Local tendon transfer for knee extensor mechanism reconstruction after soft tissue sarcoma resection

Fischer, Sebastian; Soimaru, Silke; Hirsch, Tobias; Kueckelhaus, Maximilian; Seitz, Christoph; Lehnhardt, Marcus; Goertz, Ole; Steinau, Hans-Ulrich; Daigeler, Adrien

doi:10.1016/j.bjps.2015.01.002

Cited by 31 publications

(21 citation statements)

References 30 publications

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“…Fischer et al reported an average knee flexion of 74° (range, 35‐110°), full knee extension in all patients, an average extension force of 44% (range, 19‐79%), and flexion‐force 74% (range, 55‐100%) of the unaffected leg following hamstring (gracilis) transfer for quadriceps reconstruction after soft tissue sarcoma resection . Patients who underwent reconstruction with biceps femoris alone versus biceps combined with semitendinosus or gracilis transfer had similar functional results but greater donor site complications . Although hamstring local functional muscle transfer has improved knee extension after rectus resection, the local flaps have limited vectors of force to support a more significant anterior thigh resection, such as involving the entire rectus femoris or additional quadriceps.…”

Section: Discussionmentioning

confidence: 98%

“…Previous authors have utilized local muscle transfers in an effort to create a dynamic reconstruction of the knee extensor. Fischer et al reported an average knee flexion of 74° (range, 35‐110°), full knee extension in all patients, an average extension force of 44% (range, 19‐79%), and flexion‐force 74% (range, 55‐100%) of the unaffected leg following hamstring (gracilis) transfer for quadriceps reconstruction after soft tissue sarcoma resection . Patients who underwent reconstruction with biceps femoris alone versus biceps combined with semitendinosus or gracilis transfer had similar functional results but greater donor site complications .…”

Section: Discussionmentioning

confidence: 98%

“…As soft tissue sarcomas (STS) are most commonly located in the anterior thigh, 1 complete resection of an STS in this location may require an extensive removal of quadriceps muscle and/or extensor mechanism, resulting in diminished knee extension, and stability. [2][3][4][5][6][7][8][9] As such, a combined attempt to cover the residual vitalized tissues and reconstruct a functioning extensor mechanism can provide significant improvements in the potential for ambulation and recovery.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Reconstruction of quadriceps function with composite free tissue transfers following sarcoma resection

Walley

Taylor

Anderson

et al. 2017

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reconstruction of quadriceps function with composite free tissue transfers following sarcoma resection

Walley

Taylor

Anderson

et al. 2017

Journal of Surgical Oncology

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show abstract

“…With the active military population in mind, the response to VML injury has typically been explored in young (<50% of the median lifespan = 24 months) rat models. However, in addition to traumatic injuries, the surgical removal of muscle as a treatment for soft tissue sarcoma is another anticipated target for VML repair strategies (Fischer and others 2015). This group of patients is typically older, and therefore an improved understanding of the response to VML injury in aged muscle may provide unique insights that could guide future treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Recovery from volumetric muscle loss injury: A comparison between young and aged rats

Kim

Kasukonis

Brown

et al. 2016

Experimental Gerontology

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Termed volumetric muscle loss (VML), the bulk loss of skeletal muscle tissue either through trauma or surgery overwhelms the capacity for repair, leading to the formation of non-contractile scar tissue. The myogenic potential, along with other factors that influence wound repair are known to decline with age. In order to develop effective treatment strategies for VML injuries that are effective across a broad range of patient populations, it is necessary to understand how the response to VML injury is affected by aging. Towards this end, this study was conducted to compare the response of young and aged animal groups to a lower extremity VML injury. Young (3 months, n=12) and aged (18 months, n=8) male Fischer 344 rats underwent surgical VML injury of the tibialis anterior muscle. Three months after VML injury it was found that young TA muscle was on average 16% heavier than aged muscle when no VML injury was performed and 25% heavier when comparing VML treated young and aged animals (p<0.0001, p<0.0001). Peak contractile force for both the young and aged groups was found to decrease significantly following VML injury, producing 65% and 59% of the contralateral limbs’ peak force, respectively (p<0.0001). However, there were no differences found for peak contractile force based on age, suggesting that VML affects muscle’s ability to repair, regardless of age. In this study, we used the ratio of collagen I to MyoD expression as a metric for fibrosis vs. myogenesis. Decreasing fiber cross-sectional area with advancing age (p<0.005) coupled with the ratio of collagen I to MyoD expression, which increased with age, supports the thought that regeneration is impaired in the aged population in favor of fibrosis (p=0.0241). This impairment is also exacerbated by the contribution of VML injury, where a 77-fold increase in the ratio of collagen I to MyoD was observed in the aged group (p<0.0002). The aged animal model described in this study provides a tool for investigators exploring not only the development of VML injury strategies but also the effect of aging on muscle regeneration.

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“…Surgical muscle removal resulting from soft tissue sarcoma resection is another anticipated target for VML repair strategies like that described in this study. 53 This group of patients is typically older, and to date the regenerative response of MM in an aged model has not been investigated. Age related changes in muscle biology might be a limiting factor for MM usage in older patients.…”

Section: Decellularized Skeletal Muscle With Minced Muscle Autograftsmentioning

confidence: 99%

Codelivery of Infusion Decellularized Skeletal Muscle with Minced Muscle Autografts Improved Recovery from Volumetric Muscle Loss Injury in a Rat Model

Kasukonis

Kim

Brown

et al. 2016

Tissue Engineering Part A

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Skeletal muscle is capable of robust self-repair following mild trauma, yet in cases of traumatic volumetric muscle loss (VML), where more than 20% of a muscle's mass is lost, this capacity is overwhelmed. Current autogenic whole muscle transfer techniques are imperfect, which has motivated the exploration of implantable scaffolding strategies. In this study, the use of an allogeneic decellularized skeletal muscle (DSM) scaffold with and without the addition of minced muscle (MM) autograft tissue was explored as a repair strategy using a lower-limb VML injury model (n = 8/sample group). We found that the repair of VML injuries using DSM + MM scaffolds significantly increased recovery of peak contractile force (81 -3% of normal contralateral muscle) compared to unrepaired VML controls (62 -4%). Similar significant improvements were measured for restoration of muscle mass (88 -3%) in response to DSM + MM repair compared to unrepaired VML controls (79 -3%). Histological findings revealed a marked decrease in collagen dense repair tissue formation both at and away from the implant site for DSM + MM repaired muscles. The addition of MM to DSM significantly increased MyoD expression, compared to isolated DSM treatment (21-fold increase) and unrepaired VML (37-fold) controls. These findings support the further exploration of both DSM and MM as promising strategies for the repair of VML injury.

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Local tendon transfer for knee extensor mechanism reconstruction after soft tissue sarcoma resection

Cited by 31 publications

References 30 publications

Reconstruction of quadriceps function with composite free tissue transfers following sarcoma resection

Reconstruction of quadriceps function with composite free tissue transfers following sarcoma resection

Recovery from volumetric muscle loss injury: A comparison between young and aged rats

Codelivery of Infusion Decellularized Skeletal Muscle with Minced Muscle Autografts Improved Recovery from Volumetric Muscle Loss Injury in a Rat Model

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