Autograft

自体移植物
  • 文章类型: Case Reports
    自体移植物的来源,例如掌长或足底,通常是有限的或不存在的。我们介绍了使用低供体部位发病率方法的经验,该方法在上肢软组织重建中收获了radi伸肌短和长肌(ECRB和ECRL)作为游离肌腱自体移植物。回顾性图表审查确定了五名患者,他们从2014年1月至2021年10月接受了使用ECRB和ECRL部分肌腱自体移植的重建上肢手术,至少有12个月的随访期。计算Mayo腕部评分以证明临床结果。所有5名患者(平均随访:21个月)都能够恢复正常活动,同时证明术后6个月和12个月的Mayo腕关节评分有所改善。收获后,供体部位的发病率最低,母体肌腱没有破裂。这项研究为利用ECRB和ECRL的部分条带修复上肢肌腱间隙和韧带畸形提供了额外的支持。
    Sources of autografts such as palmaris longus or plantaris are often limited or absent. We present our experience using a low donor-site morbidity method of harvesting strips of extensor carpi radialis brevis and longus (ECRB and ECRL) as free tendon autografts in upper extremity soft tissue reconstructions. Retrospective chart review identified five patients who received reconstructive upper extremity surgeries using ECRB and ECRL partial tendon autografts from January 2014 to October 2021 with at least a 12-month follow-up period. Mayo wrist scores were calculated to demonstrate clinical outcomes. All five patients (mean follow-up: 21 months) were able to return to regular activities while demonstrating improvements in 6- and 12-month postoperative Mayo wrist scores. There was minimal donor site morbidity and no ruptures of parent tendons following harvest. This study provides additional support for utilizing partial strips of ECRB and ECRL in repairing upper extremity tendon gap and ligament deformities.
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  • 文章类型: Journal Article
    插座保存是一种外科手术,旨在保留拔牙后牙槽骨的尺寸。通过在有或没有屏障膜的情况下用骨移植材料填充拔牙槽来进行。最近,从拔牙中获得的牙本质已被尝试作为自体移植来保存牙槽。研究将牙本质的使用与其他骨移植进行了比较,然而,评估牙本质保存牙槽疗效的系统评价是有限的。因此,本系统综述方案旨在提供证据证明牙本质作为其他骨移植材料保存牙槽的可行替代方法的有效性.
    本系统评价方案是根据Cochrane干预评价(MECIR)指南的方法学期望制定的。它将使用Cochrane干预措施系统审查手册进行。PubMed,Scopus,WebofScience,EMBASE,认识论,CochraneCentral,和EBSCO数据库和临床试验注册中心,将搜索所有使用自体牙本质移植的随机对照试验(RCT)和非随机研究(无论是颗粒/腻子,或/矩阵形式)用于插座保存。将评估保留的窝的骨和软组织愈合的影像学和临床评估以及手术后与患者相关的结果。将分别使用Cochrane偏差风险评估工具(ROBII)和ROBINS-I评估RCT和非RCT的偏差风险。证据的确定性将通过等级方法进行评估。
    该证据对于牙科临床医生和公众在选择移植材料进行牙槽保存时做出明智的决定非常重要。拔下的牙齿被认为是生物废物;然而,该证据为使用侵入性较小的自体骨移植进行骨再生手术提供了空间.
    PROSPERO:CRD42021201958(2021年2月15日注册)。
    UNASSIGNED: Socket preservation is a surgical procedure aimed at preserving the dimensions of the alveolar bone following tooth extraction. It is performed by filling the extraction socket with bone graft material with or without a barrier membrane. Recently, dentine obtained from extracted teeth has been tried as an autograft for socket preservation. Studies have compared the use of dentin to other bone grafts, however, systematic reviews evaluating the efficacy of dentin for socket preservation are limited. Hence, this systematic review protocol is proposed to generate evidence on the efficacy of dentin as a viable alternative to other bone graft materials for socket preservation.
