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Hamstring strength asymmetry is common at 3 years after ACLR with a hamstring tendon autograft and affects involved knee mechanics during gait and jogging. Additional research is warranted to further investigate the longitudinal effect of these alterations on knee function and joint health after ACLR.

A simple quantitative test is described for measuring the duration of post-traumatic amnesia. It was used in a study of 336 patients with closed head injury; and the results matched closely the independent estimates of experienced neurosurgeons. A systematic procedure of this kind is clinically useful in its sensitivity to fluctuations or deterioration in the patient's mental state. It could also be used with advantage in multi-centre research by providing a standard criterion for the assessment of post-traumatic amnesia.

Introduction: Current guidelines suggest a multimodal approach to treating scars but there is no gold standard for treatment; however, there is exciting therapeutic potential for the use of autologous fat grafting (AFG). Functional and aesthetic improvements have been reported, including pain relief and scar quality improvement.Aims:To explore the current evidence regarding the use of AFG in hypertrophic and painful scars.Methods:A systematic review of the literature was conducted using 11 MeSH terms in PubMed, Medline and EMBASE. English studies that used AFG to treat scars in human participants were included.Results: A total of 746 studies were found and 23 studies (from 2008 to 2016) were included: five studies were evidence level V; nine studies were evidence level IV; eight were evidence level III; and one study was evidence level II. A total of 1158 patients were assessed for improvement in scar characteristics including colour, thickness, volume, pain and restoration of function at affected sites, following treatment. Positive outcomes were noted for all parameters and a significant improvement in AFG’s analgesic effect was recorded in 567 out of 966 patients, P < 0.05.Discussion: AFG is a minimally invasive and safe approach to treating scars, a promising alternative to surgical excision. The technique of blunt cannula insertion optimises the release of scar retraction, which contributes to the analgesic effect of this treatment method. The evidence supports current theories of mesenchymal stem cell’s regenerative and anti-inflammatory properties responsible for scar healing. There are limited high quality studies to support its use and future randomised controlled trials should be conducted.

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