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Background: Due to the complexity of the thoracic spine's surrounding structures, thoracic tuberculosis surgery is challenging to perform, with difficult exposure, complex operations, numerous complications, and often unsatisfactory prognoses. Currently, it is believed that the posterior approach alone is superior to both the anterior and the combined anterior-posterior surgical methods in correcting spinal kyphosis and maintaining spinal stability. The posterior approach encompasses the transpedicular approach, costotransverse approach, and lateral thoracic approach. The aim of this study is to explore the clinical safety and efficacy of a modified costotransverse approach, originally known as 'banana peel preservation surgery,' combined with autogenous iliac bone graft fusion and internal fixation for the treatment of thoracic tuberculosis patients., Methods: From July 2016 to December 2024, 23 patients with thoracic tuberculosis were continuously treated using a modified costotransverse approach combined with autogenous iliac bone graft fusion and internal fixation. All patients were treated by the same surgical team, which also used other methods to perform surgeries on other patients (non-participants) during the study period. The group included 12 males and 11 females with an average age of 65.7 years. The duration of surgery, intraoperative blood loss, and visual analog scale (VAS) pain scores, Oswestry disability index (ODI) were recorded and analyzed before surgery, two weeks after surgery, and at the final follow-up. Neurological function was evaluated using the ASIA classification, and radiological results were assessed by measuring changes in the Cobb angle and the bone fusion status of the corrected fusion segment., Results: The recorded surgical time for 23 patients ranged from 110 to 160 min (mean 133.7 ± 14.3 min), and blood loss ranged from 400 to 650 mL (mean 501.3 ± 74.9 mL). All incisions had healed by the first stage. The fusion time for the transplanted bone was between 3 and 7 months, with a median fusion time of 4 months. There was no loosening or breakage of internal fixation. At the final follow-up, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were both normal. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores showed significant improvement compared to preoperative values (P < 0.05). By the last follow-up, excluding patients who had normal neurological function previously, the remaining patients showed varying degrees of improvement in neurological function. The distribution of ASIA grades was as follows: 2 cases at grade C, 8 cases at grade D, and 13 cases at grade E. The average follow-up period for patients was 25 months, ranging from 13 to 36 months. Postoperative kyphosis did not progress significantly, and there was no recurrence of tuberculosis. In this group of 23 patients, the ASIA grade distribution at the last follow-up was 1 case at grade D and 22 cases at grade E, with a recovery rate of 90%. All patients received adequate decompression and bone grafting, leading to significant symptom improvement. There were no instances of pleural damage and all patients were free from symptomatic pleural effusion., Conclusions: The costotransverse process and the rib head provide sufficient surgical space of 1.1-2.1 cm to serve as decompression and bone graft channels. The preservation of the outer cortex of the rib can effectively prevent the risk of pleural injury and reduce the occurrence of pleural effusion. The modified costotransverse approach, "banana peel preservation surgery(Fig. 1)", combined with autologous iliac bone graft and internal fixation for the treatment of thoracic tuberculosis is a safe and effective surgical method for the treatment of thoracic tuberculosis., Competing Interests: Declarations. Ethics approval consent to participate: This study was approved by the medical ethics board committee of Wuhan Fourth Hospital and in accordance with the Declaration of Helsinki (Ethical Principles for Medical Research Involving Human Subjects). All the patients agreed with the data and publication of the manuscript and all patients provided written informed consent. Consent for publication: All of the collected patients had written informed consent before participate in this study, and the consent of publication was obtained from patients. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: Exercise and nutrition interventions are not part of routine care for those undergoing autologous stem cell transplant (autoSCT). We aimed to explore estimates of effect, safety and feasibility of multidisciplinary prehabilitation for improving physical capacity after autoSCT., Methods: This single-blinded, parallel, two-armed pilot randomized trial included adults receiving autoSCT. Participants were randomized to twice-weekly, supervised, tailored exercise and fortnightly telephone-based nutrition education, for up to 8-weeks prior to autoSCT (n = 11) or usual care (n = 11). Blinded assessments occurred at baseline (T0), pre-transplant (T1), and 4-weeks post-transplant (T2). The primary outcome was physical capacity (6-min walk test). Secondary measures included recruitment rate, adverse events, exercise adherence, physical status, nutritional status, health-related quality of life, and health service outcomes., Results: Positive estimates of effect for walking capacity in favour of the experimental group were demonstrated at T2 (MD + 141 m, 95% CI 24 to 257 m). There was high recruitment (81%) and adherence and no major adverse events. At T2 there were large estimates of effect favoring the experimental group for higher bodyweight, and less dyspnea and gastrointenstinal symptoms. There were no between-group differences in other outcomes., Conclusion: Prehabilitation is safe, feasible and may improve walking capacity after autoSCT. Findings support a future fully-scaled trial of prehabilitation for autoSCT., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12620000496910. Registered April 20, 2020., Competing Interests: Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Eastern Health Human Research Ethics Committee E20/003/61055 11th March 2020. Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests., (© 2025. Crown.)

Kidney autotransplantation is a surgical procedure with multiple indications and advancing technological approaches. Kidney autotransplantation is used to address complex kidney-related diseases including renal vascular lesions, ureteral diseases, tumors, loin pain-hematuria syndrome, and conditions affecting a solitary kidney or both kidneys. Renal artery lesions, including aneurysms and stenoses, often necessitate kidney autotransplantation in cases involving renal artery bifurcation or distant failure of endovascular repair. Complex ureteral lesions such as ureteral avulsions are commonly treated with kidney autotransplantation. Renal tumors, especially centrally located tumors or those involving the renal hilum, are treated using this technique while preserving renal function. It is worth emphasizing that this would be a rarely used last-resort technique in the modern era of minimally invasive nephron-sparing surgery. Kidney autotransplantation may be indicated for the rare condition of loin pain-hematuria syndrome when conservative measures fail. Additionally, individuals with solitary or bilateral kidney disease benefit from kidney autotransplantation to preserve their renal function. Traditional open-kidney autotransplantation involves renal extraction, workbench repair, and renal reimplantation. Technological advancements have introduced minimally invasive techniques including laparoscopic- and robot-assisted kidney autotransplantation, which reduce surgical trauma and recovery times. These techniques have shown promising outcomes, and robotic platforms have the potential to further reduce complications. In this study, we reviewed diverse indications and recent technological innovations in the field of kidney autotransplantation., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Subchondral bone cysts (SBCs) can significantly impact the outcomes of cartilage repair procedures such as autologous chondrocyte implantation (ACI). However, the etiology and progression of SBCs following ACI remain poorly understood. This case report highlights a progressively enlarging SBC following ACI using all-suture anchors, treated with autologous osteochondral transplantation (AOT)., Case Presentation: A 58-year-old female with progressive right knee pain, varus alignment, and Kellgren-Lawrence grade 3 osteoarthritis underwent atelocollagen-associated ACI combined with medial opening wedge high tibial osteotomy. Longitudinal radiological assessment revealed bone hole enlargement corresponding to all-suture anchor sites, with one hole continuing to expand up to 15 months postoperatively, reaching a size of 11 × 13 × 13 mm. This expanding SBC exhibited a connection to the joint cavity via a tiny fissure, scant osteosclerotic rim on CT, and fluid intensity on MRI. Histological analysis of tissue obtained during subsequent AOT revealed several findings. The SBC was located at the anterior portion of the medial femoral condyle, just beneath the all-suture anchor. Osteochondral necrosis was observed surrounding the anchor site, with no evidence of foreign body reaction. The cyst was filled with a mucoid substance and featured an aggregation of foamy macrophages. A sclerotic wall indicative of a strain response was observed. Notably, the presence of osteoclasts along the adjacent bone surface indicated ongoing bone resorption. The patient underwent AOT, which resulted in confirmed bone union. Postoperative follow-up demonstrated successful integration of the osteochondral graft and improved knee function scores over three years., Conclusion: This case report documents SBC formation following knee surgery with all-suture anchors and provides histological evaluation of such a cyst. The observed histological findings may contribute to our understanding of SBC pathophysiology in the context of cartilage repair procedures. This case underscores the importance of secure suturing techniques in high-stress areas and suggests the potential benefit of extended post-operative monitoring of SBC progression beyond one year. These observations may inform future strategies for the early detection of SBC formation and its progression, as well as timely intervention to prevent further joint damage in similar cases, though further research is needed to establish broader clinical implications., Competing Interests: Declarations. Ethics approval and consent to participate: This case report was performed in line with the principles of the Declaration of Helsinki. Written informed consent was obtained from the patient for publication of this case report. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: To systematically evaluate the efficacy of culture and nonculture autologous melanocyte transplantation and other methods for stable vitiligo., Methods: PubMed, Embase, WebofScience, TheCochraneLibrary, Chinese Journal Full-text Database (CNKI), VIP Chinese Scientific Journal Full-text Database (VIP), Wanfang database, were included in the clinical study of autologous cell transplantation for the treatment of stable vitiligo. For the meta-analysis of the corresponding studies with Revman5.3 software., Results: 17 high-quality studies were included in this meta-analysis, totaling 1199 patients, Meta-analysis showed that there was no significant difference in the efficacy of autologous cultured melanocytes transplantation (CMT) and melanocytes + keratinocytes, CMT and autologous nonculture suspension transplantation (NCES) in stable vitiligo (P > 0.05); There was a significant difference between CMT and CMT + phototherapy in stable vitiligo (P < 0.00001); There was no significant difference in the efficacy of NCES and NCES + other components, NCES and NCES + other therapies, and NCES and NCES + phototherapy for stable vitiligo (P > 0.05); There was a significant difference in the efficacy of cell transplantation and cell transplantation and cell transplantation + other therapy, cell transplantation and cell transplantation + phototherapy,cell transplantation and cell transplantation + narrow spectrum ultraviolet (NBUVB) in stable vitiligo (P < 0.00001)., Conclusion: Both NCES and CMT transplantation treated stable vitiligo and had no direct relationship with the components contained in the suspension. Melanocyte transplantation and melanocyte transplantation combined with other treatment methods is better than single melanocyte transplantation for vitiligo. Due to the number and quality of included studies, the above conclusions need to be confirmed by more reasonably designed randomized controlled clinical studies., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Consent for publication: Not applicable., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Ovarian tissue transplantation (OTT) has been suggested as an alternative to preserving female fertility in livestock species, as currently performed in women. The OTT technique has been tested as xenografting or autografting in different body sites and animal species. Currently, there are no reports available regarding the autotransplantation of ovarian tissue using the bovine model and also testing the effect of vascular endothelial growth factor (VEGF) on graft survival. This study evaluated the effects of ovarian tissue short-term exposure to VEGF before heterotopic autotransplantation into a subcutaneous site (flank region) for 7 days in cattle. The initial finding was that after OTT and without pre-exposure to VEGF, the ovarian grafts had 42% of normal preantral follicles, which indicates a substantial step forward for this technique in cattle. Furthermore, VEGF exposure actively facilitated the process of neoangiogenesis, the proliferation capability of the stromal cells for activation of the cell cycle, maintained the balance between types I and III collagen fibers, and reduced the total collagen of the grafted tissue. Moreover, ovarian fragments previously exposed to VEGF tended to have greater follicular density; however, a detrimental effect of VEGF on follicular morphology was noticed. In conclusion, this study marks a significant step forward in bovine OTT and provides a foundation for further investigations into the specific pathways, stages, and durations of VEGF exposure to unveil strategies for refining ovarian transplantation techniques in cattle and other species., (© 2025 Wiley Periodicals LLC.)

