title: Heterotopic neo-osteogenesis from vascularized periosteum and bone grafts.
abstract: BACKGROUND
  Periosteum is an osteogenic, flexible tissue. This study investigated the osteogenic potential of vascularized periosteal flaps in heterotopic conditions and compared it to the neo-osteogenesis from vascularized periosteal flaps combined with bone grafts with different properties (autologous and xenograft).
  
  
  METHODS
  Vascularized periosteal flaps from the hindlimbs of 48 rabbits formed cylindrical pouches that were buried in muscles. The pouches were filled with autologous bone grafts (P/A group, n = 16), xenograft (P/X group, n = 16), or left empty (P/E group, n = 16). Specimens were harvested between 1 and 4 months and underwent radiographic, histologic, and histomorphometric evaluation.
  
  
  RESULTS
  The total surface area was larger in the groups combined with bone grafts. Osseous apposition did not differ significantly in the P/A and P/X groups (p > 0.05). The central cavity contained hematopoietic cells (P/A), xenograft (P/X), or was absent (P/E).
  
  
  CONCLUSIONS
  Vascularized periosteal flaps presented strong osteogenic capacity in heterotopic conditions. Combination with bone grafts resulted in larger specimens. The quality of neo-osteogenesis was not influenced by the different properties of combined bone grafts.
authors.affiliation: Department of Orthopaedic Surgery, School of Health Sciences, University of Thessalia, Larissa, Greece.
authors.forename: Zoe H
authors.initials: ZH
authors.lastname: Dailiana
authors.forename: George
authors.initials: G
authors.lastname: Shiamishis
authors.forename: Dimitra
authors.initials: D
authors.lastname: Niokou
authors.forename: Elli
authors.initials: E
authors.lastname: Ioachim
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
mesh_terms: D000818:Animals; D016025:Bone Transplantation; D010012:Osteogenesis / Q000502:physiology*; D010521:Periosteum / Q000098:blood supply* / Q000637:transplantation; D010784:Photomicrography; D011817:Rabbits; D013524:Surgical Flaps; D014182:Transplantation, Autologous