The development of early, biological concepts, techniques, and methods for joint reconstruction.
This article describes the development of techniques for the surgical mobilization of ankylosed joints, with particular emphasis on "interposition material," i.e. a substitute for the destroyed articular cartilage, used to present limitations of movement. In the 19th and 20th century, various different organic and non-organic materials were used experimentally as interposition material. The most commonly used tissue was fascia, but this was not fully satisfactory due its very low mechanical endurance. Research was then undertaken on using skin, given its resistance to pressure, better vascularization, and higher level of metabolic activity. The article describes one of the pioneering experiments, based on the observation of the first author, that under certain circumstances connective tissue cells undergo metaplasia into cartilage cells. The method of applying skin tissue in the place of the destroyed joint surface was successfully used in the past at the Orthopedics Clinic of the Cracow Academy of Medicine, under the direction of Prof. Juliusz Zaremba and his team. The research described here, conducted simultaneously in many places around the world, formed the foundation for our still growing knowledge in the area of multipotential human cells. It should be pointed out that after an initial period of fascination with joint endoprothesis, we are observing a return to biological methods, now based on genetic engineering.
Adam
A
Pachalski
Bogusław
B
Frańczuk