The use of fibrin adhesive in the repair of chondral and osteochondral injuries

Abstract

Fibrin adhesive proved to be useful in the reattachment of chondral and osteochondral fragments. Its use is based on sound biological principles. It offers a number of advantages over internal fixation; it causes no further damage to the cartilage, even small chondral fragments can be reattached and a second operation for the removal of metalwork is unnecessary. Its bonding strength provides only contact stability, so that immobilization in plaster for 3 weeks is always necessary. In the last 5 years we have used fibrin adhesive in 28 patients for the fixation of 39 chondral or osteochondral fragments. Of these, 26 cases were followed up for periods of 6 months to 5 years. Twelve patients were examined arthroscopically; 9 of them showed complete healing of the fragments, and only 3 slight localized degenerative changes. In 15 cases we were able to see radiological healing. All except two showed union of the fragments and restoration of the joint surface. In view of our results fibrin adhesive can be recommended for the operative management of cartilage injuries.