Surgeries, Volume 6, Issue 4 (December 2025) – 2 articles

Background: Primary cicatricial alopecias (PCA) are inflammatory disorders that cause permanent hair loss through follicular destruction and fibrosis. Hair transplantation (HT) may restore coverage in stable or end-stage PCA cases. This review assesses the efficacy of HT in PCA including optimal timing, graft survival rates, and the risk of disease reactivation. Material & Methods: A PubMed literature search identified 33 studies of HT in lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), discoid lupus erythematosus, central centrifugal cicatricial alopecia, pseudopelade of Brocq, morphea en coup de sabre, and folliculitis decalvans from the 1960s to present. Reviews were excluded. Results: Among 147 PCA patients, 87.8% had positive HT outcomes. LPP showed high graft survival (70–90%). In contrast, eyebrow FFA (75%), folliculitis decalvans (25%), and scalp FFA (8.6%) had the highest failure rates. Follicular unit extraction was used slightly more than follicular unit transplantation. Notably, 46 patients developed PCA post-HT for presumed androgenetic alopecia. Discussion: HT in PCA can succeed with careful patient selection and stable disease (ideally ≥12–24 months). Graft survival varies by subtype. LPP has consistently reported successful outcomes post-transplantation, whereas folliculitis decalvans and FFA had the poorest outcomes. Adjuncts like immunosuppressants, PRP, and minoxidil may enhance results. Conclusions: Hair transplantation is viable in quiescent PCA, but outcomes are subtype-dependent. Many surgeons already perform these surgeries, but the published literature is lacking, and more research is needed to establish standardized timing, improve long-term graft survival, and clarify the risk of post-HT PCA onset. Full article

Background/Objectives: Meniscectomy is commonly performed to treat meniscal injury. Recovery of patients and restoration of functional capacity may be influenced by several factors, among which postoperative rehabilitation could play a significant role. The objective was to compare clinical and functional status in patients undergoing meniscectomy according to receipt of postoperative rehabilitation. Methods: An ambispective cohort study was conducted in 89 patients who underwent meniscectomy. The primary outcome was functional capacity, assessed using the Timed Up and Go (TUG) test. The primary exposure was receipt of postoperative rehabilitation. Secondary outcomes included knee range of motion (goniometry), pain intensity (visual analogue scale, VAS), and kinesiophobia (Tampa Scale of Kinesiophobia). Results: Functional capacity differed significantly between patients who received postoperative rehabilitation and those who did not (U = 490; p = 0.03), with lower (better) TUG times in the rehabilitation group. A significant difference was also observed between patients who did and did not engage in preoperative regular physical exercise (U = 680.0; p = 0.01), with better postoperative functional performance in those who had not exercised preoperatively. A sex difference was identified, with females demonstrating superior functional performances compared with males (U = 1187.0; p = 0.01). Older age was positively associated with functional impairment (β = 0.02; p = 0.02). Conclusions: Postoperative rehabilitation was associated with superior objective functional performance after meniscectomy, alongside improvements in pain, range of motion, and kinesiophobia. Female sex and younger age predicted better function; preoperative inactivity was associated with superior postoperative performance, while postoperative exercise showed no clear association. Findings should be interpreted cautiously in view of potential residual confounding and the small non-rehabilitation subgroup, and warrant validation in larger, preferably randomised, cohorts. Full article