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Soft Tissue Surgery of the Knee
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Stephen Key, Jonathan Miles, Richard Carrington
As with other ligament reconstructions around the knee, there are many options and controversies surrounding the optimal graft choice, construct and fixation. Both single- and double-bundle techniques can be used but the relative benefits of each continue to be debated. Single-bundle techniques typically aim to restore the larger anterolateral bundle. Graft choice may depend on previous surgery or combined injuries; autograft and allograft have both been used successfully. Later we describe the use of quadrupled hamstring graft, similar to that for ACL reconstruction, but consideration needs to be given to ensuring sufficient length of graft, which is longer than that for ACL reconstruction. Grafts with bone blocks may present challenges with graft passage because of the angle the graft needs to turn on exiting the tibial tunnel. For those reasons some surgeons will routinely use allograft as their primary graft choice.
Craniofacial Regeneration—Bone
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Laura Guadalupe Hernandez, Lucia Pérez Sánchez, Rafael Hernández González, Janeth Serrano-Bello
Autologous bone is still considered as the gold standard since all the necessary properties required in bone regeneration are present, it holds viable cells that can form new bone tissue (osteogenic), it provides a scaffold for the ingrowth of cells necessary for bone regeneration (osteoconductive); and promotes the proliferation of stem cells and their differentiation into osteogenic cells (osteoinductive). It is ideal in many situations because it is harvested from the patient himself or herself, thus less likely to be rejected and more likely to be incorporated. However, the use of an autograft has limitations, including donor site morbidity, limited availability of tissue, an additional operation and prolonged healing time (Henkel et al. 2013). The major and minor complication rates of autogenous bone graft harvest have been reported at 8.6 and 20.6%, respectively (Fillingham and Jacobs 2016).
Tissue Grafting Techniques
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Skin grafts have been used to achieve successful repigmentation in vitiligo patients. Traditional types of autografts include full-thickness and split-thickness skin grafts. Some disadvantages of autografts include the need for a surgical procedure with anesthesia, creation of a second wound at the donor site, difficulty in obtaining uniform graft thickness, pain, and challenges with graft take and graft rejection. Allografts and xenografts address some of these disadvantages. However, chances of graft rejection are greater with allografts and xenografts than autografts. Some of these treatment modalities are painful procedures, require long recovery times for the donor site, and may increase operating room costs and potential donor site complications, such as infection. The rates of donor site complications vary, depending on donor site location, comorbidities of the patient, and other risk factors, and can be as high as 28% [1,2].
Efficacy of endoscopic porcine small intestinal submucosa graft myringoplasty: a retrospective comparative study
Published in Acta Oto-Laryngologica, 2023
Li Jin, Xueying Pan, Tuanfang Yin, Jihao Ren, Wei Liu
Compared to autologous TF and PC, use of PSISG in myringoplasty by endoscope to repair TM perforations is minimally invasive and avoids external incision for harvest of autograft with patients (Figure 4), reduces the donor site morbidity as well. Besides, postoperative dressings are not required. For revision cases, PSISG can solve the disadvantages caused by TF and PC, such as the privation of graft material and a second incision [6–8]. Furthermore, the mean operation time of the PSISG group was shorter than autologous TF (p < .001) and PC groups (p < .001) in this research. Previous study also reported that PSISG myringoplasty time was significantly shorter when compared to autologous TF [8]. The overall surgical time reduced predominantly associated with no need to harvest autograft from the donor site.
Numerical modelling of osteocyte growth on different bone tissue scaffolds
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Concepción Paz, Eduardo Suárez, Christian Gil, Oscar Parga
These methodologies extract and subsequently implant bone tissue. Depending on the origin and destination of the bone tissue transfer, three main methodologies can be distinguished as xenografts (tissue transfer between individuals of different species), allografts (tissue transfer between two different individuals of the same species), and autografts (extracting a portion of bone from a healthy area of a patient and transplanting it to the affected area of the same patient). The latter has been the most used methodology in recent years. In order to achieve autograft implants, firstly autologous bone tissue is extracted from a healthy area of the patient, typically through a biopsy. Then, cells are introduced into a three-dimensional matrix or scaffold. These cells grow in vitro and are subjected to mechanical and chemical stimuli exerted by growth factors or bioactive molecules. Finally, the formed biocompatible structure is implanted in the affected area of the individual.
Comparison of the Effects of Extracorporeal Irradiation and Liquid Nitrogen on Nerve Recovery in a Rat Model
Published in Journal of Investigative Surgery, 2021
Hüseyin Kaya, Dündar Sabah, Burçin Keçeci, Levent Küçük, Oytun Erbaş, Fatih Oltulu, Gürkan Yiğittürk, Dilek Taskiran
The limitations of this study may be listed as follows: lack of the electron microscopic assessment, lack of tumor-contaminated nerve tissue and lack of allograft model. Tumor-contaminated neural tissue was not used in the study because the oncological sterilization methods utilized (radiotherapy and liquid nitrogen) are oncologically reliable methods which are currently used in clinical practice. Also, an allograft model was not deemed necessary because previous studies have shown that autografts are superior to allografts. For example, in a longer follow-up experimental study, Strasberg et al. have compared the fresh and cold-preserved autografts and allografts each other at 6 and 10 months. They have found that autografts had significant superiority over allografts, and cold nerve preservation did not enhanced the regeneration [39].