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Spine Aug 2023Controlled animal study.
STUDY DESIGN
Controlled animal study.
OBJECTIVE
To assess the cellular contribution of autograft to spinal fusion and determine the effects of intraoperative storage conditions on fusion.
SUMMARY OF BACKGROUND DATA
Autograft is considered the gold standard graft material in spinal fusion, purportedly due to its osteogenic properties. Autograft consists of adherent and non-adherent cellular components within a cancellous bone scaffold. However, neither the contribution of each component to bone healing is well understood nor are the effects of intraoperative storage of autograft.
MATERIALS AND METHODS
Posterolateral spinal fusion was performed in 48 rabbits. Autograft groups evaluated included: (1) Viable, (2) partially devitalized, (3) devitalized, (4) dried, and (5) hydrated iliac crest. Partially devitalized and devitalized grafts were rinsed with saline, removing nonadherent cells. Devitalized graft was, in addition, freeze/thawed, lysing adherent cells. For 90 minutes before implantation, air dried iliac crest was left on the back table whereas the hydrated iliac crest was immersed in saline. At 8 weeks, fusion was assessed through manual palpation, radiography, and microcomputed tomography. In addition, the cellular viability of cancellous bone was assayed over 4 hours.
RESULTS
Spinal fusion rates by manual palpation were not statistically different between viable (58%) and partially devitalized (86%) autografts ( P = 0.19). Both rates were significantly higher than devitalized and dried autograft (both 0%, P < 0.001). In vitro bone cell viability was reduced by 37% after 1 hour and by 63% after 4 hours when the bone was left dry ( P < 0.001). Bone cell viability and fusion performance (88%, P < 0.001 vs . dried autograft) were maintained when the graft was stored in saline.
CONCLUSIONS
The cellular component of autograft is important for spinal fusion. Adherent graft cells seem to be the more important cellular component in the rabbit model. Autograft left dry on the back table showed a rapid decline in cell viability and fusion but was maintained with storage in saline.
Topics: Animals; Rabbits; Spinal Fusion; Autografts; X-Ray Microtomography; Spine; Transplantation, Autologous; Bone Transplantation; Lumbar Vertebrae; Ilium
PubMed: 37078877
DOI: 10.1097/BRS.0000000000004688 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Dec 2022To review the research progress of the application of autologous fat grafting in perioral and lower face rejuvenation. (Review)
Review
OBJECTIVE
To review the research progress of the application of autologous fat grafting in perioral and lower face rejuvenation.
METHODS
By extensively reviewing related articles and combining the clinical experiences, the anatomic features (fat compartments and blood supply), aging features of the perioral and lower face, and the application advancement and related complications of autologous fat grafting in this area were generally summarized.
RESULTS
The aesthetic features of perioral and lower face include the lip, chin, and so on, and the anatomic structures relating autologous fat grafting include the mandibular fat compartments, chin fat compartments, and other fat compartments. Meanwhile, the facial artery passes through this area and spreads out several important branches. The aging features of perioral and lower face include the depening of nasolabial fold, the aging lip, perioral wrinkles, "marionette lines", and so on. Autologous fat grafting can improve perioral and lower face rejuvenation by restoring volume loss of facial fat compartments, correcting aging malformation, and improving skin quality. But there are neurovascular injuries, facial aesthetic problems, and other related complications.
CONCLUSION
Autologous fat grafting can be applied in perioral and lower face rejuvenation, and it can effectively improve related aging features. There are several aspects developing aggressively, including the research of facial asthetics features of Chinese people, combining autologous fat grafting with surgery as well as other methods to comprehensively treat facial aging, and the application of fat tissue related derivatives in perioral and lower face rejuvenation. However, the resorption rate of facial grafted fat tissue is still too high, and the long-term effectiveness can not be assured. In the future, the solutions related to improving the survival rate of grafted fat tissue need to be explored in the future.
