Effect of cortical perforations of both graft and host bed on onlay incorporation to the rat skull

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Abstract
The mechanisms involved in the integration of autogeneic bone grafts still attract much interest due to their clinical importance. The purpose of this study was to obtain data on the effects of a combination of cortical bone perforations both at the recipient site and the inner layer of a bicortical graft. 12 adult rats obtained femoral or tibial bicortical bone grafts from isogeneic donors to the tibia, one on each leg. On the experimental side, both the recipient bed and the inner cortical graft layer received multiple perforations (0.25 mm in diameter), while on the control side, only perforations of the recipient cortical bed were made. The findings were assessed by routine histology and immunohistochemical analysis for some bone and cartilage matrix proteins after 4 and 20 weeks. The combined cortical perforations of the graft and the host bed induced a locally improved bony incorporation of the graft and a corticalization of the graft marrow, implying improved mechanical stability. The graft height persistence was similar between groups. Intense labelling of the bone matrix proteins was apparent in all bone tissue and by diversified intensity at its various components, demonstrating ongoing remodeling activities. PRELP and fibromodulin mainly outlined the soft tissues surrounding the graft and compact bone sealing off the graft marrow. Immunolabelling contributed a more delicate picture of the mechanisms involved in graft incorporation.