Use of vascularized periosteum or bone to improve healing of segmental allografts after tumor resection: an ovine rib model.
BACKGROUND
Despite technical advances, nonunion or delayed union remains an important clinical problem when segmental allografts are used to repair diaphyseal defects after bone tumor resection. Using an ovine rib model, the authors studied whether the addition of a vascularized periosteum or bone flap improved healing compared with a segmental allograft alone.


METHODS
A 4-cm segment of rib was resected from four consecutive ribs of 15 sheep. Three different reconstructions were compared within the same sheep: allograft alone, allograft and vascularized periosteum, and allograft and vascularized bone. One defect was not reconstructed and served as a control. Five sheep were humanely killed at each of the following time points: 9, 12, and 15 weeks. The host-allograft junctions were analyzed using plain radiographs, micro-computed tomography, and histologic examination.


RESULTS
Micro-computed tomographic analysis showed significant improvement with each reconstruction technique over time. Plain radiographs and histologic analyses demonstrated earlier bridging of the host-allograft junction when either vascularized periosteum or vascularized bone was used compared with allograft alone.


CONCLUSIONS
Use of vascularized periosteum or bone may facilitate healing of the host-allograft junction after intercalary allograft reconstruction.
Chang
David W
DW
Houston, Texas; and Baltimore, Md. From the Departments of Plastic Surgery, Veterinary Sciences, Diagnostic Radiology, Pathology, and Biomedical Engineering, University of Texas M. D. Anderson Cancer Center, and the Department of Orthopaedic Surgery, Johns Hopkins School of Medicine.
Satterfield
William C
WC
Son
Daegu
D
Neto
Nicole
N
Madewell
John E
JE
Raymond
A Kevin
AK
Patrick
Charles W
CW
Miller
Michael J
MJ
Costelloe
Colleen M
CM
Weber
Kristy L
KL
D000818:Animals; D001859:Bone Neoplasms / Q000601:surgery*; D001842:Bone and Bones / Q000098:blood supply*; D005260:Female; D010521:Periosteum / Q000098:blood supply*; D012272:Ribs; D012756:Sheep; D014184:Transplantation, Homologous; D014945:Wound Healing / Q000502:physiology*