Autologous hematopoietic cell transplants (auto-HCTs) remain the standard of care for transplant-eligible MM patients. The general practice has been to undergo upfront apheresis following induction to collect sufficient number of CD34+ cells to facilitate two auto-HCTs. However, 5-30% of MM patients do not initially mobilise a sufficient number of hematopoietic stem cells and are classified as poor mobilizers (PM). We compared the baseline characteristics and outcomes of 61 PMs and 816 non-PM patients who underwent a second auto-HCT and who were enrolled in the non-interventional CALM study (NCT01362972). Only patients who collected CD34+ prior to auto-HCT1 were included. Auto-HCT2 comprised both tandem and salvage transplants. PMs were re-mobilized with plerixafor (n = 24, 39.3%) or non-plerixafor-based regimens (n = 37, 60.7%). There were no significant differences in engraftment, progression-free survival (PFS) or overall survival (OS) after the second auto-HCT between PM and non-PM patients. There was a trend to shorter PFS in PM patients undergoing salvage auto-HCT (median 9.6 vs. 12.9 months; p = 0.08) but no significant difference in OS. The median OS was 41.1 months for PM and 41.2 months for non-PM patients (p = 0.86). These data suggest that salvage mobilization is effective and does not affect overall outcomes after a second auto-HCT., Competing Interests: Competing interests: JDS – honoraria AbbVie, Roche, Janssen, Astra Zeneca, SOBI, Takeda, BMS, Novartis, Swixx; Advisory board meetings organized by Janssen-Cilag, Sanofi, AstraZeneca, Roche, BeiGene; AP - honoraria from Behring and Abbvie, participation in scientific Advisory board meetings organized by Abbvie, Janssen-Cilag, Novartis, Pfizer, Sanofi and Takeda; none of COI directly related to the study. Ethics approval: This retrospective study was approved by the Chronic Malignancies Working Party (CMWP) of the EBMT and was performed in accordance with the Declaration of Helsinki., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Cell-assisted lipotransfer (CAL) and platelet-rich plasma (PRP)-assisted lipotransfer have been used to overcome the low survival rate of conventional lipotransfer. However, there is still insufficient evidence to determine which technique is the best strategy for autologous fat grafting in breast cosmetic and reconstructive surgery. The present study aimed to compare the efficacy of traditional fat transplantation, CAL, and PRP-assisted lipotransfer., Methods: A systematic search was conducted in several databases, including PubMed, Web of Science, Cochrane, ClinicalTrials.gov, and Embase, concluding on January 21, 2024, to identify studies that met the inclusion criteria. Twelve studies were included after a rigorous selection process based on predefined criteria. Statistical analyses were conducted using R version 4.0.5 software with the netmeta and dmetar packages, utilizing a frequentist approach with a random-effects model. A network meta-analysis was performed to compare different fat graft procedures with regard to fat survival rate and complication events., Results: CAL and PRP-assisted lipotransfer were better than traditional fat grafting in terms of fat survival rate. In addition, there was no significant difference in the incidence of postoperative complications among the CAL, PRP, and traditional groups., Conclusions: Given the results of network meta-analysis, it appears that both CAL and PRP-assisted lipotransfer have a higher fat survival rate for autologous fat grafting in breast augmentation and reconstruction. However, the transplantation strategy still needs to be analyzed based on actual conditions in clinical applications., (Copyright © 2024 by the American Society of Plastic Surgeons.)

Background: Neuroblastoma (NB) is the most common extracranial solid tumor in pediatric. In highrisk NB patients, the 5-year overall survival rate (OS) remains a stark < 50 % with conventional therapies. Autologous hematopoietic stem cell transplantation with high dose chemotherapies was used in poor prognosis and high-risk patients.Today, Plerixafor is used to increase stem cells mobilization in patients who are candidates for autologous transplantation., Objective: This study examined safety and efficacy Plerixafor is administered as a subcutaneous injection in pediatric NB patients for stem cell mobilization STUDY DESIGN: A cohort of 19 pediatric neuroblastoma (NB) patients underwent autologous hematopoietic stem cell transplantation (HSCT) between February 2017 and April 2019, receiving G-CSF mobilization only. Subsequently, 37 NB patients underwent HSCT between December 2019 and October 2023, receiving both G-CSF and plerixafor for mobilization (auto-HSCT)., Results: The final product CD34 cell dose /kg was evidently higher in combination group at 5.363 ± 4.243 vs. G-CSF group at 2.827 ± 3.586 × 106(P value= 0.001). Neutrophils and platelet engraftment were occurred sooner in combination group compared with G-CSF group. The 1-year overall survival (OS) rate for the G-CSF and G-CSF-and-plerixafor combination group was 70.8 % and 63.3 %, respectively (P = 0.874). No statistically significant difference in OS or disease-free survival (DFS) was observed between the two treatment groups., Conclusion: The results show that plerixafor may be safe and effective in NB pediatric patients in routine clinical practice. It was well tolerated in NB patients and no specific side effects were observed. It was not associated with improved survival., (Copyright © 2025. Published by Elsevier Ltd.)

Autologous hematopoietic stem cell transplantation is used to restore bone marrow function after high-dose chemotherapy. For apheresis, granulocyte colony-stimulating factor (G-CSF) is standard of care, but obtaining sufficient stem cells can be challenging. Other mobilization agents include plerixafor and PEGylated G-CSF (PEG-G-CSF). While efficacy of these is established in adults, limited data for their use in pediatric patients are available. Here, we compare Good versus Poor Mobilizers and study success of different mobilization regimens in regard to CD34 + cell-collection, -quality, -phenotype and hematologic reconstitution in pediatric patients. In this multi-center retrospective study, we analyzed data of 278 patients with solid tumors and lymphoma, mobilized with either G-CSF ( n = 224), PEG-G-CSF ( n = 34), or G-CSF/PEG-G-CSF with additional plerixafor ( n = 20). In Poor Mobilizers (13.7% of all patients), addition of plerixafor to G-CSF augmented CD34 + cell collection, without adverse effects on hematologic reconstitution and CD34 + cell quality. PEG-G-CSF-aided mobilization was successful as first-line treatment in two-thirds of patients and did not impair hematological reconstitution, compared to G-CSF-only. Within the Poor Mobilizer group, G-CSF+plerixafor increased primitive (CD45RA - CD38 - CD90 + CD49f + ) and CXCR4-expressing CD34 + cells in apheresis products compared to G-CSF-only, without exceeding levels of Good Mobilizers. No plerixafor-related increase in tumor cells was observed in apheresis products. In conclusion, our comprehensive study supports the use of plerixafor and furthermore demonstrates the potential of patient-friendly PEG-G-CSF for mobilization of pediatric patients.

Hematopoietic cell transplantation requires higher doses of chemotherapy, and practices of adjusting the weight because of concerns of organ toxicity are common. This retrospective analysis of 239 adult recipients of autologous hematopoietic cell transplantation for lymphoma assessed the effect of obesity on transplantation outcomes., Background: Prior data evaluating the impact of obesity in autologous hematopoietic cell transplantation (AHCT) for lymphomas have provided differing results when assessing overall (OS) and progression-free survival (PFS). Impact on survival outcomes have been described, but direct comparison of discrete toxicities is lacking., Patients and Methods: We retrospectively compared outcomes with patients divided between 3 groups: nonobese patients (n = 129), obese patients dosed on adjusted body weight (AdjBW) (n = 32), and obese patients dosed on total body weight (TBW) (n = 78)., Results: In multivariate analysis of OS with the nonobese group as the comparator, outcomes trended worse in obese patients dosed on AdjBW (HR 1.22, 95% CI 0.52-2.85) but were improved in obese patients dosed on TBW (HR 0.19, 95% CI 0.04-0.85, P = .012). PFS of obese patients dosed on AdjBW vs. the nonobese group was comparable (HR 1.19, 95% CI 0.63-2.24), but improved in obese patients dosed on TBW (HR 0.45, 95% CI 0.23-0.89, P = .021). Notably, no differences were noted between groups in gastrointestinal, infectious, renal, or hepatic toxicities., Conclusion: In summary, our data suggest that recipients of AHCT for lymphoma should be dosed on TBW to maximize curative outcomes with no apparent increase in toxicities., Competing Interests: Disclosure AL has performed consulting for Sanofi. NP is currently employed at Carsgen Therapeutics. GLS has research funding to the institution from Janssen, Amgen, BMS, Beyond Spring, and GPCR, and is on the DSMB for ArcellX. MS served as a paid consultant for McKinsey & Company, Angiocrine Bioscience, Inc., and Omeros Corporation; received research funding from Angiocrine Bioscience, Inc., Omeros Corporation, and Amgen, Inc.; served on ad hoc advisory boards for Kite—A Gilead Company; and received honoraria from i3Health, Medscape, CancerNetwork for CME-related activity and honoraria from IDEOlogy. MP reports honoraria from Adicet, Allogene, AlloVir, Caribou Biosciences, Celgene, Bristol-Myers Squibb, Equilium, Exevir, ImmPACT Bio, Incyte, Karyopharm, Kite/Gilead, Merck, Miltenyi Biotec, MorphoSys, Nektar Therapeutics, Novartis, Omeros, OrcaBio, Syncopation, VectivBio AG, and Vor Biopharma; serving on data safety and monitoring boards for Cidara Therapeutics, Medigene, and Sellas Life Sciences and the scientific advisory board of NexImmune; has ownership interests in NexImmune, Omeros, and OrcaBio; and has received institutional research support for clinical trials from Allogene, Incyte, Kite/Gilead, Miltenyi Biotec, Nektar Therapeutics, and Novartis. M.S. has served as a paid consultant for McKinsey & Company, Angiocrine Bioscience, and Omeros; received research funding from Angiocrine Bioscience, Omeros, and Amgen; served on ad hoc advisory boards for Kite Pharma; and received honoraria from i3Health, Medscape, and CancerNetwork for CME-related activity., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Summary: Autologous reconstruction accounts for approximately 20% of all breast reconstruction procedures. In cases of unilateral reconstruction, contralateral breast augmentation using autologous tissue can be performed to improve symmetry, and it is a viable option for patients interested in having more volume relative to their current size without the use of implants. Computed tomography scans have been used for preoperative planning in autologous reconstruction to evaluate available perforators. In this article, the authors report their experience using computed tomography angiography for preoperative volumetric assessment for autologous contralateral breast augmentation in the setting of unilateral autologous breast reconstruction. Twelve patients underwent autologous augmentation during the study period. The average reconstruction flap weight was 561.2 ± 253.6 g, and the average augmentation flap weight was 218.0 ± 133.7 g. No patients experienced flap loss. The authors demonstrate that the predicted volumes for the augmented and reconstructed breasts were comparable to the actual respective flap volumes. In addition, postoperative patient-reported outcome measures demonstrated high levels of satisfaction across multiple BREAST-Q subscales. This study demonstrates the utility of using computed tomography angiography to estimate reconstructive volumes to help preoperative planning and achieve predictable postoperative breast volumes. It also supports that contralateral autologous augmentation is a good option for patients who would like to avoid implants and are interested in a small to moderate increase in size., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2024 by the American Society of Plastic Surgeons.)

