OBJECTIVE: To investigate the anthropometric parameters that can accurately predict the diameter of the hamstring tendon graft, and to examine the correlation between disease etiology, duration, and graft diameter. METHODS: A retrospective analysis was conducted on data from 166 patients who underwent anterior cruciate ligament reconstruction using hamstring tendon autografts (semitendinosus and gracilis tendon) between January 2013 and December 2023. The cohort conprised 135 males and 31 females;the age ranged from 14 to 62 years old with an average of (28.87±10.46) years old. Pearson correlation coefficients, partial correlation coefficients, and stepwise multiple linear regression analysis were utilized to elucidate the relationship between the outcome variable (diameter of hamstring tendon grafts) and predictive variables (e.g., height). RESULTS: Correlation analysis revealed significant associations between the diameter of hamstring tendon grafts and height (r=0.379, P<0.001), weight (r=0.225, P=0.002), male gender (r=0.302, P<0.001), age(r=-0.218, P=0.002), and sports injury etiology (r=0.167, P=0.016). No significant correlations were found with surgical side, body mass index (BMI), or injury duration (P>0.05). Stepwise multiple linear regression analysis using a backward elimination method indicated that height was the sole significant predictive variable (R²=0.144, P<0.001), with the optimal predictive equation being:Graft size =2.636+0.029×Height (cm). Partial correlation analysis, after controlling for height, showed no significant association between age, gender, weight, and injury etiology with graft diameter. CONCLUSION Height is an effective predictive factor for the diameter of autologous hamstring tendon grafts. Factors such as gender, age, surgical side, body weight, and BMI are not influential to the diameter of the hamstring tendon grafts. Under the condition of the same height, there is no significant difference in the influence of these factors on the graft diameter. Preoperative physical activity level and the duration of injury do not significantly affect the diameter of the hamstring tendon grafts obtained during surgery. It is recommended to use the formula 'Graft Diameter=2.636 + 0.029 × Height (cm)' for preoperative prediction.
Humans ; Male ; Female ; Adult ; Middle Aged ; Retrospective Studies ; Adolescent ; Young Adult ; Transplantation, Autologous ; Anthropometry ; Anterior Cruciate Ligament Reconstruction ; Tendons/anatomy & histology* ; Autografts ; Hamstring Tendons/transplantation* ; Quadriceps Muscle/surgery*

OBJECTIVE: To retrospectively analyze the healing degree of graft in patients who underwent over-the-top reconstruction of the anterior cruciate ligament(ACL) using autologous tendon 1 year postoperatively to find out possible risk factors. METHODS: From January 2017 to March 2023, 207 patients with more than 1 year of follow-up and 1-year postoperative MRI were selected from that receiving ACL autograft tendon over-the-top reconstruction surgery including 137 males and 70 females, with a mean age of (28.01±9.71) years rangeding 12 to 56 years old;time from trauma to surgery was (5.80±3.78) months. All patients had intra-operative pivoshift tested asⅠtoⅡdegree. The 1-year postoperative magnetic resonance imaging (MRI) results were categorized by Howell's method, classifying degreesⅠandⅡas group BHD (better healing degree), while degrees Ⅲ and Ⅳ as group PHD (poorer healing degree). Potential influencing factors such as age, gender, whether it was a sports injury, time from injury to surgery, time to return to sports after surgery, body mass index (BMI), Beighton score, knee hyper-extension, diameter of the graft, whether it was remnant-preserving or not, whether the medial and lateral meniscus were resected, sutured or not, posterior lateral tibial slope, intercondylar notch width ratio (ICNWR), and lateral femoral condyle depth ratio (LFCDR) were analyzed by univariate analysis and Logistic regression to find the influencing factors. RESULTS: All patients were follow-up time for (18.59±4.63) months, and all the patients had good wound healing without any infection after surgery. There were 3 cases of re-ruptrure and 2 cases with secondary medial meniscus barrel handle-like tear 1 year after surgery, which received arthroscopic surgical treatment. Univariate analysis showed statistically significant difference in time from injury to surgery, time from surgery to return to sports, ICNWR, posterior lateral tibial slope, and BMI between the two groups(P<0.05). Multi-factorial regression analysis showed that smaller ICNWR, OR=0.684, 95%CI(0.528, 0.886), P=0.004; larger posterior lateral tibial slope, OR=1.557, 95%CI(1.222, 1.984), P<0.001;larger BMI, OR=1.724, 95%CI(1.369, 2.172), P<0.001;and shorter return-to-sport time<6 months vs. 6 to 12 months, OR=0.167, 95%CI(0.041, 0.672), P=0.012;<6 months vs.>12 months, OR=0.022, 95%CI(0.004, 0.108), P<0.001 might be risk factors for poor MRI healing degree 1 year postoperatively. CONCLUSION In patients received ACL autograft tendon over-the-top reconstruction, smaller ICNWR, larger posterior lateral tibial slope, larger BMI, and shorter time to return to sports may all be high-risk factors for poor graft healing degree on MRI 1 year postoperatively, and the surgical technique and the postoperative rehabilitation are supposed to be individualized for such patients.
Humans ; Male ; Female ; Adult ; Magnetic Resonance Imaging ; Anterior Cruciate Ligament Reconstruction/methods* ; Middle Aged ; Adolescent ; Young Adult ; Tendons/transplantation* ; Child ; Risk Factors ; Retrospective Studies ; Transplantation, Autologous ; Anterior Cruciate Ligament Injuries/diagnostic imaging* ; Anterior Cruciate Ligament/diagnostic imaging* ; Autografts ; Wound Healing

