Summary
Free, autogenous periosteal grafts from the medial metaphysis of the proximal tibia have been used to reconstruct full thickness cartilage defects of the articular surfaces of the knee joint. If there was a bone defect, it was initially filled with cancellous bone graft. The method is illustrated by six patients, three with acute traumatic patellar defects and three with local sclerotic osteochondritis of the medial femoral condyle. The latter had loose fragments unsuitable for fixation and single excision would have left a large and deep defect. The grafts have given satisfactory results, 14 to 59 months after the procedures. Clinical grading of the defects has been monitored by radiographs with arthroscopy of two knees and CT scan of one knee.
Résumé
On a eu recours, pour reconstruire toute l'apaisseur de pertes de substance cartilagineuses des surfaces articulaires du genou, à des greffes libres de périoste autologue, prélevées sur la face interne de la métaphyse supérieure du tibia. En cas de perte de substance osseuse on a commencé par la combler à l'aide de greffons d'os spongieux. Six cas illustrent cette technique, trois pertes de substance rotulienne d'origine traumatique et trois ostéochondrites du condyle fémoral interne. Le dernier cas présentait des corps étrangers dont la fixation était impossible et dont la résection simple aurait déterminé une vaste et profonde cavité. Les greffes ont donné des résultats satisfaisants, de 14 à 59 mois après l'opération. L'évolution locale a été suivie par des radiographies, par arthroscopie deux fois et par tomodensitométrie dans un cas.
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Korkala, O., Kuokkanen, H. Autogenous osteoperiosteal grafts in the reconstruction of full-thickness joint surface defects. International Orthopaedics 15, 233–237 (1991). https://doi.org/10.1007/BF00192300
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DOI: https://doi.org/10.1007/BF00192300