Background: Anterior shoulder instability with glenoid bone loss presents a challenge in orthopedic surgery. The Latarjet and iliac crest bone graft transfer (ICBGT) procedures are commonly employed for its management, but direct comparative evidence is insufficient., Methods: Following PRISMA guidelines, a comprehensive search of PubMed, EMBASE, Cochrane Library, and Web of Science was conducted. Randomized controlled trials (RCTs) and cohort studies directly comparing the Latarjet and ICBGT procedures were included. Primary outcomes included postoperative recurrent instability, apprehension test, and complications, while secondary outcomes comprised Rowe score, Subjective Shoulder Value (SSV), pain level assessed by visual analogue scale (VAS), range of motion (ROM), and radiologic outcomes. Quality assessment was performed using RoB2 and MINORS tools. The weighted mean difference (WMD) for continuous variables and odds ratio (OR) for dichotomous variables were calculated, along with 95% confidence intervals (CIs). Meta-analysis was performed using RevMan 5.4.1 software., Results: A total of 6 studies with 409 patients were included. There was no significant difference in postoperative recurrent instability (OR, 1.33; 95% CI, 0.44 to 4.03; P = 0.61), positive apprehension test (OR, 0.78; 95% CI, 0.20 to 3.10; P = 0.73), revision surgery (OR, 2.06; 95% CI, 0.74 to 5.71; P = 0.16), mild complications (OR, 0.49; 95% CI, 0.23 to 1.06; 0.07), SSV (WMD, -1.94; 95% CI, -3.94 to 0.06; P = 0.06) or VAS score (WMD, 0.15; 95% CI, -0.17 to 0.47; P = 0.36) between the two procedures. The ICBGT group exhibited statistically superior Rowe scores (WMD, -3.10; 95% CI, -5.10 to -1.10; P = 0.002), as well as improved external (WMD, -5.32; 95% CI, -7.30 to -3.30; P < 0.001) and internal rotation (WMD, -5.11; 95% CI, -6.76 to -3.45; P < 0.001). However, these differences did not surpass the minimal clinically important difference (MCID). Radiological evaluations showed that the ICBGT procedure had statistically better outcomes in immediate glenoid augmentation, preservation and reduced fatty degeneration of the subscapularis (SSC) tendon, and graft remodeling at short-term follow-up., Conclusions: The ICBGT procedure showed statistically superior Rowe scores and range of motion, but these differences may not be clinically significant. Both procedures had comparable outcomes in recurrent instability, apprehension test results, revision surgery, mild complications, SSV, and pain levels. ICBGT appears to offer advantages in glenoid augmentation and SSC preservation at short-term follow-up., Prospero Registration Id: CRD42024586157., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: The importance of parathyroid gland preservation in thyroid surgery has been well recognized; however, the rapid identification of the parathyroid gland, particularly the inferior parathyroid gland (IPG), remains challenging. This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation., Methods: A total of 236 patients were enrolled in this study between August 2019 and December 2020. RIPPT was employed to identify and protect the inferior parathyroid gland (IPG), and its identification rate and the anatomical variations were analyzed. The parathyroid hormone (PTH) and serum calcium levels were compared between patients who underwent IPG orthotopic retention and those who received IPG auto-transplantation, stratified by the anatomical type of the IPG., Results: In total, the IPG identification rate was 97.88% (231/236), and the auto-transplantation rate was 74.46% (172/231). The anatomical relationship between IPG and thymus was observed in 77.97% of patients (184/236). Additionally, PTH levels were higher in patients with IPG orthotopic retention compared to those with IPG auto-transplantation both on postoperative day 1 (POD1) and at 6 months. PTH levels were also higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention compared to those who underwent both auto-transplantation procedures., Conclusion: Retrograde inferior parathyroid protection technique (RIPPT) underscores the importance of protecting inferior parathyroid gland (IPG) in thyroid surgery and has been demonstrated to be effective in the rapid identification and functional preservation of IPG, based on short-term outcomes., Clinical Trial Number: Not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the Ethics Committee of Fujian Medical University Union Hospital (2019KY122), and consent obtained was written. All patients provided informed consent. All experiments were performed in accordance with relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Implantation of minced cartilage is a one-step-procedure that leads to satisfactory results in osteochondral defects., Material and Methods: A retrospective review was performed on a consecutive cohort of patients that received minced cartilage with fibrin (MCF), minced cartilage with membrane and fibrin (MCMF) and minced cartilage with the "AutoCart"-procedure (MCAC) between January 2019 and December 2023. Radiological outcome parameters were evaluated via Magnet-Resonance-Tomography (MRI) within one year using Ankle-Osteoarthritis-Scoring-System (AOSS)., Results: Final data included 25 patients: 13 women and 12 men with a mean age of 28.2 years ± 10.9(range:18-51). Mean defect size was 103.6mm 2  ± 59.0(95% CI = 79.2-128.0), mean depth 5.2 mm ± 3.6(3.7-6.6). Differences between groups in defect sizes were not significant (p = 0.999). MCF was carried out in 9(36.0%), MCMF in 7(28.0%) and MCAC in 9(36.0%) patients. Mean postoperative AOSS values were 2.6 ± 1.9(95%CI:1.1-4.1) for MCF-patients, 3.3 ± 2.9(0.6-5.9) for MCMF patients and 3.9 ± 2.8(1.7-6.1) for MCAC-patients, respectively. Differences were not significant (p = 0.639). Revision surgery because of symptomatic non-integration of the graft or ventral impingement occurred in 5(20%) of cases - all part of MCAC-patients that did not receive additional fibrin fixation as the top layer of transplant (p < 0.05)., Conclusions: Autologous minced cartilage implantation seems to be sufficient as a viable, one-step treatment for osteochondral lesions of the talus. It leads to low complication rates and excellent AOSS values within a 12-month period whereas the application of fibrin as the last fixation layer seems to be advisory, which demands further investigation., Competing Interests: Declarations. Conflict of interests: The authors declare no competing interests., (© 2025. The Author(s).)

Limited magnetic resonance imaging (MRI) data on autograft dilatation following the Ross procedure in congenital cohorts presents challenges in understanding its evolution and impact on clinical outcomes. This study, spanning from February 2003 to December 2022, included patients under 40 years at the time of the Ross procedure, with MRI follow-ups assessing dimensions at key aortic sites. Among 307 patients, 132 MRIs were analyzed from 76 individuals, revealing that autograft z-scores increase primarily with time post-procedure (Coef. 0.13; 95% CI:0.051-0.216; P = 0.002). Additionally, older patients at the time of surgery showed larger ascending aortic dimensions (Coef. 0.13; 95% CI:0.099-0.165; P = 0.001). Notably, autograft dilation at the sinus of Valsalva significantly predicted higher reintervention risks (HR 1.57; 95% CI:1.21-2.04; P = 0.001). Surgical reinforcement techniques of the autograft, via subcoronary implantation or external support, prevented such dilation (P < 0.001) and mitigated aortic regurgitation. In conclusion, our model predicted autograft dilation over time in patients after Ross procedure, aiding clinicians in making data-driven decisions regarding the optimal timing of the procedure and the selection of the most effective surgical strategy., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Surgical management methods for Hepple IV-V osteochondral lesions of the talus (OLT) are diverse. This study aimed to compare the clinical efficacy of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting in the treatment of medial Hepple IV-V OLT., Methods: A retrospective analysis of clinical data from patients who underwent surgical treatment for Hepple IV-V OLT (2020-2023) was conducted. A total of 37 patients were included, with 17 receiving arthroscopic autologous cancellous bone grafting (Group A) and 20 receiving medial malleolar osteotomy combined with autologous periosteal iliac bone grafting (Group B). Compared the surgical time of the two groups; the visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and ankle joint mobility were used preoperatively, and at 3 months and 1 year postoperatively to assess clinical efficacy; the magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 ankle scores were evaluated at early postoperatively and 1 year postoperatively to assess cartilage repair., Results: The surgical time for Group A was significantly shorter than Group B (P < 0.05). At 3 months and 1 year postoperatively, both groups showed a significant improvements in VAS scores, AOFAS scores, and ankle joint mobility compared to preoperative levels (P < 0.05). At 3 months postoperatively, Group A had significantly higher AOFAS scores and ankle joint mobility than Group B (P < 0.05), while there was no statistically significant difference in VAS scores between the two groups (P > 0.05). At 1 year postoperatively, no significant differences in any of the assessed parameters were found between the two groups (P > 0.05). The MOCART 2.0 ankle scores at 1 year postoperatively were significantly higher than early postoperatively for both groups (P < 0.05), with no significant differences between the two groups (P > 0.05)., Conclusion: Arthroscopic autologous cancellous bone grafting showed superior early functional recovery at the 3-month follow-up compared to medial malleolar osteotomy combined with autologous periosteal iliac bone grafting, with shorter surgical time and avoiding osteotomy. Both surgical methods were able to relieve patients' pain, restore function, and improve cartilage repair., Level of Evidence: III, retrospective comparative study., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was reviewed and approved by the Medical Ethics Committee of the Affiliated Hospital of Qingdao University (QYFY WZLL 29235). Before the start of the study, all participating patients were fully informed about the study and had voluntarily signed an informed consent form. Consent for publication: The study obtained informed consent from all individual participants. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: As a result of increased incidence of anterior cruciate ligament (ACL) injury in young athletes, there is a rise in the indications surgical ACL reconstruction procedures. The value of anterolateral ligament (ALL) reconstruction emerges as a proposed solution to prevent graft failures and improve stability in this high demanding category of patients. The purpose of this study is to present our experience with a novel hamstring auto-grafting technique, the single antegrade sling graft (SASG), for combined reconstruction of both ACL and ALL using autologous gracilis (GR) and semitendinosus (ST) grafts utilizing a single femoral tunnel and double tibial tunnels., Materials and Methods: From January 2020 to December 2021, 21 soccer players were operated utilizing the SASG technique, a modification of the technique of SANTI study group. Inclusion criteria were participating in pivoting sport, high-grade pivot shift examination (Grade 2-3), and evidence of a lateral femoral notch sign or Segond's fracture on preoperative imaging. Patients were assessed for 2 years postoperatively by Lachman's test for anteroposterior laxity and pivot shift test for rotational laxity. The postoperative outcomes were assessed by Tegner-Lysholm and International knee documentation committee scores. Also, the postoperative complications such as stiffness, infection and graft failure were reported., Results: 21 male soccer players with a mean age 26.4 years were included in this study. After 2 years follow up there was a statistically significant improvement in the both post-operative functional scores, P value < 0.001. Fifteen patients (71.4%) could return to their preoperative sport activity level with no giving-way symptoms. Only one case of graft failure was reported in the follow up., Conclusions: The single antegrade sling graft (SASG), for combined reconstruction of both ACL and ALL yielded good results in terms of stability and return to sports. The technique is reproducible, and results are comparable to the available published literature., Competing Interests: Declarations. Conflict of interest: On behalf of all authors, the corresponding author states that There are no relevant financial or non-financial interests to disclose. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Faiyum university, EGYPT. Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: The authors affirm that human research participants provided informed consent for publication of the images in the manuscript., (© 2024. The Author(s).)

