Dolph Houben

21 Introduction and Outline of the Thesis 1 Hypothesis 4: Surgical angiogenesis will preserve viability, permit healing and maintain articular function of whole joint allotransplantation Aim 14: To successfully reconstruct complete loss of a whole knee joint by microsurgical transplantation of a whole knee joint VCA in a porcine model (Chapter 8). We will orthotopically transplant a whole porcine knee VCA with microsurgical anastomosis. Simultaneously, an autogenous cranial tibial AV bundle is implanted in the tibia and a muscular branch of the femoral biceps is implanted in the femur. The complete reconstruction will be covered by a pedicled gracilis muscle flap. Short-term immunosuppression will prevent rejection of the allogeneic pedicle during neo-angiogenesis occuring from the AV bundle. The entire knee joint VCA will be internally fixed with an intramedullary fixator system. Aim 15: To study allotransplant viability, healing and biomechanical properties of bone and joint tissues (Chapter 8). We will evaluate the viability of femoral and tibial bone and hyaline by histology and correlate these findings with mechanical properties, joint movement, weight bearing, and neo-angiogenesis measured by micro-CT.