title: Joint Arthroplasty With Osteochondral Grafting From the Knee for Posttraumatic or Degenerative Hand Joint Disorders.
abstract: OBJECTIVE
  To describe the operative procedure and report the clinical outcomes of articular surface reconstruction for various hand joint disorders using autologous osteochondral grafts from the knee.
  
  
  METHODS
  Ten patients underwent articular surface reconstruction for hand joint disorders with autologous osteochondral grafts from the patellofemoral joint. Mean patient age was 35 years (range, 15-52 y). The patients were followed for an average of 48 months (range, 16-89 mo). Arthroplasty was performed on the metacarpophalangeal joint in 4 cases, and on the proximal interphalangeal joint in 6 cases. The patients' clinical outcomes were evaluated with joint range of motion, visual analog scale (0-10 points), and Disabilities of the Arm, Shoulder, and Hand (DASH) score. Histological examination was performed in 3 cases after surgery.
  
  
  RESULTS
  Graft union was confirmed in all cases without radiographic evidence of resorption or necrosis. Follow-up radiographic examinations showed good graft incorporation without signs of osteoarthritis such as joint space narrowing. The finger flexion-extension arc improved significantly from an average of 21° to 61°. The mean visual analog scale also improved significantly from 7.0 to 1.5. The mean total active motion showed a significant improvement from 151° before surgery to 201° after surgery, and the mean DASH score improved significantly from 33 to 12. There were no significant differences for the arc of finger motion and DASH score between metacarpophalangeal and proximal interphalangeal joint disorders or between hemiarthroplasty and total joint arthroplasty. Histological examination revealed viable chondrocytes in the implanted cartilage.
  
  
  CONCLUSIONS
  Autologous osteochondral grafting from the patellofemoral joint provided satisfactory outcomes and may be a useful option for joint surface reconstruction of traumatic or degenerative hand joint disorders.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan. Electronic address: koda62@belle.shiga-med.ac.jp.
authors.forename: Narihito
authors.initials: N
authors.lastname: Kodama
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ueba
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takemura
authors.affiliation: Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Ishida
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Imai
authors.affiliation: Department of Orthopaedic Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Matsusue
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D050823:Hand Joints; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Osteochondral grafting; cartilage lesions; hand disorders; joint arthroplasty