UNASSIGNED: Selecting an appropriate graft for anterior cruciate ligament (ACL) reconstruction requires consideration of a patient\'s preferences, goals, age, and physical demands alongside the risks and benefits of each graft choice.
UNASSIGNED: To determine the most popular ACL reconstruction grafts among patients and the most important factors influencing their decisions.
UNASSIGNED: Cross-sectional study; Level of evidence, 3.
UNASSIGNED: Patients undergoing ACL reconstruction between October 2022 and April 2023 completed a survey either before (nonconsult group) or after (consult group) speaking with their surgeon, who provided an evidence-based description of the pros and cons of an allograft and the following autografts: bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT). Patient characteristics, graft choice, information influencing their graft choice, and surgeon recommendation were collected and compared between the groups.
UNASSIGNED: Among the 100 included patients, 59.0% were male, and the mean age was 28.3 ± 10.4 years. The most popular grafts were the BPTB (56.0%), followed by the QT (29.0%), HT (8.0%), and allograft (7.0%). No significant difference was observed in the graft selection between the consult group (n = 60; BPTB, 46.7%; QT, 38.3%; HT, 8.3%; allograft, 6.7%) and nonconsult group (n = 40; BPTB, 70.0%; QT, 15.0%; HT, 7.5%; allograft, 7.5%) (P = .0757). In the consult group, 81.7% of patients selected the graft recommended to them by their surgeon. The top 2 graft selection reasons were usage in professional athletes and failure rates, while the top 2 ACL surgery concerns were returning to their desired level of athletics and graft failure risk. Among the 93 patients who researched their ACL graft options before their visit, the most popular information source was some form of media (72.0% [67/93]).
UNASSIGNED: The study findings underscore the importance of patient preference and surgeon recommendation in a patient\'s graft selection and highlight the need to be cognizant of the information sources available to patients when researching their graft options.

Introduction Restoring knee joint stability and resuming sports activities are important objectives of anterior cruciate ligament (ACL) reconstruction. The maintenance of anterior knee stability after ACL reconstruction is contingent on graft tension. Various devices and techniques have been used to achieve robust tibial graft tendon fixation, and their advantages and disadvantages are established. However, a gold standard has not been established. Therefore, we aimed to determine whether anterior knee joint stability and clinical outcomes of graft tendon fixation could be improved using a recently modified suture button (MSB) compared with using an adjustable suspensory fixator (ASF) at 1 year after double-bundle ACL reconstruction. Methods This study retrospectively analyzed postoperative data derived from 79 patients at a single center between January 2016 and December 2021. The patients were assigned to groups that underwent double-bundle ACL reconstruction with tibial fixation using an MSB (n = 30) that maintains tension while tying sutures, or an ASF (n = 49). We then compared complications, clinical outcomes and knee joint stability at 1 year postoperatively. Rates of postoperative infection, graft rupture, implant removal and residual anterior knee laxity (AKL) were compared between the groups using chi-square tests. Patient-reported outcome measures (PROM) based on Forgot Joint Score-12, Knee Injury and Osteoarthritis Outcome, and Lysholm Knee scores were compared using Mann-Whitney U tests. Results One patient in the MSB group developed postoperative infection. Rates of graft rupture and implant removal in the MSB and ASF groups were 3.3% and 4.1%, and 3.6% and 10.2%, respectively. None of the PROMs differed between the groups. The proportions of postoperative AKL were 3.6% and 14.9% in the MSB and ASF groups, respectively. A trend towards lower postoperative AKL in the MSB group did not reach statistical significance (p = 0.25). Conclusions The incidence of AKL at a year after ACL reconstruction using the MSB was 3%. Postoperative AKL and clinical outcomes were comparable between the MSB and ASF groups. A low AKL rate and positive postoperative outcomes indicated that MSB could be an option for tibial-side fixation in ACL reconstruction.

