+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Articular reconstructions by a costochondral grafting (or osteochondral costal grafting)

Articular reconstructions by a costochondral grafting (or osteochondral costal grafting)

Bulletin de l'Academie Nationale de Medecine 190(7): 1439-56; Discussion 1456-7, 1475-7

We describe a novel technique of costochondral autografting for the treatment of trapeziometacarpal arthritis, radioscaphoid osteoarthritis, malunion of the distal end of the radius, and osteoarticular loss of the MP joints of long fingers. The costal graft harvest technique is always the same. A 5-cm horizontal incision is made over the 9th rib, and the rib is exposed at the osteocartilaginous junction. Cartilaginous grafts are harvested with a scalpel, and osteocartilaginous grafts with a saw. Since 1992, 116 patients with trapezio-metacarpal arthritis have been treated by partial trapeziectomy and autologous rib cartilage grafting. One hundred patients were reviewed with an average follow-up of 5.6 years. The results were better than those of trapeziectomy with tendon interposition or ligamentous reconstruction, owing to good stability of the thumb ray height. For the treatment of radioscaphoid osteoarthritis following scaphoid non union or chronic scapholunate instability, partial carpal arthrodesis and resection of the first row are the classical techniques. As an alternative to these procedures, 18 patients were treated by resection of the proximal portion of the scaphoid and insertion of an osteochondral costal autograft. Mean follow-up is 4.1 years. The results are excellent or good in 15 cases, fair in 2 cases, and poor in 1 case (luxation of the graft). Four patients with articular malunion of the distal radius received an osteocartilaginous costal graft to reconstruct the articular surface of the radius while avoiding partial or total arthrodesis of the wrist. Four patients with segmental osteoarticular loss of the longfingers were treated with the same technique, thereby avoiding silicone arthroplasty. We review the literature on cartilaginous rib grafts in maxillofajcial and orthopaedic surgery. In our experience, MRI and biopsy show viable cartilage but also histologic changes such as revascularization, fibrous transformation and bone metaplasia.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 051641843

Download citation: RISBibTeXText

PMID: 17450679

Related references

Arthroplasty of the interphalangeal joint of the great toe using costal osteochondral grafting. Journal of the American Podiatric Medical Association 96(6): 508-512, 2006

Intra-articular ramus ostectomy combined with costochondral grafting for the treatment of recurrent ankylosis of the mandible. British Journal of Oral and Maxillofacial Surgery 44(6): 497-500, 2005

Costal osteochondral grafting as a treatment method for avascular necrosis of the ring finger metacarpal: a case report. Journal of Hand Surgery, European Volume 39(3): 320-321, 2016

Intra-articular hyaluronan following autogenous osteochondral grafting of the knee. Arthroscopy 21(8): 999-1005, 2005

Can osteochondral grafting be augmented with microfracture in an extended-size lesion of articular cartilage?. American Journal of Sports Medicine 38(7): 1316-1323, 2010

Osteochondral grafting: effect of graft alignment, material properties, and articular geometry. Open Orthopaedics Journal 3: 61-68, 2009

Two-stage arthroplasty with joint distraction and costal osteochondral grafting for ankylosis of a metacarpophalangeal joint: nine years' follow-up. Journal of Plastic, Reconstructive and Aesthetic Surgery 61(6): E1-E4, 2008

Effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee. Knee Surgery, Sports Traumatology, Arthroscopy 20(1): 160-165, 2012

Mechanical effects of autogenous osteochondral surgical grafting procedures and instrumentation on grafts of articular cartilage. American Journal of Sports Medicine 32(3): 612-620, 2004

Effects of cryopreservation on the depth-dependent elastic modulus in articular cartilage and implications for osteochondral grafting. Journal of Biomechanical Engineering 137(5): 054502, 2015

Intra-articular osteoid osteoma of the lateral tibial plateau treated with arthroscopically assisted removal and retrograde osteochondral grafting. Knee 21(1): 343-348, 2014

Ultrasound properties of articular cartilage immediately after osteochondral grafting surgery: in cases of traumatic cartilage lesions and osteonecrosis. Knee Surgery, Sports Traumatology, Arthroscopy 17(1): 11-18, 2008

A comparison of patient-reported outcomes and arthroscopic findings between drilling and autologous osteochondral grafting for the treatment of articular cartilage defects combined with anterior cruciate ligament injury. Knee 20(5): 354-359, 2014

Costochondral rib grafting. Atlas of the Oral and Maxillofacial Surgery Clinics of North America 13(2): 139-149, 2005

Retrograde osteochondral grafting for osteochondral lesion of the talus: a new technique eliminating malleolar osteotomy. Acta Orthopaedica et Traumatologica Turcica 39(3): 274-279, 2005