Tissue Eng Regen Med.  2020 Oct;17(5):717-727. 10.1007/s13770-020-00282-4.

Irregular Bone Defect Repair Using Tissue-Engineered Periosteum in a Rabbit Model

  • 1Orthopaedic Department of Guangming Traditional Chinese Medicine Hospital of Pudong New Area, Shanghai 201399, People’s Republic of China
  • 2Department of Nephrology, Shanghai University of Medicine & Health Sciences affiliated Zhoupu Hospital, Pudong New District, Shanghai 201318, People’s Republic of China
  • 3Department of the Joint Surgery, Yuncheng Central Hospital, Hongqi West Street 173, Yanhu District, Yuncheng City 044000, Shanxi Province, People’s Republic of China
  • 4Orthopaedic Department of the 2nd Hospital of Lanzhou University, 80 Cui Ying Men, Cheng Guan District, Lanzhou City 730030, People’s Republic of China


In previous studies, we succeeded in repairing a long bone defect with tissue-engineered periosteum (TEP), fabricated by incorporating rabbit mesenchymal stem cells with small intestinal submucosa. In this study, we investigated the feasibility of allogeneic irregular bone defect repair using TEP.
We performed a subtotal resection of the scapula in 36 rabbits to establish a large irregular bone defect model. The rabbits were then randomly divided into three groups (n = 12 per group) and the defects were treated with TEP (Group 1), allogeneic deproteinized bone (DPB) (Group 2) or a hybrid of TEP and DPB (Group 3). At 4, 8, and 12 weeks after surgery, the rabbits were sacrificed, and the implants were harvested. X-ray radiographic and histological examinations were performed to detect bone healing. Ink-formaldehyde perfusion was introduced to qualitatively analyze vascularization in TEP engineered new bone.
The repair of scapular defects was diverse in all groups, shown by radiographic and histological tests. The radiographic scores in Group 1 and Group 3 were significantly higher than Group 2 at 8 and 12 weeks (p < 0.05). Histological scores further proved that Group 1 had significantly greater new bone formation compared to Group 3 (p < 0.05), while Group 2 had the lowest osteogenesis at all time-points (p < 0.001). Ink-formaldehyde perfusion revealed aboundant microvessels in TEP engineered new bone.
We conclude that TEP is promising for the repair of large irregular bone defects. As a 3D scaffold, DPB could provide mechanical support and a shaping guide when combined with TEP. TEP engineered new bone has aboundant microvessels.


Tissue engineering; Periosteum; Irregular bone; Bone defect
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