Objective: This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. Methods: This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft. Results: We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00). Conclusion There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.
Pterygium Of Conjunctiva And Cornea ; Pterygium ; Mitomycin ; Autografts ; Conjunctiva ; Conjunctivitis ; Transplantation, Autologous

OBJECTIVE: To evaluate clinical effect of quadriceps tendon autograft and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction by Meta-analysis. METHODS: From the time of building databases to May 2019, literatures on case control study on quadriceps tendon and bone-patellar tendon-bone autograft on anterior cruciate ligament reconstruction were searched form PubMed, EMbase, the Cochrane library, Wanfang and CNKI database. Literature screening, quality evaluation and data extraction were carried out according to include and exclude standard. Difference of forward displacement between the affected and health knee, Lachman test, axial shift test, Lysholm score, international knee documentation committee (IKDC) objective grade, anterior knee joint pain and transplant failure rate were analyzed by Meta analysis. RESULTS: Totally 6 literatures were included, including 915 patients with anterior cruciate ligament reconstruction, 495 patients with quadriceps tendon autograft and 420 patients with bone patellar tendon bone autograft. There were no statistical differences in anterior displacement of tibia was less than 3 mm[=1.53, 95%CI(0.68, 3.44), =0.31], 3 to 5 mm [=0.64, 95%CI(0.31, 1.35), =0.24], greater than 5 mm[=1.18, 95%CI(0.33, 4.22), =0.80], negative rate of Lachman test[=0.88, 95%CI(0.38, 2.02), =0.76], negative rate of axial shift test[=0.63, 95%CI(0.24, 1.68), =0.36] between two groups. There were no differences in Lyshlom score[=-0.56, 95%CI(-2.00, 0.89), =0.45], IKDC objective grade A and B[=0.87, 95%CI (0.47, 1.60), =0.66], and transplant failure rate [=0.76, 95%CI (0.28, 2.02), = 0.58]. In reducing anterior knee pain, quadriceps tendon autograft was better than that of bone patellar tendon bone autograft [=0.16, 95%CI (0.09, 0.29), <0.000 01]. CONCLUSION Quadriceps tendon autograft and bone patellar tendon bone autograft on anterior cruciate ligament reconstruction has equal clinical and functional outcomes, transplant failure rate, quadriceps tendon autograft could reduce anterior knee pain. For patients with anterior cruciate ligament reconstruction, quadriceps tendon autograft could be seen as suitable alternative bone graft substitutes for anterior cruciate ligament reconstruction.
Anterior Cruciate Ligament Injuries ; surgery ; Anterior Cruciate Ligament Reconstruction ; Autografts ; Case-Control Studies ; Humans ; Patellar Ligament ; surgery ; Tendons ; Transplantation, Autologous ; Treatment Outcome

Despite the correction of secondary renal hyperparathyroidism after successful kidney transplantation, some recipients have persistent hyperparathyroidism due to autonomous hypertrophied parathyroid glands. St. Goar first identified and termed this disease as tertiary hyperparathyroidism. Surgery, either subtotal parathyroidectomy or total parathyroidectomy with autotransplantation, is the main treatment for tertiary hyperparathyroidism. Here, we report a case of a patient with tertiary hyperparathyroidism after two times of kidney transplantation who underwent subtotal parathyroidectomy and also review the relevant literature.
Autografts ; Humans ; Hyperparathyroidism ; Kidney Transplantation ; Parathyroid Glands ; Parathyroidectomy ; Transplantation, Autologous