Topics: Humans; Rejuvenation; Adipose Tissue; Rhytidoplasty; Autografts; Chin
PubMed: 36545864
DOI: 10.7507/1002-1892.202207044 -
Orthopaedics & Traumatology, Surgery &... Dec 2021Superior capsular reconstruction (SCR) is a treatment option for patients with massive irreparable rotator cuff tears. Different types of grafts from various donor sites...
AIMS
Superior capsular reconstruction (SCR) is a treatment option for patients with massive irreparable rotator cuff tears. Different types of grafts from various donor sites have been described. There are no clinical studies comparing the different grafts available. The aim of this study is to compare the early clinical outcomes of patients who have undergone arthroscopic SCR with different types of grafts (allograft vs. autograft).
MATERIAL AND METHODS
This study is a retrospective analysis of data collected prospectively, from patients who underwent arthroscopic SCR with either a long head of biceps autograft (LHB) (n=40) or an acellular dermal allograft (n=40), between March 2015 and April 2018. The pre- and postoperative clinical data were compared between the 2 groups, as well as the incidence and type of complications.
RESULTS
All patients were monitored with a minimum follow-up of one year. Three patients (7.5%) in the autograft group, and 14 (35%) in the allograft group (p=0.005) had a complication, of which 2 (5%) and 5 (12.5%) respectively, required revision surgery (p=0.432). Linear regression ruled out any significant difference between the 2 groups, with respect to clinical scores. However, patients with a history of prior rotator cuff surgery had poorer results with regard to active elevation (β, -29.3; p=0.020), internal rotation (β, -3.4; p=0.003) and Subjective Shoulder Value (SSV) (β, -17.2; p=0.023). Older patients, as well as men, are associated with poorer postoperative internal rotation (β, -0.1; p=0.003 and β, -1.9; p=0.039 respectively), and type D lesions are associated with poorer external rotation and postoperative SSV (β, -11.3; p=0.012 and β, -12.4; p=0.048 respectively), compared to type C lesions. Postoperative graft integrity was improved in the autograft group compared to the allograft group. (Grade 1: 65.8% vs. 2.9%; Grade 5: 5.3% vs. 28.6%; p<0.001).
CONCLUSIONS
In both groups, clinical scores improved after SCR in patients with irreparable rotator cuff tears. Fewer complications and revisions were observed with the autograft compared to the allograft. If the LHB was still in place during surgery, its use appears valid, given the reasonable cost and low rate of complications associated with it. If absent, an allograft is also an option, considering the potential clinical improvement.
LEVEL OF EVIDENCE
III; Case-control study.
Topics: Allografts; Arthroscopy; Autografts; Case-Control Studies; Humans; Male; Range of Motion, Articular; Retrospective Studies; Rotator Cuff Injuries; Shoulder Joint; Treatment Outcome
PubMed: 34537391
DOI: 10.1016/j.otsr.2021.103059 -
BMC Musculoskeletal Disorders Sep 2022For patients with malignant limb tumors, salvage surgery can be achieved using endoprosthesis or biological reconstructions like allograft or autograft. In carefully... (Review)
Review
BACKGROUND
For patients with malignant limb tumors, salvage surgery can be achieved using endoprosthesis or biological reconstructions like allograft or autograft. In carefully selected patients, resected bone can be recycled after sterilization using methods like autoclaving, irradiation, pasteurization or freezing with liquid nitrogen. We evaluated the clinical outcome and complications of malignant limb tumors treated with intercalary resection and frozen autograft reconstruction.
