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DOI: 10.1055/s-0039-1697609
Autologous Costal Cartilage Graft—A New Method to Treat Articular Cartilage Defects: Case Report and Note of Surgical Technique
Publikationsverlauf
18. März 2018
06. August 2019
Publikationsdatum:
11. Oktober 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00033766/201804/lookinside/thumbnails/10-1055-s-0039-1697609_1800020-1.jpg)
Abstract
Full-thickness articular cartilage defects do not heal spontaneously. Several techniques have been developed to address this issue, but none resulted in the restitutio ad integrum of the articular cartilage. The most frequent sites of chondral lesion in the knee are medial femoral condyle and patella. The patellofemoral lesions are characterized by outcomes that are generally worse than those of tibiofemoral ones. To date, it has been well recognized the chondrogenic potential of rib perichondrium, and costal cartilage grafts have been extensively used in reconstructive surgery. Considering the need to find a gold standard technique to restore articular defect, we developed and here described a new technique to repair cartilage lesions of the knee using autologous costal cartilage graft with its perichondrium. This innovative surgical approach can be used to treat full thickness articular defects using autologous hyaline cartilage, making it possible to cover wide defects. This one step technique is low invasive, not technically demanding with minimal donor site morbidity and it has low costs. The long-term clinical efficacy of the method remains to be evaluated.
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References
- 1 Detterline AJ, Goldberg S, Bach Jr BR, Cole BJ. Treatment options for articular cartilage defects of the knee. Orthop Nurs 2005; 24 (05) 361-366
- 2 Richter DL, Schenck Jr RC, Wascher DC, Treme G. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health 2016; 8 (02) 153-160
- 3 Steadman JR, Rodkey WG, Briggs KK, Rodrigo JJ. [The microfracture technic in the management of complete cartilage defects in the knee joint]. Orthopade 1999; 28 (01) 26-32
- 4 Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 1994; 331 (14) 889-895
- 5 Enea D, Cecconi S, Busilacchi A, Manzotti S, Gesuita R, Gigante A. Matrix-induced autologous chondrocyte implantation (MACI) in the knee. Knee Surg Sports Traumatol Arthrosc 2012; 20 (05) 862-869
- 6 Gigante A, Enea D, Greco F. , et al. Distal realignment and patellar autologous chondrocyte implantation: mid-term results in a selected population. Knee Surg Sports Traumatol Arthrosc 2009; 17 (01) 2-10
- 7 Gille J, Schuseil E, Wimmer J, Gellissen J, Schulz AP, Behrens P. Mid-term results of autologous matrix-induced chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 2010; 18 (11) 1456-1464
- 8 Enea D, Cecconi S, Calcagno S, Busilacchi A, Manzotti S, Gigante A. One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study. Knee 2015; 22 (01) 30-35
- 9 Hangody L, Ráthonyi GK, Duska Z, Vásárhelyi G, Füles P, Módis L. Autologous osteochondral mosaicplasty. Surgical technique. J Bone Joint Surg Am 2004; 86-A (01) (Suppl. 01) 65-72
- 10 Bugbee WD, Convery FR. Osteochondral allograft transplantation. Clin Sports Med 1999; 18 (01) 67-75
- 11 Seo S-S, Kim C-W, Jung D-W. Management of focal chondral lesion in the knee joint. Knee Surg Relat Res 2011; 23 (04) 185-196
- 12 Gigante A, Calcagno S, Cecconi S, Ramazzotti D, Manzotti S, Enea D. Use of collagen scaffold and autologous bone marrow concentrate as a one-step cartilage repair in the knee: histological results of second-look biopsies at 1 year follow-up. Int J Immunopathol Pharmacol 2011; 24 (01) (Suppl. 02) 69-72
- 13 Brun P, Dickinson SC, Zavan B, Cortivo R, Hollander AP, Abatangelo G. Characteristics of repair tissue in second-look and third-look biopsies from patients treated with engineered cartilage: relationship to symptomatology and time after implantation. Arthritis Res Ther 2008; 10 (06) R132
- 14 Strauss EJ, Galos DK. The evaluation and management of cartilage lesions affecting the patellofemoral joint. Curr Rev Musculoskelet Med 2013; 6 (02) 141-149
- 15 Brophy RH, Wojahn RD, Lamplot JD. Cartilage restoration techniques for the patellofemoral joint. J Am Acad Orthop Surg 2017; 25 (05) 321-329
- 16 Du D, Sugita N, Liu Z. , et al. Repairing osteochondral defects of critical size using multiple costal grafts: an experimental study. Cartilage 2015; 6 (04) 241-251
- 17 Ohlsén L. Cartilage formation from free perichondrial grafts: an experimental study in rabbits. Br J Plast Surg 1976; 29 (03) 262-267
- 18 Ho TT, Cochran T, Sykes KJ, Humphrey CD, Kriet JD. Costal and auricular cartilage grafts for nasal reconstruction: an anatomic analysis. Ann Otol Rhinol Laryngol 2017; 126 (10) 706-711
- 19 Obert L, Loisel F, Gindraux F, Tropet Y, Lepage D. Rib cartilage grafting in upper limb surgery: an overview. SICOT J 2015; 1 (19) 13
- 20 Uppal RS, Sabbagh W, Chana J, Gault DT. Donor-site morbidity after autologous costal cartilage harvest in ear reconstruction and approaches to reducing donor-site contour deformity. Plast Reconstr Surg 2008; 121 (06) 1949-1955
- 21 Arøen A, Løken S, Heir S. , et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med 2004; 32 (01) 211-215
- 22 Yanke AB, Wuerz T, Saltzman BM, Butty D, Cole BJ. Management of patellofemoral chondral injuries. Clin Sports Med 2014; 33 (03) 477-500
- 23 Kitaoka E, Satomura K, Hayashi E. , et al. Establishment and characterization of chondrocyte cell lines from the costal cartilage of SV40 large T antigen transgenic mice. J Cell Biochem 2001; 81 (04) 571-582
- 24 Skoog T, Ohlsén L, Sohn SA. Perichondrial potential for cartilaginous regeneration. Scand J Plast Reconstr Surg 1972; 6 (02) 123-125