000			04213nam a22005297a 4500
008			171110s20182018 xxu||||| |||| 00| 0 eng d
022			_a0363-5023
040			_aOvid MEDLINE(R)
099			_a29033290
245			_aNonvascularized Cartilage Grafts Versus Vascularized Cartilage Flaps: Comparison of Cartilage Quality 6 Months After Transfer and Isolated From Surrounding Bone Ingrowth.
251			_aJournal of Hand Surgery - American Volume. 43(2):188.e1-188.e8, 2018 02.
252			_aJ Hand Surg [Am]. 43(2):188.e1-188.e8, 2018 02.
252			_zJ Hand Surg [Am]. , 2017 Oct 12
253			_aThe Journal of hand surgery
260			_c2018
260			_fFY2018
266			_d2017-11-10
268			_aJournal of Hand Surgery - American Volume. , 2017 Oct 12
501			_aAvailable in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present
520			_aCLINICAL RELEVANCE: In locations in which perfusion from surrounding bone may be limited (ie, proximal scaphoid or proximal lunate reconstruction), articular reconstruction using vascularized osteochondral flaps will yield superior cartilage organization and architecture than nonvascularized osteochondral grafts. The clinical and functional relevance of this finding requires further study.
520			_aCONCLUSIONS: When deprived of subchondral perfusion from underlying bone, osteochondral vascularized flaps in an intrasynovial environment demonstrate superior cartilage quality and survival compared with nonvascularized grafts.
520			_aCopyright (c) 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
520			_aMETHODS: Two adjacent osteochondral segments were harvested on the medial femoral trochlea in domestic 6- to 8-month-old pigs. Each segment measured approximately 12 mm x 15 mm x 17 mm. One segment was maintained on the descending geniculate artery vascular pedicle. The adjacent segment was separated from the pedicle to serve as a nonvascularized graft. A thin layer of methylmethacrylate cement was used to line the harvest site defect to prevent vascular ingrowth to the subsequently replaced specimens. The pigs were maintained on a high-calorie feed and returned to ambulation and full weight-bearing on the surgical legs. The animals were sacrificed after 6 months and the specimens were reharvested, sectioned, and examined. The cartilage was graded by 2 pathologists blinded to the origin of specimens as vascularized flaps or nonvascularized grafts.
520			_aPURPOSE: Subchondral perfusion of osteochondral grafts has been shown to be important in preventing long-term cartilage degeneration. In carpal reconstruction, subchondral perfusion from the graft bed is limited. This study's purpose was to compare the histological characteristics of cartilage in osteochondral grafts supported by synovial imbibition alone to cartilage of vascularized osteochondral flaps that have both synovial and vascular pedicle perfusion.
520			_aRESULTS: All specimens were assigned scores utilizing the International Cartilage Repair Society grading system. Scoring for chondrocyte viability, cartilage surface morphology, and cell and matrix appearance was significantly higher in the vascularized osteochondral group than in the graft group.
546			_aEnglish
650			_a*Cartilage
650			_a*Femur
650			_a*Surgical Flaps/bs [Blood Supply]
650			_aAnimals
650			_aCartilage/bs [Blood Supply]
650			_aCartilage/tr [Transplantation]
650			_aCell Survival
650			_aChondrocytes/cy [Cytology]
650			_aFemur/bs [Blood Supply]
650			_aFemur/tr [Transplantation]
650			_aMicroscopy
650			_aModels, Animal
650			_aSwine
651			_aMedStar Union Memorial Hospital
656			_aCurtis National Hand Center
657			_aJournal Article
700			_aHiggins, James P
790			_aBenlidayi ME, Borumandi F, Burger HK, Gaggl AJ, Higgins JP, Polat S, Sencar L, Vasilyeva A
856			_uhttps://dx.doi.org/10.1016/j.jhsa.2017.09.014 _zhttps://dx.doi.org/10.1016/j.jhsa.2017.09.014
942			_cART _dArticle
999			_c2815 _d2815