    UNASSIGNED: This systematic review protocol was prepared according to the Methodological Expectations of the Cochrane Intervention Reviews (MECIR) guidelines. It will be conducted using the Cochrane Handbook for Systematic Review of Interventions. PubMed, Scopus, Web of Science, EMBASE, Epistemonikos, Cochrane Central, and EBSCO databases and clinical trial registries, will be searched for all randomized controlled trials (RCTs) and non-randomized studies that have used autologous dentin graft (either in particulate/putty, or/matrix form) for socket preservation. The radiographic and clinical assessment of bone and soft tissue healing of the preserved sockets along with patient-related outcomes following surgery will be assessed. The risk of bias assessment of the RCTs and Non-RCTs will be assessed using the \'Cochrane Risk of Bias assessment tool (ROB II) and ROBINS-I respectively. The certainty of evidence will be assessed by the GRADE approach.
    UNASSIGNED: This evidence is important for dental clinicians and the public to make an informed decision when choosing graft material for socket preservation. The extracted teeth are considered biological waste; however, this evidence provides scope for using a less invasive autograft for bone regenerative procedures.
    UNASSIGNED: PROSPERO: CRD42021201958 (Registered on 15/02/2021).
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  • 文章类型: Case Reports
    我们回顾了一例由于石蜡瘤导致的全阴茎皮肤置换,并进行了厚度分裂的微网状皮肤移植(微网状STSG)。
    We review a case of total penile skin replacement with split-thickness micromesh skin graft (micromesh STSG) due to paraffinoma.
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  • 文章类型: Journal Article
    最近,腓骨长肌腱(PLT)在前交叉韧带(ACL)重建中越来越受欢迎,并已获得令人满意的结果。然而,有关于供体部位发病率的担忧。本研究旨在比较使用绳肌腱(HT)和PLT自体移植物重建ACL的功能结果,并评估供体部位的发病率。
    将接受ACL重建的患者分为两组(HT和PLT)。术中测量移植物直径。术前使用IKDC和Tegner-Lysholm评分评估膝关节功能结局,术后3个月,6个月,和1年。通过大腿围测量来评估供体部位的发病率。感觉障碍的主观评价,和脚踝得分与AOFAS和FADI得分。
    在1年的随访中,PLT组的IKDC(p=0.925)和Tegner-Lysholm(p=0.600)评分与HT组相当.PLT组的平均移植物直径(7.93±0.52mm)大于HT组(7.43±0.50mm)(p<0.001)。大腿萎缩的发生率(HT-16.7%,PLT-10%)和感觉障碍(HT-73.3%,HT组PLT-10%)更大。PLT组无明显踝关节供体部位发病率(AOFAS-98.67±3.45,FADI-99.23±1.69)。
    用PLT重建ACL在1年时具有与HT相当的功能结果。然而,PLT显示较大的移植物直径,供体部位发病率较低,增强肌肉恢复而不显著影响踝关节功能。PLT可以安全地用作从膝关节外收获的可接受的替代移植物选择,用于ACL重建。
    UNASSIGNED: Recently the peroneus longus tendon (PLT) gained popularity in anterior cruciate ligament (ACL) reconstruction and has been utilized with satisfactory outcomes. However, there are concerns regarding donor site morbidity. This study aims to compare the functional outcome of ACL reconstruction using hamstring (HT) and PLT autografts and evaluate the donor site morbidity.
    UNASSIGNED: Patients who underwent ACL reconstruction were allocated to two groups (HT and PLT). Graft diameter was measured intraoperatively. Knee functional outcome was evaluated with IKDC and Tegner-Lysholm scores preoperatively, and postoperatively after 3 months, 6 months, and 1 year. Donor site morbidities were assessed with thigh circumference measurements, subjective evaluation of sensory disturbances, and ankle scoring with AOFAS and FADI scores.
    UNASSIGNED: At 1-year follow-up, the PLT group showed comparable IKDC (p = 0.925) and Tegner-Lysholm (p = 0.600) scores with those of the HT group. The mean graft diameter in the PLT group (7.93 ± 0.52 mm) was larger compared with the HT group (7.43 ± 0.50 mm) (p < 0.001). The incidence of thigh atrophy (HT-16.7%, PLT-10%) and sensory disturbances (HT-73.3%, PLT-10%) was greater in the HT group. There was no significant ankle donor site morbidity in the PLT group (AOFAS-98.67 ± 3.45, FADI-99.23 ± 1.69).
