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Introduction Many reports have indicated that adipose‐derived stem cells (ADSCs) are effective for nerve regeneration. We investigated nerve regeneration by combining a polyglycolic acid collagen (PGA‐c) tube, which is approved for clinical use, and Schwann cell‐like differentiated ADSCs (dADSCs). Methods Fifteen‐millimeter‐long gaps in the sciatic nerve of rats were bridged in each group using tubes (group I), with tubes injected with dADSCs (group II), or by resected nerve (group III). Results Axonal outgrowth was greater in group II than in group I. Tibialis anterior muscle weight revealed recovery only in group III. Latency in nerve conduction studies was equivalent in group II and III, but action potential was lower in group II. Transplanted dADSCs maintained Schwann cell marker expression. ATF3 expression level in the dorsal root ganglia was equivalent in groups II and III. Discussion dADSCs maintained their differentiated state in the tubes and are believed to have contributed to nerve regeneration.

Introduction:The options for the reconstruction of diaphyseal defects following the resection of bone tumors include biological or prosthetic implants. The purpose of our study was to evaluate different types of intercalary reconstruction techniques, including massive bone allograft, extracorporeal devitalized autograft, vascularized free fibula, and modular prosthesis. Methods: We performed a systematic review of articles using the terms diaphyseal bone tumor and intercalary reconstruction. All the studies reporting the non-oncological complications such as infection, nonunion and fracture of the intercalary reconstructions were included. We excluded articles published before 2000 or did not involve humans in the study. Case reports, reviews, technique notes and opinion articles were also excluded based on the abstracts. Thirty-three articles included in this review were then studied to evaluate failure rates, complications and functional outcome of different surgical intercalary reconstruction techniques. Results: Nonunion rates of allograft ranged 6%e43%, while aseptic loosening rates of modular prosthesis ranged 0%e33%. Nonunion rates of allograft alone and allograft with a vascularized fibula graft ranged 6% e43% and 0%e33%, respectively. Fracture rates of allograft alone and allograft with a vascularized fibula graft ranged 7%e45% and 0%e44%, respectively. Infection rates of allograft alone and allograft with a vascularized fibula graft ranged 0%e28% and 0%e17%, respectively. All of the allograft (range: 67%e92%), extracorporeal devitalized autograft including irradiation (87%), autoclaving (70%), pasteurization (88%), low-heat (90%) or freezing with liquid nitrogen (90%), and modular prosthesis (range: 77%e93%) had similar Musculoskeletal Tumor Society functional scores. Addition of a vascularized fibula graft to allograft did not affect functional outcome [allograft with a vascularized fibula graft (range: 86%e94%) vs. allograft alone (range: 67%e92%)]. Conclusion: Aseptic loosening rates of modular prosthesis seem to be less than nonunion rates of allograft. Adding a vascularized fibula graft to allograft seems to increase bone union rate and reduce the risk of fractures and infections, though a vascularized fibula graft needs longer surgical time and has the disadvantage of donor site morbidity. These various intercalary reconstruction techniques with or without a vascularized fibula autograft had similar functional outcome.

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Although nerve autografts have been considered the standard treatment for peripheral nerve defects, limited studies have reported long-term outcomes of nerve harvesting over 15 years after surgery. This study aimed to evaluate the long-term outcomes of donor site morbidity after sural nerve graft harvesting. Methods: Thirteen patients for whom more than 15 years had passed after harvesting of the sural nerve for peripheral nerve defects were included. Mean follow-up was 29.5 years. Sensory disturbances and difficulty in performing foot movements immediately after surgery and currently were evaluated on a 10-point scale. Influences on daily living and work and current satisfaction with the autologous sural nerve graft were evaluated. Results: Sensory disturbances and difficulty in movement tended to improve; however, the differences between time points were not significant. Influences on activities of daily living and work were mild, and the satisfaction level for autologous sural nerve graft was high. Conclusions: Although donor site morbidity after sural nerve graft harvesting persisted for a long time after surgery, foot symptoms and functional impairment were mild. Type of study/level of evidence: Therapeutic V.