One type of graft for reconstruction of the ACL does not suit all patients based on their characteristics and sports: a scoping review.

The selection of graft type for anterior cruciate ligament reconstruction remains a topic of debate, taking into consideration patient characteristics, as well as the type and level of sports involvement. The aim of this scoping review was to investigate patient characteristics that might influence the selection of graft type for anterior cruciate ligament reconstruction. PubMed and Scopus were searched to identify articles for inclusion. All included studies focused on one or more patient characteristics involved in the decision-making process regarding anterior cruciate ligament reconstruction autograft, including the hamstrings tendon (HT), patellar tendon (BPTB) and quadriceps tendon (QT). Out of the 1,977 initial studies, 27 studies were included in this review. The BPTB graft seems to be the preferred choice in young patients, females, and athletes-especially those engaged in pivoting sports. The HT graft seems to be the preferred choice in less active and older patients, along with those involved in sports where knee extensors are vital. The HT graft is not preferable in patients with a small body height and graft diameter. Moreover, surgeon preferences were also of importance for graft selection. The success of a specific graft type in anterior cruciate ligament reconstruction is highly dependent on the patient's characteristics and type of sport. Patient characteristics such as age, gender, body height, graft diameter, and the patient's activity level should all be considered when choosing the appropriate graft type.

Lower anxiety level to perform movements after revision anterior cruciate ligament reconstruction with lateral extra-articular tenodesis compared to without lateral extra-articular tenodesis.

PURPOSE: To evaluate the anxiety level to perform movements in patients after revision anterior cruciate ligament reconstruction (ACLR) combined with lateral extra-articular tenodesis (LET) compared to patients after revision ACLR without LET. METHODS: Ninety patients who underwent revision ACLR with ipsilateral bone-patellar tendon-bone autograft and with a minimum of 12 months follow-up were included in this study. Patients were divided into two groups: patients who received revision ACLR in combination with LET (revision ACLR_LET group; mean follow-up: 29.4 months, range: 12-80 months), and patients who received revision ACLR without LET (revision ACLR group; mean follow-up: 61.1 months, range: 22-192 months). All patients filled in a questionnaire about anxiety level related to physical activity and sports, the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee subjective form (IKDCsubjective), and the Tegner Activity Score. RESULTS: Patients in the revision ACLR_LET group had a significantly lower anxiety level to perform movements than patients in the revision ACLR group (p < 0.05). No significant differences were found in KOOS, IKDCsubjective, and Tegner Activity Scores. CONCLUSIONS: Patients who received LET in addition to revision ACLR have a lower anxiety level to perform movements than patients with revision ACLR alone, despite non-different subjective functional outcomes. STUDY DESIGN: Retrospective cohort study, Level of evidence: III.

A calfluxin-related peptide is present in the bag cells and atrial gland of Aplysia.

The caudodorsal cells of Lymnaea and the bag cells of Aplysia are neuroendocrine cells whose peptide products have homologous functions, i.e., regulation of egg deposition. One of the Lymnaea products, calfluxin, increases cytosolic and hence mitochondrial calcium concentrations in secretory cells of the albumen gland, an exocrine organ that secretes perivitellin fluid around the egg cells during packaging; the changes can be visualized at the ultrastructural level for quantification with the pyroantimonate precipitation technique and are correlated with changes in the secretory and biosynthetic activity in the gland. Comparable studies have now been carried out with Aplysia and indicate that the bag cells of A. californica and A. brasiliana also contain a factor with calfluxin-related activity, and that the factor is not the egg-laying hormone (ELH). The bag cell factor does not affect mitochondrial calcium levels in the Lymnaea albumen gland, and synthetic calfluxin does not affect the Aplysia gland. Thus, although the bag cell and caudodorsal cell peptides have the same activity in their respective genera, the sequences have diverged sufficiently during the course of evolution to preclude cross-reactivity. Calfluxin-related activity was also detected in the atrial gland of A. californica and the atrial gland-like epithelium of A. brasiliana, two exocrine organs in the oviduct that express genes structurally related to the bag cell ELH gene. It is postulated that the active atrial gland factors may be peptides A and B.