Purpose: To evaluate repair of articular cartilage.

Methods: Ten cases of ten knees (6 males and 4 females) were evaluated in the current study. Seven knees treated by osteochondral graft including six receiving mosaic plasty and one receiving Pasteurization. Four knees treated by periosteal graft. One knee received both mosaicplasty and periosteal graft. Mean patient age at surgery was 31 years old. Eight knees underwent follow-up MRI, 6 knees underwent follow-up arthroscopy, and 4 knees underwent needle biopsy after informed consent was obtained. The mean period from the surgery to final follow-up was 21 months. The mean period from surgery to follow-up arthroscopy was 10 months.

Results: Seven cases of osteochondral graft presented good regeneration of articular surface by MRI and arthroscopic examination. Two knees receiving mosaic plasty demonstrated regeneration of hyaline cartilage even between the gaps in mosaicplasty. However, the structure of hyaline cartilage differed from that of normal cartilage. Pasteurization in one case also demonstrated good regeneration of hyaline cartilage. One knee treated by periosteal graft demonstrated regeneration of hyaline cartilage. However, the graft area in another such knee was covered by fibrous tissue. One periosteal graft became detached 14 days after surgery. There were no cases showing ossification after periosteal graft.

Conclusion: Periosteal graft could cover a wide defect of articular surface. However, induction of cartilage was not good. Osteochondral graft is a sure method of repairing hyaline cartilage where there is a small defect in the articular surface. Our results from needle biopsy demonstrated hyaline cartilage in the gaps among mosaicplasty areas, but the structure of hyaline cartilage was not good. There is a risk of re-degeneration due to the poor structure of hyaline cartilage. Careful observation is needed in both periosteal graft and mosaic plasty cases.

We have examined whether the rotatory subluxation of the scaphoid which is seen in patients with advanced Kienböck’s disease is associated with scapholunate advanced collapse (SLAC) wrist. We studied 16 patients (11 men, 5 women) who had stage-IV Kienböck’s disease with chronic subluxation of the scaphoid. All had received conservative treatment. The mean period of affection with Kienböck’s disease was 30 years (14 to 49). No wrist had SLAC. In eight patients, 24 years or more after the onset of the disease, the articular surface of the radius had been remodelled by the subluxed scaphoid with maintenance of the joint space. The wrists of six patients were considered to be excellent, nine good, and one fair according to the clinical criteria of Dornan.

Our findings have shown that rotatory subluxation of the scaphoid in Kienböck’s disease is not a cause of SLAC wrist and therefore that scaphotrapezio-trapezoid arthrodesis is not required for the management of these patients.