暂无摘要。

UNASSIGNED: Disruption of the medial patellofemoral ligament (MPFL) may lead to recurrent lateral patellar dislocation and patellofemoral chondral injury. Despite significant previous work investigating numerous performance parameters, the optimal graft choice for MPFL reconstruction for patellar instability remains unclear.
UNASSIGNED: To compare functional outcomes scores, subjective recurrent instability, and revision rates between autograft and allograft in MPFL reconstruction.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: Patients who underwent MPFL reconstruction with autograft between 2013 and 2018 were identified. A 2:1 comparison group of patients who underwent MPFL reconstruction with allograft was matched by sex, age (±3 years), and body mass index (BMI) (±3 kg/m2). Patient characteristics, preoperative radiograph measurements, and intraoperative data were compared between the groups, as were patient-reported outcome measures, including International Knee Documentation Committee (IKDC) score, Lysholm score, Single Assessment Numerical Evaluation (SANE), and visual analog scale (VAS) for pain. Subjective recurrent instability and revision rate were also compared between groups.
UNASSIGNED: The autograft group was composed of 30 patients (13 male, 17 female) with a mean age of 24.4 years and mean BMI of 25.0 kg/m2, and the allograft group was composed of 60 matched patients (25 male, 35 female) with a mean age of 24.1 years and mean BMI of 25.1 kg/m2. The autograft and allograft groups reported similar IKDC scores (73.0 vs 73.7; P = .678), Lysholm scores (77.5 vs 80.7; P = .514), SANE (72.0 vs 75.8; P = .236), and VAS pain (30.7 vs 26.6; P = .482), as well as similar rates of postoperative patellar subluxations (20.0% vs 19.3%; P = .867) and dislocations (10.0% vs 15.0%; P = .805).
UNASSIGNED: Both allograft and autograft were found to be viable options for MPFL reconstruction. There were no significant group differences in failure rates, patient-reported outcomes, pain, or complications between autograft and allograft MPFL reconstruction in this series.

UNASSIGNED: The interaction between the recipient area and the graft is one of the key factors in the success of periodontal plastic surgery. This randomized controlled, split-mouth, double-blinded clinical trial aimed to compare the clinical and aesthetic outcomes of epithelialized palatal graft (EPG) and gingival unit graft (GUG) in achieving root coverage in localized (Recession Type 1) RT1 recession defects.
UNASSIGNED: Twenty participants with forty bilateral recession defects randomly received EPG or GUG surgical treatment modalities for each of the recession defects. Clinical measurements recorded at baseline and after six months included recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), and the average width of mesial and distal interdental papilla (aWIDP).
UNASSIGNED: There was a statistically significant greater mean root coverage (MRC) percentage at GUG sites (80.68 ± 16.12%) in comparison to EPG sites (71.05 ± 17.23%) (p = 0.01). The treatment satisfaction (p = 0.009) and aesthetic satisfaction (p < 0.001) experienced were significantly better for GUG as compared to EPG. The regression model (R 2 = 0.56) significantly predicted MRC percentage in GUG sites with baseline RD (β = -12.49; p = 0.02) and aWIDP (β = -9.31; p = 0.02).
UNASSIGNED: GUG showed a better MRC, aesthetics and increased KTW. Root coverage procedures often need to suffice the dual objective of coverage and aesthetics at the same time. GUG is a simple modification of the conventional EPG that can provide better clinical and aesthetic outcomes.

暂无摘要。

UNASSIGNED: Mycotic carotid pseudoaneurysms represent a challenge for surgeons. They are rare and associated with high mortality and morbidity.
UNASSIGNED: We reported a case of a 61-year-old man with a mycotic pseudoaneurysm of carotid bifurcation. The case was managed by a staged procedure, starting with initial endovascular control using a stent graft, followed by open arterial reconstruction using a saphenous vein graft.
UNASSIGNED: The patient was discharged home with a patent carotid artery and no sign of infection or bleeding. A computed tomography scan performed at 1 month, 6 months, and 1 year later confirmed good patency of the graft without imaging of cerebral ischemia.
UNASSIGNED: Mycotic pseudoaneurysms of the extracranial carotid artery are rare and should always be treated surgically. This disease, despite its rarity, requires early detection and treatment to avoid fatal outcomes. A hybrid staged approach is suggested, compared to one-staged surgery, to avoid rupture and improve clinical outcomes. This approach involves using a stent graft combined with antibiotic therapy as bridge treatment until definitive surgery can be performed to enable arterial reconstruction with an autologous graft.

