TY - JOUR
T1 - Use of vascularized periosteum or bone to improve healing of segmental allografts after tumor resection
T2 - An ovine rib model
AU - Chang, David W.
AU - Satterfield, William C.
AU - Son, Daegu
AU - Neto, Nicole
AU - Madewell, John E.
AU - Raymond, A. Kevin
AU - Patrick, Charles W.
AU - Miller, Michael J.
AU - Costelloe, Colleen M.
AU - Weber, Kristy L.
PY - 2009/1
Y1 - 2009/1
N2 - 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. CONCLUSION: Use of vascularized periosteum or bone may facilitate healing of the host-allograft junction after intercalary allograft reconstruction.
AB - 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. CONCLUSION: Use of vascularized periosteum or bone may facilitate healing of the host-allograft junction after intercalary allograft reconstruction.
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U2 - 10.1097/PRS.0b013e3181904baf
DO - 10.1097/PRS.0b013e3181904baf
M3 - Article
C2 - 19116538
AN - SCOPUS:60549117502
SN - 0032-1052
VL - 123
SP - 71
EP - 78
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 1
ER -