Autologous osteoarticular transfer from the proximal tibiofibular joint to the scaphoid and lunate facets in the treatment of severe distal radial fractures: A report of two cases

Mehin, Ramin; Giachino, A. Alan; Bäckman, David; Grabowski, Jenny; Fazekas, A

doi:10.1053/jhsu.2003.50030

Cited by 25 publications

(21 citation statements)

References 15 publications

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“…Mehin et al reported two cases where an osteochondral graft from the proximal tibiofibular joint was used to reconstruct the scaphoid and lunate facets of the distal radius [3]. Roux described the use of the sigmoid notch of the distal radius to reconstruct the lunate fossa as an island transfer in five patients [4].…”

Section: Discussionmentioning

confidence: 99%

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A Novel Computational Method for Evaluating Osteochondral Autografts in Distal Radius Reconstruction

Kollitz

Huang

Hsu

et al. 2014

Hand (New York, N,Y.)

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Background We describe a novel computational method for assessing the fit of an osteochondral graft. We applied our software to five normal wrist computed tomography (CT) scans to determine the fit of the scaphoid to the lunate fossa of the distal radius. Methods CT scans of five wrists were digitally rendered. The capitate facet of the scaphoid was fit to the lunate fossa of the distal radius using custom software based on the iterative closest point (ICP) algorithm. This approach iteratively determines the optimal position of a model surface to minimize the sum of squares of distances from all points on a target surface. The fit of the two surfaces was reported by calculating the mean residual distance (MRD) between each point on one surface and its nearest neighbor on the other. Results The MRD for the five subjects was found to be 0.25 mm, with 82.8-98.3 % of the articular surfaces within 0.5 mm of each other. Conclusions We have developed a software algorithm for comparing two articular surfaces to test fit for a proposed joint reconstruction. The software is versatile and may be applied to any bony surface to identify new graft donor sites. The fit assessment renders a richer, three-dimensional understanding of the fit of the graft as compared to traditional twodimensional assessments.Level of Evidence: Decision analysis, Level V

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Section: Discussionmentioning

confidence: 99%

“…Autogenous osteochondral graft reconstruction of the articular surface of the distal radius has been described in small clinical case series [3][4][5][6][7]. Prior studies of osteochondral graft reconstruction of the distal radius have not included quantitative analysis of fit.…”

Section: Introductionmentioning

confidence: 99%

A Novel Computational Method for Evaluating Osteochondral Autografts in Distal Radius Reconstruction

Kollitz

Huang

Hsu

et al. 2014

Hand (New York, N,Y.)

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“…44 Lastly, osteoarticular grafts from the proximal tibiofibular joint have been used to reconstruct the scaphoid and lunate facets in severe distal radius fractures. 45 Our technique has several advantages including the lack of donor site morbidity since the grafts are harvested from resected carpal bones. There is usually sufficient healthy cartilage to allow graft harvest since the radiolunate joint is preserved even in advanced SLAC and SNAC wrist.…”

Section: Discussionmentioning

confidence: 99%

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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Proximal row carpectomy (PRC) has been shown in multiple studies to be an effective motion-preserving procedure for wrist arthritis. The operation consists of resection of the scaphoid, lunate, and triquetrum. 1 The proximal capitate and lunate fossa of the radius form the new wrist articulation, which makes the ideal patient free of degenerative changes at those articular surfaces. 2-8 Various authors, as well as the senior author, have maintained that when there is mild degeneration of these articular surfaces, PRC can still provide good to excellent results. [2][3][4][5][6]9 However, as wrist arthritis progresses, as in stage III scapholunate advanced collapse (SLAC) wrist or stage II/III scaphoid nonunion advanced collapse (SNAC) wrist, the proximal capitate becomes arthritic. With advanced degeneration, alternative surgical procedures include scaphoid excision, four-bone fusion, and wrist fusion. However, there Keywords ► osteochondral graft ► proximal row carpectomy AbstractBackground Proximal row carpectomy (PRC) is a useful treatment option for wrist arthritis, but the operation is contraindicated when there is arthritis of the capitate head. We describe a technique that involves resurfacing of a capitate that has focal chondrosis, using an osteochondral graft harvested from the resected carpal bones. Materials and Methods PRC patients who had a focal area of capitate chondrosis underwent osteochondral grafting of the capitate. Pre-and postoperative pain level, employment status, motion, grip strength, and Modified Mayo Wrist Scores (MMWS) were assessed. Postoperative Disability of the Arm, Shoulder, and Hand (DASH) scores were also calculated.

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“…region, Mehin et al reported two cases of autogenous osteochondral graft transfer from the proximal tibiofibular joint to resurface the distal radius in 2000. 20 Merrell et al described a technique of using the scaphoid facet of the same wrist as a nonvascularised osteochondral graft to reconstruct the sigmoid fossa in one patient in 2002. 21 In 2005 del Piñal et al published the case report on the use of a free vascularized osteochondral autograft from the second toe to reconstruct a defect involving 70% of the scaphoid facet of the distal radius in a 33-year-old male patient.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Osteochondral Grafting for Radiocarpal Joint Defects

Tse

Wong

et al. 2013

Jnl Wrist Surg

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Background?Focal chondral lesion is a common cause of chronic wrist pain. The best treatment remains unknown. We have developed a technique of arthroscopic transplantation of an osteochondral autograft from the knee joint to the distal radius with satisfactory clinical results. Materials and Methods?Between December 2006 and December 2010, four patients (average age 31 years) with posttraumatic osteochondral lesions over the dorsal lunate fossa were treated with arthroscopic osteochondral grafting. Pre- and postoperative motion, grip strength, wrist functional performance score, pain score, and return to work status were charted. Postoperative computed tomography (CT) scan, magnetic resonance imaging (MRI), and second-look arthroscopy were performed to assess graft incorporation. Description of Technique?With the arthroscope in the 3?4 portal, synovitis over the dorsal lunate fossa was d?brided to uncover the underlying osteochondral lesion. We employed the 6-mm trephine of the Osteoarticular Transfer System (OATS) to remove the osteochondral defect. Osteochondral graft was harvested from the lateral femoral condyle and delivered into the wrist joint arthroscopically. Results?In all cases, grafts incorporation was completed by 3?4 months postoperative. All patients showed improvement in the wrist performance score (preoperative 27.5, postoperative 39 out of 40) with no pain on final follow-up at average 48.5 months (range 24?68 months). Grip strength improved from 62.6 to 98.2% of the contralateral side. Motion improved from 115.5 to 131.3?. X-ray images showed preserved joint space. Patient satisfaction was high with no complication. Conclusion?An arthroscopic-assisted transfer of an osteochondral graft is a viable treatment option for chondral defects of the distal radius.

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Autologous osteoarticular transfer from the proximal tibiofibular joint to the scaphoid and lunate facets in the treatment of severe distal radial fractures: A report of two cases

Cited by 25 publications

References 15 publications

A Novel Computational Method for Evaluating Osteochondral Autografts in Distal Radius Reconstruction

A Novel Computational Method for Evaluating Osteochondral Autografts in Distal Radius Reconstruction

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Arthroscopic Osteochondral Grafting for Radiocarpal Joint Defects

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