    UNASSIGNED: ACL reconstruction with PLT had comparable functional outcome with that of HT at 1 year. However, PLT demonstrated larger graft diameter, less donor site morbidity, and enhanced muscle recovery without significantly affecting the ankle function. PLT can be safely used as an acceptable alternative graft choice harvested from outside the knee for ACL reconstruction.
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  • 文章类型: Journal Article
    通过放松来评估抗氧化活性和氧化损伤,受伤,在胸骨寄主上播种不同来源的saibo,包括五种牡蛎治疗:(1)放松(REL),但既不受伤也不播种;(2)放松和受伤(WOU),但未播种;(3)放松,受伤,并用同种异体移植物(ALL)播种;(4)放松,受伤,并用自体移植物(AUT)播种;(5)不放松,没有受伤,并且未播种作为对照(CTR)。超氧化物歧化酶(SOD),过氧化氢酶(CAT),谷胱甘肽过氧化物酶(GPx),和硫代巴比妥酸(TBARS)活性在接种后3至24小时之间进行定量。与CTR牡蛎相比,没有遭受氧化应激,在所有处理中,性腺和消化腺中的SOD活性均显着降低,而AUT牡蛎中的地幔组织则降低;这表明准备牡蛎进行珍珠培养的整个过程(放松,受伤,和播种)在宿主中产生氧化应激。CAT不是测量牡蛎对受伤播种过程的短期反应的敏感酶,而是更长时间或慢性的压力。类似于SOD,接种牡蛎中GPx和TBARS活性最低,证明了它们对氧化应激和损伤的敏感性,特别是在WOU治疗中。这项研究的证据表明,SOD是一种更敏感的酶,可用于测量寄主牡蛎对赛博受伤和播种的短期反应。很明显,在珍珠培养过程的所有阶段,宿主都会受到压力,主要是在性腺受伤期间,无论赛博的起源如何。
    To evaluate the antioxidant activity and oxidative damage by relaxing, wounding, and seeding of a saibo of different origin on Pteria sterna hosts, five oyster treatments were included: (1) relaxed (REL) but neither wounded nor seeded; (2) relaxed and wounded (WOU) but not seeded; (3) relaxed, wounded, and seeded with an allograft (ALL); (4) relaxed, wounded, and seeded with an autograft (AUT); and (5) unrelaxed, unwounded, and unseeded as control (CTR). Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and thiobarbituric acid (TBARS) activity were quantified between 3 and 24 h post-seeding. Compared to the CTR oysters, which did not suffer oxidative stress, SOD activity significantly decreased in the gonad and digestive gland in all treatments and decreased in mantle tissue in AUT oysters; this indicates that the entire process of preparing oysters for pearl culture (relaxing, wounding, and seeding) generates oxidative stress in the host. CAT was not a sensitive enzyme for measuring the short-term response of oysters to the wounding-seeding processes but rather a more prolonged or chronic stress. Similar to SOD, the lowest GPx and TBARS activity in seeded oysters evidenced their susceptibility to oxidative stress and damage, particularly in the WOU treatment. Evidence from this study indicates that SOD is a more sensitive enzyme for measuring the short-term response of the host oyster to the wounding and seeding of a saibo. It is also clear that the host undergoes stress at all stages of the pearl culture process, mostly during gonad wounding and regardless of the origin of saibo.
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  • 文章类型: Case Reports
    在牙周护理中,患者的结果对于指导外科技术的发展至关重要,牙龈衰退管理是一个关键问题。骨膜外翻技术(PET)是一种现代策略,它利用骨膜的内在再生能力来实现根覆盖。一个详细的案例研究展示了PET在处理MillerI类牙龈萎缩以及辅助富血小板纤维蛋白(PRF)手术中的有效性。这种方法需要将骨膜瓣故意抬高和外翻以包围衰退区域。通过缝合精心固定。在六个月的观察期中,这种方法表现出成功的根覆盖,角化组织的增加,增强了患者的舒适度,据报道,无明显并发症。这些结果为将PET纳入标准牙周治疗方案提供了支持,强调其重塑牙龈衰退治疗景观的能力。
    In periodontal care, where patient results are crucial in guiding the development of surgical techniques, gingival recession management is a critical issue. The periosteum eversion technique (PET) emerges as a modern strategy that leverages the intrinsic regenerative capabilities of the periosteum to attain root coverage. A detailed case study showcases the effectiveness of PET in managing a Miller Class I gingival recession alongside an adjunctive platelet-rich fibrin (PRF) procedure. This approach entailed the deliberate elevation and eversion of the periosteal flap to encompass the recession area, securing it meticulously through suturing. Across a six-month observation period, this method exhibited successful root coverage, augmentation of keratinized tissue, and enhanced patient comfort, as reported, with no significant complications observed. These outcomes provide support for the incorporation of PET into standard periodontal protocols, underscoring its capacity to reshape the treatment landscape for gingival recession.
