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Bone Marrow Transplantation May 2020
Topics: Autografts; Cost-Benefit Analysis; Hematopoietic Stem Cells; Humans; Lenalidomide; Multiple Myeloma
PubMed: 31969679
DOI: 10.1038/s41409-020-0787-7 -
Blood Advances Jun 2023
Topics: Humans; Transplantation, Autologous; Multiple Myeloma; Neoplasms, Second Primary; Autografts; Hematopoietic Stem Cell Transplantation
PubMed: 37318936
DOI: 10.1182/bloodadvances.2023010051 -
European Journal of Orthopaedic Surgery... Oct 2020The purpose of the current study was to clarify the role of the quadriceps tendon (QT) autograft for primary ACL reconstruction. Thus, a Bayesian network meta-analysis... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The purpose of the current study was to clarify the role of the quadriceps tendon (QT) autograft for primary ACL reconstruction. Thus, a Bayesian network meta-analysis comparing patients undergoing a primary ACL reconstruction with QT versus patellar tendon (PT) and hamstring tendon (HT) autografts was conducted.
MATERIAL AND METHODS
This Bayesian network meta-analysis was conducted according to the PRISMA extension statement for reporting systematic reviews incorporating network meta-analyses of health care interventions. In January 2020, the main databases were accessed. Articles comparing the outcomes of the QT autograft versus HT autograft and/or PT autograft for primary ACL reconstruction were included in the present study. The statistical analysis was performed with STATA Software/MP, through a Bayesian hierarchical random-effect model analysis.
RESULTS
Data from a total of 2603 knees were analysed. The overall mean follow-up was 35.0 months. Among the different grafts were evidenced comparable values of IKDC, Tegner and Lysholm score. The QT autograft detected comparable rate of Lachman test > 3 mm, Pivot shift test > 3 m and instrumental laxity > 3 mm. The QT autograft showed a lower rate of autograft failure above all. The QT autograft detected the reduced rate of AKP than the PT.
CONCLUSION
Quadriceps tendon autograft may represent a feasible option for primary ACL reconstruction. These results must be interpret within the limitations of the present network meta-anlaysis.
Topics: Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Autografts; Bayes Theorem; Humans; Network Meta-Analysis; Tendons; Transplantation, Autologous
PubMed: 32367221
DOI: 10.1007/s00590-020-02680-9 -
Multimedia Manual of Cardiothoracic... Nov 2023The Ross-Personalized External Aortic Root Support procedure is a surgical aortic valve replacement technique in which the autologous pulmonary valve is transposed in...
The Ross-Personalized External Aortic Root Support procedure is a surgical aortic valve replacement technique in which the autologous pulmonary valve is transposed in the aortic position to replace the malfunctioning aortic valve and a homograft is implanted in the pulmonary position. To prevent autograft dilatation, a Personalized External Aortic Root Support prosthesis is included in the proximal autograft anastomosis and wrapped around the ascending aorta. The aorta is transected transversely, the aortic valve is resected, and the coronary arteries are mobilized and cut out of the sinuses, leaving a rim. The pulmonary autograft is harvested by transecting the pulmonary artery and part of the right ventricular outflow tract. The autograft is approximated to the aortic root and inverted inside the ventricle. The proximal anastomosis is performed including the prosthesis between the aortic root and the autograft. The coronary buttons are threaded through appropriately positioned and sized holes in the prosthesis and reimplanted into the autograft. The ascending aorta is appropriately adapted and anastomosed with the distal autograft. When the patient is off cardiopulmonary bypass, the prosthesis can be closed longitudinally and is anchored to the distal aortic adventitia.
Topics: Humans; Autografts; Aorta, Thoracic; Transplantation, Autologous; Aortic Valve; Aorta; Aortic Valve Stenosis; Aortic Valve Insufficiency; Pulmonary Valve; Heart Valve Prosthesis Implantation; Reoperation
PubMed: 37942704
DOI: 10.1510/mmcts.2023.077 -
Journal of Burn Care & Research :... Jan 2023Autologous skin grafting has permitted survival and restoration of function in burn injuries of ever larger total body surface area (TBSA) sizes. However, the goal of... (Review)
Review
Autologous skin grafting has permitted survival and restoration of function in burn injuries of ever larger total body surface area (TBSA) sizes. However, the goal of replacing "like with like" skin structures is often impossible because full-thickness donor harvesting requires primary closure at the donor site for it to heal. Split-thickness skin grafting (STSG), on the other hand, only harvests part of the dermis at the donor site, allowing it to re-epithelialize on its own. The development of the first dermal regenerative template (DRT) in the late 1970s represented a major advance in tissue engineering that addresses the issue of insufficient dermal replacement when STSGs are applied to the full-thickness defect. This review aims to provide an overview of currently available DRTs in burn management from a clinician's perspective. It focuses on the main strengths and pitfalls of each product and provides clinical pearls based on clinical experience and evidence.
