Introduction. Injuries of the ACL are the most common ligamentous injuries of the knee joint, highlighting the importance of tools to easily determine the patients from a risk group. Aims. The aims of this study were: to establish whether the posterior condylar angle (PCA) is a risk factor of ACL injury among 18-30 year-old males and to assess the differences in PCA among patients with isolated ACL injury vs. ACL injury combined with acute MCL, or meniscal injury. Methods and materials. A case group was formed, according to a priori power analysis (α = 0.05, β = 0.95), with 44 patients with an ACL injury and a control group with 44 healthy patients. Then, the case group was subdivided into three subgroups: the MCL and meniscal injured. Two lines were drawn on the axial MRI – the posterior condylar axis and the surgical transepicondylar axis. The PCA was defined as the angle between them. Statistical analyses included U Mann-Whitney, t-student independent-sample tests, linear regression models and correlation analyses. Results. The mean PCA in the control and study group was 1.90° ±1.25° and 1.30° ±2.49°(p = 0.178), respectively. Univariate analyses of PCA in isolated ACL injury vs. ACL injury combined with acute MCL, MM or LM injury had p values of 0.981, 0.814 and 0.813, respectively. Multivariable analysis had p values of 0.744, 0.421 and 0.873, respectively. Intrarater ICCs were 0.931 and 0.928 (excellent reliability) and interrater ICCs was 0.868 (good reliability). Conclusions. PCA is not associated with acute ACL injuries in the studied population. MCL or meniscal injuries did not alter PCA values among patients with an ACL injury.

Aim of the study: To compare the serum levels of IL-12 and IL-23 between healthy volunteers and patients with multiple sclerosis with regard to their cognitive function. Materials and methods: A total of 21 patients with multiple sclerosis and 21 healthy individuals were enrolled into the study. The individuals were age- and sex-matched. Each participant was evaluated using the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), and the Pittsburgh Sleep Quality Index (PSQI). The enzyme-linked immunosorbent assay was performed to assess the serum levels of IL-12 and IL-23. Results: The concentration of IL-12 was 1.61 ± 4.61 pg/mL in the group of patients with multiple sclerosis and 1.78 ± 3.54 pg/mL in the control group, p = 0.5009. The concentration of IL-23 was 19.04 ± 75.50 pg/mL in the study group and 5.50 ± 14.4 pg/mL in the control group, p = 0.5170. A significant difference was found between the control and study groups in the MoCA cognitive test (28 vs. 24 points, respectively, p < 0.0001). There was no significant difference in the Beck Depression Inventory and PSQI between the control and study groups. No significant correlations were found between the IL-12/IL-23 serum levels and psychological evaluations. Conclusions and clinical implications: The results obtained indicate that IL-12 and IL-23 may not play a role in the development of cognitive impairment. The assessment of cognitive impairment in patients with multiple sclerosis may have a screening value in preventing their cognitive deterioration.

Introduction. Medial tibial plateau fracture (MTPF) after medial unicompartmental knee arthroplasty (UKA) is a rare but significant complication. Materials and methods. MEDLINE, ScienceDirect and Cochrane Library databases were searched using specific search terms. The inclusion criteria were articles in English, medial unicompartmental knee arthroplasty intraoperative or stress MTPF, reported patients’ demographics and fracture characteristics, the treatment process, any case with a follow-up for a minimum of 3 months and the reported outcome. The exclusion criteria were lateral tibial plateau fracture, traumatic injury, all cases with a follow-up shorter than 3 months and no reported outcome. Results. From 374 records initially found, 36 were included in the analysis highlighting the characteristics, causes and mechanisms of UKA-related MTPF. As to the treatment outcomes, only 10 studies with a total of 19 cases met our inclusion and exclusion criteria. What was also reported was a case report of a 52-year-old patient diagnosed with MTPF one week after UKA and treated using ORIF with support plate and bone augmentation. At the 8-month follow-up, the patient was complaint-free and received 88 points in the KOOS Score. Conclusions. Several measures were proposed in the literature to minimize the risk of UKA-related MTPF. One of them is appropriate patient selection (BMI, BMD). As to the operative technique, positioning tibial pins too close to the medial tibial cortex and tibial plateau, extending the sagittal and vertical cut, damaging the posterior cortex and using excessive force during hammering should be avoided. In addition, the proper tibial component size and placement (considering the gender, race and knee alignment) is also important. UKA-related MTPF was reported to be managed with either conservative treatment, ORIF or revision to total knee arthroplasty (TKA). While conservative treatment carries a high risk of failure, and the revision to TKA is a massive procedure associated with the removal of all UKA components, ORIF was reported to bring favorable outcomes, being less invasive than revision to TKA.