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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 -
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 -
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 -
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 -
Cartilage 2022The aim of this study is to assess the variability of postoperative rehabilitation protocols used by orthopedic surgery residency programs for osteochondral autograft...
OBJECTIVE
The aim of this study is to assess the variability of postoperative rehabilitation protocols used by orthopedic surgery residency programs for osteochondral autograft transplantation (OAT) and osteochondral allograft transplantation (OCA) of the knee.
DESIGN
Online postoperative OAT and OCA rehabilitation protocols from US orthopedic programs and the scientific literature were reviewed. A custom scoring rubric was developed to analyze each protocol for the presence of discrete rehabilitation modalities and the timing of each intervention.
RESULTS
A total of 16 programs (10.3%) from 155 US academic orthopedic programs published online protocols and a total of 35 protocols were analyzed. Twenty-one protocols (88%) recommended immediate postoperative bracing following OAT and 17 protocols (100%) recommended immediate postoperative bracing following OCA. The average time protocols permitted weight-bearing as tolerated (WBAT) was 5.2 weeks (range = 0-8 weeks) following OAT and 6.2 weeks (range = 0-8 weeks) following OCA. There was considerable variation in the inclusion and timing of strength, proprioception, agility, and pivoting exercises. Following OAT, 2 protocols (8%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks). Following OCA, 1 protocol (6%) recommended functional testing as criteria for return to sport at an average time of 12.0 weeks (range = 12-24 weeks).
CONCLUSION
A minority of US academic orthopedic programs publish OAT and OCA rehabilitation protocols online. Among the protocols currently available, there is significant variability in the inclusion of specific rehabilitation components and timing of many modalities. Evidence-based standardization of elements of postoperative rehabilitation may help improve patient care and subsequent outcomes.
Topics: Allografts; Autografts; Humans; Knee Joint; Transplantation, Homologous; Weight-Bearing
PubMed: 35762400
DOI: 10.1177/19476035221093071 -
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 -
Cells Jul 2022Autologous stem cell transplantation treatment has been viewed as a therapeutic modality to enable the infusion of higher doses of chemotherapy to eradicate tumor cells.... (Review)
Review
Autologous stem cell transplantation treatment has been viewed as a therapeutic modality to enable the infusion of higher doses of chemotherapy to eradicate tumor cells. Nevertheless, recent reports have shown that, in addition to stem cells, infusion of autograft immune effector cells produces an autologous graft-versus-tumor effect, similar to the graft-versus-tumor effect observed in allogeneic-stem cell transplantation, but without the clinical complications of graft-versus-host disease. In this review, I assess the impact on clinical outcomes following infusions of autograft-antigen presenting cells, autograft innate and adaptive immune effector cells, and autograft immunosuppressive cells during autologous stem cell transplantation. This article is intended to provide a platform to change the current paradigmatic view of autologous stem cell transplantation, from a high-dose chemotherapy-based treatment to an adoptive immunotherapeutic intervention.
Topics: Autografts; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Lymphocytes; Transplantation, Autologous
PubMed: 35883639
DOI: 10.3390/cells11142197 -
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 -
Journal of ISAKOS : Joint Disorders &... Dec 2022The ideal graft for anterior cruciate ligament reconstruction (ACLR) continues to be debated. Although first described in 1984, use of the quadriceps tendon (QT)... (Review)
Review
The ideal graft for anterior cruciate ligament reconstruction (ACLR) continues to be debated. Although first described in 1984, use of the quadriceps tendon (QT) autograft has only recently gained popularity. The biomechanical properties of the QT autograft are favourable compared to bone-patellar tendon-bone (BPTB) and doubled hamstring (HS) grafts with a higher load to failure and a modulus of elasticity that more closely approximates the native anterior cruciate ligament (ACL). The QT graft can be harvested with or without a bone plug, as either a full thickness or a partial thickness graft, and even through minimally invasive techniques. The surgeon must be aware of potential harvest risks including patellar fracture or a graft that is of insufficient length. Numerous short-term studies have shown comparable results when compared to BPTB or hamstring HS autografts with similar graft failure rates, patient-reported outcomes. A major advantage of QT ACLR is reduced donor site morbidity compared to BPTB. However, some persistent quadriceps weakness after QT ACLR has also been reported. The current literature shows that use of the QT autograft for ACLR provides equivalent clinical results compared to other autografts with less donor site morbidity. However, future studies with longer follow-up and higher level of evidence are needed to identify specific populations where the QT may have additional advantage.
Topics: Humans; Autografts; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Anterior Cruciate Ligament; Tendons
PubMed: 36096362
DOI: 10.1016/j.jisako.2022.08.010 -
BioMed Research International 2020. In the field of orthopaedic surgery, the use of osteogenic material in larger defects is essential. Autograft and allograft are both known methods, and autograft is...
UNLABELLED
. In the field of orthopaedic surgery, the use of osteogenic material in larger defects is essential. Autograft and allograft are both known methods, and autograft is believed to be the best choice. But autograft is associated with additional invasive procedures which can prove difficult in fragile patients and can cause local side effect after bone harvest. For feasible purposes, the use of allograft is hereby rising and comparing efficacies, and the differences between autograft and allograft are essential for the clinical outcome for the patients.
METHOD
24 female Norwegian brown rats were included, 12 normal rats and 12 induced with osteoporosis (OP). OP inducement was verified in vivo by bone volume fraction (BV/TV) at 90 days after ovariectomy (OVX). The primary surgery in each rat consisted of a 2.5 × 3 mm hole in the proximal tibia, bilaterally. Autograft and allograft were randomly allocated in the right and left tibia. After an observation of 21 days, the rats were sacrificed. Tibia samples were harvested, micro-CT scanned for bone inducement and microarchitectural properties, and then embedded for histology.
RESULTS
The OP induction was verified three months after the OVX by a reduction of 68.5% in the trabecular bone BV/TV compared to normal bone. Microarchitectural analysis and histology showed no significant differences in the bone-forming capabilities between autograft and allograft in normal or osteoporotic bone after 3 weeks.
CONCLUSION
This study did not demonstrate any difference between autograft and allograft in a normal or osteoporotic rat tibial defect model after 21 days, suggesting allograft is a good alternative to autograft.
Topics: Allografts; Animals; Autografts; Bone Density; Bone Transplantation; Bone and Bones; Female; Osteoporosis; Ovariectomy; Rats; Tibia; Transplantation, Autologous; Transplantation, Homologous; X-Ray Microtomography
PubMed: 32190690
DOI: 10.1155/2020/9358989