Structurally and Functionally Adaptive Biomimetic Periosteum: Materials, Fabrication, and Construction Strategies

The periosteum is crucial in the processes of bone formation, regeneration, and remodelling. Specifically, periosteal progenitor cells contribute a major force to the initiation of bone healing. Biomimetic periosteum (BP), employed for treating bone defects, exhibits superior outcomes in terms of bone integrity, proper vascularization, and minimal heterotopic ossification when compared to conventional direct graft bone void fillers. Therefore, BP has emerged as a contemporary and effective approach for addressing bone defects. As an in vivo graft, BP necessitates excellent biocompatibility and appropriate mechanical properties. Furthermore, it should closely mirror the architecture and functionality of the natural periosteum. This review provides a detailed summary of recent research progress on BP, incorporating inspiring studies that contribute to the future development of this field. Initially, the review examines the structure and function of the periosteum in the context of bone defect repair. Subsequently, it analyzes the current research and design concept for BP construction and provides a comprehensive overview of the materials and techniques employed in constructing BP. Finally, it summarizes the construction strategies of BP used for treating bone defects from various perspectives including structural and functional biomimicry, and discusses the latest advances in current research.