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  • 文章类型: Journal Article
    在后外侧角(PLC)重建中存在几种手术技术和移植物类型的方法。文献缺乏有关PLC损伤的自体移植与同种异体移植重建后结果的知识。
    全面回顾目前关于PLC重建的文献,并比较自体移植和同种异体移植组织的结果。
    系统评价;证据水平,4.
    搜索PubMed和Scopus在线数据库时使用术语“PLC,膝关节后外侧,“后外侧角”,\"和\"重建\"在不同的组合。患者特征,移植物类型,移植失败,外科技术,功能结果评分,回顾了应力X线片上的内翻松弛度,并比较了自体移植物和同种异体移植物的PLC重建。
    包括22项研究,包括33个队列:16个自体移植物(n=280个膝盖)和17个同种异体移植物(336个膝盖)。有69个分离的PLC重建(58个同种异体移植物和11个自体移植物)和493个多韧带重建(269个自体移植物和224个同种异体移植物)。患者平均年龄没有差异(30.5岁vs33.5岁,分别为;P=.11)或平均随访时间(39.5vs37.7个月,分别;P=0.68)在自体移植组和同种异体移植组之间。没有证据表明移植物类型之间的移植物失败存在差异(自体移植物与同种异体移植物的合并平均值:0.44对0.41失败;P=.95)。自体移植物与同种异体移植物的术后Lysholm平均评分有显著差异(分别为89.6vs85.5;P=.04)。两组在术前或术后国际膝关节文献委员会(IKDC)评分或术后内翻松弛度方面没有差异。
    我们的综述和荟萃分析表明,仅基于移植物类型的PLC重建后,移植物失败率或客观结果没有显着差异。术后Lysholm评分与自体移植组有显著差异,IKDC主观评分无显著差异。
    UNASSIGNED: Several approaches to surgical techniques and graft types exist in posterolateral corner (PLC) reconstruction. The literature lacks knowledge regarding outcomes after autograft versus allograft reconstruction for PLC injuries.
    UNASSIGNED: To comprehensively review the current literature on PLC reconstruction and compare outcomes between autograft and allograft tissues.
    UNASSIGNED: Systematic review; Level of evidence, 4.
    UNASSIGNED: The PubMed and Scopus online databases were searched with the terms \"PLC,\"\"posterolateral knee,\"\"posterolateral corner,\" and \"reconstruction\" in varying combinations. Patient characteristics, graft type, graft failure, surgical techniques, functional outcome scores, and varus laxity on stress radiographs were reviewed and compared between PLC reconstruction with autografts versus allografts.
    UNASSIGNED: Included were 22 studies comprising 33 cohorts: 16 autografts (n = 280 knees) and 17 allografts (336 knees). There were 69 isolated PLC reconstructions (58 allografts and 11 autografts) and 493 multiligament reconstructions (269 autografts and 224 allografts). There was no difference in the mean patient age (30.5 vs 33.5 years, respectively; P = .11) or mean follow-up (39.5 vs 37.7 months, respectively; P = .68) between the autograft and allograft groups. There was no evidence to suggest a difference in graft failures between graft types (pooled mean autograft vs allograft: 0.44 vs 0.41 failures; P = .95). There was a significant difference in the mean postoperative Lysholm scores for autografts versus allografts (89.6 vs 85.5, respectively; P = .04). There was no difference between the cohorts in preoperative or postoperative International Knee Documentation Committee (IKDC) scores or postoperative varus laxity.
    UNASSIGNED: Our review and meta-analysis indicated no significant differences in graft failure rates or objective outcomes after PLC reconstruction based on graft type alone. There was a significant difference in postoperative Lysholm scores in favor of the autograft group and no significant difference in IKDC subjective scores.