Topics: Humans; Burns; Skin; Wound Healing; Skin Transplantation; Autografts
PubMed: 36567477
DOI: 10.1093/jbcr/irac135 -
Journal of Esthetic and Restorative... Oct 2022Autogenous bone grafts are considered the gold standard due to their compatibility and osteogenic potential to induce new bone formation through osteogenesis,...
OBJECTIVE
Autogenous bone grafts are considered the gold standard due to their compatibility and osteogenic potential to induce new bone formation through osteogenesis, osteoinduction, and osteoconduction. The aim of this paper was to describe clinical applications of the maxillary tuberosity block autograft in small and moderate localized defects of the alveolar process around implants and teeth.
CLINICAL CONSIDERATIONS
Maxillary tuberosity is often used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion, but not as a bone block graft. The maxillary tuberosity block autograft may also provide a valuable bone source for challenging situations such as immediate implant placement into types II and III extraction sockets, treatment of horizontal and vertical bone defects with simultaneous implantation, reconstruction of circumferential defects around implants, and preservation of alveolar ridge.
CONCLUSIONS
The advantages of the maxillary tuberosity include intraoral corticocancellous autogenous graft with fewer intraoperative difficulties, no need for donor site restoration, less morbidity, and an excellent correction of localized alveolar ridge defects.
CLINICAL SIGNIFICANCE
Within the limitations of the presented case reports, the use of maxillary tuberosity block autograft has shown to be successful in alveolar ridges augmentation that lack both width and height.
Topics: Alveolar Ridge Augmentation; Autografts; Bone Transplantation; Dental Implantation, Endosseous; Maxilla
PubMed: 35384291
DOI: 10.1111/jerd.12911 -
International Journal of Molecular... Jan 2021Angiogenesis is a broad spread term of high interest in regenerative medicine and tissue engineering including the dental field. In the last two decades, researchers... (Review)
Review
Angiogenesis is a broad spread term of high interest in regenerative medicine and tissue engineering including the dental field. In the last two decades, researchers worldwide struggled to find the best ways to accelerate healing, stimulate soft, and hard tissue remodeling. Stem cells, growth factors, pathways, signals, receptors, genetics are just a few words that describe this area in medicine. Dental implants, bone and soft tissue regeneration using autologous grafts, or xenografts, allografts, their integration and acceptance rely on their material properties. However, the host response, through its vascularization, plays a significant role. The present paper aims to analyze and organize the latest information about the available dental stem cells, the types of growth factors with pro-angiogenic effect and the possible therapeutic effect of enhanced angiogenesis in regenerative dentistry.
Topics: Autografts; Dentistry; Humans; Neovascularization, Physiologic; Regeneration; Regenerative Medicine; Tissue Engineering; Transplantation, Homologous
PubMed: 33477745
DOI: 10.3390/ijms22020929 -
Journal of ISAKOS : Joint Disorders &... Feb 2022The posterior cruciate ligament (PCL) is involved in almost one-third of all knee injuries. Surgical management of PCL injuries is currently controversial, and no single... (Review)
Review
IMPORTANCE
The posterior cruciate ligament (PCL) is involved in almost one-third of all knee injuries. Surgical management of PCL injuries is currently controversial, and no single graft material is determined as superior in primary PCL reconstruction. A growing body of literature has demonstrated the safety and versatility of the quadriceps tendon (QT) autograft in arthroscopic knee ligament reconstruction.
OBJECTIVE
The objective of the study was to assess the QT autograft for use in primary PCL reconstruction with a focus on complication rates, revision rates, and functional outcomes.
EVIDENCE REVIEW
The online databases Medline, Embase, Web of Science, and CENTRAL were searched on April 30, 2020. Retrieved records were screened by two independent reviewers. Eligible studies assessed the QT autograft in skeletally mature participants undergoing primary PCL reconstruction. Studies of multiligamentous repairs and revisions were excluded. A narrative summary of results from individual studies is presented.
FINDINGS
Six articles met inclusion criteria with n = 119 participants (21% female) and a follow-up range from 12 months to 84 months. Complication rates ranged from 13% to 65% and included moderate (n = 4) and mild (n = 4) knee pain, reflex sympathetic dystrophy (n = 3), joint space narrowing (n = 3), superficial wound infections (n = 2), complex regional pain syndrome (n = 2), and flexion deficiency (n = 2). Revision rates ranged from 0% to 15% and included hardware removal (n = 4), manipulation under anaesthesia (n = 2), arthroscopic arthrolysis (n = 2), and arthroscopic refixation (n = 2). Subjective International Knee Documentation Committee scores increased from a preoperative range of 37.7 ± 21.4 to 39.5 ± 21 to a postoperative range of 74.5 ± 17.7 to 84.7. Lysholm scores, Tegner activity scores, and posterior tibial laxity also demonstrated improvements postoperatively. No statistically significant differences were reported in the study that compared the QT autograft with the hamstring tendon autograft.
