This research study was awarded the JK Hardesty Award at the 54th Annual Meeting of Plastic Surgery Research Council (PSRC), Santa Monica, CA (May 2013). This project was also selected as a Poster of Distinction at the American Transplant Congress 2013, Seattle, WA (May 2013).

Surgical Procedure

The alloflap consisted of the distal femur, knee joint, proximal tibia and fibula, surrounding muscle and a well-vascularized skin component (average diameter: 7±1 cm) (Figure 1). Near infrared laser angiography was used to identify the vascular perforator in the anteromedial thigh prior to flap harvest and perfusion with Histidine-Tryptophan-Ketoglutarate (HTK) (Custodiol, Newtown PA). The osteomyocutaneous flap was transplanted to a subcutaneous abdominal pocket in the recipient with end-to-end femoral anastomosis without neurorrhaphy (Figure 1). Two flaps were harvested from each donor and transplanted to two recipients in a way that the right limb was transplanted to the left groin and vice versa. The skin component of the graft was positioned in a standardized fashion at the dorsolateral abdominal wall equidistant from the spine and ventral midline.

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