METHODS
We reviewed 33 patients whose malignant bone tumors were treated by wide resection and reconstruction with recycling liquid nitrogen-treated autografts between 2006 and 2017. Limb function, bone union at the osteotomy site and complications were evaluated. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
RESULTS
The cohort comprised 16 males and 17 females, with a mean age of 35.4 years (14-76 years). The most common tumor was osteosarcoma (7 cases). Tumors were located in the humerus (5), ulna (1), femur (10) and tibia (17). The mean follow-up was 49.9 months (range 12-127 months). Of the 33 patients, 16 remained disease-free, and 3 were alive with disease. The mean size of the defect after tumor resection was 11.6 cm (range 6-25 cm). Bone union was achieved in 32 patients, with a mean union time of 8.8 months (range 4-18 months). Complications included 1 graft nonunion, 2 infections (1 superficial, 1 deep infection), 1 leg length discrepancy, 2 graft fractures and 3 local recurrences. The mean MSTS score was 87.2% (range 70-100%).
CONCLUSION
Liquid nitrogen-treated tumor-bearing autograft is an effective option for biological reconstruction after meta-/diaphyseal tumor resection of long bones. This method has excellent clinical outcomes and is especially recommended for patients with no severe osteolytic bone tumors.
Topics: Adult; Autografts; Bone Neoplasms; Bone Transplantation; Extremities; Female; Freezing; Humans; Humerus; Male; Nitrogen; Osteosarcoma; Plastic Surgery Procedures; Retrospective Studies; Treatment Outcome
PubMed: 36180843
DOI: 10.1186/s12891-022-05840-6 -
The Journal of Thoracic and... Jun 2018
Topics: Aneurysm; Aortic Valve; Autografts; Humans; Pulmonary Valve
PubMed: 29523402
DOI: 10.1016/j.jtcvs.2018.01.045 -
Clinics in Orthopedic Surgery Mar 2021A small autograft diameter negatively affects functional outcomes, knee stability, and the risk of rerupture after anterior cruciate ligament (ACL) reconstruction,... (Comparative Study)
Comparative Study Observational Study
BACKGROUND
A small autograft diameter negatively affects functional outcomes, knee stability, and the risk of rerupture after anterior cruciate ligament (ACL) reconstruction, whereas the strength of allograft decreases over time. Therefore, it is not clear whether the use of smaller autografts or the use of larger allografts in ACL yields better results. The aim of this study was to compare the outcome of smaller autografts and larger allografts for ACL reconstruction.
METHODS
Fifty-one patients who underwent ACL reconstruction with hamstring tendon autografts (size ≤ 8 mm) and 21 patients who underwent ACL reconstruction with allografts (size ≥ 10 mm) were included in our study. All patients underwent the same aggressive early postoperative rehabilitation program. There were no significant differences between the autograft and allograft groups regarding the preoperative patient age, sex, time from injury to surgery, and average follow-up time.
RESULTS
The mean diameter of the 4-stranded hamstring tendon grafts used as autografts was 7.48 ± 0.33 mm and the mean diameter of the allografts was 10.76 ± 0.67 mm. According to specific tests for the ACL (anterior drawer, Lachman, and pivot shift) and clinical evaluation tests (Lysholm knee scoring scale and International Knee Documentation Committee questionnaire), the final follow-up results were significantly better than the preoperative status in both autograft and allograft ACL reconstruction groups. Therefore, there were no significant differences between the autograft and allograft groups preoperatively and at the final follow-up.
CONCLUSIONS
The large size of the graft in ACL reconstruction has been reported to affect results positively. However, in our study, we could not find any significant differences between the smaller size autografts and larger size allografts in terms of inadequacy, rerupture, and final follow-up functional results. Although allografts were significantly larger than autografts, we did not have the positive effect of larger size grafts. Smaller size autografts were as effective as the larger size allografts.
Topics: Allografts; Anterior Cruciate Ligament Reconstruction; Autografts; Female; Hamstring Tendons; Humans; Lysholm Knee Score; Male; Retrospective Studies
PubMed: 33747377
DOI: 10.4055/cios20008 -
Transplantation and Cellular Therapy Jun 2023Consolidation with autologous hematopoietic stem cell transplantation (HSCT) has improved survival for patients with central nervous system tumors (CNSTs). The impact of...
