TRANSPLANTATION OF AUTOGENOUS PERICHONDRI AL GRAFTS FOR TREATMENT OF HYALINE-CARTILAGE LESIONS

The purpose of this study was to examine the fate of autologous perich ondrial grafts after transplantation into cartilage lesions in weight- bearing joints. Results were evaluated depending on the age of the ani mals and on the weight-bearing conditions. Osteochondral lesions were drilled in the articular surface of knee joints in 36 adolescent sheep . The defects were filled with autologous rib perichondrial grafts whi ch were secured by either collagen sponges (n = 12) or fibrin glue (n = 12). Twelve animals served as controls. Following one week of immobi lisation the animals were allowed to move freely. Animals were sacrifi ced after 4, 8, 12, and 16 weeks. The same procedure was performed in three adult animals in order to achieve hints regarding the age-depend ent ingrowth of the transplants. In two of them the transplantation wa s done using fibrin glue for fixation; one animal served as control. G rafts were removed corresponding to the time intervalls and investigat ed histologically. In adolescent animals grafts from weight-bearing ar eas and control defects did not show a regular cartilaginuous differen tiation. In contrast to that, hyaline-like cartilage formation could b e noted in non-weight-bearing areas even after 4 weeks. In principle, the same results were found in adult sheep but a delay of cartilaginuo us differentiation of four weeks was observed. Depending on these resu lts we use the procedure of perichondrial transplantation clinically f or treatment of circumscript deep lesions of articular cartilage provi ded no osteoarthritis or any other overlying general diseases are evid ent. By means of the Lysholm- and Ranawat-score all six patients demon strated postoperative improvement. Furthermore, in two patients arthro scopic controls exhibited sufficient filling of the defects and ingrow th to the surrounding cartilage. Thus, autogenuous perichondrial trans plantation can be recommended for treatment of circumscript deep carti laginuous lesions of articular cartilage.