Background: In the case of end-stage hallux rigidus, first metatarsophalangeal (MTP) joint arthrodesis is the gold-standard and is traditionally performed via an open approach. However, complications such as nonunion have been reported to be as high as 30%. Recently, there have been reports demonstrating a percutaneous approach to be effective and safe., Methods: Forty-nine patients with end-stage hallux rigidus underwent percutaneous first MTP joint arthrodesis with calcaneus autograft performed by a single surgeon. Each patient underwent a minimum of 24 month clinical and radiographic follow up, including 3 month post operative computed tomography scans. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Foot Function Index (FFI) preoperatively and at final follow-up., Results: Mean follow-up was 27.3 months. Bone union was observed in 46 patients (93.9%). Mean time to union was 3.1 months. Nonunion rate was 6.1%. Overall complication rate was 12.2%. Mean pre- and postoperative VAS scores were 7.5 and 0.2, respectively (P < .0001). Mean pre- and postoperative total FFI values were 56.3 and 15.7 (P < .0001), respectively. Patient satisfaction after the procedure was 93.9%., Conclusion: Observed union rate is comparable to the average fusion rate previously reported for open and minimally invasive procedure union rates. Mean time to union was observed to be comparable to open procedures union time. Observed overall complication rate is similar to those reported for open techniques as well. Patient reported outcomes demonstrated a significant reduction in postoperative VAS and FFI for the percutaneous metatarsophalangeal arthrodesis with calcaneus bone autograft. Patient satisfaction rates compared favorably to those reported following open surgery., Competing Interests: Declarations. Conflict of interest: Ettore Vulcano is a consultant for Vilex and Novastep. Marco Minelli has no disclosures. Alirio J. deMeireles has no disclosures. Gerard F. Marciano has no disclosures. Bonnie Y. Chien has no disclosures. Mahant Malempati has no disclosures. Ethical approval Ethical approval for this study was obtained from the Institutional Review Board of Columbia University (FWA00000176). Informed consent: The informed consent requirement for this study was waived by the Institutional Review Board (IRB) because it involved a retrospective chart review. The study posed minimal risk to participants and did not involve any direct patient interaction, making it impracticable to obtain informed consent from all subjects included in the study., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Autogenous tooth transplantation offers significant advantages and promising success rates for replacing non-retainable teeth. This study aimed to investigate the prognostic factors, especially the impact of root canal treatment (RCT), of autotransplanted teeth in an up-to-6-year follow-up cohort of 167 teeth in Southern China., Methods: We enrolled adult patients from the Southern Medical University-Shenzhen Stomatology Hospital between 2017 and 2023. Patients underwent autogenous tooth transplantation to replace non-retainable molars with upper or lower third molars with Moorrees tooth development stage ≥5. All surgical procedures were performed by an experienced surgeon. The included patients were followed up for 6~72 (median 28.5) months. Success, failure, and survival rate and prognostic factors were evaluated using univariable Kaplan-Meier, multivariable generalized linear regression, and multivariable COX regression analyses., Results: The overall success rate is 97.6% with four unsuccessful cases. Herein, two of them were removed, leading to an overall survival rate of 98.8%. A total of 159 cases (95%) received RCT in 3 months. Univariable log-rank analysis showed that RCT (RR 0.109, 95%CI 0.010 to 1.202, P = 0.028) and site relationship between donor and receipt sites (RR 3.359, 95% CI [1.210-9.329], P = 0.020) were two significant prognostic factors of autotransplanted teeth. Multivariable generalized linear regression revealed that RCT is the only significant factor protecting the success rate of autotransplanted teeth (HR 0.003, 95% CI [0.000-0.249], P = 0.010). However, in the Cox regression model, the effects of RCT (HR 0.009, 95% CI [0.000-2.514], P = 0.101) did not reach statistical significance. Other factors did not demonstrate a significant impact in this cohort. These results supported that autogenous tooth transplantation is a viable alternative to conventional implant treatment with strict indications. Our findings underscore the importance of RCT in transplanted teeth with closed or semi-closed apices. Multi-center observational studies with larger sample size and extended follow-up duration may be needed to validate the conclusion., Competing Interests: The authors declare that they have no competing interests., (© 2025 Han et al.)

Background: There is emerging evidence for the role of exercise in optimising function, quality of life (QoL) and reducing hospital length-of-stay if commenced prior to undergoing autologous stem cell transplantation (ASCT). A local pilot study of a prehabilitation and rehabilitation intervention during ASCT for myeloma patients indicated promising results and was adapted to translate into local clinical care. The aim of this report is to describe an overview of a newly implemented physiotherapist-led exercise prehabilitation and rehabilitation service delivered as part of the myeloma ASCT pathway, and present real-world findings related to changes in function and QoL., Methods: A service evaluation was conducted at a single-centre tertiary referral hospital for haematopoetic stem cell transplantation in the United Kingdom. A hybrid service using face-to-face clinical assessments and weekly remotely supervised group exercise, via an online video conferencing platform, in the phase between stem cell harvest and admission (prehabilitation), and from discharge to 100 days post-ASCT (rehabilitation). Functional (6 min walk and timed sit-to-stand tests) and patient-reported outcome measures (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-C30) and EuroQol EQ5D-5L were assessed at preharvest, preadmission and in the post-ASCT evaluation (day 100) clinic., Results: Patients (n=46) with a diagnosis of multiple myeloma referred for ASCT following induction chemotherapy were assessed. Baseline assessments showed high prevalence of impaired function and lower limb strength. Improvements were evident following prehabilitation prior to admission, which were maintained post-ASCT. Changes in 6 min walk test and timed sit-to-stand were significant and beyond thresholds of clinical importance. Improvements were also seen in the domains of QoL., Conclusions: Implementation of physiotherapist-led assessments in the myeloma clinic and group exercise delivery under remote supervision are acceptable to patients undergoing ASCT and indicate benefit in improving function and QoL., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Introduction: Fat grafting has antifibrotic effects and it improves scar quality. However, the biological mechanisms of fat grafts on scar healing are poorly understood., Methods: This was a prospective study to identify differences in the epidermal and dermal structure, macrophage infiltration, or inflammatory and fibrotic markers in hypertrophic scars before and after fat grafting surgery compared to normal skin. Seven patients with hypertrophic scar completed the study. Biopsies from hypertrophic scars and normal skin were taken at the time of fat grafting surgery and follow-up biopsies 6 mo postoperatively. A clinical Patient and Observer Scar Assessment Scale was used to monitor the clinical aspects of the scars. Immunohistochemical stainings were performed to analyze the changes occurring in the hypertrophic scar tissue after fat grafting., Results: Hypertrophic scars demonstrated decreased presence of rete ridges and increased levels of the profibrotic transforming growth factor beta-1 (TGF-β1) (P < 0.05) compared to normal skin. Fat grafting significantly increased the presence of rete ridges to the level of normal skin and reduced TGF-β1 expression (hypertrophic scars + fat) (P < 0.05). Fat grafting also increased the total macrophage count (CD68 pan-macrophage marker) (P < 0.05) and M1 macrophage count (inducible nitric oxide synthase M1 macrophage marker) (P < 0.05). The clinical evaluation of the scars (Patient and Observer Scar Assessment Scale) by the observer and patients improved after fat grafting (P < 0.05)., Conclusions: Our findings indicate that fat grafting promotes normalization of skin by improving epidermal structure and reducing TGF-β1 levels and favors less fibrotic healing by regulating macrophages levels., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: anterior cruciate ligament rupture has evolved to be one of the most common sports injuries with a remarkable increase in its incidence in the last two decades, with Return-To-Sport being a crucial approach in the choice of autologous graft for its surgical repair, the most commonly used being hamstring and quadriceps tendon graft., Material and Methods: a prospective randomized study was performed with 32 patients divided into two groups, one for each type of graft, with 13 patients in each. They were evaluated before surgery, at 30, 180 and 360 days after the procedure using scales such as Lysholm, mCKRS and ACL-RSI, and their previous activity level was considered using the Tegner score., Results: it was observed that, at 30 and 180 days after surgery, there were significant differences in pain assessment using the VAS scale between the groups, while at 360 days no significant differences were observed. No significant differences were found in Lysholm and mCKRS scale scores in either group at days 30, 180, and 360, but significant differences were found in ACL-RSI scale scores at 30 and 180 days between the two groups, which did not hold at 360 days., Conclusion: despite the difference in postoperative pain, Return-To-Sport times and overall recovery showed no significant differences between the two types of grafts in this study.

Background: The optimal timing of reconstruction for patients with facial localized scleroderma is uncertain. The purpose of this study was to compare the outcomes of autologous fat transplantation in adolescent and adult patients with stable localized scleroderma., Methods: Adolescent (age 10 to 19 years) and adult (age >19 years) patients with no previous surgery were enrolled ( n = 10, each group). Preoperative magnetic resonance imaging, blood tests, and dermatological assessments were used to assess disease activity. All patients underwent autologous fat transplantation for anatomic facial fat restoration with preoperative magnetic resonance imaging planning. Preoperative, immediate, and 1-year postoperative 3-dimensional Dixon magnetic resonance imaging scans, with image registration and fusion techniques, were used to track fat grafts. Patient satisfaction was assessed with a 5-point Likert scale., Results: There was no significant difference in sex, body mass index, disease severity, or volume of injected fat between the 2 groups ( P > 0.05), except for age ( P < 0.05). The 1-year postoperative fat graft retention rate was not significantly different, with 36.6% ± 2.4% (range, 25.3% to 49.3%) in the adolescent group and 32.9% ± 1.7% (range, 27.3% to 40.1%) in the adult group ( P > 0.05). Surgical outcomes were favorable in all patients, with satisfaction scores of 3.8 ± 0.2 points in the adolescent group and 3.6 ± 0.2 points in the adult group ( P > 0.05)., Conclusion: In patients with stable localized scleroderma, the initial autologous fat transplantation was equally effective in improving facial contour deformity, with no significant difference in fat graft retention or patient satisfaction., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons.)

