The following two papers show the gradually increasing genetic knowledge base in ACL science, and medicine generally. The first paper is illustrative of the impressive work being done showing that not all connective tissue is created equal. At the extremes, such as Ehlers Danlos syndrome, this has always been appreciated. But scientists are now able to correlate genetically different collagen with differing injury rates. In this study, different haplotypes of the COL5A1 gene were associated with greater or lesser risk of ACL tears. A study group and control group of soccer players was used. As the authors state, this a non-modifiable risk factor physically. However, one might, for example, counsel an athlete with a high risk haplotype to undertake an ACL prevention program given the greater risk. MORE

Oral anticoagulation (OAC) is superior to dual antiplatelet therapy (DAT) in preventing stroke in patients with atrial fibrillation (AF), but DAT is superior to OAC in preventing stent thrombosis and ischemic events after percutaneous coronary intervention (PCI). MORE

Difficulties with harvest of the Semitendinosus (ST) and, if necessary, Gracilis are vexing for many Orthopaedic Surgeons. It is the primary force that drives many surgeons to use allografts despite the fact the results of allografts are clearly substantially inferior to autografts. I used hamstrings from the beginning of my career in 1985 for open ACL reconstruction. I used large incisions and harvest was easy. MORE

There are conflicting data on the comparative safety and effectiveness of bivalirudin compared with unfractionated heparin (UFH) in relation to the planned use of glycoprotein IIb/IIIa inhibitors (GPIs). The issue has been made more unclear with the expansion of antithrombotic therapies available for patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI), which has led to a reduction in planned GPI use. This analysis of the MATRIX trial assessed the efficacy and safety of bivalirudin compared with UFH with or without GPIs in patients with ACS who underwent invasive management. In the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX) trial, 7,213 patients with ACS were randomly assigned to receive either bivalirudin (with GPIs restricted to bailout use) or UFH (with GPIs use left to the discretion of the operator). MORE