Abstract THE feasibility of whole-joint transplantation as a means of replacement of destroyed joints has long intrigued surgeons interested in reconstruction. Although it has been shown that articular cartilage of autogenous whole joints appears to survive transplantation, it ultimately undergoes progressive destruction.1,2 While the sequence of changes has been studied extensively, the mechanism is not yet understood. It would be considerably more practical, if it were possible, to replace the destroyed joints with homografts, but even without the genetic factors of rejection, the autografts are not able to withstand the long-term effects of transplantation. In previous experiments from this Department attempts have been made to analyze the factors contributing to the ultimate destruction of articular cartilage.1,3 The following have been considered as possible contributing factors: mechanical stress, disturbance of vascular and nerve supply, and alteration of synovial fluid. However, with whole-joint transplants it was not possible to differentiate the References 1. Entin, M.A.; Alger, J.R.; and Baird, R.M.: Experimental and Clinical Transplantation of Autogenous Whole-Joints , J Bone Joint Surg 44A:1518, 1962. 2. Herndon, C.H., and Chase, S.W.: The Fate of Massive Autogenous and Homogenous Bone Grafts Including Articular Surfaces , Surg Gynec Obstet 98:273-290, 1954. 3. Entin, M.A.; Daniel, G.A.; and Kahn, D.S.: The Role of Vascularization and Nerve Supply in Experimental Transplantation of Autogenous Bone and Joint Component, Proceeding of the III International Congress of Plastic Surgery, October, 1963. 4. Erdelyi, R.: Experimental Autotransplantation of Small Joints , Plast Reconstr Surg 31:129-139, 1963.Crossref 5. Erdelyi, R.: Histological and Clinical Picture of Transplanted Joints in Experimental Conditions , Acta Chir Orthop Traum Cech 29:493-502 ( (Dec) ) 1962. 6. Herndon, C.H., and Chase, S.W.: Experimental Studies in the Transplantation of Whole-Joints , J Bone Joint Surg 34A:564-578 ( (July) ) 1952. 7. Impallomeni, G.: Sul Trapianto delle Articolazioni , Arch Ortop 28:342-368, 1911. 8. Minoura, M.: Studien uber Gelenktransplantation (inkl. Intermediarknorpel) in Weichteile , Frankfurt Z Path 15:379-458, 1914. 9. Allbrook, D.N., and Kirkaldy-Willis, W.H.: The Restoration of Articular Surfaces After Joint Excision , J Bone Joint Surg 40B:742-764, 1958. 10. Dingman, R.O., and Grabb, W.C.: Reconstruction of Both Mandibular Condyles With Metatarsal Bone Grafts , Plast Reconstr Surg 34:441-451, 1964.Crossref 11. Entin, M.A., and Petrie, J.G.: Congenital Absence of the Radius, Transactions of the International Congress of Plastic Surgery, Vol. 1, 1956. 12. Imamalie, A.S.: Transplantation of Semi-Joint in Experiment , Orthop Traum Protex 2:43-46, 1960. 13. Kahn, D.S.; Baird, R.M.; and Entin, M.A.: Histopathological Study of Experimental Transplantation of Autogenous Whole-Joints (to be published). 14. Brodin, H.: Paths of Nutrition in Articular Cartilage and Intervertebral Discs , Acta Orthop Scand 24:177-183, 1955.Crossref 15. Ekholm, R.: Articular Cartilage Nutrition: How Radioactive Gold Reaches the Cartilage in Rabbit Knee Joint , Acta Anat 15( (suppl) ):1-76, 1951. 16. Ekholm, R.: Nutrition of Articular Cartilage: A Radioautographic Study , Acta Anat 24:329-338, 1955.Crossref 17. Eloesser, Leo: On the Nature of Neuropathic Affections of the Joints , Ann Surg 166:201-207, 1917.Crossref 18. Heller, L.; Heller, H.I.; and Petrie, J.G.: Orthopedic Problems of Hereditary Sensory Neuropathy , J Bone Joint Surg 37B:632-638, 1955. 19. Bennet, G.A., and Bauer, W.: Joint Changes Resulting From Patella Displacement and Their Relation to Degenerative Joint Disease , J Bone Joint Surg 19:667, 1937. 20. Charnley, J.: Lubrication of Joints , Ann Rheum Dis 19:10-19, 1960.Crossref 21. Hall, M.C.: Cartilage Changes After Experimental Immobilization of the Knee Joint of the Young Rat , J Bone Joint Surg 45A:36-44, 1963. 22. Salter, R.B., and Field, P.: The Effects of Continuous Compression on Living Articular Cartilage , J Bone Joint Surg 42A:31-49, 1960.
Archives of Surgery – American Medical Association
Published: Mar 1, 1968