Autologer Ersatz zerstörter Gelenkflächenanteile des Daumensattelgelenkes durch Knorpel-Knochen-Dübel bei posttraumatischer Arthrose

Abstract

We report about a successful reconstruction of the first carpometacarpal joint (CMC-joint) of the right hand in a 23 years old man with a posttraumatic defect using the OATS-technique (Osteochondral Autologous Transfer System). 2 autologous osteochondral cylinders with matching surfaces were harvested from the knee joint and implanted in osteoarthritic areas of the CMC-1 joint surface in press fit technique. After primary healing clinical and radiological controls were assessed 6 and 12 weeks postoperatively. At clinical follow-up 1 year after the function of the CMC-1 joint was completely free, function nearly fully restored. The osteochondral grafts revealed a sound healing in an additional MRI-investigation. 3 years after the operation, the DASH-score of the patient was measured with 4.2 points. With view to the encouraging results of the OATS technique in other joints it should be taken into consideration in cases of osteoarthritic CMC-1 joint respecting indicatory limitations.