rabbit critical-sized radial defect model.

The purpose of this study was to compare the efficacy of tissue-engineered periosteum (TEP) to allgeneic bone in repairing segmental bone defect. TEP was fabricated with osteoinduced rabbit bone marrow mesenchymal stem cells (MSCs) and porcine small intestinal submucosa (SIS). Allogrfats were cryopreserved radial segments of New Zealand Rabbits. Forty-eight radial critical-sized defects (CSD) were bilaterally produced in 24 rabbits. The defects were divided into three groups, group A, TEP implantation, group B, SIS implantation, and group C allograft. Bone defect reconstruction was kinetically analyzed at 4, 8, and 12 weeks by radiographic and histological scoring system. In group A, bone defects were radiographically and histologically healed with mature cortex and marrow cavity by 12 weeks, while none of the defects healed in group B. Group C showed a slow process of creeping substitution with lymphocyte infiltration. Statistical comparison confirmed that group A had a more efficient and rapid bone defect reparation as well as remodelling than Group B and C. In conclusion, TEP is superior to structural allograft in reconstruction of allogenic segmental bone defect. Pure SIS cannot guide bone regeneration in this rabbit model.