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  • 文章类型: Journal Article
    绳肌腱(HT)自体移植是目前用于前交叉韧带(ACL)重建的最广泛使用的自体移植选择。然而,最近的研究表明腓骨长肌腱(PLT)是一种可行的替代方法。为了评估这一点,我们系统回顾了随机对照试验(RCTs),以比较PLT对HT自体移植物的疗效.我们的搜索包括Cochrane,Embase,OVID,PubMed,和Scopus数据库,用于比较PLT和HT自体移植在ACL重建中的结果。主要结果包括Lysholm和国际膝关节文献委员会(IKDC)评分,次要结局涉及美国骨科足踝协会(AOFAS)评分,移植物直径和供体部位并发症。使用ReviewManager5.4(CochraneCollaboration)进行统计分析,并使用I2统计量评估异质性。纳入6个RCT的683例患者,338例(49.5%)患者接受PLT自体移植物治疗。随访时间为12~30个月。尽管PLT组术前Lysholm评分较低,在6个月和12个月时没有观察到显著差异.尽管PLT组术前和6个月IKDC评分较低,在12个月和24个月时没有发现显著差异.AOFAS评分术前差异无统计学意义,但PLT组在12个月或24个月时得分略低.移植物直径无显著差异,而PLT组供体部位并发症较少。总之,PLT自体移植物是HT自体移植物的一种有前途且非劣质的替代品,显示患者报告的膝关节和踝关节指标的等效结果,相当的移植物直径和较少的供体部位并发症。
    The hamstring tendon (HT) autograft is currently the most widely utilised autograft option for anterior cruciate ligament (ACL) reconstruction. However, recent studies endorse the peroneus longus tendon (PLT) autograft as a viable alternative. To evaluate this, we systematically reviewed randomised controlled trials (RCTs) to compare the efficacy of PLT against HT autografts. Our search encompassed Cochrane, Embase, OVID, PubMed, and Scopus databases for RCTs comparing outcomes of PLT and HT autografts in ACL reconstruction. Primary outcomes included Lysholm and International Knee Documentation Committee (IKDC) scores, while secondary outcomes involved American Orthopaedic Foot and Ankle Society (AOFAS) scores, graft diameters and donor-site complications. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration) and heterogeneity was assessed with I2 statistics. 683 patients from 6 RCTs were included, with 338 (49.5%) patients treated with PLT autografts. Follow-up ranged from 12 to 30 months. Despite lower preoperative Lysholm scores in the PLT group, no significant differences were observed at 6 and 12 months. Although preoperative and 6-month IKDC scores were lower in the PLT group, no significant differences were found at 12 and 24 months. AOFAS scores showed no significant preoperative difference, but slightly lower scores were noted in the PLT group at 12 or 24 months. There was no significant difference in graft diameter, while donor-site complications were fewer in the PLT group. In summary, the PLT autograft is a promising and non-inferior alternative to the HT autograft, demonstrating equivalent outcomes in patient-reported knee and ankle metrics, comparable graft diameters and fewer donor-site complications.
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  • 文章类型: Journal Article
    与重返运动相比,前十字韧带(ACL)重建(ACLR)后重返工作(RTW)的时机是一个研究较少的里程碑。
    系统评价ACLR后RTW的发生率和术后时机。
    系统评价;证据水平,4.
    这项研究是根据2020PRISMA(系统审查和荟萃分析的首选报告项目)声明进行的。在PubMed中进行了文献检索,Embase,科克伦,以及用于报告ACLR后RTW的临床研究的Ovid数据库,2022年8月确定了806项研究。使用非随机研究方法学指数(MINORS)分级系统进行质量评估。从研究中提取以下数据:研究特征,队列人口统计,ACLR技术,伴随半月板和/或软骨手术,术前患者报告的结果,RTW的比率,以及ACLR后RTW所需的天数。
    共有13项研究符合纳入标准,总计1791名患者(86.4%为男性)。在评估研究的方法学质量中观察到广泛的差异(MINORS评分范围,8-17).76.8%的人使用了绳肌腱(HT)自体移植(n=1377;平均年龄,30.5岁),同种异体移植物占17.1%(n=308;平均年龄,33.1岁),韧带高级加固系统占2.5%(n=46;平均年龄,33.2岁),骨-髌腱-自体骨移植占2%(n=36;平均年龄,28.5岁),股四头肌腱自体移植占1.3%(n=24;平均年龄,24.1岁)。在纳入的患者中,99.1%(n=1781)报告术后RTW成功。RTW的平均时间为84.2天(范围,31.4-107.1天),适用于HT和69.5天(范围,49-56.6天)用于同种异体移植。
    虽然没有关于ACL损伤前后工作强度的数据,我们的研究结果表明,患者最常发生RTW在手术后90天内.同种异体移植物ACLR患者可能比接受HT自体移植物ACLR患者更早发生RTW。
    UNASSIGNED: The timing of return to work (RTW) after anterior cruciate ligament (ACL) reconstruction (ACLR) is a less studied milestone compared with return to sports.
