Tissue engineering is a promising approach for bone regeneration. In this study, we aimed to investigate whether tissue engineered periosteum (TEP), which was fabricated by combining osteogenically-induced mesenchymal stem cells (MSCs) with porcine small intestinal submucosa (SIS), could restore long bone defects of large size in rabbits. Twenty-four adult New Zealand white rabbits (NZWRs) were used in the experiments. Long bone defects of large size (30 mm-50 mm; average, 40 mm) were established on both sides of NZWRs’ radii. The defects were treated with TEP (Group A), allogeneic deproteinized bone (DPB, Group B), TEP combined with DPB (Group C), and pure SIS (Group D). The healing outcome was evaluated by radiography and histological examination at 4, 8, and 12 weeks post-treatment. The radiographical findings showed that bone defects of large size were all repaired in Groups A, B and C within 12 weeks, whereas Group D (pure SIS group) failed to result in defect healing at 4, 8, and 12 weeks. Although there was some new bone regeneration connecting the allografts and bone ends, as observed under radiographical and histological observations, bone defects of large sizes were restored primarily by structurally allografted DPB within 12 weeks. The TEP groups (Groups A and C) showed partial or total bone regeneration upon histological inspection. Based on 12-week histological examinations, significantly more bone was formed in Group A than Group C (P < 0.05), and both groups formed significantly more bone than in Groups B and D. The results indicated that long bone defects of a large size could be restored by TEP or TEP combined with the DPB scaffold, and such materials provide an alternative approach to resolving pathological bone defects in clinical settings.

组织工程是一种很有前途的骨再生方法。在这项研究中，我们旨在研究通过将成骨诱导的间充质干细胞 (MSCs) 与猪小肠黏膜下层 (SIS) 结合制造的组织工程骨膜 (TEP) 是否可以修复兔子的大尺寸长骨缺损。实验中使用了 24 只成年新西兰白兔 (NZWR)。在 NZWR 半径的两侧建立了大尺寸（30 mm-50 mm；平均 40 mm）的长骨缺损。采用TEP（A组）、异体去蛋白骨（DPB，B组）、TEP联合DPB（C组）和纯SIS（D组）治疗缺损。在治疗后 4、8 和 12 周通过放射照相和组织学检查评估愈合结果。影像学检查结果显示，A、B、C组大尺寸骨缺损均在12周内得到修复，而D组（纯SIS组）在4、8、12周均未出现缺损愈合。尽管在同种异体移植物和骨末端之间有一些新的骨再生，但正如在放射学和组织学观察下所观察到的那样，大尺寸的骨缺损主要通过结构同种异体移植的 DPB 在 12 周内恢复。TEP 组（A 组和 C 组）在组织学检查中显示部分或全部骨再生。根据 12 周的组织学检查，A 组的骨形成明显多于 C 组（尽管在同种异体移植物和骨末端之间有一些新的骨再生，但正如在放射学和组织学观察下所观察到的那样，大尺寸的骨缺损主要通过结构同种异体移植的 DPB 在 12 周内恢复。TEP 组（A 组和 C 组）在组织学检查中显示部分或全部骨再生。根据 12 周的组织学检查，A 组的骨形成明显多于 C 组（尽管在同种异体移植物和骨末端之间有一些新的骨再生，但正如在放射学和组织学观察下所观察到的那样，大尺寸的骨缺损主要通过结构同种异体移植的 DPB 在 12 周内恢复。TEP 组（A 组和 C 组）在组织学检查中显示部分或全部骨再生。根据 12 周的组织学检查，A 组的骨形成明显多于 C 组（P  < 0.05), 两组形成的骨明显多于 B 组和 D 组。结果表明 TEP 或 TEP 结合 DPB 支架可以修复大尺寸的长骨缺损, 此类材料提供了替代方法解决临床环境中的病理性骨缺损。