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Vascularized osteochondral graft from the medial femoral trochlea: anatomical study and clinical perspectives

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Hugon, Sébastien Koninckx, Alain Barbier, Olivier [UCL]

PURPOSE: Few donor sites for vascularized reconstruction of convex joint surfaces have been described. We studied the feasibility of a convex vascularized osteochondral graft harvested from the medial femoral condyle and trochlea, on an anatomical and practical point of view. METHODS: An injection-corrosion technique was used on 16 fresh cadaver specimens, and completed by a modified Spalteholz clearing. The extra- and intraosseous vascularization of the medial femoral condyle was systematized and the luminal diameter of the arteries was microscopically measured. Radii of curvature of the medial trochlea and of the carpal bones were measured on arthro-CT-scanner reconstructed images. RESULTS: The periosteal vessels of the medial condyle are responsible for the whole peripheral intraosseous vascularization, without any watershed region. They are fed by the articular branch of the descending genicular artery and/or the superomedial genicular artery. Several constant vascular axes can be found, and may serve as a pedicle for a vascularized osteochondral graft from the medial femoral trochlea. The radii of curvature of this graft do fit those of the proximal carpal row. A simple surgical approach is suggested. CONCLUSIONS: A vascularized graft harvested on the medial femoral trochlea is a technically feasible procedure that could represent a new reconstructive tool for convex joint surfaces. Osteonecrosis of the proximal pole of the scaphoid or Kienböck's disease are among several situations

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2010
Language Anglais
Journal information "Surgical and Radiologic Anatomy : journal of clinical anatomy" - Vol. 32, no. 9, p. 817-25 (2010)
Peer reviewed yes
Publisher Springer France ((France) Paris)
issn 0930-1038
e-issn 1279-8517
Publication status Publié
Affiliations UCL - SSS/IREC/CARS - Computer Assisted Robotic Surgery
UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur
MESH Subject Bone Transplantation ; Cartilage, Articular ; Feasibility Studies ; Femur ; Humans ; Knee Joint ; Surgical Flaps
Links
  1. Ahmad CS, Cohen ZA, Levine WN, Ateshian G, Mow VC (2001) Biomechanical and topographic considerations for autologous osteochondral grafting in the knee. Am J Sports Med 29(2):201–206
  2. Al-Shaikh RA, Chou LB, Mann JA, Dreeben SM, Prieskorn D (2002) Autologous osteochondral grafting for talar cartilage defects. Foot Ankle Int 23(5):381–389
  3. Ansah Patrick, Osteochondral Transplantation to Treat Osteochondral Lesions in the Elbow, 10.2106/jbjs.f.00299
  4. Chettouane I., Kohler R., Dohin B., Brunet-Guedj E., Lecoq C., Chrestian P., Traitement de l’ostéochondrite disséquante du capitulum chez l’adolescent par autogreffe ostéochondrale monobloc : à propos de six cas et revue de la littérature, 10.1016/j.rco.2008.03.004
  5. del Piñal Francisco, García-Bernal Francisco J., Delgado Julio, Sanmartín Marcos, Regalado Javier, Reconstruction of the Distal Radius Facet by a Free Vascularized Osteochondral Autograft: Anatomic Study and Report of a Patient, 10.1016/j.jhsa.2005.07.005
  6. DEL PIÑAL F., GARCÍA-BERNAL F. J., REGALADO J., AYALA H., CAGIGAL L., STUDER A., Vascularised Corticoperiosteal Grafts from the Medial Femoral Condyle for Difficult Non-Unions of the Upper Limb, 10.1016/j.jhsb.2006.10.015
  7. Depreux R, Mestdagh H, Fontaine C, Moulleront S (1974) Vascularisation artérielle des condyles fémoraux. Lille chir 29(1):32–34
  8. Doi Kazuteru, Oda Tatsunori, Soo-Heong Tan, Nanda Vipul, Free vascularized bone graft for nonunion of the scaphoid, 10.1053/jhsu.2000.5993