Consolidation with autologous hematopoietic stem cell transplantation (HSCT) has improved survival for patients with central nervous system tumors (CNSTs). The impact of the autologous graft CD34+ dose on patient outcomes is unknown. We wanted to analyze the relationship between CD34 dose, total nucleated cell (TNC) dose, and clinical outcomes, including overall survival (OS), progression-free survival (PFS), relapse, non-relapse mortality (NRM), endothelial-injury complications (EIC), and time to neutrophil engraftment in children undergoing autologous HSCT for CNSTs. A retrospective analysis of the CIBMTR database was performed. Children aged <10 years who underwent autologous HSCT between 2008 to 2018 for an indication of CNST were included. An optimal cut point was identified for patient age, CD34 cell dose, and TNC, using the maximum likelihood method and PFS as an endpoint. Univariable analysis for PFS, OS, and relapse was described using the Kaplan-Meier estimator. Cox models were fitted for PFS and OS outcomes. Cause-specific hazards models were fitted for relapse and NRM. One hundred fifteen patients met the inclusion criteria. A statistically significant association was identified between autograft CD34+ content and clinical outcomes. Children receiving >3.6×10/kg CD34 cells experienced superior PFS (p = .04) and OS (p = .04) compared to children receiving ≤3.6 × 10/kg. Relapse rates were lower in patients receiving >3.6 × 10/kg CD34 cells (p = .05). Higher CD34 doses were not associated with increased NRM (p = .59). Stratification of CD34 dose by quartile did not reveal any statistically significant differences between quartiles for 3-year PFS (p = .66), OS (p = .29), risk of relapse (p = .57), or EIC (p = .87). There were no significant differences in patient outcomes based on TNC, and those receiving a TNC >4.4 × 10/kg did not experience superior PFS (p = .26), superior OS (p = .14), reduced risk of relapse (p = .37), or reduced NRM (p = .25). Children with medulloblastoma had superior PFS (p < .001), OS (p = .01), and relapse rates (p = .001) compared to those with other CNS tumor types. Median time to neutrophil engraftment was 10 days versus 12 days in the highest and lowest infused CD34+ quartiles, respectively. For children undergoing autologous HSCT for CNSTs, increasing CD34 cell dose was associated with significantly improved OS and PFS, and lower relapse rates, without increased NRM or EICs.
Topics: Humans; Child; Retrospective Studies; Autografts; Neoplasm Recurrence, Local; Hematopoietic Stem Cell Transplantation; Antigens, CD34; Central Nervous System Neoplasms
PubMed: 36990222
DOI: 10.1016/j.jtct.2023.03.024 -
Biology of Blood and Marrow... Sep 2019The clinical outcomes of autologous hematopoietic stem cell transplantation (ASCT) in acute myelogenous leukemia (AML) have improved over time. Indeed, numerous studies... (Review)
Review
The clinical outcomes of autologous hematopoietic stem cell transplantation (ASCT) in acute myelogenous leukemia (AML) have improved over time. Indeed, numerous studies have demonstrated that ASCT is associated with a lower relapse rate and acceptable nonrelapse mortality compared with chemotherapy alone in patients with AML. In addition, ASCT is also associated with comparable overall survival outcomes to those of allogeneic hematopoietic stem cell transplantation in some patients with AML. To date, age, cytogenetic and molecular risk stratification, and minimal residual disease (MRD) status have been shown to be closely related to clinical outcomes following ASCT. ASCT is recommended for patients with favorable-risk and intermediate-risk AML in first complete remission and patients with acute promyelocytic leukemia in second complete remission for whom a matched sibling donor is not available. MRD status pre-ASCT is the most important factor to consider when determining whether a patient is eligible for ASCT and can effectively predict clinical outcomes after ASCT. Advanced age is not an absolute contradiction for ASCT. In this review, we describe the literature and clinical trials evaluating the outcomes of ASCT in patients with AML and discuss the indications for ASCT therapy. Because the greatest concern in ASCT recipients is early relapse, important factors that should be monitored before ASCT and future perspectives in this area are also presented.
