Coronary artery bypass surgery can result in endothelial dysfunction due to ischemia/reperfusion (IR) injury. Previous studies have demonstrated that DuraGraft helps maintain endothelial integrity of saphenous vein grafts during ischemic conditions. In this study, we investigated the potential of DuraGraft to mitigate endothelial dysfunction in arterial grafts after IR injury using an aortic transplantation model. Lewis rats (n = 7-9/group) were divided in three groups. Aortic arches from the control group were prepared and rings were immediately placed in organ baths, while the aortic arches of IR and IR + DuraGraft rats were preserved in saline or DuraGraft, respectively, for 1 h before being transplanted heterotopically. After 1 h after reperfusion, the grafts were explanted, rings were prepared, and mounted in organ baths. Our results demonstrated that the maximum endothelium-dependent vasorelaxation to acetylcholine was significantly impaired in the IR group compared to the control group, but DuraGraft improved it (control: 89 ± 2%; IR: 24 ± 1%; IR + DuraGraft: 48 ± 1%, p < 0.05). Immunohistochemical analysis revealed decreased intercellular adhesion molecule-1, 4-hydroxy-2-nonenal, caspase-3 and caspase-8 expression, while endothelial cell adhesion molecule-1 immunoreactivity was increased in the IR + DuraGraft grafts compared to the IR-group. DuraGraft mitigates endothelial dysfunction following IR injury in a rat bypass model. Its protective effect may be attributed, at least in part, to its ability to reduce the inflammatory response, oxidative stress, and apoptosis.

The most prevalent type of hemodialysis membrane is polysulfone (PSf). However, due to inadequate biocompatibility, it significantly compromises the safety of dialysis for patients. In this study, we modify the surface of the PSf membrane with 2,4-dihydroxybenzophenone (DBPh) groups to serve as anchoring sites during UV irradiation. Subsequently, a tailored sulfonated dihydroxy propyl chitosan (SDHPCS) is grafted onto the modified PSf membrane to compensate for the deficiencies in hydrophilic additives. The modified PSf membrane exhibits outstanding hydrophilicity and stability, as demonstrated by its characterization and evaluation. This paper focuses on investigating the interaction between platelet membrane formation, protein adsorption, and anticoagulant activity. The results show that the modified PSf membrane exhibits remarkable enhancement in surface hydrophilicity, leading to a significant reduction in protein and platelet adsorption as well as adhesion.

UNASSIGNED: Various studies have suggested use of socket grafting materials after dental extraction for socket preservation. However, there is no single material that has been accepted as standard for preserving the socket. The purpose of this systematic review was to analyze the evidence for the use of biphasic calcium phosphate for socket regeneration.
UNASSIGNED: The team conducted a systematic literature search in accordance with the protocol registered at PROSPERO. PubMed, OVID, and EMBASE databases were used in the search. The articles were then screened using RAYYAN open-source software for the synthesis of evidence.
UNASSIGNED: Of the 240 articles found in the search, two studies could be included in the review.
UNASSIGNED: Biphasic calcium phosphate (60% hydroxyapatite, HA and 40% beta-tricalcium phosphate, β-TCP) has a significant effect in the socket preservation and quality of bone regeneration.

Open reduction with internal fixation is the gold standard treatment for tibial plateau fractures. However, some complications can be observed despite a well-established procedure. Apart from stiffness, malunion is the most frequent complication of tibial plateau fractures. These malunions may be intra-articular or extra-articular or combined. Intra-articular or extra-articular osteotomy is a good option to treat malunion in young and active patients without significant joint damage. When malunion is associated with extensive joint involvement or the initial cartilage damage has resulted in knee osteoarthritis, the surgical option is a total replacement of the knee joint with arthroplasty. We report the case of a patient with a tibial plateau fracture treated initially at a traditional bonesetter complicated at the end of the treatment with the persistent of the knee pain and limping.

UNASSIGNED: The timing of return to work (RTW) after anterior cruciate ligament (ACL) reconstruction (ACLR) is a less studied milestone compared with return to sports.
UNASSIGNED: To systematically review the rate and postoperative timing of RTW after ACLR.
UNASSIGNED: Systematic review; Level of evidence, 4.
UNASSIGNED: This study was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search was performed in PubMed, Embase, Cochrane, and Ovid databases for clinical studies reporting RTW after ACLR, and 806 studies were identified in August 2022. A quality assessment was performed using the Methodological Index of Nonrandomized Studies (MINORS) grading system. The following data were extracted from studies: study characteristics, cohort demographics, ACLR technique, concomitant meniscal and/or cartilage procedures, preoperative patient-reported outcomes, rates of RTW, and days required for RTW after ACLR.
UNASSIGNED: A total of 13 studies met inclusion criteria, totaling 1791 patients (86.4% male). Wide variability was observed in the methodological quality of the assessed studies (MINORS score range, 8-17). Hamstring tendon (HT) autograft was used in 76.8% (n = 1377; mean age, 30.5 years old), allograft in 17.1% (n = 308; mean age, 33.1 years old), the ligament advanced reinforcement system in 2.5% (n = 46; mean age, 33.2 years old), bone-patellar tendon-bone autograft in 2% (n = 36; mean age, 28.5 years old), and quadriceps tendon autograft in 1.3% (n = 24; mean age, 24.1 years old). Among the included patients, 99.1% (n = 1781) reported successful RTW after surgery. The mean time to RTW was 84.2 days (range, 31.4-107.1 days) for HT and 69.5 days (range, 49-56.6 days) for allograft.
UNASSIGNED: While data regarding work intensity before and after ACL injury were absent, our study results suggested that patients most often RTW within 90 days of surgery. Patients with allograft ACLR may RTW earlier than patients undergoing ACLR with HT autograft.

