EPIPHYSEAL PLATE TRANSPLANTATION - AN HISTORICAL REVIEW

Non-vascularized and vascularized transplantation of epiphyseal plate autografts have been performed both clinically and experimentally for over 100 years. However, the ultimate clinical goal of vascularized tr ansplantation of epiphyseal plate allografts for paediatric extremity reconstruction remains elusive, due primarily to the lack of suitably nontoxic techniques to prevent graft rejection. We have summarized the published clinical and experimental investigations of vascularized ep iphyseal plate transplantation, and organized the experiments and clin ical operations into four main groups: (1) local vascular studies on u nmanipulated epiphyseal plates, (2) studies of epiphyseal plate behavi our after orthotopic replantation, (3) studies of epiphyseal plate beh aviour after heterotopic transplantation, and (4) studies of epiphysea l plate behaviour after allograft transplantation. Prior investigation s into the non-vascularized transplantation of epiphyseal plate autogr afts and allografts are presented as background. These groups of studi es serve as the building blocks for the more clinically applicable exp erimental investigations outlined in the final section of this review.