• Title/Summary/Keyword: autograft

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Comparison of Clinical Results and Second-Look Arthroscopy after Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Autograft, Mixed graft and Tibialis Tendon Allograft (자가슬괵건, 혼합건 및 동종 경골건을 이용하여 실시한 전방십자인대 재건술후 임상결과 및 이차관절경 검사 비교)

  • Cho, Jin-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2011
  • Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

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Comparison of Anterior Cruciate Ligament Reconstructions Using Hamstring Tendon Autograft and Tibialis Tendon Allograft (자가 슬괵건 및 동종 경골건을 이용한 전방 십자 인대 재건술의 결과 비교)

  • Song, Eun-Kyoo;Seon, Jong-Keun;Bae, Bong-Hyun;Park, Sang-Jin;Kim, Jong-Seon;Lee, Dam-Seon
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.141-147
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    • 2006
  • Purpose: To compare the clinical and radiological results of anterior cruciate ligament(ACL) reconstruction using hamstring autograft and tibialis tendon allograft. Materials and Methods: Twenty four ACL reconstructions using hamstring autograft and 30 using tibialis anterior tendon altograft were followed up at least 1 year. We performed femoral tunnel fixation with Ligament Anchor(LA) screw and tibial tunnel fixation with biodegradable interference screw. Evaluations included Lysholm knee(LK) score, Tegner activity scale, Lachman test, Pivot-Shift test, Quardriceps atrophy, incision site numbness, anterior knee pain and instrumented anterior laxity with $Telos^{(R)}$ device. Results: Preoperativ mean LK score was $60.3(18{\sim}82)$ in autograft group and 61.2(25-80) in allograft group. Mean LK score improved to $91.6(68{\sim}100)\;and\;92.6(77{\sim}100)$ respectively. Activity level, using Tegner activity scale, slightly decreased compared with that of Preinjury state in both groups. Lachman test, pivot-shift test, Quadriceps atrophy, anterior knee pain, incision site numbness, and anterior drawer test using $Telos^{(R)}$ device showed no significant difference between two groups (p>0.05). Conclusion: In performing the ACL reconstruction, there was no statistically significant difference between hamstring autograft group and tibilis anterior allograft group in clinical or in radiological results.

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Graft Considerations for Successful Anterior Cruciate Ligament Reconstruction (성공적인 전방십자인대 재건술을 위한 적절한 이식건의 선택)

  • Kyung, Hee-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.14-25
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    • 2021
  • Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.

Efficacy of Calcium Sulfate Pellets as Bone Graft Substitute in Lumbar Posterolateral Fusion - Preliminary Report - (요추부 후측방 유합술에서 골편대체물로서 황산칼슘의 효과에 대한 연구)

  • Lee, Seung Ku;Kim, Choong Hyun;Cheong, Jin Hwan;Bak, Koang Hum;Kim, Jae Min;Oh, Suck Jun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.605-610
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    • 2001
  • Objective : The authors investigated the efficacy of the calcium sulfate(OsteoSet$^{(R)}$ pellets) as an autograft extender when used to perform posterolateral lumbar fusions. Patients and Methods : Twenty patients who underwent lumbar posterolateral arthrodesis for various spinal diseases between October 1999 and March 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation and bone grafting with a mixture of autograft + calcium sulfate in a 1 : 1 ratio. At time intervals of 1, 2, 3, and 6 months, postoperative radiographs were obtained to review the resorption of calcium sulfate and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. Results : At 2 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 3.8. However at 6 months after operation, the average modified Lenke scale score for the OsteoSet$^{(R)}$ pellets group was 1.8. Resorption of calcium sulfate pellets was revealed in all cases at 6 months after surgery. Conclusion : It is presumed that a combination of calcium sulfate and autograft can play a role as an effective autograft extender in the posterolateral spinal fusion.

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One Stage Metatarsal Lengthening of Brachymetatarsia Involving Both 1st and 4th Metatarsal Bone (A case report) (양측 제 1,4 단중족증의 자가골을 이용한 일단계 골연장술(1예 보고))

  • Kim, Dong-Hee;Chung, Duke-Whan;Han, Chung-Soo;Lee, Jae-Hoon;Park, Jae-Yong;Oh, Kyung-Il;Tak, Dae-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.182-185
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    • 2010
  • 19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

  • Han, Sanghyun;Park, Bumsoo;Lim, Jeong-Wook;Youm, Jin-Young;Choi, Seoung-Won;Kim, Dae Hwan;Ahn, Dong Ki
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.673-680
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    • 2020
  • The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

Radiologic and clinical outcomes of an arthroscopic bridging graft for irreparable rotator cuff tears with a modified Mason-Allen stitch using a plantaris tendon autograft: a case series with minimum 2-year outcomes

  • Hyun-Gyu Seok;Sam-Guk Park
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.406-415
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    • 2023
  • Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT. Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon. Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (-3.0, P=0.003), ASES (24.9, P=0.002), D ASH (-20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported. Conclusions: An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.

ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft (전방 십자 인대 재건술: 골-슬개건-골 자가이식물)

  • Koh, Hae-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.102-108
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    • 2005
  • The incidence of anterior cruciate ligament tears is increasing as a result of the increasing participation of individuals of all ages in high-risk sports. Endoscopic anterior cruciate ligament reconstruction using autogenous central third bone-patellar tendon-bone graft is the most commonly used method. With regard to BPTB graft as the go]d standard in ACL reconstruction, there are no data that refute this claim to date. Author reviewed the biomechanical properties, donor site morbidity and selection of the bone-patellar tendon-bone graft and described the surgical technique of endoscopic ACL reconstruction using BPTB autograft.

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Treatment of Aplasia Cuti Congenita Using Allogenic Dermal matrix and Cultured Epithelial Autograft: A Case Report (동종사체진피와 배양한 자가상피세포를 이용한 선천성 피부 형성 부전증 환자의 치험례)

  • Lee, Jin Hwa;Kim, Yong Kyu;Lee, Sang Joon
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.672-675
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    • 2006
  • Purpose: The purpose of this study is to document the surgical methods used in infants with aplasia cutis congenita treated with allogenic dermal matrix and cultured epithelial autografts. Methods: The large defects in both lower legs were replaced with allogenic dermal matrix to avoid the postoperative hypertrophic scar contracture and a full-thickness skin biopsy was taken from right groin area simultaneously. We sent the specimen to a commercial laboratory for culture and obtained cultured epithelial autografts($Holoderm^{(R)}$) after 2 weeks, placed it over the allogenic dermal matrix. Results: The skin-defected area were nearly epithelialized after 2 weeks and there were no significant problem on during 6 months follow-up. Conclusion: The surgical method using allogenic dermal matrix and cultured epithelial autograft provided an excellent coverage of large skin defects of infant with aplasia cutis congenita.