Treatment of deep hyalin cartilage defects with autologous perichondrial grafts
Deutscher übersetzter Titel: | Behandlung tiefer Hyalinknorpeldefekte mit autologem perichondralem Gewebe |
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Autor: | Bruns, J.; Steinhagen, J. |
Erschienen in: | International journal of sports medicine |
Veröffentlicht: | 24 (2003), 5, S. 382-388, Lit. |
Format: | Literatur (SPOLIT) |
Publikationstyp: | Zeitschriftenartikel |
Medienart: | Gedruckte Ressource Elektronische Ressource (online) |
Sprache: | Englisch |
ISSN: | 0172-4622, 1439-3964 |
Schlagworte: | |
Online Zugang: | |
Erfassungsnummer: | PU200411002971 |
Quelle: | BISp |
Abstract des Autors
Perichondrial transplantation was performed in 29 patients suffering from a deep chondral lesion with different etiologies. Only those patients with a cartilage lesion in the knee joint were included. Patients were initially and postoperatively examined using the Lysholm- and HSS-Score. In most of the patients (20/29) trauma and the recurrence of osteochondrosis dissecans (6/29) were the cause of the cartilage lesion. Most often the medial femoral condyle (19/29) and, secondly, the lateral femoral condyle (5/29) were involved. In six patients additional thera-peutic measures (ACL-plasty, n=2; high tibial osteotomy because of varus mal-alignment, n=4) had to be adopted. Follow-up examination was possible in 26/29 patients after a minimum postoperative period of 12 months. All patients exhibited a distinct and significant increase in both the Lysholm and the HSS-score. A follow-up after a minimum of 24 months was possible in 13/29 patients. Even these patients exhibited a distinct and significant improvement. Multiple follow-up examinations in 9/29 patients demonstrated maintenance of the first postoperative results obtained after one postoperative year for a maximum of 49 months in most of the patients. Only in one female patient, implantation of a semi-constrained total knee replacement was necessary because of osteoarthrosis resulting from crystal arthropathy (chondrocalcino-sis). It was possible to obtain biopsies from three patients at the time osteosynthetic material was removed. In all cases hyaline-like cartilage was histologically observed. In the treatment of selected patients suffering from a circumscript cartilaginous lesion resulting from trauma or the recurrence of osteochondritis dissecans with a concomitant cartilage lesion but without major signs of osteoarthritis, perichondrial grafting can achieve acceptable clinical results, after a short follow-up period. In order to achieve satisfying results a good selection of patients and additional treatment of other articular disorders, such as ACL-instability or axial mal-alignment, is necessary. Further studies have to be undertaken to evaluate the durability of these results over a longer period of time to see if osteoarthrosis can be avoided. Verf.-Referat