Periosteal Augmentation of Allograft Bone and its Effect on Implant Fixation - An Experimental Study on 12 Dogs§

Jeppe Barckman*, 1, Jorgen Baas 1, Mette Sørensen 1, Joan E Bechtold 2, Kjeld Soballe 1
1 Orthopaedic Research Laboratory, Aarhus University Hospital, Denmark
2 Orthopaedic Biomechanics Laboratory, Excelen and Minneapolis Medical Research Foundations, University of Minnesota, Minneapolis MN 55415, Minnesota, USA

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 932
Abstract HTML Views: 408
PDF Downloads: 247
Total Views/Downloads: 1587
Unique Statistics:

Full-Text HTML Views: 528
Abstract HTML Views: 262
PDF Downloads: 177
Total Views/Downloads: 967

Creative Commons License
© Barckman et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Orthopaedic Research Laboratory, Aarhus University Hospital, Nørrebrogade 44, Build. 1A, 8000 Aarhus C, Denmark; Tel: +45 89 49 41 35; Fax: +45 8949 4150; E-mails:,



Periosteum provides essential cellular and biological components necessary for fracture healing and bone repair. We hypothesized that augmenting allograft bone by adding fragmented autologous periosteum would improve fixation of grafted implants.


In each of twelve dogs, we implanted two unloaded cylindrical (10 mm x 6 mm) titanium implants into the distal femur. The implants were surrounded by a 2.5-mm gap into which morselized allograft bone with or without addition of fragmented autologous periosteum was impacted. After four weeks, the animals were euthanized and the implants were evaluated by histomorphometric analysis and mechanical push-out test.


Although less new bone was found on the implant surface and increased volume of fibrous tissue was present in the gap around the implant, no difference was found between treatment groups regarding the mechanical parameters. Increased new bone formation was observed in the immediate vicinity of the periosteum fragments within the bone graft.


The method for periosteal augmentation used in this study did not alter the mechanical fixation although osseointegration was impaired. The observed activity of new bone formation at the boundary of the periosteum fragments may indicate maintained bone stimulating properties of the transplanted cambium layer. Augmenting the bone graft by smaller fragments of periosteum, isolated cambium layer tissue or cultured periosteal cells could be studied in the future.

Keywords: Allograft bone, autologous, implant fixation, morselized, osseointegration, periosteum.