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Background-This study evaluated a possible relationship between levels of endothelial microparticles (EMPs), known to be a sensitive indicator of endothelial disturbance, and changes in postprandial lipid levels in healthy volunteers after a low-or high-fat meal. Methods and Results-Eighteen healthy subjects without known cardiovascular risk factors were evaluated. Lipid and EMP levels were measured before and 1 and 3 hours after a single low-or high-fat isocaloric meal. The low-fat meal had no significant postprandial effect on EMPs or lipids compared with fasting levels. In contrast, a single high-fat meal significantly increased EMP levels after 1 and 3 hours, from 389Ϯ54 (thousands per milliliter) when fasting to 541Ϯ139 (Pϭ0.0002) and 677Ϯ159 (PϽ0.0001), respectively, and correlated with a postprandial elevation in serum triglycerides. Conclusions-A single high-fat meal led to a significant elevation of plasma EMP levels in healthy, normolipidemic subjects and correlated with a postprandial elevation of serum triglycerides. 4,5 Hypertriglyceridemia has been shown to be an independent risk factor for coronary artery disease, 6,7 and increasing evidence suggests that postprandial hyperlipidemia contributes to the development of atherosclerosis and coronary artery disease. 8 -11 Moreover, several studies have demonstrated that postprandial hypertriglyceridemia can impair endothelial function, suggesting a role for triglycerides in the initiation and progression of atherosclerosis. [12][13][14] In vitro activation or apoptosis of cultured ECs induces the release of endothelial microparticles (EMPs). 15 EMPs in plasma exhibit the same antigenic markers and are detected and counted by flow cytometry, providing information on the degree of endothelial injury 16 -18 and even on the nature of the damage. 15 High levels of EMPs were reported in patients with thrombotic thrombocytopenic purpura, 16 preeclampsia, 17 acute coronary syndromes, 18,21 malignant hypertension, 19 multiple sclerosis, 20 and atherosclerotic plaques, 22 implicating EMPs as a marker of endothelial damage.In this article, we demonstrate a direct correlation between endothelial disturbance, measured by plasma EMP levels, and postprandial changes in serum triglycerides in healthy individuals after a single high-fat meal. No changes in EMP levels or serum lipids were observed after an isocaloric low-fat meal. These results suggest a link between postprandial hyperlipidemia and injury of the blood vessel wall. Methods Study SubjectsWe enrolled a total of 18 (10 male, 8 female; mean age, 26Ϯ3.8 years) healthy normolipidemic volunteers randomly selected from the medical center house staff. Subjects were nonobese, with a mean body mass index of 23Ϯ2.3 kg/m 2 , and normoglycemic, with a mean insulin level of 10Ϯ14 IU/mL. Subjects with dyslipidemia were excluded. The study protocol was approved and performed under the guidelines of our Institutional Review Board. Informed consent was obtained from each individual. Diet ProtocolThe diet protocol cons...

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Background: There has been increasing interest in anterior cruciate ligament (ACL) repair because of theoretical advantages over ACL reconstruction; however, the contemporary literature has failed to provide high-quality evidence to demonstrate these advantages. Purpose: To compare the clinical and functional outcomes of ACL repair versus ACL reconstruction at a minimum follow-up of 2 years. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent ACL repair were propensity matched (based on demographics, time between injury and surgery, knee laxity parameters, presence of meniscal lesions, preoperative activity level, and sport participation), in a 1:1 ratio, to those who underwent ACL reconstruction during the same period. Isokinetic testing was used to evaluate strength deficits at 6 months postoperatively. Knee laxity parameters were evaluated at 12 months. Complications, return to sport, and patient-reported outcome scores were recorded at final follow-up. Results: In total, 75 matched pairs (150 patients) were evaluated. The repair group had significantly better mean hamstring muscle strength at 6 months compared with the reconstruction group (1.7% ± 12.2% vs −10.0% ± 12.8%, respectively; P < .0001). At a mean final follow-up of 30.0 ± 4.8 months, the repair group had a significantly better mean Forgotten Joint Score–12 (FJS-12) score compared with the reconstruction group (82.0 ± 15.1 vs 74.2 ± 21.7, respectively; P = .017). Noninferiority criteria were met for ACL repair, compared with ACL reconstruction, with respect to the subjective International Knee Documentation Committee score (86.8 ± 9.0 vs 86.7 ± 10.1, respectively; P < .0001) and side-to-side anteroposterior laxity difference (1.1 ± 1.4 vs 0.6 ± 1.0 mm, respectively; P < .0001). No significant differences were found for other functional outcomes or the pivot-shift grade. There were no significant differences in the rate of return to the preinjury level of sport (repair group: 74.7%; reconstruction group: 60.0%; P = .078). A significant difference was observed regarding the occurrence of ACL reruptures (repair group: 5.3%; reconstruction group: 0.0%; P = .045). Patients who experienced a failure of ACL repair were significantly younger than those who did not (26.8 vs 40.7 years, respectively; P = .013). There was no significant difference in rupture rates between the repair and reconstruction groups when only patients aged >21 years were considered (2.9% vs 0.0%, respectively; P = .157). The minimal clinically important difference and Patient Acceptable Symptom State (PASS) thresholds were defined for the ACL repair group. A significantly greater proportion of patients in the repair group achieved the PASS for the FJS-12 compared with their counterparts in the reconstruction group (77.3% vs 60.0%, respectively; P = .034). Conclusion: ACL repair was associated with some advantages over ACL reconstruction including superior hamstring muscle strength at 6 months and significantly better FJS-12 scores. However, the failure rate was significantly higher after ACL repair, and younger patients were particularly at risk.