Background: For females in puberty, mastectomy caused by pathological gigantomastia usually brings significant psychological problems. Appropriate immediate breast reconstruction method is necessary., Objectives: The aim of this study is to present a novel method of breast reconstruction that requires neither implants nor donor-site sacrifice., Methods: All patients who were diagnosed with pathological gigantomastia and indicated for nipple-sparing or skin-sparing mastectomy (NSM or SSM) were selected. All extra skin was de-epithelialized, followed by NSM or SSM through a vertical incision on the lower pole of the breast. Then, a skin and dermal envelope in all directions was formed. Whether to preserve the nipple-areolar complex depended on its perfusion. The dermal flap was folded inward to serve as the "autologous dermal filler" and reconstruct the breast. A second surgery of inframammary fold elevation for larger projection was performed at least 6 months. Follow up for at least 1 year and record complications as well as pre- and postoperative BREAST-Q Scores., Results: A total of 11 breasts were included. Four (36.4%) were NSM and seven (63.6%) were SSM. Nipple to sternal notch distance in NSM and SSM was 32.3±9.1cm and 35.1±4.4cm, respectively. No complications occurred, while one breast with NSM showed nipple upward displacement. The BREAST-Q indicated significant postoperative improvements in breast satisfaction (20.5 ± 11.3 vs 80.2 ± 10.4) and psychosocial well-being (23.4 ± 8.9 vs. 81.4 ± 11.3)., Conclusions: Preliminary study demonstrated the efficacy and long-term safety of "autologous breast dermal filler." For adolescents, it is a less invasive autologous breast reconstruction method, or transitional plan for further adjustment in adulthood., Level of Evidence Iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., Competing Interests: Declarations. Conflict of interest: There is no financial or other interest to declare in relation to the content of this article for all named authors. The authors declare that they have no conflict of interest. Ethical Approval: All procedures performed in studies were in accordance with the ethical standards of our institution and with the 1964 Declaration of Helsinki., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Autologous peripheral blood stem cell (PBSC) transplantation is a standard treatment of multiple myeloma (MM), Hodgkin lymphoma and various subtypes of non-Hodgkin lymphoma. Cryopreservation of hematopoietic stem cells is standard practice that allows time for delivery of conditioning regimen prior to cell infusion. The aim of this Worldwide Network for Blood & Marrow Transplantation (WBMT) work was to assess existing evidence on non-cryopreserved autologous transplants through a systematic review/meta-analysis, to study feasibility and safety of this approach. We searched PubMed, Web of Science and SCOPUS for studies that utilized non-cryopreserved autologous PBSC transplantation. Identified literature was reviewed for information on mobilization, apheresis, preservation and viability, conditioning regimen, engraftment, response, and survival. Results highlight collective experience from 19 transplant centers (1686 patients), that performed autologous transplants using non-cryopreserved PBSCs. The mean of infused CD34+ was 5.6 × 10 6 /kg. Stem cell viability at transplantation was >90% in MM and >75% in lymphomas, after a storage time of 24-144 h at +4 °C. Mean time-to-neutrophil engraftment was 12 days and 15.3 days for platelets. Pooled proportion estimates of day 100 transplant-related mortality and graft failure were 1% and 0%, respectively. Non-cryopreservation of apheresed autologous PBSCs appears feasible and safe., Competing Interests: Competing interests: MAB, DN, REF, DJW, SG, AR, AB, AH, YK, AK, TE, MM, WR declare no conflicts of interest MAK-D: declares research/grant from Bristol Myers Squibb, Novartis, and Pharmacyclics, and lecture/honoraria from Kite Pharma; LG: declares relationship with Bristol Myers Squibb, Sanofi, Janssen, Pfizer; IY-A: declares honoraria from Kite Pharma, Novartis and Bristol Myers Squibb; HG: declares speaker bureau and consultancy for Therakos, Gilead, Novartis, Stemline, Neovii, Sanofi, and Takeda; SOA: declares advisory board with Kite Pharma and Novartis, and speaker honoraria from Kite Pharma, Novartis, and Johnson & Johnson; CC: declares honoraria (personal and institutional) for lectures and advisory boards from Bristol Myers Squibb, Kite Pharma/Gilead, Janssen, Jazz, Novartis, and Miltenyi Biotec; SKH: declares educational/travel grants from Novartis, Pfizer, Janssen, Therakos, Vertex, MSD, Roche; UG: declares consultancy/Honoraria :Kite Pharma, Incyte, Astellas, Jazz,and Vor; NH: honoria from Janssen, Novartis, Takeda, Abbvie, Roche, Astellas, Bigene; AA: declares lecture-Advisor /honoraria from Kite Pharma, Novartis, Takeda and Janssen; MP: declares research with Bristol Myers Squibb, Janssen, Kite Pharma, Novartis, and consultancy for Bristol Myers Squibb, Novartis, and honoraria from Gilead; JS: declares consultancy for Sanofi and ADRx, honoraria from Sanofi, Alexion, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, and Novartis, advisory committees for Sanofi, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, Novartis, speaker bureau for Sanofi, AstraZeneca Rare Disease, Prevail Therapeutics (Eli–Lilly), Pfizer, Sobi Pharmaceuticals, Novartis; DMc: declares lecture/honoraria from GSK, Novartis, Abbvie. Research funding from Imago Biosciences; NW: declares speakers fees from BMS Celgene, Kite Gilead, Novartis, Pierre Fabre, Sanofi Genzyme, Therakos Mallinckrodt, Travel reimbursement from Jannsen, Pierre Fabre; RG: declares speaking honoraria from Biotest, Pfizer, Medac, Neovii and Magenta; YA: declares lecture/honoraria from Otsuka Pharmaceutical Co., Ltd, Chugai Pharmaceutical Co., Ltd., Novartis Pharma KK, Meiji Seika Pharma Co., Ltd, Janssen Pharmaceutical K.K., and consultancy fee from JCR Pharmaceuticals Co., Ltd and Kyowa Kirin Co., Ltd; MK: declares non-specified relationship with Kite Pharma, Takeda and Gilead; AS: declares honoraria from Takeda, Bristol Myers Squibb /Celgene, MSD, Janssen, Amgen, Novartis, Gilead Kite, Sanofi, Roche, Genmab, AbbVie, Jazz Pharmaceuticals, consultancy from Takeda, Bristol Myers Squibb/Celgene, Novartis, Janssen, Gilead, Sanofi, Genmab, AbbVie, speaker bureau for Takeda and Research support from Takeda; MA: declares lecture/honoraria from Kite Pharma and Vertex Pharma., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Multiple myeloma (MM) is an incurable hematologic malignancy characterized by the neoplastic proliferation of plasma cells, which produce monoclonal immunoglobulin that can cause vital organ damage, subsequently leading to significant morbidity and mortality. Autologous hematopoietic stem cell transplant (ASCT) is the standard-of-care management of eligible patients with newly diagnosed MM. Experts recommend collecting enough stem cells upfront to support a possible tandem transplant, salvage ASCT, or a stem cell "boost" to allow for the administration of multiagent cytotoxic chemotherapy in patients with relapsed/refractory disease., Objective: There is currently a paucity of data on the response rates and outcomes of patients with relapsed MM who undergo cytotoxic chemotherapy followed by a stem cell boost; this study examines the outcomes of patients treated with this approach., Methods: We conducted a retrospective chart review from two oncologic treatment centers in the United States of adult patients who underwent a first ASCT between 1999 and 2021 and subsequently received cytotoxic chemotherapy followed by stem cell boost further on in their disease course. Survival analysis was carried out using the Kaplan-Meier method, and the log-rank test was used to compare survival curves., Results: We found that the majority (56.6%) of these patients responded to therapy and that 60.6% of these patients were able to receive at least one subsequent line of therapy post-boost. Furthermore, patients who responded to therapy had significantly longer median overall survival compared to those who did not respond (323 days vs 93 days, p=0.0045), and age did not affect response to therapy., Conclusion: This data allow clinicians to appropriately implement and inform patients of the therapeutic uses and clinical outcomes of stem cell boost in patients with multiply relapsed/refractory MM., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The aim of our study is to establish whether the bone graft harvested and stored in the surgical wound by our novel technique is safe, reproducible and preserves the viability of the graft. In doing so, it promises successful bony fusion in spine and orthopaedic surgeries., Methods: A prospective clinical case series was conducted for autogenous bone graft storage in complex spine surgeries requiring staged procedures, in resource constrained settings. The bone graft harvested was morselized, wrapped in moist sterile gauze and stored in the paraspinal gutter within the operative site. Thereafter, the surgical wound was easily closed without tension. During the second stage surgery, the stored bone was retrieved and mixed with more autologous/allogenic bone (if necessary) and appropriately laid at fusion sites. Bacterial samples were sent before implantation., Results: 16 complex spinal deformity patients who underwent surgery in a resource constrained hospital over a period of 5 years were included. Duration between both stages was within 2 weeks. All patients showed successful fusion, with mean follow-up of 2.6 years. There were no cases of deep or systemic infection in our series. Surgeons found harvesting, storing and retrieval of graft to be straightforward., Conclusion: The operative site provides an ideal, safe and reproducible location for bone graft storage for staged surgeries conducted in resource constrained situations. The osteogenic potential of the autogenous bone graft is retained. This technique can be extrapolated to other orthopaedic surgeries conducted under resource limited environments like in surgical camps or combat medical facilities., Competing Interests: Declarations. Conflict of interests: There are no conflict of interests or financial disclosures to declare., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The purse-string DIEPplasty technique is a method to improve aesthetic outcomes in breast reconstruction using deep inferior epigastric perforator (DIEP) free flaps. Traditionally, DIEP flaps, harvested from the lower abdomen, take on a triangular shape that can lead to sub-optimal aesthetic outcomes with occasionally poor breast projection, irregular contours, or minimal upper pole fullness. The purse-string DIEPplasty technique addresses these issues by using a 0 Polydioxanone continuous purse-string suture through the Scarpa's fascia to modify the harvested flap's shape before inset, giving it a more round base and a central dome-like projection similar to an implant. This method mimics the shape of a breast implant, enhancing the flap's projection, volumetric efficiency, and overall shape, leading to a reconstructed breast with improved aesthetic qualities. This technique represents a potential advancement in reconstructive breast surgery, aiming to reduce the extent of revision procedures and improve patient satisfaction. Further research, however, is needed to validate its effectiveness over time and assess potential complications.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ., Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflicts of interest to disclose. Human or Animal Rights: This study received institutional approval, and appropriate consent was obtained from the patients prior to the study conduction. Informed Consent: As per the forms submitted to the journal, consent was obtained from the patients for this study, and it is available if requested., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.)

