Minimally Invasive Fascia Lata Harvest

Tay, Valerie; Tan, Kar Su; Loh, Ian

doi:10.1097/gox.0b013e31828c4406

Cited by 15 publications

(16 citation statements)

References 5 publications

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“…Our minimally invasive fascia lata harvesting technique did not produce subjectively important donor site dysfunction, probably because damage to the tensor fascia lata muscle superiorly (hip) and the distal iliotibial band inferiorly (knee) was avoided. 42 Furthermore, we attempted to achieve good cosmesis through the use of 2 small skin incisions. Mihata et al 32 used an open superior approach.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

Azevedo

Ângelo

Vinga

2018

Orthopaedic Journal of Sports Medicine

188

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Background:Painful dysfunctional shoulders with irreparable rotator cuff tears (IRCTs) in active patients are a challenge. Arthroscopic superior capsular reconstruction (ASCR) is a new treatment option originally described using a fascia lata autograft harvested through an open approach. However, concerns about donor site morbidity have discouraged surgeons from using this type of graft.Hypothesis:ASCR using a minimally invasive harvested fascia lata autograft produces good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years.Study Design:Case series; Level of evidence, 4.Methods:From 2015 to 2016, a total of 22 consecutive patients (mean age, 64.8 ± 8.6 years) with chronic IRCTs (Hamada grade 1-2; Goutallier cumulative grade ≥3; Patte stage 1: 2 patients; Patte stage 2: 6 patients; Patte stage 3: 14 patients) underwent ASCR using a minimally invasive harvested fascia lata autograft. All patients completed preoperative and 6-month evaluations consisting of the Simple Shoulder Test (SST), subjective shoulder value (SSV), Constant score (CS), range of motion (ROM), acromiohumeral interval (AHI), and magnetic resonance imaging. Twenty-one patients completed the 2-year shoulder and donor site morbidity assessments.Results:The mean active ROMs improved significantly (P < .001): elevation, from 74.8° ± 55.5° to 104.5° ± 41.9° (6 months) and 143.8° ± 31.7° (2 years); abduction, from 53.2° ± 43.3° to 86.6° ± 32.9° (6 months) and 120.7° ± 37.7° (2 years); external rotation, from 13.2° ± 18.4° to 27.0° ± 16.1° (6 months) and 35.6° ± 17.3° (2 years); and internal rotation, from 1.2 ± 1.5 points to 2.6 ± 1.5 points (6 months) and 3.8 ± 1.2 points (2 years). The mean functional shoulder scores improved significantly (P < .001): SST, from 2.1 ± 2.9 to 6.8 ± 3.5 (6 months) and 8.6 ± 3.5 (2 years); SSV, from 33.0% ± 17.4% to 55.7% ± 25.6% (6 months) and 70.0% ± 23.0% (2 years); CS, from 17.5 ± 13.4 to 42.5 ± 14.9 (6 months) and 64.9 ± 18.0 (2 years). The mean shoulder abduction strength improved significantly (P < .001) from 0.0 to 1.1 ± 1.4 kg (6 months) and 2.8 ± 2.6 kg (2 years). The mean AHI improved from 6.4 ± 3.3 mm to 8.0 ± 2.5 mm (6 months) and decreased to 7.1 ± 2.5 mm (2 years). This 0.7 ± 1.5–mm overall decrease was statistically significant (P = .042). At 6 months, 20 of 22 patients (90.9%) had no graft tears. At 2 years, 12 of 21 patients (57.1%) were bothered by their harvested thigh, 16 (76.2%) noticed donor site changes, 16 (76.2%) considered that the shoulder surgery’s end result compensated for the thigh’s changes, and 18 (85.7%) would undergo the same surgery again.Conclusion:ASCR using a minimally invasive harvested fascia lata autograft produced good 6-month and 2-year shoulder outcomes in IRCTs, with low-impact thigh morbidity at 2 years.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

Azevedo

Ângelo

Vinga

2018

Orthopaedic Journal of Sports Medicine

188

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“…These data indicate that fascia lata has a strength per unit weight that is comparable to that of steel [11]. Moreover, autologous fascia is minimally absorbed over time after the graft [16]. The use of this material made it possible to properly fix the lower eyelid of our patient and permanently prevent its future retraction.…”

Section: Discussionmentioning

confidence: 65%

The Use of Fascia Lata Free Graft for Lateral Canthus Reconstruction Following Mohs Lower Lid Surgery

Nowak¹

2020

Surgeries

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We present a case of a 75-year-old patient who underwent reconstruction of the lower eyelid and lateral canthus following removal of 80% of the lower eyelid due to basal cell carcinoma. A Hughes transconjunctival eyelid-sharing flap was used to form the posterior lamella, and a free skin graft from the ipsilateral upper lid was used to recreate the anterior lamella. The lateral canthal ligament was reconstructed using a free fascia lata graft. A periosteal flap was not used due to local scarring that was the result of previous multiple lateral canthal surgeries. Skin preservation in the lateral canthal area and additional horizontal support for the lower eyelid were achieved by using a local advancement flap. This two-stage surgery produced excellent functional and cosmetic effects. Fascia lata free graft can be an alternative to the periosteal flap for reconstruction of the lateral canthal ligament when use of the lateral orbital periosteum is not feasible.

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“…Other innovative minimally invasive techniques [ Table 2 ] have been described in the literature to harvest autogenous fascia lata without using a fasciotome. [ 4 5 6 ] Kashkouli, Tay et al ., and Bhatti et al . have individually described twin-incision techniques where the proximal and distal incisions were placed at the lower third of the line joining the lateral condyle of tibia with anterior superior iliac spine.…”

Section: Discussionmentioning

confidence: 99%

“…All of these techniques allow harvest of large sheets of fascia lata which are utilized in a variety of surgical specialties given the versatility of autogenous fascia lata graft. [ 4 5 6 ] The twin incisions leave two small scars on the lateral thigh. [ 4 5 6 ]…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have described innovative minimally invasive harvesting techniques exemplified by the kite-tail fascia lata strip technique by Evereklioglu and twin small-incision techniques by Kashkouli, Tay et al ., and Bhatti et al . [ 3 4 5 6 ] A rigid endoscope-assisted fascial harvest technique was first described by Tucker et al . for repair of recurrent ventral hernia and later by Malhotra et al .…”

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confidence: 99%

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Endoscope-assisted harvest of autogenous fascia lata in frontalis suspension surgery: A minimally invasive approach revisited

Naik

Patel

Bothra

et al. 2018

Indian J Ophthalmol

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Minimally Invasive Fascia Lata Harvest

Cited by 15 publications

References 5 publications

Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

Arthroscopic Superior Capsular Reconstruction With a Minimally Invasive Harvested Fascia Lata Autograft Produces Good Clinical Results

The Use of Fascia Lata Free Graft for Lateral Canthus Reconstruction Following Mohs Lower Lid Surgery

Endoscope-assisted harvest of autogenous fascia lata in frontalis suspension surgery: A minimally invasive approach revisited

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