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The Fascia Lata Anterolateral Tenodesis Technique.

ABSTRACT: A technique for anatomic reconstruction of the anterolateral complex addressing anterolateral rotatory instability both in primary anterior cruciate ligament reconstruction and in revision cases is presented. The extra-articular reconstruction is performed with a pedicle strip of iliotibial tract, fixed on the anatomic origin and insertion points of the anterolateral ligament of the knee in a double-bundle V-shaped fashion.

SUBMITTER: Ferretti A

PROVIDER: S-EPMC5368164 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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The Fascia Lata Anterolateral Tenodesis Technique.

Ferretti Andrea A Monaco Edoardo E Fabbri Mattia M Mazza Daniele D De Carli Angelo A

Arthroscopy techniques 20170116 1

A technique for anatomic reconstruction of the anterolateral complex addressing anterolateral rotatory instability both in primary anterior cruciate ligament reconstruction and in revision cases is presented. The extra-articular reconstruction is performed with a pedicle strip of iliotibial tract, fixed on the anatomic origin and insertion points of the anterolateral ligament of the knee in a double-bundle V-shaped fashion. ...[more]

PMID: 28373944

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Project description:PurposeWe systematically reviewed the literature to compare the clinical and radiologic outcomes and retear rates of superior capsular reconstruction (SCR) using fascia lata autograft (FLA) versus human dermal allograft (HDA) in cases of massive irreparable rotator cuff tears.MethodsSearches of Pub Med and Cochrane Library identified clinical studies addressing SCR using FLA and HDA. Two reviewers independently screened the titles, abstracts and full texts to extract data from eligible studies. Reported outcome measures were descriptively analyzed.ResultsA total of 6 studies with 2 study groups satisfied the inclusion criteria. The number of shoulders in the HDA group was 155, and in the FLA group, the number was 140 shoulders. The mean age at time of surgery for the HDA group and the FLA group was 60.49 years and 65.8 years, respectively, and the mean follow-up was 15.2 months and 44.6 months, respectively. Active elevation improved from of 121°-130° to 158°-160° in the HDA group and from 74.8°-133° to 130.4°-146° in the FLA group. Active external rotation improved from 36°-45° in the HDA group and from 13°-28° to 30°-43° in the FLA group. The Visual Analog Scale for pain improved from 4-6.25 to 0.38-1.7 points in the HDA group, whereas in the FLA group, it improved from 6-2.5 points. In the HDA group, American Shoulder and Elbow Surgeons scores improved from 42-52 to 77.5-86.5, whereas in the FLA group scores improved from 35-54.4 to 73.7-94.3. The acromiohumeral distance improved in both groups. The retear rate was 3.4%-55% in the HDA group and 4.5%-29% % in the FLA group.ConclusionsArthroscopic SCR for massive, irreparable rotator cuff tears using both fascia lata allograft and human dermal allograft leads to improvement in clinical outcomes and radiologic outcomes. There is a lower retear rate in fascia lata allografts. The current literature is heterogeneous and has low levels of evidence.Level of evidenceLevel IV, systematic review of level IV studies.

Project description:IntroductionRenal allograft compartment syndrome (RACS) is a complication that infrequently occurs after renal transplantation. Tight muscle closure may lead to RACS due to compression of renal parenchyma or kinking of the renal vessels. Many techniques have been proposed in an attempt to achieve tension-free closure, which can be specially challenging in child recipients. We present our experience with Tutoplast® Fascia Lata (RTI Surgical Tutogen Medical GmbH Industriestrasse 6, 91077 Neunkirchen am Brand, Germany) closure.MethodsAll pediatric patients who underwent renal transplantation in our center between 2012 and 2021 were reviewed. Eight patients with Tutoplast® Fascia Lata placed at the time of initial transplantation were identified. Donor and recipient characteristics, Doppler ultrasound findings, and overall patient and graft survival rates were analyzed.ResultsDoppler ultrasound was performed intra-operatively after abdominal wall closure. If any sign of vascular compromise was seen, the abdominal wall was opened and the graft was revised. The Tutoplast® Fascia Lata implant was used to perform tension-free fascia closure and, afterwards, a Doppler ultrasound was performed to confirm the optimal renal artery perfusion and venous patency. Three of the renal transplantations were from a cadaver donor, with two of them en bloc. Living donor transplantation was performed in four cases. Among which, there was a case of auto-transplantation due to bilateral renal artery stenosis. None of the patients presented any complications of either short or long term that was derived from the abdominal closure with Tutoplast® Fascia Lata. There was also no record of graft failure till datum.ConclusionsRestricted volume of the recipient pelvic cavity and the size discrepancy between the recipient pelvic cavity space and the donor adult kidney may lead to RACS. Other situations that occur more infrequently, i.e., as en bloc or auto-transplantation, are prone to suffer the same problem. Tutoplast® Fascia Lata is a safe option for these patients.

Dataset Information

The Fascia Lata Anterolateral Tenodesis Technique.

Publications

The Fascia Lata Anterolateral Tenodesis Technique.

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