The chondrogenic potential of free autogenous periosteal and fascial grafts for biological resurfacing of major full-thickness defects in joint surfaces (an experimental investigation in the rabbit).

In the present study, 40 rabbits were used, 30 of them for the experiment and 10 as controls. Full layer defects of 7-14 mm which were produced on knee joint cartilage were repaired with free autogenous periosteal and fascial grafts. The defects were made on the weight bearing areas of the medial condyles of the femurs of rabbits. The full layer periosteal grafts which were taken from the upper parts of the anterior tibia of 15 rabbits were located so that the combium layer faced the joint, and sutured to synovial membrane with 6.0 vicryl. The defects of the other rabbits were covered with fascial grafts obtained from fascia lata and were sutured to synovial membrane with 6.0 vicryl. No grafting was performed on the 10 rabbits in the control group after production of defects. The rabbits were immobilized for two hours postoperatively, and then allowed to be active. The rabbits in the experimental group were sacrificed in the third, sixth and ninth weeks respectively, and the rabbits of the control group were sacrificed in the ninth week. The distal femurs of 40 rabbits were removed and examined both macroscopically and histologically. The collagen phenotype was determined biochemically. When the assessments were made, it was noticed that the joint faces of the rabbits which were repaired with periosteal grafts were smooth, a tissue resembling hyaline joint cartilage had developed, and the synthesis of collagen of type II increased. On the other hand, the joint faces of the rabbits which were repaired with fascial grafts were not smooth, immature cartilage had with fibrous tissue developed, and the synthesis of type II collagen accounted for 50 per cent. The joint faces of the control group were course and covered with fibrous tissue, and the collagen synthesized was type I. According to these findings, we suggest that the biological repair of joint cartilage defects is possible with free autogenous periosteal grafts.