Pigmented villonodular synovitis (PVNS) is a rare benign condition that is locally aggressive and may destructively invade the surrounding soft tissues and bone causing functional loss of the joint and the limb. The knee is the most affected joint (range, 28% to 70%) but involvement of the bone is not a common feature seen at this site. We present a rare case of diffuse PVNS of the knee associated with subchondral cyst of the lateral femoral condyle. This posed a diagnostic dilemma because of bone invasion. The radiological image of synovitis was pathognomonic of PVNS but etiology of the osteolytic lesion was confirmed only on histopathology. The large osteochondral defect was eventually managed in a staged manner with bone grafting and osteochondral autograft transfer.
Autografts ; Bone Cysts ; Bone Transplantation ; Cartilage ; Extremities ; Joints ; Knee ; Synovitis ; Synovitis, Pigmented Villonodular

PURPOSE: This study aimed to investigate anterior knee symptoms in patients who underwent anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) graft followed by implantation of a beta-tricalcium phosphate (β-TCP) block as a bone void filler. MATERIALS AND METHODS: We retrospectively reviewed 84 cases of synthetic bone grafting using a β-TCP block for the patellar bone defect in ACL reconstruction with a BPTB autograft. Computed tomography of the operated knee was performed immediately after the surgery to evaluate whether the grafted β-TCP block protruded forward from the anterior surface of the patella. On the basis of the results, the cases were divided into a protrusion group (n=31) and a non-protrusion group (n=53). Anterior knee symptoms at 12 months postoperatively and absorption of the grafted β-TCP block were compared between the two groups. RESULTS: Except for patellofemoral crepitus, there was no significant difference in anterior knee symptoms between the two groups (p>0.05). The incidence of patellofemoral crepitus was significantly lower in the protrusion group than in the non-protrusion group (p=0.027). The groups showed no significant difference in β-TCP absorption. CONCLUSIONS: The present study demonstrated that the protrusion of β-TCP that was used as a bone void filler had no adverse effects.
Absorption ; Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Bone Transplantation ; Bone-Patellar Tendon-Bone Grafts ; Humans ; Incidence ; Knee ; Patella ; Retrospective Studies ; Tissue Donors ; Transplants

PURPOSE: To compare the efficacy and safety of recombinant human bone morphogenetic protein (rhBMP) and iliac crest autograft in the fusion treatment of lumbar spondylolisthesis. METHODS: The studies using randomized controlled trials to compare the rhBMP with iliac crest autograft in the treatment of lumbar spondylolisthesis were retrieved from Embase, Pubmed, ProQuest dissertations & theses (PQDT), China national knowledge infrastructure (CNKI), Chinese Biomedical Database, Wanfang Data, Cochrane Library (from March 1998 to March 2018). Postoperative fusion rate, clinical success rate, postoperative intervertebral height, complications, operation time, blood loss and duration of hospitalization were chosen as the outcome indicators. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.3 was used for data-analysis. RESULTS: Eleven articles were included in the meta-analysis. The results showed that, comparing the efficacy of rhBMP with iliac crest autograft, statistical significance was found in the 24-month fusion rate post operation [95% CI (1.38, 24.70), p = 0.02] and operation time [95% CI (-14.22, -2.08), p = 0.008]. There is not sufficient evidence for statistical differences in the remaining indicators. CONCLUSION The current literature shows rhBMP is a safe and effective grafting material in the treatment of lumbar spondylolisthesis. Further evidence is dependent on the emergence of more randomized controlled trials with higher quality and larger sample sizes in the future.
Autografts ; Bone Morphogenetic Proteins ; administration & dosage ; Databases, Bibliographic ; Humans ; Ilium ; transplantation ; Lumbar Vertebrae ; surgery ; Randomized Controlled Trials as Topic ; Recombinant Proteins ; administration & dosage ; Spinal Fusion ; methods ; Spondylolisthesis ; surgery ; Time Factors ; Treatment Outcome

Secondary hyperparathyroidism (HPT) usually result from parathyroid gland hyperplasia that produces excess parathyroid hormone (PTH). Decreased renal function leads to elevate serum phosphate levels and reduce vitamin D production, which results in hypocalcemia. Skeletal resistance to PTH results in persistently and frequently extremely elevated PTH levels and renal osteopathy. Treatment of choice for secondary HPT is medical management including calcitriol and vitamin D. However, for some cases in calciphylaxis and the failure including PTH >800 pg/mL or osteoporosis under maximal medical management surgical intervention could be an alternative option. We described a case of 47-year-old woman with surgical intervention for secondary hyperparathyroidism.
Autografts ; Calciphylaxis ; Calcitriol ; Female ; Humans ; Hyperparathyroidism, Secondary ; Hyperplasia ; Hypocalcemia ; Middle Aged ; Osteoporosis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy ; Transplantation, Autologous ; Vitamin D

Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.
Autografts ; Cough ; Giant Lymph Node Hyperplasia ; Heartburn ; Humans ; Middle Aged ; Rare Diseases ; Rupture ; Splenectomy ; Splenosis ; Thoracic Cavity ; Transplantation, Autologous