title: Periosteal adventitia is a valuable bone graft alternative.
abstract: BACKGROUND
  Periosteal adventitia is believed to consist of fibrous tissue without any regenerative potential. This theory results in the assumption that surgically stripped periosteum which is also adventitial has no bone regeneration potential. We decided to test whether the periosteal adventitia is osteoinductive and whether it is suitable for a commonly faced clinical situation in an animal model.
  
  
  METHODS
  This study used 24 femurs from 12 rabbits, which were separated into 3 groups. Lateral femoral condylar cavitary defects were created with a 5 mm drill bit. In group I, the defects were left empty as the control. In group II, the defects were only filled with ceramic graft particles. In group III, the defects were filled with a mixture of ceramic graft particles and autogenous, adventitial, periosteal particles. All animals were sacrificed at the end of the 6th week and were evaluated histologically.
  
  
  RESULTS
  The microscopy of 3 different histologists suggested that group III had far superior healing when compared to the control group and group II. The statistical evaluation of the histomorphometrically gathered quantitative results revealed a meaningful increase in woven bone and a decrease in fibrous tissue in group III, confirming the histological analysis.
  
  
  CONCLUSIONS
  In this study we observed that the composite graft obtained by mixing ceramics and free adventitial periosteal grafts offers healing potential surpassing both the ceramic-only group as well as the control group. We conclude that adventitial periosteal graft greatly facilitates new bone formation.
authors.affiliation: Department of Orthopedics and Traumatology, Gazi University School of Medicine, Ankara, Turkey. cgemalmaz@gmail.com
authors.forename: Halil Can
authors.initials: HC
authors.lastname: Gemalmaz
authors.forename: Selcuk
authors.initials: S
authors.lastname: Bolukbasi
authors.forename: Erdinc
authors.initials: E
authors.lastname: Esen
authors.forename: Deniz
authors.initials: D
authors.lastname: Erdogan
authors.forename: Seren Gülsen
authors.initials: SG
authors.lastname: Gürgen
authors.forename: Seren Gulsen
authors.initials: SG
authors.lastname: Giray
authors.forename: Yesim
authors.initials: Y
authors.lastname: Bardakci
mesh_terms: D063194:Adventitia / Q000637:transplantation*; D000818:Animals; D001861:Bone Regeneration; D018786:Bone Substitutes / Q000494:pharmacology*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005269:Femur / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D010027:Osteotomy; D010521:Periosteum / Q000637:transplantation*; D011817:Rabbits; D013997:Time Factors; D014182:Transplantation, Autologous; D014945:Wound Healing
chemical_list: D018786:Bone Substitutes