Arthroplasties of PIP and MP joints using free perichondrium with thin layer of the costal cartilage called "chondro-perichondrial graft" were reported. Twenty-seven PIP joints and three MP joints were reconstructed between 1981 and 1997. They were nine ankylosis and twenty-severe severe contructures derived from septic arthritis or trauma. The results were satisfactory considering the pre-operative status; a great range of motion was achieved and it was maintained for a long time. We believe that the chondro-perichondrial graft is a useful technique for the reconstruction of severe damaged PIP and MP joints.