UNASSIGNED: The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear.
UNASSIGNED: To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index.
UNASSIGNED: At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, P = .038; middle: 13.45 ± 5.15 vs. 17.75 ± 5.75, P = .001; mean: 12.37 ± 2.74 vs 15.07 ± 3.32, P < .001). The T2* values were lower in the RTS group (14.92 ± 2.28 vs 17.69 ± 2.48; P < .001) and were correlated with RTS (r = -0.41; P = .02). The area under the curve of T2* was 0.79 (95% CI, 0.75-0.83), and the optimal cutoff value for T2* was 16.65, with a sensitivity and specificity for predicting failure to RTS of 67.9% and 88.2%, respectively.
UNASSIGNED: Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.

UNASSIGNED: The etiology and pathogenesis of osteochondritis dissecans (OCDs) lesions remain controversial.
UNASSIGNED: This review presents the recent evolution about the healing, imaging, pathogenesis, and how to treat OCD of the capitellum in overhead athletes.
UNASSIGNED: Compressive and shear forces to the growing capitellum can cause subchondral separation, leading to OCD, composed of 3 layers: articular fragment, gap, and underlying bone. Subchondral separation can cause ossification arrest (stage IA), followed by cartilage degeneration (stage IB) or delayed ossification (stage IIA), occasionally leading to osteonecrosis (stage IIB) in the articular fragment. Articular cartilage fracture and gap reseparation make the articular fragment unstable. The mean tilting angle of capitellar OCD is 57.6 degrees in throwers. Anteroposterior radiography of the elbow at 45 degrees of flexion (APR45) can increase the diagnostic reliability, showing OCD healing stages, as follows: I) radiolucency, II) delayed ossification, and III) union. Coronal computed tomography and magnetic resonance imaging with an appropriate tilting angle can also increase the reliability. MRI is most useful to show the instability, although it occasionally underestimates. Sonography contributes to detection of early OCD in adolescent throwers on the field. OCD lesions in the central aspect of the capitellum can be more unstable and may not heal. Cast immobilization has a positive effect on healing for stable lesions. Arthroscopic removal provides early return to sports, although a large osteochondral defect is associated with a poor prognosis. Fragment fixation, osteochondral autograft transplantation, and their hybrid technique have provided better results.
UNASSIGNED: Further studies are needed to prevent problematic complications of capitellar OCD, such as osteoarthritis and chondrolysis.

Anterior cruciate ligament (ACL) tears are one of the most common sport-related injuries and occur in greater than 3% of athletes in a four-year window of sports participation. Non-contact injuries are the most common mechanism for ACL injury in elite-level athletes, especially with increased valgus and external rotation of the knee when loading eccentrically in flexion. Because of the immense toll these injuries and their recovery take on athletes especially, optimal treatment has been a subject of great interest for some time. Many ACL reconstruction (ACLR) and repair techniques have been implemented and improved in the last two decades, leading to many surgical options for this type of injury. The surgical approach to high-level athletes in particular requires additional attention that may not be necessary in the general population. Important considerations for optimizing ACL treatment in high-level athletes include choosing repair vs. reconstruction, surgical techniques, choice of auto- or allograft, and associated concomitant procedures including other injuries or reinforcing techniques as well as attention to rehabilitation. Here, we discuss a range of surgical techniques from repair to reconstruction, and compare and contrast various reconstructive and reinforcing techniques as well as associated surgical pearls and pitfalls. Good outcomes for athletes suffering from ACL injury are attainable with proper treatment including the principles discussed herein.

Gallstone-related diseases like cholelithiasis contribute significantly to global morbidity and mortality. Laparoscopic cholecystectomy (LC) is the gold standard for gallbladder removal but is associated with rare but severe complications, including hepatic artery pseudoaneurysms (PAs). A 72-year-old female presented with acute abdominal pain and upper gastrointestinal bleeding following a recent LC. Laboratory studies confirmed anemia with a hemoglobin level of 10 g/dL. Liver function tests were deranged, showing elevated alanine aminotransferase (ALT) at 209 U/L, aspartate aminotransferase (AST) at 472 U/L, total bilirubin levels at 3.29 mg/dL, and direct bilirubin levels at 2.7 mg/dL. A contrast-enhanced computed tomography scan revealed a PA adjacent to the right hepatic artery. Given the strong suspicion of a hepatic PA as the source of her symptoms, an endovascular stent was placed by an interventional radiologist. Post-procedure, the patient showed a favorable clinical course with cessation of symptoms and was discharged after eight days. This case emphasizes the importance of early identification of hepatic artery PAs following LC, a potentially life-threatening complication. It also suggests that endovascular stent placement can be an effective alternative to traditional transarterial embolization for managing these PAs. Additional research is needed to evaluate the long-term effectiveness and safety of these two methods in comparison.

Kidney transplantation offers a longer life expectancy and a better quality of life than dialysis to patients with end-stage kidney disease. Ischemia-reperfusion injury (IRI) is thought to be a cornerstone in delayed or reduced graft function and increases the risk of rejection by triggering the immunogenicity of the organ. IRI is an unavoidable event that happens when the blood supply is temporarily reduced and then restored to an organ. IRI is the result of several biological pathways, such as transcriptional reprogramming, apoptosis and necrosis, innate and adaptive immune responses, and endothelial dysfunction. Tubular cells mostly depend on fatty acid (FA) β-oxidation for energy production since more ATP molecules are yielded per substrate molecule than glucose oxidation. Upon ischemia-reperfusion damage, the innate and adaptive immune system activates to achieve tissue clearance and repair. Several cells, cytokines, enzymes, receptors, and ligands are known to take part in these events. The complement cascade might start even before organ procurement in deceased donors. However, additional experimental and clinical data are required to better understand the pathogenic events that take place during this complex process.