    UNASSIGNED: To systematically review the rate and postoperative timing of RTW after ACLR.
    UNASSIGNED: Systematic review; Level of evidence, 4.
    UNASSIGNED: This study was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search was performed in PubMed, Embase, Cochrane, and Ovid databases for clinical studies reporting RTW after ACLR, and 806 studies were identified in August 2022. A quality assessment was performed using the Methodological Index of Nonrandomized Studies (MINORS) grading system. The following data were extracted from studies: study characteristics, cohort demographics, ACLR technique, concomitant meniscal and/or cartilage procedures, preoperative patient-reported outcomes, rates of RTW, and days required for RTW after ACLR.
    UNASSIGNED: A total of 13 studies met inclusion criteria, totaling 1791 patients (86.4% male). Wide variability was observed in the methodological quality of the assessed studies (MINORS score range, 8-17). Hamstring tendon (HT) autograft was used in 76.8% (n = 1377; mean age, 30.5 years old), allograft in 17.1% (n = 308; mean age, 33.1 years old), the ligament advanced reinforcement system in 2.5% (n = 46; mean age, 33.2 years old), bone-patellar tendon-bone autograft in 2% (n = 36; mean age, 28.5 years old), and quadriceps tendon autograft in 1.3% (n = 24; mean age, 24.1 years old). Among the included patients, 99.1% (n = 1781) reported successful RTW after surgery. The mean time to RTW was 84.2 days (range, 31.4-107.1 days) for HT and 69.5 days (range, 49-56.6 days) for allograft.
    UNASSIGNED: While data regarding work intensity before and after ACL injury were absent, our study results suggested that patients most often RTW within 90 days of surgery. Patients with allograft ACLR may RTW earlier than patients undergoing ACLR with HT autograft.
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  • 文章类型: Journal Article
    内侧髌股韧带重建是髌骨不稳定患者的标准治疗选择。这项研究的主要目的是确定是否使用双折叠分离解剖内侧髌股韧带重建,四股足底肌腱自体移植可恢复青少年患者的髌骨稳定性。通过近端入路收获植前肌腱移植物,并用于四名青少年患者。准备了双肢结构的四股自体移植物,并用缝合锚和干涉螺钉固定在髌骨和股骨上,分别。平均Kujala评分从44±24SD(范围,术前19至69)分至94±10SD(范围,术后78至100)分(P<0.001)。所有患者均报告了出色的主观结果,并恢复了受伤前的体育活动水平。在孤立的解剖内侧髌股韧带重建中使用四股肌腱自体移植物可以恢复青少年的髌骨稳定性。
    Medial patellofemoral ligament reconstruction is a standard treatment option for patients with patellar instability. The main purpose of this study was to determine whether isolated anatomic medial patellofemoral ligament reconstruction using double folded, four-strand plantaris tendon autograft restores patellar stability in adolescent patients. Plantaris tendon autografts were harvested through proximal approach and used in four adolescent patients. A four-strand autograft was prepared in a double-limbed configuration and fixed on the patella and the femur with suture anchors and interference screws, respectively. The mean Kujala score improved significantly from 44 ± 24 SD (range, 19 to 69) points preoperatively to 94 ± 10 SD (range, 78 to 100) points postoperatively (P< 0.001). All patients reported excellent subjective outcomes and returned to their pre-injury level of sporting activities. The use of a four-strand plantaris tendon autograft in isolated anatomic medial patellofemoral ligament reconstruction can restore patellar stability in adolescents.
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