  9. Doi Kazuteru, Sakai Kazuhiro, Vascularized periosteal bone graft from the supracondylar region of the femur, 10.1002/micr.1920150505
  10. Garretson Ralph B., Katolik Leonid I., Verma Nikhil, Beck Paul R., Bach Bernard R., Cole Brian J., Contact Pressure at Osteochondral Donor Sites in the Patellofemoral Joint, 10.1177/0363546503261706
  11. Gautier E., Kolker D., Jakob R. P., Treatment of cartilage defects of the talus by autologous osteochondral grafts, 10.1302/0301-620x.84b2.11735
  12. Gelberman Richard H., Panagis James S., Taleisnik Julio, Baumgaertner Michael, The arterial anatomy of the human carpus. Part I: The extraosseous vascularity, 10.1016/s0363-5023(83)80194-4
  13. Glowacki Julie, Angiogenesis in Fracture Repair : , 10.1097/00003086-199810001-00010
  14. Hangody László, Vásárhelyi Gábor, Hangody László Rudolf, Sükösd Zita, Tibay György, Bartha Lajos, Bodó Gábor, Autologous osteochondral grafting—Technique and long-term results, 10.1016/j.injury.2008.01.041
  15. Huntley J.S., Bush P.G., McBirnie J.M., Simpson A.H., Hall A.C., Chondrocyte Death Associated with Human Femoral Osteochondral Harvest as Performed for Mosaicplasty : , 10.2106/jbjs.d.02086
  16. Imhof H, Breitenseher M, Kainberger F, Rand T, Trattnig S, Importance of Subchondral Bone to Articular Cartilage in Health and Disease : , 10.1097/00002142-199906000-00002
  17. IMHOF HERWIG, SULZBACHER IRENE, GRAMPP STEFAN, CZERNY CHRISTIAN, YOUSSEFZADEH SORAYA, KAINBERGER FRANZ, Subchondral Bone and Cartilage Disease : A Rediscovered Functional Unit, 10.1097/00004424-200010000-00004
  18. Iwasaki Norimasa, Kato Hiroyuki, Kamishima Tamotsu, Suenaga Naoki, Minami Akio, Donor Site Evaluation after Autologous Osteochondral Mosaicplasty for Cartilaginous Lesions of the Elbow Joint, 10.1177/0363546507306465
  19. Jones David B, Bürger Heinz, Bishop Allen T, Shin Alexander Y, Treatment of Scaphoid Waist Nonunions with an Avascular Proximal Pole and Carpal Collapse : A Comparison of Two Vascularized Bone Grafts, 10.2106/jbjs.g.01503
  20. Judet R, Roy-Camille R, Guillamon JL (1972) Traitement de la pseudarthrose du scaphoïde carpien par le greffon pédiculé. Rev Chir Orthop Reparatrice Appar Mot 58(7):699–705
  21. Kälicke T., Bürger H., Müller E.J., Freies gefäßgestieltes Knorpel-Knochen-Transplantat bei avaskulärer Nekrose des proximalen Kahnbeinpols : Beschreibung eines neuartigen Operationsverfahrens, 10.1007/s00113-007-1308-5
  22. Kirschner Martin H., Importance of Arterial Blood Supply to the Femur and Tibia for Transplantation of Vascularized Femoral Diaphyses and Knee Joints, 10.1007/s002689900480
  23. Kirschner MH, Menck J, Hofmann GO, Anatomic bases of a vascularized allogenic knee joint transplantation: arterial blood supply of the human knee joint, 10.1007/bf01627603
  24. KUHLMANN J, MIMOUN M, BOABIGHI A, BAUX S, Vascularized bone graft pedicled on the volar carpal artery for non-union of the scaphoid, 10.1016/0266-7681(87)90014-3
  25. Larson Annalise Noelle, Bishop Allen T., Shin Alexander Y., Free Medial Femoral Condyle Bone Grafting for Scaphoid Nonunions With Humpback Deformity and Proximal Pole Avascular Necrosis : , 10.1097/bth.0b013e3180cab17c
  26. Lyons Tim J, McClure Sheena F, Stoddart Robert W, McClure John, The normal human chondro-osseous junctional region: evidence for contact of uncalcified cartilage with subchondral bone and marrow spaces, 10.1186/1471-2474-7-52
  27. Malinin T, Ouellette E.A, Articular cartilage nutrition is mediated by subchondral bone: a long-term autograft study in baboons, 10.1053/joca.1999.0324
  28. Masquelet A. C., Romana C., Penteado C. V., Vascularized Periosteal Grafts, Bone Transplantation (1989) ISBN:9783642835735 p.259-262, 10.1007/978-3-642-83571-1_57
  29. Oakeshott RD, Farine I, Pritzker KPH, Langer F, Gross AE (1988) A clinical and histologic analysis of failed fresh osteochondral allografts. Clin Orthop Relat Res 233:283–294
