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At least 19 recordsLinked to original sources
PubMed1985

Periosteal chondroma and periosteal chondrosarcoma.

A clinicopathologic study of 46 patients with periosteal chondroma and 14 patients with periosteal chondrosarcoma revealed that periosteal chondroma tended to affect younger patients and that the lesion was usually smaller. Radiographically, the typical periosteal chondroma was a small, well-marginated tumor on the outer surface of a long bone. Erosion of the cortical surface and marginal buttresses were usually present. Periosteal chondrosarcoma had a more aggressive appearance and was seen as a large mass located superficially on the cortex; the margins of the mass were more irregular than those of chondroma. Histologically, periosteal chondroma frequently showed hypercellularity, plump nuclei, and binucleation. Thus, the differentiation of chondroma from chondrosarcoma is difficult and is based mainly on evidence of invasion. The prognosis in periosteal chondroma is good: only one patient had a local recurrence, none of the tumors underwent malignant change, and excision seems to be curative. However, the prognosis in periosteal chondrosarcoma is not as good: two patients died of metastasis to the lungs after local excision and two patients had recurrences after local resection. Periosteal chondrosarcoma should be treated more aggressively than periosteal chondroma.

Adolescent↗
PubMed1982

Periosteal chondrosarcoma and periosteal osteosarcoma. Two distinct entities.

This review of 27 cases serves to emphasis that periosteal chondrosarcoma and periosteal osteosarcoma are two distinct entities. Clinically, periosteal chondrosarcoma is less painful than periosteal osteosarcoma and runs a slower course. Radiographically, periosteal chondrosarcoma tends to affect the metaphysis and contains granular or "popcorn" opacities; while periosteal osteosarcoma more often affects the mid-diaphysis and shows lytic lesions with some spicules of reactive bone perpendicular to the underlying cortex. Histologically, periosteal chondrosarcoma shows lobular well-differentiated cartilage with Grade I or II (rarely Grade III) malignancy; periosteal osteosarcoma has a chondroid matrix with some osteoid component and Grade II or III malignancy. The prognosis in periosteal chondrosarcoma is good; conservative surgery is usually effective and metastases are very uncommon. In periosteal osteosarcoma the prognosis is less satisfactory but is better than that of other osteosarcomata; wide surgical excision is, however, needed and the incidence of metastases is about 15 per cent.

Adolescent↗
PubMed1978

Premature fusion of facial sutures with free periosteal grafts. An experimental study with special reference to bone formation with free periosteal grafts from the tibia, the scapula and the calvarium.

The present study was undertaken to obtain more information on the bone forming mechanisms with free periosteal grafts and to study premature synostosis of facial sutures achieved with free periosteal grafts. The results are based on a material of 196 rabbits operated on at the age of two weeks. It was found that the bone forming mechanism with free periosteal grafts from the tibia, the scapula and the calvarium is essentially the same. When implanted in the tibialis anterior muscle of the leg of the same animal they all produced bone. The mechanism of bone formation is reminiscent of the enchondral bone formation seen in fracture healing. There is no difference in the bone forming mechanism with the periosteum from an enchondrally ossifying bone when compared with the periosteum of an intramembranously ossifying bone. In all the three different periosteal grafts studied, there was a cartilage stage before bone formation. In the muscle, all these three periosteal grafts, in spite of their tubular or membranous bone origin, produced bones tubular in shape. When the transplants were overlying the membranaceous facial bones, membrane shaped bone developed via intramembraneceous type of ossification in the recipient area. It can be concluded from these experiments that the shape and type of bone developed with free periosteal grafts depends mainly on the environmental conditions in the recipient area. Fusion of the premaxillo-maxillary and fronto-nasal sutures was achieved with free periosteal grafts from the tibia. Free periosteal grafts from the scapula and the calvarium failed to develop premature fusion of the sutures. The fusion developed due to increased bone formation in the suture area. The fusion of the premaxillo-maxillary suture stopped the growth in this area and caused a severe growth disturbance of the whole snout. The fusion of the fronto-nasal suture by the bone bridge retarded the growth of the nasal bone on the fused side and led to deviation of the snout to the operated side. Compensatory changes developed in other sites of the cranio-facial skeleton in order to minimize the effects of the growth disturbance. The fused fronto-nasal suture was used as a model to study the treatment of premature synostosis of facial bones. Resection of the fused area led to correction of the developed growth disturbance and to subsequent normal growth of the snout.

Animals↗
PubMed1982

Microvascular free bone transfer with revascularization of the medullary and periosteal circulation or the periosteal circulation alone. A comparative experimental study.

