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Limb transplant in particular and vascularized composite allotransplant (VCA) in general have wide therapeutic promise that have been stymied by current limitations in immunosuppression and functional neuromotor recovery. Many animal models have been developed for studying unique features of VCA, but here we present a robust reproducible model of orthotopic hind limb transplant in rats designed to simultaneously investigate both aspects of current VCA limitation: immunosuppression strategies and functional neuromotor recovery. At the core of the model rests a commitment to meticulous, time-tested microsurgical techniques such as hand sewn vascular anastomoses and hand sewn neural coaptation of the femoral nerve and the sciatic nerve. This approach yields durable limb reconstructions that allow for longer lived animals capable of rehabilitation, resumption of daily activities, and functional testing. With short-term treatment of conventional immunosuppressive agents, allotransplanted animals survived up to 70 days post-transplant, and isotransplanted animals provide long lived controls beyond 200 days post-operatively. Evidence of neurologic functional recovery is present by 30 days post operatively. This model not only provides a useful platform for interrogating immunological questions unique to VCA and nerve regeneration, but also allows for in vivo testing of new therapeutic strategies specifically tailored for VCA.
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http://dx.doi.org/10.3791/60777 | DOI Listing |
Front Med (Lausanne)
December 2024
Department of Hematology, Xuanwu Hospital, Capital Medical University, Beijing, China.
POEMS syndrome is a complex and rare hematological disease involving multiple physiological systems. According to the currently accepted diagnostic criteria for POEMS syndrome, polyneuropathy is one of the primary mandatory criteria. A patient presented with M protein, Castleman disease (CD), elevated vascular endothelial growth factor (VEGF), extravascular volume overload, and endocrinopathy.
View Article and Find Full Text PDFJt Dis Relat Surg
January 2025
İnönü Üniversitesi Tıp Fakültesi Turgut Özal Tıp Merkezi, Ortopedi ve Travmatoloji Anabilim Dalı, 44280 Malatya, Türkiye.
Objectives: In this study, we aimed to evaluate microvascular changes using nailfold capillaroscopy in patients who underwent digit replantation and revascularization.
Patients And Methods: A total of 46 patients (34 males, 12 females; mean age: 45.8±17.
Arch Orthop Trauma Surg
December 2024
Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro- gu, Seoul, 08308, Korea.
Introduction: Although sesamoid-preserving procedures have been attempted to complement sesamoidectomy for hallux sesamoid fracture nonunion, few reports document the results. Accordingly, the objective of this study was to review the outcomes of patients with hallux sesamoid fracture nonunion who underwent screw fixation with autogenous bone grafting.
Materials And Methods: Medical records of patients who underwent surgery between January 2013 and September 2022 were reviewed.
Front Surg
December 2024
Department of General, Visceral, Vascular and Transplant Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Background: Chronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease (PAD). Patients with diabetes mellitus (DM) have a faster progression of PAD and a fourfold increased risk of CLTI compared to patients without DM. Epidural spinal cord stimulation (SCS) has been used as a method to improve microcirculation, relieve ischemic pain and reduce the number of amputations in patients with PAD.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Background: Achondroplasia, the most common form of rhizomelic dwarfism, occurs in approximately 1 in 25,000 individuals. Clinical features include attenuated growth, rhizomelic limb shortening, and craniofacial abnormalities. Limb-lengthening surgery is widely employed to improve quality of life.
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