Effects of mechanical loading patterns, bone graft, and proximity to periosteum on bone defect healing

Effect of extracorporeal shock wave therapy on fracture healing in rat femural fractures with intact and excised periosteum

“…Many studies related to the periosteum showed that periosteum serves as a niche for progenitor cells and supplies a rich vascularization to the bone which it envelops. [22] In our study, ESWT applied groups (group 3 and 4) had statistically similar results. Instead of periosteum, ESWT may play a role for releasing local growth factors and the recruitment of appropriate stem cells leading to improved tissue healing.…”

Elucidating Multiscale Periosteal Mechanobiology: A Key to Unlocking the Smart Properties and Regenerative Capacity of the Periosteum?

“…40 PDCs have been shown to play a major role in bone fracture healing by constantly building 34 and repairing bone. 12,15,[41][42][43] Adjacent PDCs are joined together by tight junctions, 44 hallmarks of epithelial membrane morphology that allow for vectorial transport to apical and basal sides of the tissue. 45 The progenitor cells proliferate and then differentiate into osteoblastic and chondroblastic cells, respectively driving the process of bone repair via either direct intramembranous bone formation or indirect endochondral mechanisms.…”

“…28,29 Whereas the periosteum is sometimes assumed to exhibit a complete barrier function, acting as an outer seal to bone, 84 it has been postulated that the robust regenerative capacity of the periosteum to infill defects derives from pluripotent cells that ingress, via the periosteum, to the defect site. 3,12,15 Recent studies indicate that the periosteum may exhibit directionally dependent permeability and that permeability is highly dependent on the stress-state of the tissue. 28,29 The mechanical response of the periosteum to injury may greatly vary dependent upon the location and severity of injury.…”

“…3,5,[12][13][14][15] Specifically, the periosteum has been found to regenerate woven bone within a critical size defect within as little as 2 weeks from time of treatment. 3,12,13 Periosteum tissue generation within the defect correlates significantly to mechanical loading as well as periosteal proximity. Furthermore, packing of the defect with morcellized autologous bone graft retards the ingression of PDCs and, thus, infilling of the defect with intramembranous bone.…”

Fluid Flow Shear Stress Stimulation on a Multiplex Microfluidic Device for Rat Bone Marrow Stromal Cell Differentiation Enhancement

“…Stress generated by physical stimulation is known to affect the structure, composition, and function of living tissues [41][42][43], probably through alterations in the extracellular matrix [44][45][46]. Chung et al demonstrated a gradient-generating microfluidic device that could be a platform for minimizing autocrine and paracrine signaling and optimizing proliferation and differentiation of neural stem cells in culture [47].…”