Background: Color match of a reconstructed breast with the surrounding area is of importance for the overall aesthetic result. The objective of the authors' study was to quantify the degree of color match achieved with different autologous breast reconstructions and to analyze the changes in color over time by analyzing digital photographs., Methods: A total of 193 patients who underwent a delayed autologous breast reconstruction (deep inferior epigastric perforator [DIEP], profunda artery perforator [PAP], lumbar artery perforator [LAP], latissimus dorsi [LD]) were included. Standardized photographs from 242 flaps at 3 months and 9 to 12 months postoperatively were analyzed, and the L*a*b* values and delta E2000 (dE) values were determined to qualify the color match. The Kruskal-Wallis and Wilcoxon rank sum tests were used for statistical analysis., Results: Initially, DIEP flaps had a significant lower dE value compared with LD ( P = 0.012) and PAP flaps ( P < 0.001), when compared with the natural breast. PAP flaps showed a significant decrease after 9 to 12 months ( P = 0.003). Perception of color match was comparable in all flaps. Compared with the cleavage, at late follow-up, DIEP flaps had a significant higher dE value compared with LD ( P = 0.017) and PAP flaps ( P < 0.001). PAP flaps presented a significant decrease of dE after 9 to 12 months ( P = 0.031). Abdominal skin presented no better skin color match in patients with PAP, LD, and LAP flaps., Conclusions: All analyzed flaps had a comparable color match with the surrounding tissue and with the contralateral breast approximately 1 year after surgery. The color of PAP flaps changes more, which leads to an improvement at a later follow-up., Clinical Question/level of Evidence: Therapeutic, III., (Copyright © 2024 by the American Society of Plastic Surgeons.)

Background: The advent of autologous gene modified cell therapies to treat monogenic disorders has been a major step forward for the field of hematopoietic stem cell transplantation (HCT) and cellular therapies. The need for disease-specific conditioning to enable these products to provide a potential cure has required extrapolation from experience in myeloablative and non-myeloablative HCT for these disorders., Methods: In this manuscript, we review the current datasets and clinical experience using different conditioning regimens for autologous gene therapies in hemoglobinopathies, metabolic and lysosomal disorders, inborn errors of immunity (IEI) and bone marrow failure (BMF) syndromes., Results: The disease specific and unique conditioning requirements of each disorder are considered in order to achieve maximal benefit while minimizing associated toxicities., Conclusions: Standardized recommendations based on these data are made for each set of disorders to harmonize treatment. Future directions and the possibility of non-genotoxic conditioning regimens for autologous gene therapies are also discussed. Ethical Statement: The authors followed all relevant ethical considerations in writing this manuscript., Competing Interests: Declaration of Competing Interest Joseph Oved received consulting fees and/or honoraria from Emendo Bio, Turn.Bio, Grifols, Ensoma, Sobi and Amgen. He receives research support from Sobi and is the site PI for the Jasper SCID trial (NCT02963064). Akshay Sharma has received consultant fee from Spotlight Therapeutics, Medexus Inc., Vertex Pharmaceuticals, BioLineRx, Sangamo Therapeutics and Editas Medicine. He is a medical monitor for RCI BMT CSIDE clinical trial for which receives financial compensation. He has also received research funding from CRISPR Therapeutics and honoraria from Vindico Medical Education. Dr Sharma is the St. Jude Children's Research Hospital site principal investigator of clinical trials for genome editing of sickle cell disease sponsored by Vertex Pharmaceuticals/CRISPR Therapeutics (NCT03745287), Novartis Pharmaceuticals (NCT04443907) and Beam Therapeutics (NCT05456880). The industry sponsors provide funding for the clinical trial, which includes salary support paid to Dr Sharma's institution. Dr Sharma has no direct financial interest in these therapies. Amy E DeZern participated in advisory boards and/or had a consultancy with and received honoraria from Celgene/BMS, Agios, Novartis, Appellis and Gilead. AED served on clinical trial committees or DSMB for Novartis, Abbvie, Kura, Geron, Servier, Keros, Shuattuck labs and Celgene/BMS. SEP receives support for the conduct of clinical trials through Boston Children's Hospital from AlloVir, Atara, and Jasper Therapeutics. Honoraria from Pierre Fabre, and Regeneron. Consulting for Century, CellEvolve and VOR. Carmem Bonfim consults for Zodiac, Amgen and Novartis. Duncan Purtill receives honoraris (to Fiona Stanley Hospital and not the author) from Novartis, Gilead, BMS-Celgene and Jazz Pharmaceuticals. Sandeep Soni is employed by CRSPR Therapeutics AG. Jaap Jan Boelens consults for Advanced Clinical, Sanofi, Sobi, Immusoft, SmartImmune and Merck and receives research funding from Sanofi. Allistair Abraham served on the safety monitoring committee for Sangamo Therapeutics and has no financial interest in the development of gene therapies. Remaining authors have no conflicts of interest., (Copyright © 2024 International Society for Cell & Gene Therapy. All rights reserved.)

Purpose: To explore the clinical outcomes of combining anterior cruciate ligament (ACL) reconstruction and anterolateral structure (ALS) reconstruction through a modified single femoral tunnel in patients with high risk of clinical failure., Methods: From December 2018 to August 2022, a total of 62 patients with ACL injury in our institution were enrolled in this study. All patients were associated with high risk of clinical failure, meeting the indications of ALS reconstruction. All patients accepted arthroscopic single-bundle ACL reconstruction and ALS reconstruction using hamstring autograft through a modified single femoral tunnel. Perioperative clinical outcome measurements consisted of functions, stability and safety evaluation at different time points (preoperative, postoperative three month, six month, one year, two year, three year and more). Functional evaluation included Lysholm score, Tegner activity scale, subjective and objective International Knee Documentation Committee (IKDC) score., Results: All patients, including 47 males and 15 females, aged 16-52 years with an average age of 29.3 ± 9.2 years, were followed up for 12-58 months. At the last follow-up, the Lysholm, subjective IKDC and Tegner activity scale (93.8 ± 7.0, 88.8 ± 10.7 and 5.8 ± 1.4 respectively) were significantly higher than those before surgery (65.0 ± 20.8, 51.2 ± 21.1 and 2.3 ± 1.3 respectively)(P < 0.05). Postoperative pivot shift and Lachman test were markedly improved (P < 0.05). One patient still had grade II pivot shift, defined as clinical failure. During follow-up, no graft rupture occurred according to magnetic resonance imaging and physical examination, no lateral compartment osteoarthritis were found in all patients., Conclusions: Combined single bundle ACL reconstruction and ALS reconstruction through a modified single femoral tunnel could significantly improve knee function and stability with low related risk in patients with high risk of failure in ACL injury., (© 2024. The Author(s) under exclusive licence to SICOT aisbl.)

Bilio-biliary anastomosis (BBA) is a critical surgical procedure that is performed with the objective of restoring bile duct continuity. This procedure is often required in cases where there has been an injury to the extrahepatic bile ducts or during liver transplantation. Despite advances in surgical techniques, the healing of BBA remains a significant challenge, with complications such as stricture formation and leakage affecting patient outcomes. The stromal vascular fraction (SVF), a heterogeneous cell population derived from adipose tissue, has demonstrated promise in regenerative medicine due to its rich content of stem cells, endothelial progenitor cells, and growth factors. The objective of this study was to evaluate the potential of locally administered autologous SVF to enhance the healing of BBAs. Bilio-biliary anastomosis was performed on a swine model (female Landrace pigs). Six swine were divided into two groups: the treatment group ( n = 3) received a local application of autologous SVF around the anastomosis site immediately following BBA formation, while the control group ( n = 3) received saline. The primary outcomes were assessed over an eight-week period post-surgery, and included anastomosis healing, stricture formation, and bile leakage. Histological analysis was performed to evaluate fibrosis, angiogenesis, and inflammation. Immunohistochemistry was conducted to assess healing-related markers (CD34, α-SMA) and the immunological microenvironment (CD3, CD10, tryptase). The SVF-treated group exhibited significantly enhanced healing of the BBA. Histological examination revealed increased angiogenesis and reduced fibrosis in the SVF group. Immunohistochemical staining demonstrated higher vascular density in the anastomosed area of the SVF-treated group (390 vs. 210 vessels per 1 mm 2 , p = 0.0027), as well as a decrease in wall thickness (1.9 vs. 1.0 mm, p = 0.0014). There were no statistically significant differences in mast cell presence ( p = 0.40). Immunohistochemical staining confirmed the overexpression of markers associated with tissue repair. Local injections of autologous SVF at the site of BBA have been demonstrated to significantly enhance healing and promote tissue regeneration. These findings suggest that SVF could be a valuable adjunctive therapy in BBA surgery, potentially improving surgical outcomes. However, further investigation is needed to explore the clinical applicability and long-term benefits of this novel approach in clinical practice as a minimally manipulated cell application.

Aims: This study presents clinical outcomes, functional results, and return to sports after anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft or peroneus longus tendon autograft in a randomized controlled trial., Patients and Methods: Between February 2018 and July 2019, patients who underwent ACL reconstruction were randomly assigned to two groups: hamstring and peroneus longus. Patient related outcome measurements and pain intensity were evaluated using IKDC, Lysholm, and visual analog scores at 3 and 6 months, 1, 2, and 5 years after the surgery. At the 5 year follow-up, anterior stability was tested using the 3D printable Knee Arthrometer. In addition, in the peroneus longus group, ankle functional assessment was performed using the American foot and ankle score. Additionally, data on the return to sports/activities was collected for both groups at the last follow-up., Results: Sixty patients, with 30 in the hamstring group and 30 in the peroneus group, were included in the study. Patients were predominately male and with low activity demands. After five years of follow-up, there was no significant difference in functional assessment scores (IKDC and Lysholm) between the two groups (P n.s). The median graft diameter was 7.9 ± 0.4 mm in the hamstring tendon group and 8.9 ± 0.2 mm in the PL group (P < 0.001). The improvement in Arthrometer testing measurements (AMT) for the operated knees in the hamstring and peroneus longus groups were similar. In the peroneus longus group, the mean postoperative foot and ankle score was 98.6 ± 3.9 (range = 85-100)., Conclusion: Using Peroneus longus tendon autograft for arthroscopic ACL reconstruction is a feasible alternative as studied in this cohort of predominately male patients with low activity demands. The graft diameter in this study was sufficient, and the results regarding laxity and patient related outcome measurements were similar to those achieved with hamstring tendon autografts., Level of Evidence: Level I TRIAL REGISTRATION: ChiCTR2000036989., Competing Interests: Declarations. Conflict of interest: The authors have no competing interests to declare that are relevant to the content of this article. Ethical approval: The ethical approval was obtained from United medical and dental college (board (UMDC/Ethics/2016/15/06/391). Patient consent: The informed consent was taken from all patients before enrolment in the study. Clinical trial registration: The trial was registered in the Chinese clinical trial registry with the registration number ChiCTR2000036989., (© 2024. The Author(s).)

