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Objective: This study presents an up-to-date overview of the literature on autologous fat grafting (AFG) in onco-plastic breast reconstruction, with respect to complications, oncological and radiological safety, volume retention and patient/surgeon satisfaction., Background: Although AFG is increasingly being applied in onco-plastic breast reconstruction, a comprehensive overview of the available evidence for this procedure is still lacking., Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was conducted. Case series, cohort studies and randomized controlled trials (RCTs) reporting on relevant outcomes of breast reconstruction with supplemental AFG were included., Results: In total, 43 studies were included reporting on 6260 patients with a follow-up period ranging from 12 to 136 months. The average locoregional and distant oncological recurrence rates after breast reconstruction with AFG were 2.5% (95% confidence interval (CI) 1.7-3.7) and 2.0% (95% CI 1.1-3.5), respectively. Fewer cysts and calcifications were seen on radiological images for this procedure than for other types of breast surgery. However, more biopsies were performed based on radiological findings (3.7% vs. 1.6%), and more cases of fat necrosis (9.0% vs 4.7%) were seen after treatment with AFG. The total complication rate of 8.4% (95% CI 7.6-9.1) is lower than those reported following other reconstructive breast procedures. The mean volume retention was 76.8% (range 44.7-82.6%) with a satisfaction rate of 93.4% for patients and 90.1% for surgeons., Conclusions: AFG in breast reconstruction is a promising technique. Safety is not compromised as cancer recurrence and complications are not observed. Whether AFG interferes with radiological follow-up remains to be elucidated. Randomized trials with sound methodology are needed to confirm these conclusions., (Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Questions: What proportion of people after total knee arthroplasty adheres to the physical activity regimen recommended for maintenance of health (moderate intensity physical activity for at least 30min on 5 days/week)? What proportion adheres to the activity regimen recommended to improve fitness (vigorous intensity physical activity for at least 20min on 3 days/week)? What factors are associated with adherence to these recommendations?, Design: An observational study., Participants: 830 adults who underwent a total knee arthroplasty between 2002 and 2006 at University Medical Center Gronigen or Martini Hospital Gronigen, the Netherlands., Outcome Measures: The Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) was used to measure the physical activity behaviour of the participants. These data were analysed as adherence to each recommendation., Results: The health recommendation was adhered to by 51% of the participants. The fitness recommendation was adhered to by 53% of participants. Almost half (46%) of the participants fulfilled both recommendations, and 42% did not fulfil either recommendation. Males and more educated participants had higher odds of meeting the health, fitness, and both recommendations. Respondents living with family had higher odds of meeting the fitness recommendation., Conclusion: After total knee arthroplasty, 42% of people are not active enough to maintain their health and fitness. Physiotherapists should encourage people with a total knee arthroplasty to undertake the recommended exercise regimens to maintain health and fitness, with particular attention to those people with characteristics known to be associated with poor adherence to the recommendations., (Copyright © 2012 Australian Physiotherapy Association. Published by .. All rights reserved.)