The experimental reconstruction of articular cartilage using autogenous periosteal and perichondreal implants.

Injured cartilage has a limited capacity to heal itself. Untreated damage leads to secondary osteoarthritis. There is a need to find a way to reconstruct cartilage in order to prevent secondary osteoarthritis. The aim this study was to evaluate and compare the chondrogenic potential of three different cell materials: perichonrdrial grafts, periosteal grafts and bone marrow in situ. The mesenchemal cells contained in these materials can differentiate in the joint environment into chondrocytes and rebuild articular cartilage.
Forty nine (49) White New Zealand rabbits were used in our experiment. An osteochondrial (full-thickness) defect was created in the joint surface of both ends of the femoral bone. The animals were divided according to the procedure used:
I - cartilage reconstruction by periosteal grat,
II - cartilage reconstruction by perichondrial graft,
III - no graft.
The joint was not immobilized after surgery. Follow-up exams were performed at 4, 8, and 12 weeks. The results were evaluated macroscopically and microscopically.
The results pointed to the chondrogenic potential of periosteum and perichondrium after grafting to cartilage defects. On gross examination the articular surface was found to be reconstructed. Microscopic examination revealed regeneration, with the formation of hyaline-like cartilage. Regenerating tissue was also found in the group without grafts. The structure resembled normal articular cartilage; however, neither the joint surface nor the subchondrial bone were fully reconstructed. No qualitative or quantitative differences were found between the groups treated with periosteal and perichondral grafts.
Our study confirmed that grafts of periosteum or perichondrium have chondrogenic potential, i.e. the ability to generate cartilage tissue whose features are similar to those of the hyaline chondrial tissue in the joint. Both materials have similar chondrogenic potential. The chondrogenic properties of perichondrium and perisostem produce better results in the various categories in comparison to those of bone marrow.

[Free vascularized joint transfer during surgery for hypoplastic thumb]. / Wolny unaczyniony przeszczep stawu w leczeniu operacyjnym wrodzonej hipoplazji kciuka.

Hypoplasia and aplasia of the thumb constitute approximately 11% of congenital disorders of the upper extremity. Surgical treatment depends on type of disorder in Blauth classification used in our Department. Soft tissue procedures and pollicisations are performed most often. Microsurgical transplantation of interphalangeal joint from the toe is an alternative. This paper describes a case of microsurgical treatment in 20 years old patient with hypoplastic thumb. Two months after surgery the range of motion in transplanted joint was between 20 and 75 degrees.

Histopathology of muscle flap microcirculation following prolonged ischemia.

The purpose of this study was to evaluate histological changes occurring in the microcirculation of a muscle flap following prolonged ischemia and to correlate them with the flow hemodynamics. The cremaster muscle flap model was used for direct in vivo studies of the microcirculation. In 45 rats, vascular clamps were applied to the iliac and femoral vessels following flap isolation. Flaps were subjected to various periods of ischemia, ranging from 4 to 6 hours, and 2 hr of reperfusion. In vivo observations of the microcirculation and vessel diameter measurements were taken at 1 hour intervals for an 8 hr period. With prolonged ischemia, return of circulation to the flap was delayed and no flow was observed following 6 hr of ischemia. Morphologic changes at 6 hr revealed red cell and platelet thrombi formation within the capillaries, marked dilatation of postcapillary venules, endothelial swelling in the capillaries, and microhemorrhage formation around the venules.

[Is the giant cell tumor in the distal part of the radius a tumor with a high potential malignancy?]. / Czy guz olbrzymiokomórkowy dalszej czesci kosci promieniowej jest nowotworem o wiekszej potencjalnej zlosliwosci?

The effects of the cure of four patients with the giant-cell tumor in the distal part of the radius have been resumed by the authors. In their opinion positive effects of the cure depend on suitable radical of surgery but not on primary location of the tumor.

[Apert Syndrome--orthopedic aspects and treatment outcome]. / Zespól Aperta--aspekty ortopedyczne i wyniki leczenia.

Several years follow up of 3 patients aged from 4 to 14 years with acrocephalosyndactyly of Apert Syndrome type is described. Functional evaluation of the hands was performed before the onset and after completion of treatment. Psychological tests run since the beginning of treatment were analyzed. In all cases remarkable improvement of function and shape was achieved, but progressive bony changes within phalanges negatively influence all over results.