Periosteal transplantation in the treatment of osteochondritis dissecans

Abstract

transplantation in the treatment of osteochondritis dissecans. Scand J Med Sci Sports 1992: 2: 32-36.Osteochondritis dissecans in the femoral condyle of the knee in 3 patients was treated with periosteal transplantation. The cavities were curetted to cancellous bone and a tibial periosteal graft was lined to the excavation and fixed with human tissue glue (Tisseel R). By clinical and radiographic follow-up, we find this modality of treatment as a hopeful prospect in severe cases, though a demarcation of indication is still a challenge for investigation.The advocated treatment of a large osteochondritis dissecans (OD) process in the femoral condyles consists of replacement of the fragment and preparation of the bed to secure revascularization, since established juvenile or adult OD does not always heal spontaneously (1).Fixation of the fragment with Kirschner wires and cancellous bone grafting is often necessary to bring the fragment in level with the surrounding surface. Lipscomb et al.(2) used this procedure with a postoperative plaster immobqization period of 12.5 weeks (3-28) and a non-weight-bearing period of 10 weeks (6-16).Inspired by the excellent results obtained by Niedermann et al. (3) in the treatment of OD with periosteal transplantation to the excavated and t.

Skeletal Cell Fate Decisions Within Periosteum and Bone Marrow During Bone Regeneration

“…A better understanding of the fate of cells within the fracture callus is necessary to assess the success of future cell‐based therapies. Several methods can be used to enhance bone repair in human, such as iliac crest bone grafts, cortical bone grafts, and periosteal grafts. Whether MSCs from bone marrow or other sources actually contribute to repair or support healing by providing factors inducing chondrogenesis or osteogenesis is not known. MSCs from the bone marrow have been shown to differentiate into osteoblasts and chondrocytes in vitro and are largely used in multiple tissue engineering approaches. Data show here that cells derived from bone marrow behave differently when they are recruited from their original niche because they mainly support osteogenesis in vivo. Although MSCs remain the most promising source of cells for human therapy, the mode of delivery and the fate of these cells once transplanted in vivo need to be considered.…”

Treatment of tear of the anterior cruciate ligament combined with localised deep cartilage defects in the knee with ligament reconstruction and autologous periosteum transplantation

“…In experimental studies it has been shown that the periosteum has a chondrogenic potential [8,18,20], and a few clinical studies indicate a chondrogenic effect in hu- mans [1,5,9,10,14]. Recently, we reported excellent and good short-term (mean follow-up 27 months) results for 18 patients with deep cartilage lesions of the patella that were treated with autologous periosteum transplants fixed to the patellar subchondral bone bed with resorbable throughout sutures and fibrin glue (Tisseel) [11].…”

“…In the few clinical reports on autologous periosteum transplantation, the fixation of the transplant varies. In some reports the transplant is sutured to the surrounding cartilage [2, 5, 10], while in others [1, 9,14] it is glued to the underlying bed with fibrin glue (Tisseel). With our method, the periosteum transplant is anchored to the bottom of the cartilage defect on the femoral condyle with the use of suture anchors and fibrin glue, to minimize the risk of loosening during rehabilitation training.…”

“…The fixation of the periosteum transplant varies in the different studies. In some the transplant is sutured to the surrounding cartilage [5, 10], while in others [1, 9,14] it is glued to the underlying bed with fibrin glue (Tisseel). Recently, we reported a method for fixation of the periosteum transplant to the patellar subchondral bone bed with resorbable throughout sutures and fibrin glue (Tisseel) injected under the transplant [11].…”

Ευοδωτικοί Και Ανασταλτικοί Παράγοντες Στη Μέθοδο Εμφύτευσης Ομόλογου Περιοστέου Σε Βλάβες Του Αρθρικού Χόνδρου Του Γόνατος

“…Ένα άλλο πεδίο που έχουν χρησιμοποιηθεί κλινικά τα περιοστικά μοσχεύματα είναι στη διαχωριστική οστεοχονδρίτιδα (109,125,195) . Η μεγαλύτερη σειρά είναι του Masden 163 και συνεργατών οι οποίοι αντιμετώπισαν 18 ασθενείς (11 άνδρες και 7 γυναίκες) με μέσο όριο ηλικίας τα 19 έτη.…”