Engkvist O, Johansson S H
Scand J Plast Reconstr Surg. 1980;14(1):71-87. doi: 10.3109/02844318009105737.
26 patients with painful and/or rigid small joints of the extremities have undergone surgery by a new arthroplasty method, utilizing the cartilaginous potential of the perichondrium demonstrated earlier in animal experiments. Perichondrium from the rib has been grafted to the articular surfaces of the affected joint after removal of the remaining ordinary articular cartilage. In 12 cases the joint disease was a sequela after trauma--either fracture involving the joint surfaces, or an open joint injury complicated by a purulent arthritis. In 6 cases there was an idiopathic degenerative joint disease and in 5 the arthritis was of rheumatic origin. In a further 3 cases the indications for operation were various. The follow-up period varied between 3 and 41 months. 13 patients classified as excellent regained range of motion and power and had no pain either at rest or at work. In 3 cases range of motion and power improved, but there was still some pain in the affected joint at work. Ten cases were not improved by the perichondrial arthroplasty and possible reasons for this are discussed. The results indicate that it is possible to restore joint function using free autologous perichondrial grafts from the rib.
26例患有四肢小关节疼痛和/或僵硬的患者接受了一种新的关节成形术，该方法利用了早期动物实验中所证实的软骨膜的软骨生成潜能。在去除剩余的普通关节软骨后，取自肋骨的软骨膜被移植到患关节的关节面上。12例患者的关节疾病是创伤后的后遗症——要么是累及关节面的骨折，要么是开放性关节损伤并发脓性关节炎。6例为特发性退行性关节病，5例为风湿性关节炎。另外3例的手术指征各不相同。随访期为3至41个月。13例患者恢复良好，恢复了活动范围和力量，休息和工作时均无疼痛。3例患者的活动范围和力量有所改善，但患关节在工作时仍有一些疼痛。10例患者接受软骨膜关节成形术后未见改善，并讨论了可能的原因。结果表明，使用取自肋骨的自体游离软骨膜移植有可能恢复关节功能。