CONCLUSIONS AND RELEVANCE
This systematic review reported functional outcomes and complication rates of a small QT autograft sample that were comparable with other graft materials used in PCL reconstruction. Heterogeneity of the included studies and reported outcomes precluded meta-analysis. Future studies of better methodological quality and larger sample sizes need to be conducted before the QT autograft may be concluded as safe and effective in primary PCL reconstruction.
LEVEL OF EVIDENCE
IV.
Topics: Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Autografts; Female; Hamstring Tendons; Humans; Male; Tendons
PubMed: 35543656
DOI: 10.1016/j.jisako.2021.08.002 -
Blood Cancer Journal May 2023Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of...
Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC- in the autograft by next-generation flow cytometry (NGF). There were 75 CPC + autografts (18%) and 341 CPC- (82%). The CPC + group was less likely to achieve MRD-negative complete remission post-transplant (11% vs. 42%; p < 0.001). Median progression free survival (PFS) and overall survival (OS) were (12.8 vs. 32.1 months) and (36.4 vs. 81.2 months) in the CPC + and CPC- groups, respectively (both p < 0.001). Also in the subset of patients with MRD-negative ≥VGPR prior to autoHCT, those with CPC + autografts had inferior PFS (HR 4.21, p = 0.006) and OS (HR 7.04, p = 0.002) compared to CPC-. In multivariable analysis, the degree of CPC positivity in the autograft was independently predictive of worse PFS (HR 1.50, p = 0.001) and OS (HR 1.37, p = 0.001). In conclusion, both the presence and degree of CPC in the autograft were highly predictive of inferior PFS and OS.
Topics: Humans; Multiple Myeloma; Plasma Cells; Autografts; Retrospective Studies; Neoplasm Recurrence, Local; Transplantation, Autologous; Hematopoietic Stem Cell Transplantation
PubMed: 37137874
DOI: 10.1038/s41408-023-00842-6 -
The American Journal of Sports Medicine Dec 2023Reconstruction using autograft remains the gold standard surgical treatment for anterior cruciate ligament (ACL) injuries. However, up to 10% to 15% of patients will...
BACKGROUND
Reconstruction using autograft remains the gold standard surgical treatment for anterior cruciate ligament (ACL) injuries. However, up to 10% to 15% of patients will suffer a graft failure in the future. Cadaveric studies have demonstrated that the addition of suture tape augmentation to ACL autograft constructs can increase graft strength and reduce elongation under cyclical loading.
PURPOSE/HYPOTHESIS
This study aimed to investigate the clinical outcomes and rerupture rates after ACL reconstruction (ACLR) with suture tape augmentation. We hypothesized that augmentation with suture tape would lead to lower rerupture rates.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
Patients undergoing primary ACLR using hamstring or patellar tendon autografts augmented with suture tape between 2015 and 2019 were recruited prospectively. Patients with multiligament injuries or a concomitant lateral extra-articular procedure were excluded. Patients were observed in person for 6 months, and patient-reported outcome measures (PROMs) were collected at 2 and 5 years postoperatively. All patients were contacted, and records were reviewed to determine the incidence of graft failure. PROMs collected were as follows: Knee injury and Osteoarthritis Outcome Score (KOOS), Veterans RAND 12-Item Health Survey (VR-12), Tegner and Marx activity scores, and visual analog scale for pain (VAS).
RESULTS
A total of 97 patients, with a mean age of 34.7 (±13.4) years, were included (76% men; 52 hamstring and 45 patellar tendon grafts). The mean graft diameter was 8 (±1) mm. There was 1 rerupture (1.1%) out of the 90 patients who were contactable at a mean of 5 years postoperatively. Median KOOS scores at 2 years were as follows: Pain, 94; Symptoms, 86; Activities of Daily Living, 99; Sport and Recreation, 82; and Quality of Life, 81. The postoperative scores were significantly higher than the preoperative scores ( < .001). The VR-12 Physical score improved from 43 preoperatively to 55 at 2 years and remained at 56 at 5 years. The VAS pain, Tegner, and Marx scores were 0, 6, and 9, respectively, at 2 years postoperatively. There was no difference in PROMs between graft types.
CONCLUSION
This study demonstrates encouraging results of suture tape augmentation of autograft ACLR for both hamstring and patellar tendon grafts. The failure rate of 1.1% at a mean follow-up of 5 years is lower than published rates for reconstruction, and PROMs results are satisfactory. The technique is safe to use and may permit a return to the preinjury sporting level with a lower chance of reinjury.
Topics: Male; Humans; Adult; Female; Follow-Up Studies; Activities of Daily Living; Quality of Life; Anterior Cruciate Ligament Reconstruction; Anterior Cruciate Ligament Injuries; Sutures; Autografts; Pain; Hamstring Tendons
PubMed: 37975527
DOI: 10.1177/03635465231207623