Restoration of extensive tracheal damage remains a significant challenge in respiratory medicine, particularly in instances stemming from conditions like infection, congenital anomalies, or stenosis. The trachea, an essential element of the lower respiratory tract, constitutes a fibrocartilaginous tube spanning approximately 10-12 cm in length. It is characterized by 18 ± 2 tracheal cartilages distributed anterolaterally with the dynamic trachealis muscle located posteriorly. While tracheotomy is a common approach for patients with short-length defects, situations requiring replacement arise when the extent of lesion exceeds 1/2 of the length in adults (or 1/3 in children). Tissue engineering (TE) holds promise in developing biocompatible airway grafts for addressing challenges in tracheal regeneration. Despite the potential, the extensive clinical application of tissue-engineered tracheal substitutes encounters obstacles, including insufficient revascularization, inadequate re-epithelialization, suboptimal mechanical properties, and insufficient durability. These limitations have led to limited success in implementing tissue-engineered tracheal implants in clinical settings. This review provides a comprehensive exploration of historical attempts and lessons learned in the field of tracheal TE, contextualizing the clinical prerequisites and vital criteria for effective tracheal grafts. The manufacturing approaches employed in TE, along with the clinical application of both tissue-engineered and non-tissue-engineered approaches for tracheal reconstruction, are discussed in detail. By offering a holistic view on TE substitutes and their implications for the clinical management of long-segment tracheal lesions, this review aims to contribute to the understanding and advancement of strategies in this critical area of respiratory medicine.

BACKGROUND: Tooth extraction procedures often lead to bone resorption, which can have adverse effects on the dimensions of the alveolar ridge. Research has shown that socket preservation techniques using bone graft substitutes can effectively minimize early bone loss in such cases. α-calcium sulfate hemihydrate (α-CSH) has garnered significant attention as a potential bone graft material due to its favorable properties, including osteoconductivity, angiogenic potential, and biocompatibility. Considering these facts, we developed a preliminary protocol for applying α-CSH in addressing alveolar bone loss following tooth extraction.
OBJECTIVE: This research\'s general objective is to evaluate the feasibility and initial effectiveness of α-CSH as bone-inducing graft material for socket preservation after tooth extraction.
METHODS: This preliminary clinical trial will involve 30 fresh extraction sockets from individuals aged 18-35 years. The participants will be divided into 2 groups: one group will receive α-CSH graft material after tooth extraction for socket preservation, while the other group will not receive any graft material. Throughout the study, the participants will be closely monitored for safety measures, which will include clinical examinations, radiographic imaging, and blood tests. Radiographic imaging will be used extensively to assist the progress of bone formation.
RESULTS: The study commenced enrollment in August 2022 and is scheduled to conclude post assessments and analyses by the end of 2023. The results of the study are anticipated to be accessible in late 2024.
CONCLUSIONS: This clinical study represents the initial investigation in humans to assess the feasibility and efficacy of α-CSH in alveolar bone regeneration. We hypothesize that the inclusion of α-CSH can greatly expedite the process of bone formation within fresh sockets, resulting in a swift restoration of bone height without the disadvantages associated with harvesting autogenous bone graft.
BACKGROUND: Indonesia Registry Center INA-D02FAHP; https://tinyurl.com/2jnf6n3s.
UNASSIGNED: DERR1-10.2196/49922.

Coronary artery bypass surgery can result in endothelial dysfunction due to ischemia/reperfusion (IR) injury. Previous studies have demonstrated that DuraGraft helps maintain endothelial integrity of saphenous vein grafts during ischemic conditions. In this study, we investigated the potential of DuraGraft to mitigate endothelial dysfunction in arterial grafts after IR injury using an aortic transplantation model. Lewis rats (n = 7-9/group) were divided in three groups. Aortic arches from the control group were prepared and rings were immediately placed in organ baths, while the aortic arches of IR and IR + DuraGraft rats were preserved in saline or DuraGraft, respectively, for 1 h before being transplanted heterotopically. After 1 h after reperfusion, the grafts were explanted, rings were prepared, and mounted in organ baths. Our results demonstrated that the maximum endothelium-dependent vasorelaxation to acetylcholine was significantly impaired in the IR group compared to the control group, but DuraGraft improved it (control: 89 ± 2%; IR: 24 ± 1%; IR + DuraGraft: 48 ± 1%, p < 0.05). Immunohistochemical analysis revealed decreased intercellular adhesion molecule-1, 4-hydroxy-2-nonenal, caspase-3 and caspase-8 expression, while endothelial cell adhesion molecule-1 immunoreactivity was increased in the IR + DuraGraft grafts compared to the IR-group. DuraGraft mitigates endothelial dysfunction following IR injury in a rat bypass model. Its protective effect may be attributed, at least in part, to its ability to reduce the inflammatory response, oxidative stress, and apoptosis.