J. Bruns et J. Steinhagen, Transplantation of autogenous perichondrial or periosteal grafts for treatment of deep hyalin-cartilage lesions, ORTHOPADE, 28(1), 1999, pp. 52-60
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.