title: Rib cartilage grafting in upper limb surgery: an overview.
abstract: BACKGROUND
  Used routinely in maxillofacial reconstructive surgery, the chondrocostal graft is also used in hand surgery. The purpose of this overview was to analyze at long follow-up the radiological and histological evolution of this autograft, in the hand and wrist surgery.
  
  
  METHODS
  Since 1992, 144 patients have benefitted from a chondrocostal autograft: 116 osteoarthritis of the thumb carpometacarpal joint, 18 radioscaphoid arthritis, six articular malunions of the distal radius, four kienbock, and four traumatic loss of cartilage of the PIP joint. Magnetic Resonance Imaging (MRI) was performed in 19 patients and histological study in 12 patients with a mean follow-up of 68 months (4-159).
  
  
  RESULTS
  Whatever the indication, the reconstruction by a chondrocostal or ostochondrocostal graft has allowed us to obtain satisfactory clinical results at long follow-up. The main question was the viability of the graft. The radiological study has shown the non-wear of the graft and a certain degree of ossification. The MRI confirmed a very small degree of osseous metaplasia but its viability. The biopsies showed a neo-vascularization of the cartilage.
  
  
  CONCLUSIONS
  Despite the strong mechanical strain in the hand and wrist, the chondrocostal graft is a biological arthroplasty, trustworthy and secure at long time even if it can cause infrequent complications inherent to this type of surgery. Despite the inevitable histological modification, the cartilage remains alive and is of satisfactory quality at long term follow-up and fulfilling the requirements for interposition and reconstruction of an articular surface.
authors.affiliation: Orthopaedic and Traumatology Surgery Service, University Hospital of Besançon 25000 Besançon France ; Intervention, Innovation, Imagery, Engineering in Health (EA 4268), Medical and Pharmacology Section, IFR 133, University of Franche-Comté 25000 Besançon France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Obert
authors.affiliation: Orthopaedic and Traumatology Surgery Service, University Hospital of Besançon 25000 Besançon France ; Intervention, Innovation, Imagery, Engineering in Health (EA 4268), Medical and Pharmacology Section, IFR 133, University of Franche-Comté 25000 Besançon France.
authors.forename: François
authors.initials: F
authors.lastname: Loisel
authors.affiliation: Clinical Investigation Center in Biotherapy, University Hospital of Besançon France.
authors.forename: Florelle
authors.initials: F
authors.lastname: Gindraux
authors.affiliation: Orthopaedic and Traumatology Surgery Service, University Hospital of Besançon 25000 Besançon France ; Intervention, Innovation, Imagery, Engineering in Health (EA 4268), Medical and Pharmacology Section, IFR 133, University of Franche-Comté 25000 Besançon France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Tropet
authors.affiliation: Orthopaedic and Traumatology Surgery Service, University Hospital of Besançon 25000 Besançon France ; Intervention, Innovation, Imagery, Engineering in Health (EA 4268), Medical and Pharmacology Section, IFR 133, University of Franche-Comté 25000 Besançon France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lepage
keywords: Chondrocostal graft; Osteoarthritis; Rib cartilage; Upper limb surgery