UNLABELLED: Two different types of vascularized rib grafts presently are used in clinical practice and as experimental models for investigations on free microvascular bone transfer: the posterior rib graft, including both medullary and periosteal blood supply to the bone; and the posterolateral segmental rib graft, supplied by periosteal vessels alone, Complete survival of bone after successful revascularization of the posterior type of graft is well established, but this graft has the disadvantage of a complicated dorsal dissection which has limited its clinical use. Instead, many microsurgeons have utilized the posterolateral rib segment, which is easy and safe to excise although its viability and adequate microcirculation have not yet been confirmed. In nine large dogs, we compared the viability and vascularity of bone after transfer of the two types of bone grafts by histological methods, fluorochrome bone-labeling, microangiography, and technetium scintigraphy. The grafts were transferred to the subcutaneous fat tissue in the groin, where blood supply was reconstituted by microvascular anastomoses to local donor vessels. The results suggest that a bone transplant with revascularization of periosteal only established a collateral circulation to medullary vessels, and that there is no difference in viability of the two kinds of grafts. CLINICAL RELEVANCE: The technique of transferring whole bone segments by microvascular anastomoses of their vascular pedicles has been employed clinically either by preserving the periosteal blood supply alone or by preserving the medullary and the periosteal blood supply. This study demonstrates that the preservation of the periosteal blood supply alone can result in complete bone-graft survival even when the graft is placed in a poorly vascularized tissue bed.

Animals↗
PubMed1989

Experimental study of free periosteal autograft. Animals age and periosteal osteogenesis.

This is a study of the correlation between the age of animals and the osteogenic potential of free periosteal autograft. The tibial periosteum of 27 rabbits, ranging in age from 4-104 weeks, was stripped and implanted into the quadriceps. Radiographic and histologic examination demonstrated that new bone was formed in both the young and adult rabbits. The morphologic basis and mechanism of bone formation of periosteum are discussed. Maintenance of integrity of the cambium layer of the periosteal graft is emphasized. Free periosteal graft of adult rabbits in the "resting" state can retain its osteogenic potential and produce new bone.

Aging↗
PubMed1986

Periosteal resorption and periosteal neostosis: comparison of normal subjects and renal failure patients on chronic ambulatory peritoneal dialysis using MOP-3 image analysis system and a grading method.

This is the first known attempt to quantitate periosteal resorption (PR) and perisoteal neostosis (PN) by a semi-automatic image analysis system (Zeiss MOP-3). The normal ranges and errors for PR were found to be similar to those of a previous study using a measuring magnifier. The findings in chronic renal failure patients showed that MOP-3 measurements were actually diagnostically slightly less sensitive than the results by a simple grading method. Comparison with plasma-immunoreactive parathyroid hormone (iPTH) concentrations showed that while the latter had a higher sensitivity for detection of hyperparathyroidism, the radiologic parameters nevertheless showed abnormal PR in 12% of the observations where iPTH was normal. Both PR and PN correlated significantly with iPTH (r = 0.55 and 0.30 respectively, P less than 0.01).

Adult↗
PubMed1982

Periosteal transection and periosteal stripping for correction of angular limb deformities in foals.

Valgus deformities were created in 6 pony foals by hemicircumferential transection of the periosteum and periosteal stripping (HCTP and PS) just proximally to the distal physis on the medial side of 1 radius (principal thoracic limb). The opposite thoracic limb served as a control. One month after this surgical procedure was done, the limbs were radiographed and the angle of deviation was determined. All horses developed a valgus deformity of the principal limb. In an effort to correct the acquired valgus deformity, the 2nd surgical procedure was performed--HCTP and PS on the lateral aspect of the principal radius. The carpal valgus deformities corrected within 3 months. To determine the differences in growth, stainless steel wires were introduced into both legs of each foal at certain points on the distal part of the radius. Growth changes in response to the HCTP and PS were not significantly different in the 2 groups of thoracic limbs. Increased bone growth did occur at the medial aspect of the bone in response to the 1st surgical procedure and an increase was found on the lateral aspect of the bone in response to the 2nd. The reasons for the statistically insignificant changes are discussed. A significant increase in bone width at the level of growth plate developed in response to the 1st and 2nd HCTP and PS procedures.

Animals↗
PubMed1977

[Periostitis or, rather, periosteal appositions in paediatrics (author's transl)].

