Background:
New biologic strategies are arising to enhance healing and improve the clinical outcome of anterior cruciate ligament (ACL) reconstruction.
Purpose:
To evaluate the efficacy of a new oral nutritional supplement (Progen) that contains hydrolyzed collagen peptides and plasma proteins, a hyaluronic acid–chondroitin sulfate complex, and vitamin C.
Study Design:
Randomized controlled trial; Level of evidence, 2.
Methods:
The study included patients who underwent ACL reconstruction with hamstring autografts using the same fixation method. All patients received the same analgesia and physical therapy (PT) protocol and were randomized to receive either the nutritional supplement (supplemented group) or no additional therapy (control group). Patients were followed up at days 7, 30, 60, and 90. Pain was assessed by use of a visual analog scale (VAS) and by analgesic consumption. Clinical outcome was assessed via International Knee Documentation Committee (IKDC) score and the number of PT sessions. Perceived efficacy and tolerability were rated on a 5-point Likert scale. Graft maturation was assessed by a blinded musculoskeletal radiologist using magnetic resonance imaging. The number of adverse events (AEs) was recorded.
Results:
The intention-to-treat analysis included 72 patients, 36 allocated to the supplemented group and 36 to the control group, with no significant differences regarding demographic and preoperative characteristics. Both groups showed significant improvement in pain and function (measured by VAS and IKDC scores) during the 90-day follow-up period (
P
< .001 for both), without significant differences between groups. The supplemented group had fewer patients that needed analgesics (8.5% vs 50.0%;
P
< .05) and attended fewer PT sessions (38.0 vs 48.4 sessions;
P
< .001) at 90 days and had a higher IKDC score at 60 days (62.5 vs 55.5;
P
= .029) compared with the control group. Patient- and physician-perceived efficacy was considered significantly higher in the supplemented group at 60 and 90 days (
P
< .05). Perceived tolerability of the overall intervention was better in the supplemented group at 30, 60, and 90 days (
P
< .05). Graft maturation showed more advanced degrees (grades 3 and 4) in the supplemented group at 90 days (61.8% vs 38.2%;
P
< .01). No intolerance or AEs associated with the nutritional supplement treatment were reported.
Conclusion:
The combination of the nutritional supplement and PT after ACL reconstruction improved pain, clinical outcome, and graft maturation. Nutritional supplementation showed higher efficacy during the second month of recovery, without causing AEs.
Registration:
NCT03355651 (
...
Ludloff's approach was described for open reduction of congenital dislocation of the hip. We describe the preoperative planning and the surgical procedure for removing an osteochondroma in the lesser trochanter performed by an anteromedial approach. At follow-up, the patient was asymptomatic and had no limitations in his hip motion, with no radiological relapse. This approach can be used without complications, avoiding more aggressive approaches that force to dislocate the hip and lead to sacrifice more soft tissues.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.