TY - JOUR
T1 - Expanding the top rungs of the extremity reconstructive ladder
T2 - targeted muscle reinnervation, osseointegration, and vascularized composite allotransplantation
AU - Azoury, Saïd C.
AU - Bauder, Andrew
AU - Souza, Jason M.
AU - Stranix, John T.
AU - Othman, Sammy
AU - McAndrew, Christine
AU - Tintle, Scott M.
AU - Kovach, Stephen J.
AU - Levin, Lawrence Scott
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2020
Y1 - 2020
N2 - Osseointegration (OI), targeted muscle reinnervation (TMR), and vascularized composite allotransplantation (VCA) are just a few ways by which our reconstructive ladder is evolving. It is important to recognize that amputation does not necessarily denote failure, but surgeons should strive to find ways to provide these patients with means for obtaining better satisfaction and quality of life postoperatively. TMR and OI have added options for mutilating lower extremity injuries that necessitate amputation. More recently, the senior author (Levin LS) described the “penthouse” floor of the reconstructive ladder being VCA. Despite the advances in VCA over the last 20 years, there are many challenges that face this discipline including indications for patient selection, minimizing immunosuppressive regimens, standardizing outcome measures, establishing reliable protocols for monitoring, and diagnosing and managing rejection. Herein, the authors review TMR, OI, and VCA as additional higher rungs of the reconstructive ladder.
AB - Osseointegration (OI), targeted muscle reinnervation (TMR), and vascularized composite allotransplantation (VCA) are just a few ways by which our reconstructive ladder is evolving. It is important to recognize that amputation does not necessarily denote failure, but surgeons should strive to find ways to provide these patients with means for obtaining better satisfaction and quality of life postoperatively. TMR and OI have added options for mutilating lower extremity injuries that necessitate amputation. More recently, the senior author (Levin LS) described the “penthouse” floor of the reconstructive ladder being VCA. Despite the advances in VCA over the last 20 years, there are many challenges that face this discipline including indications for patient selection, minimizing immunosuppressive regimens, standardizing outcome measures, establishing reliable protocols for monitoring, and diagnosing and managing rejection. Herein, the authors review TMR, OI, and VCA as additional higher rungs of the reconstructive ladder.
KW - Targeted muscle reinnervation
KW - osseointegration
KW - reconstruction
KW - salvage
KW - vascularized composite allotransplantation
UR - http://www.scopus.com/inward/record.url?scp=85142317182&partnerID=8YFLogxK
U2 - 10.20517/2347-9264.2019.44
DO - 10.20517/2347-9264.2019.44
M3 - Review article
AN - SCOPUS:85142317182
SN - 2347-9264
VL - 7
JO - Plastic and Aesthetic Research
JF - Plastic and Aesthetic Research
M1 - 4
ER -