Background: There is currently no consensus on the surgical treatment of lumbar spondylolysis in young adults, and the nonunion rate remains relatively high even after surgery. Therefore, in this study, we proposed a modified intravertebral screw-rod fixation technique within a single vertebral segment and investigated the clinical efficacy of this modified fixation system combined with autologous cancellous bone grafting in the treatment of lumbar spondylolysis in young adults., Methods: This study included 28 young adults with lumbar spondylolysis who were treated at our center between 2021 and 2023. All patients underwent modified intravertebral screw-rod fixation within a single vertebral segment combined with autologous cancellous bone grafting. We performed postoperative follow-ups regularly to assess the patient's pain status using the visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological findings., Results: All 28 patients successfully underwent the surgery with an average operation time and blood loss volume of 96.01 ± 21.3 min and 186.78 ± 63.43 mL, respectively. Postoperatively, patients experienced significant symptom relief, with notable decreases in VAS scores and ODI indices at 1, 3, 6, and 12 months compared with preoperative conditions. These differences were statistically significant (P < 0.05). Radiological findings revealed a healing rate of 92.86% for the 56 fractured pars interarticularis among the 28 patients. No implant-related complications, such as fracture, loosening, or pseudarthrosis, were observed., Conclusions: The modified intravertebral screw-rod fixation system within a single vertebral segment combined with autologous cancellous bone grafting is a safe and effective treatment for lumbar spondylolysis in young adults. It significantly improves pain and functional disability as it promotes bone healing., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Biomedical Ethics Committee of the 900th Hospital of the Joint Logistics Support Force (Ethics Batch No. 2021-061). Informed consent was obtained from all the participants (or their guardians) included in the study. Consent for publication: The patient described in the “Illustrative case” provided informed consent for the publication of the report and accompanying images. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Chest wall perforator flaps (CWPFs) have been a well-recognised surgical option for volume replacement following breast conservation surgery (BCS). However, the flap volume can sometimes be limited, which may adversely affect the aesthetic outcome or even disqualify the patient from having BCS. We report the first case of hybrid partial breast reconstruction using immediate autologous fat injection into CWPF., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Ruptures of the anterior cruciate ligament (ACL) are common injuries. Reconstruction using autologous grafts is recommended to prevent further damage and functional impairment. Grafts are usually prepared with stabilizing sutures. The aim of this study was to evaluate if a 4-strand semitendinosus autograft preparation technique is non-inferior to conventional preparation techniques with regard to maximum tensile strength threshold., Methods: Fresh porcine flexor tendons were used as specimens in this study. Four different preparation techniques for quadruple-folded tendons were compared. Group 1 three suture FiberWire® (n = 20) and Group 2 one suture FiberWire® (n = 20) using Krakow stitches, Group 3 (n = 10) using SPEEDTRAP® and piercing the autograft and 4 (n = 9) using SPEEDTRAP® without piercing the autograft for preparation. Biomechanical tensile testing included 50 sinusoidal cycles of preloading between 50 and 150 N at 1 Hz and load-to-failure was measured at 20 mm/min., Results: Failure at the maximum load occurred at the filament for all samples, whereas failure of the suture/tendon interface was not observed. Load-to-failure was significantly higher in Group 1 (711 ± 91 N) than in all other groups. When comparing groups 2-4 load-to-failure was significantly higher in Group 2 (347 ± 24 N) than in Group 3 (258 ± 25 N, p < 0.02) but not than in Group 4 (325 ± 26N)., Conclusion: In all 4 Groups the load to failure was higher than the maximum tension force on the construct that will be applied by hand (182N). Therefore, the needleless preparation technique seems to be a valuable alternative to conventional techniques for the insertion of the graft into the joint during joint-near tibial fixation technique., Competing Interests: Declarations. Ethics approval and consent to participate: Not relevant—The present study is a biomechanical study. No human tissue, no patient data, and no intervention or treatment was performed. The animal material used was derived from pigs used at the Institute of Food Hygiene of the University of Leipzig for training veterinarians in meat inspection. The tendons were removed prior to the disposal of the carcasses, which was planned anyway afterwards. Since neither human material nor animals were killed for the study, there is no need for an ethical vote from the authors' point of view. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: There are various surgical techniques applied for the treatment of osteochondral lesions of the talus (OLT). The mosaicplasty technique is one of the most commonly used methods for deep lesions. The all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond is a novel method as an alternative to the mosaicplasty. This study aims to compare the clinical and radiological results of these two different surgical techniques in the treatment of deep OLT., Materials and Methods: From September 2019 to July 2021, 30 patients with deep osteochondral lesions of the talus were randomly divided into two groups for either mosaicplasty or the all-arthroscopic technique, and they were evaluated prospectively. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and visual analog scale (VAS) scores were evaluated within and between groups preoperatively and postoperatively. Radiological assessments were performed at 6th and 12th month postoperatively according to the magnetic resonance observation of cartilage repair tissue (MOCART) scale., Results: Mosaicplasty was applied to 15 patients, and all-arthroscopic technique was applied to 15 patients. 14 of the patients were female and 16 were male; the mean age was 38.1. Within-group evaluations revealed significant improvements in AOFAS and VAS scores at postoperative 6th and 12th months (p < 0.05). There was no significant difference between the treatment groups in comparison of clinical scores at any time period. There was no significant difference between the two methods according to the total MOCART scores (p > 0.05). However, the all-arthroscopic technique was more successful in terms of "border integration" and "repair tissue structure" (p < 0.05). Age, body mass index (BMI) and lesion surface area were not correlated with clinical scores., Conclusions: In terms of clinical and radiological scores, similar results were obtained in the treatment groups. Both surgical techniques were found to be effective in the treatment of deep OLT., Competing Interests: Declarations. Conflict of interest: None of the authors or any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. Ethical standard: The study protocol received institutional review board approval. Decree No: İ3-62-19. Informed consent: Informed consent was obtained from all individual participants included in the study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Fixation and long-term stability of collared, uncemented stems, such as the CORAIL ® collared stem, in total hip arthroplasty (THA), depend on a strong cancellous bone sleeve and subsequent osseointegration. This study aimed to investigate bone reaction and mid-term outcomes following compaction autologous bone grafting in uncemented stems in primary THA., Materials and Methods: This study retrospectively reviewed patients with primary THA using CORAIL ® collared stem and having ≥ 5 years follow-up. Patients were divided into the bone graft and control groups based on the use of compaction autologous bone grafting. Demographic characteristics, fracture risk, operation time, complications, revisions, and radiologic measures, such as stress shielding and reactive lines were compared between the groups., Results: A total of 140 cases (85% women, mean age: 63 years, mean follow-up: 72 months) were included. Autologous bone graft was used in 32 (23%) cases. No significant differences in terms of age, sex, diagnoses, follow-up duration, or operation time were observed between the groups. Stress shielding frequency remained stable at 9.4% between 1y and 5y in the bone graft group, but increased from 13.9 to 28.7% in the control group, resulting in the latter having a higher 5-y frequency than the bone graft group (p = 0.0004). Reactive lines increased from 1y to 5y in both groups (bone graft: 6.3-37.5%, p = 0.0015; control: 4.6-26.9%, p < 0.001) with no significant differences between groups. There were no instances of stem subsidence/loosening or stem revision in either group., Conclusions: Autologous compaction bone grafting achieved satisfactory fixation of the uncemented CORAIL ® collared stem without requiring distal fixation and mitigated stress shielding. Larger, prospective studies with longer follow-ups are needed to confirm the clinical implications of these mid-term results in primary THA., Competing Interests: Declarations. Conflict of interest: Satomi Abe has received research grants from Johnson & Johnson. All other authors declare that they have no conflicts of interests. Ethical approval: The study was approved by the Wajokai Eniwa Hospital Ethics Committee (approval no. 207). Informed consent: Written informed consent was obtained from all participants., (© 2024. The Author(s).)

Introduction: Historically, anterior cruciate ligament (ACL) ruptures in the paediatric age group were managed conservatively with bracing, casting, activity modification, and physical therapy. However, most of these patients had to reduce their sports activities, and secondary damages to the affected knee were prevalent., Source of Data: Published scientific literature in Embase, Web of Science, PubMed, and Google Scholar databases., Areas of Agreement: ACL reconstruction in children with open physes patients is debated. Any damage to the physes around the knee could lead to growth abnormalities and axial deviation of the knee., Areas of Controversy: Different grafts are available and suitable for ACL reconstruction in skeletally immature patients; however, which graft performs better remains unclear., Growing Points: This systematic review compared bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts for ACL reconstruction in skeletally immature patients. The joint laxity, Patient-reported outcome measures (PROMs), return to sport, and complications were compared., Areas Timely for Developing Research: In skeletally immature patients, HT, BPTB, and QT autografts for ACL reconstruction yielded good outcomes. Comparative studies are strongly required to establish the most suitable autograft., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Utilization of autologous adipose tissue transplantation in plastic and orthopedic surgery such as breast reconstruction and intra-articular injection has become an attractive surgical treatment with satisfactory clinical outcomes. Nevertheless, repeated liposuctions necessary to harvest fatty tissue, normally performed with sedation or general anesthesia, may represent a noteworthy concern., Objectives: The aim of this study was to demonstrate through an in vitro characterization the validity of the surgical option of cryopreserved autologous adipose tissue harvested in a single shot for repeated graft transfer in breast reconstruction without impairment of cell viability and sterility., Methods: Adipose tissue was collected by standard liposuction from patients who needed numerous fat grafting procedures for breast reconstruction. According to an innovative and patented cryopreservation method, autologous adipose tissue was subsequently fractioned in a sterile bag system and frozen at the RER Tissue Bank of the Emilia Romagna Region. Each graft was evaluated for sterility and cell viability immediately after harvesting, and 1, 3, 6, 12, and preliminarily 18 months after cryopreservation and thawing., Results: In vitro results showed that after processing, middle-term and long-term cryopreservation, and subsequent thawing, autologous cryopreserved adipose tissue retained absence of bacterial contamination, high cellular viability, and unmodified histomorphological properties, thereby ensuring maintenance of the stromal vascular niche and the filling properties in different multistep surgical procedures., Conclusions: In vitro study and sterility assessment showed that autologous cryopreserved adipose tissue grafting is a safe procedure, making it possible to avoid multiple liposuction surgery. No impairment of sterility, cell viability, or morphology was observed over time., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Orofacial modifications occurring in systemic sclerosis are detrimental for patients, but the therapeutic options are limited., Objectives: This systematic review aimed to perform an up-to-date appraisal of the literature focusing on fat grafting and other adipose stem cell-based therapies for the treatment of facial systemic sclerosis, determining its efficacy and safety, and investigating the current practice for treatment optimization., Methods: The review was prospectively registered in PROSPERO (CRD42021286268) and followed the PRISMA principles. Multiple databases were searched and only original studies were included., Results: Over the 12 studies matching the inclusion criteria, 174 patients were treated. Of these, 87.3% (n = 152) were considered to have improved. The complications, graded with the Clavien-Dindo grading system, were Grade 1 (no treatment required) or Grade 2 (antibiotic required). Patients received a mean [standard deviation] of 2.5 [3.68] (median, 1.35; range, 1-14) lipotransfer procedures. Overall, an average volume of 14.60 [6.24] mL was injected in the facial area (median, 16 mL; range, 3-27 mL). The average interval between procedures was 5.30 [2.04] months (median, 6 months; range 3-6.91 months). At the time of inclusion, patients were diagnosed with scleroderma disease on average after 14.7 [7.35] years., Conclusions: Fat grafting for facial systemic sclerosis is effective and safe. The definitive durability of the effect is still unclear, and the optimal number of treatments must be determined to define a precise evidence-based protocol. The body of evidence is highly fragmented, with disagreements over surgical techniques and outcome assessments, making results from different studies often not comparable. The level of evidence is overall low or very low, and the risk of bias of published studies is overall medium to high. Randomized controlled trials are urgently needed., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society.)