  30. Peña E., Calvo B., Martínez M.A., Palanca D., Doblaré M., Finite element analysis of the effect of meniscal tears and meniscectomies on human knee biomechanics, 10.1016/j.clinbiomech.2005.01.009
  31. Penteado C. V., Masquelet A. C., Romana M. C., Chevrel J. P., Periosteal flaps: Anatomical bases of sites of elevation, 10.1007/bf02094118
  32. Pinskerova V., Iwaki H., Freeman M. A. R., The shapes and relative movements of the femur and tibia at the knee, 10.1007/pl00003679
  33. Reddy AS, Frederick RW (1998) Evaluation of the intraosseous and extraosseous blood supply to the distal femoral condyles. Am J Sports Med 26(3):415–419
  34. Reddy Sudheer, Pedowitz David I., Parekh Selene G., Sennett Brian J., Okereke Enyi, The Morbidity Associated with Osteochondral Harvest from Asymptomatic Knees for the Treatment of Osteochondral Lesions of the Talus, 10.1177/0363546506290986
  35. ROGERS WILLIAM M., GLADSTONE HERMAN, VASCULAR FORAMINA AND ARTERIAL SUPPLY OF THE DISTAL END OF THE FEMUR : , 10.2106/00004623-195032040-00016
  36. Rothenfluh Dominique, Demhartner Thomas, Fraitzl Christian, Cecchini Marco, Ganz Reinhold, Leunig Michael, Potential role of pre-existing blood vessels for vascularization and mineralization of osteochondral graftsAn intravital microscopic study in mice, 10.1080/00016470410001330
  37. Sakai Kazuhiro, Doi Kazuteru, Kawai Shinya, Free Vascularized Thin Corticoperiosteal Graft : , 10.1097/00006534-199102000-00011
  38. Salon A, Hémon C, Chirurgie conservatrice dans la maladie de Kienböck avec arthrose périlunarienne : resurfaçage articulaire grâce au principe dit du « carpe banque », 10.1016/s1297-3203(03)00040-4
  39. Shasha Nadav, 10.1023/a:1023658832356
  40. Sheetz Kydee K., Bishop Allen T., Berger Richard A., The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts, 10.1016/s0363-5023(05)80136-4
  41. Shim SS, Leung G (1986) Blood supply of the knee joint. A microangiographic study in children and adults. Clin Orthop Relat Res 208:119–125
  42. Steinmann Scott P., Bishop Allen T., Berger Richard A., Use of the 1,2 intercompartmental supraretinacular artery as a vascularized pedicle bone graft for difficult scaphoid nonunion, 10.1053/jhsu.2002.32077
  43. Tanaka Y, Omokawa S, Fujii T, Kumai T, Sugimoto K, Takakura Y (2006) Vascularized bone graft from the medial calcaneus for treatment of large osteochondral lesions of the medial talus. Foot Ankle Int 27(12):1143–1147
  44. Tang Peter, Imbriglia Joseph E., Osteochondral Resurfacing (OCRPRC) for Capitate Chondrosis in Proximal Row Carpectomy, 10.1016/j.jhsa.2007.07.013
  45. TAYLOR G. IAN, MILLER GRAEME D. H., HAM FRANK J., THE FREE VASCULARIZED BONE GRAFT : A Clinical Extension of Microvascular Techniques, 10.1097/00006534-197505000-00002
  46. Thaunat Mathieu, Couchon Sophie, Lunn John, Charrois Olivier, Fallet Laure, Beaufils Philippe, Cartilage thickness matching of selected donor and recipient sites for osteochondral autografting of the medial femoral condyle, 10.1007/s00167-006-0222-7
  47. Warren L F, Marshall J L, The supporting structures and layers on the medial side of the knee : an anatomical analysis., 10.2106/00004623-197961010-00011
  48. Williams Seth K., Amiel David, Ball Scott T., Allen R. Todd, Tontz William L., Emmerson Bryan C., Badlani Neil M., Emery Shawn C., Haghighi Parviz, Bugbee William D., Analysis of Cartilage Tissue on a Cellular Level in Fresh Osteochondral Allograft Retrievals, 10.1177/0363546507305017
Bibliographic reference Hugon, Sébastien ; Koninckx, Alain ; Barbier, Olivier. Vascularized osteochondral graft from the medial femoral trochlea: anatomical study and clinical perspectives. In: Surgical and Radiologic Anatomy : journal of clinical anatomy, Vol. 32, no. 9, p. 817-25 (2010)
Permanent URL http://hdl.handle.net/2078/122050