In relation to a case of multiple fatigue fractures definitely diagnosed by scintigraphy and xerography, the authors report two other previous cases of spontaneous fractures at a single site in which the diagnosis was made only after surgical biopsy and histological examination. Recalling the frequent confusion arising in children between periosteal appositions and osteomyelitis or Ewing's sarcoma, and the different radiological phases of this type of fracture, they stress the necessity for a maximum effort to demonstrate the key element in the diagnosis: the cortical fissure. The latter is often minimal, at the limit of visibility and developing late. Thus repeated examinations and the use of special radiological techniques are necessary.

Bone Diseases↗
PubMed2000

[Heterotopic and orthotopic bone formation with a vascularized periosteal flap, a matrix and rh-BMP-2 (bone morphogenetic protein) in the rat model].

The purpose of this study was to construct a vascularized bone graft using the osteoinductive bone morphogenetic protein (rh-BMP-2), a polylactic acid matrix (OPLA/HY), and a vascularized periosteal flap containing osteoprogenitor cells ectopically in the groin or orthotopically in a femoral defect. In the Lewis rat, periosteal flaps were harvested from the medial surface of the tibia vascularized by the saphenous artery and vein and were transferred to the groin on its vascularized pedicle. Alternatively, the periosteal flap along its pedicle was transferred between the thigh muscles to be wrapped around a femoral defect of 1 cm. The animals were divided into 10 groups (82 animals). In group 1, the periosteal flap was left empty in the groin. Groups 2 and 3 consisted of the periosteal flap and 20 micrograms rh-BMP-2, but in group 3 the vascular pedicle was ligated proximally. In group 4 the flap was harvested without the periosteal layer and turned "inside out". Groups 5 and 6 consisted of the periosteal flap and the matrix OPLA/HY +/- 20 micrograms rh-BMP-2. In the femoral defect model, bone formation was studied using the matrix OPLA/HY alone (group 7) or combined with the vascularized periosteal flap (group 8), or in combination with OPLA/HY + BMP (group 9) or OPLA/HY + BMP + the periosteal flap (group 10). The presence and density of new bone formation in the groin and femoral defect were evaluated radiologically and histologically at 4 and 8 weeks. Good bone formation in the groin chamber (ectopic) was demonstrated in the periosteal flap + OPLA/HY + BMP group. In the femoral defects, good bone formation (orthotopic) was seen in the OPLA/HY + BMP + the periosteal flap groups. However, with the presence of a vascularized periosteal flap, more bone formation along the rim of the defect was observed. This study of ectopic bone formation in the groin and orthotopic bone formation in the femoral defect demonstrates that optimal bone formation requires four factors: BMP, a biodegradable matrix, osteoprogenitor cells, and blood supply. Potentially in the future, this technique could be used to reconstruct a bony defect or a nonunion by covering the involved area with a vascularized periosteal flap and a suitable matrix combined with BMP. Alternatively, a vascularized bone graft could be prefabricated at a distant site and then transferred microsurgically into a defect.

Animals↗
PubMed1991

Magnetic resonance imaging detection of early experimental periostitis. Comparison of magnetic resonance imaging, computed tomography, and plain radiography with histopathologic correlation.

This study characterizes the appearance of periosteal reaction by magnetic resonance imaging (MRI), and evaluates the efficacy of MRI versus computed tomography (CT), and plain film radiography (PF) in detecting early, experimentally induced periostitis. Acute Staphylococcus aureus osteomyelitis was induced in 30 legs of 20 New Zealand white rabbits. The rabbits were then imaged with MR, contrast-unenhanced CT, and PF 4 days after infection. Histologically, periosteal elevation was present in 27 cases. Periosteal ossification was seen in 23 cases, and cellular reaction without ossification in 4 cases. Periosteal reaction was demonstrated by PF in 21 (78%) and by CT in 20 (74%) cases. Evidence of periostitis was seen by MR in all 27% (100%) cases. MR resulted in two false-positive diagnoses. Multiple concentric, alternating high and low signal arcs demonstrated by MR in 19 (70%) cases represented periosteal ossification surrounded by fibrous or granulation tissue. These findings demonstrate the ability of MR to detect periostitis despite the absence of periosteal ossification. MR was more sensitive than CT (P less than .05) or PF (P less than .05) in the detection of experimentally induced periostitis.

Acute Disease↗
PubMed2002

Prefabrication of bone by use of a vascularized periosteal flap and bone morphogenetic protein.

