Experimental vascularized total joint autografts--a primate study |
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Authors: | T M Tsai L Ogden S H Jaeger K Okubo |
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Affiliation: | 1. Department of Surgery, University of Louisville;2. Department of Pathology, Jewish Hospital;3. University of Louisville Affiliated Hospitals, Louisville, Ky;4. Department of Orthopaedics, The Jikei University School of Medicine, Tokyo, Japan. |
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Abstract: | Autogenous vascularized and nonvascularized total joint transfers were studied in the hands of Macaca fascicularis monkeys. Nine second toe proximal interphalangeal joints were transferred as a vascularized free graft to the hand, and the excised finger joints were transferred to the foot as a nonvascularized free graft. The grafts were examined clinically and histopathologically at 16 weeks to 10 months. Two of the nonvascularized free grafts were amputated because of infection and necrosis. Three had chronic infections. The four surviving nonvascularized grafts demonstrated necrosis of the hyaline cartilage and degenerative changes. Of the nine vascularized joints, one developed a wound infection that required amputation, another failed at 2 weeks because of wound dehiscence, and the remaining seven survived with preservation of the hyaline articular surfaces. The experimental technique was designed to be easily applied to clinical use. A skin island is provided as a "patency/viability monitor." The extensor mechanism is included in the graft for early function. |
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Keywords: | Reprint requests: Tsu-Min Tsai M.D. 1001 Doctors Office Bldg. 250 East Liberty St. Louisville KY 40202. |
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