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Background: Anterior Cruciate Ligament (ACL) reconstruction is a common surgery in orthopedics. Strategies that could reduce the bleeding during the surgery could be helpful. Here, we aimed to assess the effects of tranexamic acid injection in ACL reconstruction on patient's functions. Methods: This is a clinical trial performed in 2019–2020 in XX on 61 patients with teared ACL who were candidates of surgical reconstruction. Patients were divided into two groups receiving 15 mg/kg of intravenous tranexamic acid and normal saline. Data regarding the following items were collected: amounts of drain discharge, the severity of the swelling, the pain severity in 1, 7 and 14 days after the surgeries and restrictions in joint range of motion (ROM) in 30 and 60 days after the surgeries. Results: We observed significantly lower swelling severities in patients who received tranexamic acid in different measuring times (P = 0.029). These cases also had significantly lower pain severity after 30 days post-operation (P = 0.041). We also observed that patients in the tranexamic acid group had significantly lower ROM restriction than controls (P < 0.001). The total knee scores were similar in both groups (P > 0.05). Conclusion: Administration of intravenous tranexamic acid significantly improved swelling, pain and lower ROM restriction in patients undergoing ACL reconstruction. [ABSTRACT FROM AUTHOR]

Background: It is unclear what role COL1A1 polymorphisms play in anterior cruciate ligament (ACL) injury pathophysiology. The present study investigated the relationship between COL1A1-1997 guanine (G)/thymine (T) (rs1107946) polymorphism and ACL injury. Moreover, the possible effect of this polymorphism on the postoperative outcomes of ACL reconstruction surgery was evaluated. Methods: This prospective case–control study was performed on 200 young professional men with an ACL tear who underwent arthroscopic ACL reconstruction surgery. Moreover, 200 healthy athletes without a history of tendon or ligament injury who were matched with the case group were selected as the control group. DNA was extracted from the leukocytes of participants, and the desired allele was genotyped. Clinical outcomes were collected for the case group before and one year after surgery. Results: The genotype distribution was in accordance with the Hardy–Weinberg principle. In the ACL injury group, the G allele frequency was non-significantly higher than the healthy controls, with an odds ratio [95% CI] of 1.08 [0.79–1.47] (P = 64). We did not find a significant difference between the genotype of individuals—GG, GT, and TT—in the case and control groups (P > 0.05). Clinical outcomes of the ACL tear group were significantly improved in terms of preoperative values. However, none of them were significantly different between the three genotypes (GG, GT, and TT). Conclusion: According to the findings of the present investigation, single-nucleotide polymorphism (SNP) at COL1A1 rs1107946 (G/T) was not a predisposing genetic factor for ACL injury in a young professional male athlete population in the Middle East. Furthermore, patients' responses to treatment were not different between distinct genotypes. Level of evidence III. Highlights: Collagen gene variations seemed to have an association with anterior cruciate ligament (ACL) injury among professional athletes. This study shows no association of a type of COL1A1 polymorphism ACL injury in a young professional male athlete population. Different genotypes of COL1A1 have similar outcomes in ACL reconstruction surgery. [ABSTRACT FROM AUTHOR]

Background: One of the most common fractures in the skeleton happens in the femur. One of the important reasons for this fracture is because it is the longest bone in the body and osteoporosis affect this part a lot. The geometric complexity and anisotropy properties of this bone have received a lot of attention in the orthopedic field. Methods: In this research, a femur designed using 3D printing machine using the middle part of the hip made of polylactic acid–hydroxyapatite (PLA–HA) nanocomposite containing 0, 5, 10, 15, and 25 wt% of ceramic nanoparticle. Three different types of loadings, including centralized loading, full-scale, and partially loaded, were applied to the designed femur bone. The finite element analysis was used to analyze biomechanical components. Results: The results of the analysis showed that it is possible to use the porous scaffold model for replacement in the femur having proper strength and mechanical stability. Stress–strain analysis on femoral implant with biometric HA and PLA after modeling was performed using the finite element method under static conditions in Abaqus software. Conclusion: Three scaffold structures, i.e., mono-, hybrid, and zonal structures, that can be fabricated using current bioprinting techniques are also discussed with respect to scaffold design. [ABSTRACT FROM AUTHOR]

Purpose: High-energy tibial fractures may cause compartment syndrome, which needs fasciotomy. However, in this procedure, close fractures become an open wound and choosing the best type of fixation for this situation has been a problem. We assumed early open reduction and internal fixation (ORIF) instead of late internal fixation or external fixation, or stage-based approach is a better method.Methods: We collected fifty-seven medical records from 2012 to 2017 stored in Alzahra and Kashani University Hospital databases. We selected important information of their medical files, called the submitted phone numbers, and asked them to come to our clinic and examined their leg for any malunion and/or movement restriction postoperatively. We asked about pain and paresthesia in their leg. Twelve cases were excluded.Results: Demographic variables were not significantly different between these two groups. Deep infection, malunion, decreased range of motion in both knee and ankle joints, pain and paresthesia mainly occurred in external fixation group, except malunion (p value = 0.032), other variables were not statistically significant between two groups. More surgeries were performed predominantly for external fixation group (p value < 0.001). External fixation stayed 4.7 days longer at hospital although it was not statistically significant (p value = 0.108).Conclusion: It is better to perform fasciotomy and ORIF simultaneously in one surgery to lower the number of surgeries, days of hospitalization, decrease the risk of deep infection, malunion and movement restriction although its postoperative outcomes were not considerably different from external fixation. We indicate that stage-based approach is accompanied by poor outcomes and lesser satisfaction. [ABSTRACT FROM AUTHOR]