Background and Purpose: The aim was to determine the value of autologous haematopoietic stem cell transplantation (aHSCT) as a therapeutic intervention for progressive multiple sclerosis (PMS) based on a systematic review of the current literature., Methods: All studies from the databases PubMed and Google Scholar published in English before February 2024 which provided individual data for PMS patients were systematically reviewed. PICO was defined as population (P), primary progressive MS and secondary progressive MS patients; intervention (I), treatment with aHSCT; comparison (C), none, disease-modifying therapy treated/relapsing-remitting MS cohorts if available; outcome (O), transplant-related mortality, progression-free survival (PFS) and no evidence of disease activity., Results: A total of 15 studies met the criteria including 665 patients with PMS (74 primary progressive MS, 591 secondary progressive MS) and 801 patients with relapsing-remitting MS as controls. PFS data were available for 647 patients. PMS patients showed more severe disability at baseline than relapsing-remitting MS patients. The average transplant-related mortality for PMS in 10 studies was 1.9%, with 10 deaths in 528 patients. PFS ranged from 0% to 78% in PMS groups 5 years after treatment initiation, demonstrating a high variability. No evidence of disease activity scores at 5 years ranged from 0% to 75%., Conclusion: Based on the available data, aHSCT does not halt progression in people with PMS. However, there appears to be evidence of improved outcome in selected patients. Due to the heterogeneity of the available data, more comprehensive clinical trials assessing the efficacy of aHSCT across different patient groups are urgently needed to reduce variability and improve patient stratification., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Objective: This integrative literature review aims to discuss the benefits and limitations of postnatal surgery to correct myelomeningocele using the placenta as an autologous graft used on the lesion; in addition, it seeks to highlight the placental properties and the benefits and indications of surgery., Methods: For this production, the PRISMA criteria were used. PubMed was used as a database on October 19, 2023, and three searches were made, all using the words "myelomeningocele" and "surgery" varying only between "amnion," "placenta," and "chorion" as the third word. A total of 91 articles were found, and after analysis of duplicates and inclusion and exclusion criteria, only 11 articles were used in this systematic review., Results: Properties of the amniotic membrane were observed, such as anti-inflammatory, stimulation of native tissue growth, regenerating action by the secretion of neutrophil factors, promotion of epithelialization, inhibition of fibrosis and healing, and antibacterial effect. It is observed that there are benefits in using the placenta as an autograft and there are contradictions between the periods of surgery., Conclusion: Due to its properties that accelerate healing, the absence of the possibility of rejection, and its easy access make this choice more frequently adopted. We are confident in saying that the effectiveness of the amniotic membrane is widely reliable., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Autologous fat grafting is a widely used technique in plastic and reconstructive surgery for soft tissue augmentation. Despite its advantages, the primary limitation is the unpredictable retention rate of transplanted fat. Recent studies suggest that botulinum toxin type A (BTX-A) can enhance fat graft survival by promoting angiogenesis and muscle paralysis., Aims: This review explores the potential of BTX-A as an adjuvant in autologous fat grafting, providing insights into its mechanisms, benefits, and the need for further clinical validation., Patients/methods: A literature review was conducted using PubMed, Web of Science, MEDLINE, and Embase. Keywords related to BTX-A, fat grafting, fat graft survival, and angiogenesis were used. Comparative studies reporting histological changes following BTX-A application in fat grafting were included. Exclusion criteria involved case reports with fewer than three animals, reviews, and letters., Results: The initial search yielded 108 articles, with seven experimental studies meeting the criteria. These studies demonstrated that BTX-A enhances fat graft retention by promoting vascularization and adipose-derived stem cell differentiation. However, these results are mainly based on small animal models., Conclusions: While BTX-A shows promise in improving autologous fat grafting outcomes, its efficacy and safety in humans need validation through large-scale clinical trials. Translating these preclinical findings into human trials is crucial to establish standardized protocols and optimize clinical outcomes. Future research should focus on optimizing dosage and injection sites, conducting long-term follow-up studies, and performing multicenter trials to verify the findings., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background: This study evaluated the accuracy of the CBCT reconstruction model compared to the natural tooth and the accuracy of the replica tooth compared to the natural tooth., Objective: The hypothesis was that a replica tooth could be used as a surgical guide in autotransplantation., Methods: Three teeth were chosen and a CBCT reconstruction model was formed from each tooth. STL-data was transferred to a milling machine and replica teeth were milled from PEEK. A digitized surface model was prepared from the natural and the replica teeth by a stereophotogrammetry scanner. The surface model from the optical scan of the natural tooth was compared to the CBCT reconstruction model and the surface model of the replica tooth. The models were matched on each other, and surface-based rigid registration was performed between the surface models. Distances were calculated and visualized by MATLAB., Results: The CBCT reconstruction model and the natural tooth were compared. The largest euclidean distance was found at the root tip in the premolar (0.93 mm) and at the furcation area in the molar (2.3 mm). When the natural tooth and the replica tooth were compared, the largest euclidean distance was found at the root tip in the premolar (1.5 mm) and at the furcation area in the molar (1.9 mm)., Conclusion: A CBCT scan maintains sufficient image quality for tooth autotransplantation planning. The replica tooth corresponded in size and shape to the natural tooth in terms of clinically expected need of precision., (© 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Peripheral nerve injury occurs in a relatively large proportion of trauma patients, in whom it generally results in severe functional impairment and permanent disability. At present, however, there are no effective treatments available. Studies have shown that Schwann cells play an indispensable role in removing myelin debris and guiding axonal regeneration, and transplantation using autologous Schwann cells has shown good efficacy for patients with peripheral nerve injury. In recent years, Schwann cell autologous transplantation therapy has become an area of intensive research and is anticipated to provide a new strategy for the clinical treatment of peripheral nerve injury. In this article, we review the rationale for selecting Schwann cell autotransplantation therapy and the latest progress in key aspects of cell transplantation and clinical efficacy, and also summarize the future directions of research on this therapy. All of the above provide a strong basis for the further improvement and clinical promotion of this therapy., Competing Interests: Declaration of competing interest the authors report there are no competing interests to declare. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Early wound coverage is one of the most essential factors influencing the survival of extensively burned patients, especially those with a total body surface area (TBSA) burned greater than 50 %. In patients with limited donor sites available for autografting, techniques such as the Meek micrograft procedure or cultured epidermal allografts (CEA) have proven to be viable alternatives. In this systematic review and meta-analysis, we analyzed the outcomes of different wound coverage techniques in patients with massive burn injuries ≥ 50 % TBSA in the past 17 years., Methods: The EMBASE, PUBMED, Google Scholar and MEDLINE databases were searched from inception to December 2022 for studies investigating major burn reconstruction (>50 % TBSA) with the use of one of: a) autografts, b) allografts, c) cell-based therapies, and d) Meek micrografting. The review was conducted in accordance with the PRISMA guidelines. The outcomes evaluated were mortality, length of hospital stay, graft take and number of operations performed., Results: Following a two-stage review process, 30 studies with 1369 patients were identified for analysis. Methods of coverage comprised the original autografting, and the newer Meek micrografting, CEA autografting, and allografting. Pooled mean age of the entire cohort was 32.5 years ( ± SE 3.6) with mean burn size of 66.1 % ( ± 2.5). After pooling the data, advantages in terms of mortality rate, length of stay, graft take and number of required surgeries were seen for the Meek and CEA groups. Mortality was highest in patients treated with autografts (50 %) and lowest with cell-based therapy (11 %). Length of stay was longest with cell-based therapy (91 ± 16 days) and shortest with Meek micrografting (50 ± 24 days). Graft take was highest with autografts (96 ± 2 %) and lowest with cell-based therapy (72 ± 9 %). Average number of operations was highest with cell-based therapy (9 ± 4) and lowest with Meek micrografting (4 ± 2)., Conclusions: Comparison of the four techniques highlighted differences in terms of all outcomes assessed, and each technique was associated with different advantages. Interestingly autografting, the option with the highest graft take rate, was also associated with the highest mortality. This study not only serves to provide the first comparison of the most commonly used techniques in major burn reconstruction, but also highlights the need for prospective studies that directly compare the efficacy of the different techniques to ultimately establish whether a true superior option exists., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests. The authors declare that they have not received funding in any form for this work., (Copyright © 2024 Elsevier Ltd and International Society of Burns Injuries. All rights reserved.)

Autologous fat grafting (AFG), mostly in combination with adhesiolysis, has become the workhorse for reconstructing a dysfunctional or absent subcutaneous layer. In a previous study we showed that fat grafts isolated by centrifuging led to more than 20 % improvement in scar pliability. Nevertheless, there is still debate on which technique should be used to process and purify fat grafts. Therefore, a cohort with matured scars was obtained using the same study protocol but with filtration as processing technique. Scar quality was evaluated by the Patient and Observer Scar Assessment Scale (POSAS version 2.0), the Cutometer (pliability) and the DSM II ColorMeter (erythema and melanin). Scar evaluation was performed pre-operatively (baseline) and at 3 and 12 months after AFG. Between 2014 and 2018, 46 patients were included. Mean scar age was 20 ± 17 years and the majority of scars was caused by burns. Compared with baseline, patients showed improvement in scar quality measured by POSAS items at 12 months follow-up. The item score of 'pliability' improved the most from 7.4 to 5.8 (p = 0.001). Item scores of 'pain', 'itch' and 'color' also improved significantly. Clinicians also scored 'pliability' as most improved, but this was not statistically significant (p = 0.111). Objectively measured pliability and erythema and melanin showed no statistically significant differences at 12 months follow-up. Patient-reported outcomes revealed a significant improvement in scar quality, especially scar pliability, after AFG processed by filtration in patients with adherent scars. However, no scar quality improvement was found when assessed with objective tools., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd and ISBI. All rights reserved.)

Meniscectomy is known to alter the mechanics, stability, and kinematics of the tibiofemoral joint, leading to early knee osteoarthritis (KOA). While several meniscal substitutions exist, such as meniscus allograft transplantation, collagen meniscus implants, and artificial substitutes, they often come with technical challenges, high costs, and risks, including allograft failure, infections, and disease transmission. Tendon autografts emerge as a promising option, offering safety, availability, biocompatibility, and a reduced risk of pathophoresis. This review delves into basic, in vivo, in vitro, and biomechanical studies alongside clinical outcomes and future prospects of tendon autografts as meniscus substitutes. A thorough understanding of this option is vital for integrating these evolving techniques into clinical practice and mitigating early KOA progression., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Matthieu Ollivier reports a relationship with Newclip Technics that includes: consulting or advisory. Matthieu Ollivier is education consultant and receives royalties from Stryker. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)