BACKGROUND:The aim of this study was to determine whether graft size is associated with recurrent instability and insufficient functional outcomes after ACL reconstruction. MATERIAL AND METHODS:We analyzed 214 consecutive patients with a completed fo...

BACKGROUND:The aim of this study was to evaluate the reconstruction of a torn anterior cruciate ligament (ACL) with 10 mm diameter BPTB (bone-patellar tendon-bone) autograft versus 8 mm HT (hamstring tendon) autografts, to compare the ability to rest...

Background and Objectives: A prominent area of research in adolescent ACL reconstruction (ACLR) involves graft selection, with particular interest in the quadriceps tendon (QT) as an alternative to hamstring tendon (HT) autografts, although comparative studies on muscle strength outcomes and patient satisfaction in adolescents remain limited. This study aims to evaluate the influence of QT and HT autografts on muscle strength and satisfaction outcomes post-ACLR in adolescents. Methods: This prospective study was conducted at the Lithuanian University of Health Sciences, enrolling 68 patients aged 12–17. ACLRs were performed using QT or HT autografts. Muscle strength was assessed using an isokinetic dynamometer (Biodex), while patient satisfaction was evaluated through IKDC, Lysholm, and ACL-RSI surveys preoperatively and 12 months postoperatively. Results: 54 patients (24 QT and 30 HT) completed the study. The data are non-parametric and are presented as median (IQR). Isokinetic measurements indicated that QT harvesting led to significantly lower extension strength compared to HT 6 months (p = 0.019) and 12 months post-op (p < 0.001) but showed better H/Q ratios 6 months (p = 0.019) and 12 months post-op (p < 0.001). There was no significant difference between the QT and HT groups in ACL-RSI and Lysholm scores. IKDC scores were significantly higher in the HT group (p = 0.009). Conclusions: QT autografts provide favorable H/Q ratios, yet they exhibit weaker extension strength and lower satisfaction outcomes compared to HT. These results suggest a need for individualized rehabilitation protocols and further research to optimize ACLR graft selection for adolescents.

Lithuanian University of Health Sciences, Department of Orthopaedics and Traumatology, Kaunas, Lithuania 12 months (25 (46.3%)), (P < 0.001). The examination of possible risk factors for medial meniscus tear revealed, that BMI (overweight) (OR=2.04; 95% CI=1.091-3.814) and time from injury to surgery (weeks) (OR=1.026; 95% CI=1.012-1.04) significantly increased possibility of medial meniscus tear. We found no significant laxity difference between postoperative testings’ (3, 6 and 12 months after surgery) and the three groups, created by the time to surgery. Conclusion. The study revealed a significant difference in the incidence of meniscal tears between patients treated in the early group and in those underwent ACL-R after 12 months, which lead to significantly higher chance (every delayed week increase chance by 1.026 times and overweight (BMI ≥ 25 kg/ m2) increase chance by 2.04 times) of a medial meniscal tear occurring in patients undergoing delayed reconstruction.

Background: Anterior cruciate ligament (ACL) injuries are among the most common and impactful musculoskeletal injuries, particularly in athletic populations. A variety of biological and synthetic grafts are used in surgical reconstruction, each offering different biomechanical properties and long-term outcomes.Materials and Methods: This narrative review analyzed 42 original clinical studies published between 1989 and 2024. Articles were retrieved from PubMed and Google Scholar by using terms such as ‘ACL reconstruction’, ‘BPTB’, ‘hamstring tendon’, ‘quadriceps tendon’, ‘LARS’, ‘Leeds-Keio’, and ‘GORE-TEX’. Key outcomes included graft failure rates, postoperative knee stability (e.g., KT-1000, Lachman test), and functional outcomes (Lysholm, Tegner, IKDC). Numerical data were pooled descriptively; no formal meta-analysis was performed.Results: Biological grafts, particularly BPTB and quadriceps tendon autografts, demonstrated the lowest failure rates (as low as 1.2%) and superior mechanical stability (>95% achieving Grade 0–1 laxity) compared to synthetic options. Hamstring tendon autografts were slightly less durable but still reliable. Synthetic grafts, and especially GORE-TEX and Leeds-Keio, were associated with higher failure rates (up to 33%) and complications related to poor biological integration.Conclusions: BPTB and QT autografts remain the most reliable options for ACL reconstruction, offering excellent long-term outcomes. While synthetic grafts may be appropriate in select patients, they carry a higher risk of failure and complications. Graft selection should be individualized based on the patient activity level, anatomical considerations, and tolerance for donor-site morbidity.

Background and Objectives: Benzodiazepines (BZDs) are among the most widely prescribed psychotropic drugs globally, and Lithuania is no exception. People with osteoarthritis (OA) often experience chronic pain before arthroplasty, which can cause insomnia, anxiety, and mood disturbances, sometimes leading to BZDs or Z drug prescriptions. The use of these medications, particularly over the long term, may adversely affect cognitive function and increase the risk of falls. Cognitive and psychomotor impairments may hinder rehabilitation, delay mobilization, and reduce quality of life after elective arthroplasty. The aim of this study was to evaluate the prevalence of psychotropic drugs among Lithuanian elderly patients undergoing elective arthroplasty. Materials and Methods: The study, approved by the Regional Bioethics Committee (No. BE-2-53), was conducted at the Department of Anesthesiology, Hospital of the Lithuanian University of Health Sciences Kaunas Clinics. Data on psychotropic medication use, underlying conditions, and treatment duration were obtained from the Hospital’s Information System. Participants were adults aged ≥65 years scheduled for elective arthroplasty with ASA physical status I–III. Data were presented as frequencies (n) and percentages (%). Results: A total of 362 participants were enrolled, of whom 223 (61.6%) used psychotropic medications. Most (63.2%) took BZDs, mainly bromazepam (29.1%) and alprazolam (27.4%). The leading indication was sleep disorders (38.1%), most often treated with alprazolam (34%), followed by anxiety disorders (20.2%), typically managed with bromazepam (24.8%). 99% of participants had been receiving BZDs for more than four weeks. Conclusions: Over half of Lithuanian OA patients undergoing elective arthroplasty used BZDs, underscoring the need for cautious, evidence-based prescribing – particularly in older adults. Regular medication reviews, adherence to national and EU guidelines, and greater use of non-pharmacological therapies are advised. Future research should examine drivers of chronic BZDs use and evaluate deprescribing and alternative treatments for safer, more sustainable care.