Topics: Autografts; Hematopoietic Stem Cell Transplantation; Humans; Leukemia, Promyelocytic, Acute; Neoplasm, Residual
PubMed: 31054985
DOI: 10.1016/j.bbmt.2019.04.027 -
International Journal of Oral Science Apr 2021Mineralized tissue regeneration is an important and challenging part of the field of tissue engineering and regeneration. At present, autograft harvest procedures may...
Mineralized tissue regeneration is an important and challenging part of the field of tissue engineering and regeneration. At present, autograft harvest procedures may cause secondary trauma to patients, while bone scaffold materials lack osteogenic activity, resulting in a limited application. Loaded with osteogenic induction growth factor can improve the osteoinductive performance of bone graft, but the explosive release of growth factor may also cause side effects. In this study, we innovatively used platelet-rich fibrin (PRF)-modified bone scaffolds (Bio-Oss) to replace autograft, and used cytokine (BMP-2) to enhance osteogenesis. Encouragingly, this mixture, which we named "Autograft Mimic (AGM)", has multiple functions and advantages. (1) The fiber network provided by PRF binds the entire bone scaffold together, thereby shaping the bone grafts and maintaining the space of the defect area. (2) The sustained release of BMP-2 from bone graft promoted bone regeneration continuously. (3) AGM recruited bone marrow mesenchymal stem cells (BMSCs) and promote their proliferation, migration, and osteogenic differentiation. Thus, AGM developed in this study can improve osteogenesis, and provide new guidance for the development of clinical bone grafts.
Topics: Autografts; Bone Regeneration; Cell Differentiation; Humans; Mesenchymal Stem Cells; Osteogenesis; Tissue Engineering; Tissue Scaffolds
PubMed: 33846295
DOI: 10.1038/s41368-021-00120-w -
Medical Science Monitor : International... Aug 2022BACKGROUND Previous studies have shown that primary repair (PR) and anterior cruciate ligament reconstruction (ACLR) can effectively treat ACL injuries. Our study aimed... (Meta-Analysis)
Meta-Analysis
BACKGROUND Previous studies have shown that primary repair (PR) and anterior cruciate ligament reconstruction (ACLR) can effectively treat ACL injuries. Our study aimed to compare different treatments of ACL tears, including autograft, allograft, hybrid graft ACLR, and PR, by assessing clinical outcomes and adverse events. MATERIAL AND METHODS PubMed, Cochrane Library, Embase, and CNKI databases were searched and a frequentist-framework network meta-analysis was used. RESULTS Overall, PR with augmentation was superior to ACLR only for activity recovery (WMD 0.28 95%CI [0.07 to 0.49]), and there was no significant difference shown between PR without augmentation and ACLR. ACLR with irradiated allograft was a poor option for the treatment of ACL rupture, showing the weakest subjective evaluations and functional outcomes and worst safety profile. PR with or without augmentation provided fairly good postoperative efficacy results and produced less postoperative knee laxity than irradiated allograft ACLR (PR: standardized mean difference [SMD] -1.27 [-1.80 to -0.74]; ACLR: SMD -1.36 [-1.88 to -0.83]). However, PR without augmentation showed a high failure rate compared with autograft ACLR (autograft vs PR without augmentation: risk ratio 0.29 [0.10 to 0.85]). CONCLUSIONS For surgical treatment of ACL rupture, irradiated allograft ACLR had the worst efficacy and safety and is not recommended. PR may be an ideal treatment method in terms of efficacy but it is related to a significantly higher revision risk if without augmentation. Autograft ACLR may be the preferred method currently available for most patients requiring surgical treatment of ACL rupture.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Autografts; Humans; Knee Joint; Network Meta-Analysis; Rupture
PubMed: 35996336
DOI: 10.12659/MSM.937118