Perichondrial arthroplasty. A clinical study in twenty-six patients.

26 patients with painful and/or rigid small joints of the extremities have undergone surgery by a new arthroplasty method, utilizing the cartilaginous potential of the perichondrium demonstrated earlier in animal experiments. Perichondrium from the rib has been grafted to the articular surfaces of the affected joint after removal of the remaining ordinary articular cartilage. In 12 cases the joint disease was a sequela after trauma--either fracture involving the joint surfaces, or an open joint injury complicated by a purulent arthritis. In 6 cases there was an idiopathic degenerative joint disease and in 5 the arthritis was of rheumatic origin. In a further 3 cases the indications for operation were various. The follow-up period varied between 3 and 41 months. 13 patients classified as excellent regained range of motion and power and had no pain either at rest or at work. In 3 cases range of motion and power improved, but there was still some pain in the affected joint at work. Ten cases were not improved by the perichondrial arthroplasty and possible reasons for this are discussed. The results indicate that it is possible to restore joint function using free autologous perichondrial grafts from the rib.