The purpose of this pilot study was to prefabricate a vascularized bone graft by using a vascularized periosteal flap containing osteoprogenitor cells, a structural matrix, and recombinant human bone morphogenetic protein-2 (rhBMP-2). In a rat model, a periosteal flap vascularized by the saphenous artery and vein was dissected off the medial surface of the tibia. This flap consisted of three layers-periosteum, muscle, and fascia-and was tubed on itself to form a watertight chamber that was then transferred on its vascular pedicle to the groin. A total of 78 vascularized periosteal chambers were constructed in 39 animals and divided into 10 groups. In group 1, the periosteal chamber was left empty. Groups 2, 3, and 4 consisted of the periosteal flap and rhBMP-2, but in group 3, the proximal vascular pedicle was ligated, and in group 4, the flap was harvested without the periosteal layer and turned inside out. Groups 5 through 10 consisted of the vascularized periosteal flap containing several different structural matrices (calcium alginate spheres, polylactic acid, or demineralized bone matrix) with or without rhBMP-2. Animals were killed at 2, 4, or 8 weeks in each group. The presence and density of any new bone formation was evaluated both radiologically and histologically. Significant bone formation was seen only in those periosteal flaps containing rhBMP-2 and either the calcium alginate or polylactic acid matrix. New bone formation increased both radiologically and histologically from 2 weeks to 8 weeks only in the periosteal flaps containing the polylactic acid matrix and rhBMP-2. This preliminary study therefore suggests that four factors-blood supply, osteoprogenitor cells in the periosteal layer, a biodegradable matrix, and rhBMP-2-are required for optimal prefabrication of a vascularized bone graft.

Alginates↗
PubMed2003

Prefabrication of periosteal graft alone or with oxidised cellulose: an experimental study.

The purpose of this study was to evaluate the feasibility of prefabrication of periosteal grafts, alone or with oxidised cellulose (surgicel), which was an osteoinductive material using femoral vasculature. Fifteen white New Zealand rabbits were used in both femoral regions (30 grafts), and randomly divided into three groups including five rabbits (10 grafts): the control group, the periosteal graft group, and the periosteal graft+surgicel group. A periosteal graft, 30 x 40 mm in size, was obtained from the calvarium of each rabbit. The periosteal graft taken was divided into two equal parts, 20 x 30 mm. All these periosteal grafts were sutured in the shape of tube. In all rabbits, femoral vasculature and periosteal tube was Included in a silicone tube. Additionally, in the control group, femoral vasculature was cut above and below the silicone tube, whereas in the periosteal graft+surgicel group, surgicel was added to the periosteal graft. The results were evaluated macroscopically and histopathologically in the second (two rabbits for each group - 4 grafts) and fourth week (3 rabbits for each group - 6 grafts). In the second week, In all three groups, while no osteoid tissue that indicated osteogenesis developed, it was seen that inflammation and increased vascularity occurred. Surgicel was observed to be absorbed in the periosteal graft+surgicel group. In the fourth week, fibrotic tissue was developed whereas inflammatory tissue disappeared; any osteoid tissue or lamellar bone was not accompanied in all three groups. In conclusion, we do not believe that periosteum was able to survive as a graft, and we found that neovascularization occurred too slowly to preserve the bone forming qualities of the periosteum. We suggested that it could not be prefabricated, being taken away from its donor site although surgicel was used as a stimulating material.

Animals↗
PubMed1990

The frequency and diagnostic significance of periostitis in chondroblastoma.

A study was performed to determine the frequency of periosteal reaction associated with chondroblastoma, to investigate the underlying pathophysiology of the periosteal reaction, and to postulate the clinical importance of this radiographic observation. Two hundred fourteen histologically proved chondroblastomas were reviewed and observed for the presence or absence of periosteal reaction and for radiographic changes that might explain the cause of the periosteal reaction. A similar review was performed on 30 other epiphyseally centered lesions of various causes. A distinctive thick, solid periosteal reaction distal to the chondroblastoma was present in 47% of all chondroblastomas and 57% of chondroblastomas present in long bones (excluding the greater trochanter). No periosteal reaction was observed in any of the 30 epiphyseally centered lesions of other causes. When available for observation, plain films showed inflammatory changes in the joint surrounding the chondroblastoma, bone scintigraphy showed tracer uptake similar to that observed in inflammatory lesions and aggressive neoplasms, and MR images showed change in the marrow surrounding the chondroblastoma consistent with edema. This suggests an inflammatory reaction to the chondroblastoma, rather than mechanical stress across a weakened epiphysis, as the cause of the periostitis. We conclude that frequently the chondroblastoma produces a distinctive thick solid or layered periosteal response distant from the lesion along the diametaphyseal shaft. Observation of this unique periosteal response may help to distinguish chondroblastoma from other epiphyseally centered lesions.

Adolescent↗