Effects of extensive circumferential periosteal stripping on the microstructure and mechanical properties of the murine femoral cortex

Abstract

Extensive periosteal stripping (PS) is a risk factor for post-radiation pathologic fracture following surgery for extremity soft tissue tumors. The purpose of this study was to determine the effects of PS on bone structure and mechanical properties. Thirty-one skeletally mature mice underwent PS, with circumferential removal of periosteum from an 8-mm segment of the mid-diaphysis of the left femur. Thirty-one control mice underwent sham surgery in which the femur was isolated without manipulation of the periosteum. At 2, 6, 12, or 26 weeks following surgery, the left femora were examined by micro-CT to quantify cortical thickness (CtTh), cross-sectional area (CSA), bone volume (BV), and polar moment of inertia (PMI). Three-point mechanical bend testing was performed and peak load, stiffness, and energy to failure were determined. PS resulted in significantly decreased CtTh, CSA, BV, and PMI at all time points. Peak load, stiffness, and energy to failure were significantly reduced at 2, 6, and 12 weeks. There were no significant differences in mechanical properties at 26 weeks. In this mouse model, extensive circumferential PS resulted in sustained changes in bone structure that were still evident after 6 months, accompanied by reductions in bone strength that persisted for at least 3 months. ß

Periosteum, bone's “smart” bounding membrane, exhibits direction-dependent permeability

“…Finally, the observation that ovine periosteum thickness is anatomically site‐specific and decreases with age is consistent with human data59 and clinical observation of thick periostea in children 60. Interestingly, whereas the periosteum of the mouse is merely several cells thick and thus cannot be lifted (rather must be scraped) off of the bone,61 the thickness of ovine periosteum reported in the current study appears to be on the order of magnitude of periosteum thickness of human tissue. Specifically, here we report thickness measured in situ in the mid‐diaphysis of the femur of ∼ 4‐year‐old‐sheep as approximately 160 µm.…”

Concise Review: The Periosteum: Tapping into a Reservoir of Clinically Useful Progenitor Cells

“…Periosteum tissue can be removed from many convenient locations, such as areas adjacent to or resected during surgery (such as periosteum from the discarded femoral head during joint replacement surgery; see the section titled Feasibility of Banking Periosteum Tissue and Periosteum‐Derived Cells at the end of this review) [49]. The regeneration of the periosteum from denuded bone has just begun to be studied [17, 25, 50]; the effect of periosteum denudation on surrounding tissues is not well understood [51], but recent studies indicate that periosteum regenerates on the surface of denuded bone in rodents (rats) [52] and higher mammals (sheep) [53], even if that bone is transplanted (without an initial patent blood supply) [53]. Furthermore, recent studies demonstrate the feasibility of using periosteum substitute implants to either augment the regenerative capacity of periosteal factors and PDCs or to replace the periosteum completely [49, 54].…”

Corrective Osteotomy of a Metacarpal Deviation Caused by Fracture in a 9‐Month‐Old German Fleckvieh Heifer

“…Such techniques include growth acceleration by periosteal stripping or growth retardation by transphyseal bridging and are used in foals with angular limb deformities under the age of 2 to 6 months . Periosteal stripping increases the bone fragility . There are no reports of periosteal stripping in calves.…”