Transplantation of autogenous perichondrial or periosteal grafts for treatment of deep hyalin-cartilage lesions

The problem in the treatment of deep hyalin cartilage defects is due to the minimal regeneration potential of this specific tissue. Several attempts w ere made to solve this difficulties experimentally and clinically. The prol iferative potential of autogenous perichondrium/periost is well-known for d ecades. Perichondrium can be harvested from the lower ribs near to the sternum and periost from the adjacent bone (mostly proximal tibia). Experimentally and clinically, it has been shown that both types of tissue bear the potential to form hyalin-like cartilage under in vitro and in vivo conditions. Furthe rmore, regarding the biomechanical data (shear modulus) and the biochemical data (content of type II collagen) the newly grown tissue resembles normal hyalin cartilage. In addition, it has been shown that the transplant fixation with fibrin glu e is sufficient in order to allow early postoperative treatment with contin uous passive motion which is known to stimulate cartilaginuous regeneration . Despite the satisfying experimental and clinical results further examinat ions are needed in order to evaluate the optimal surgical technique and pos toperative regimen regarding the CPM-criteria. In addition, application of growth-factor might further improve this biological kind of treatment which has to be analysed.