$re = '/((\b[a-z]{1,}\b).*?)(\b\2\b)(.*)$/mix';
$str = 'Green shirt green hat
Green shirt greenish hat
You are an artistically gifted musically gifted individual';
$subst = "\1and\4";
$result = preg_replace($re, $subst, $str);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php