Knees with failed ACLR are associated with more anterior tibial subluxation than those with primary ACL deficiency. Using previously reported thresholds of 6 to 10 mm of lateral compartment subluxation for a positive pivot shift, between 11.1% and 37.5% of knees with failed ACLR may be in a "resting pivoted position." In primary ACL-deficient knees, anterior tibial subluxation is associated with chondral injuries and meniscal tears but not injury chronicity.

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Introduction: Lipoic acid (LA) is an organo-sulfur molecule and known component of aerobic cellular respiration that has strong antioxidant properties. In animal models it has been shown to modulate oxidative stress in ischemia reperfusion. We propose that fat-grafts undergo similar ischemic injury. Untreated fat grafts undergo apoptosis and cell-death during engraftment; leading ultimately to reabsorption. LA also has strong adipocyte specific signaling effects. LA has been shown to improve adipocyte mitochondrial function, insulin sensitivity, and glucose uptake. Thus, LA may modulate two significant pathways for cell death in adipocytes. We hypothesize that LA can reduce the oxidative stressors on fat grafts and improve mitochondrial function during the early engraftment period thereby improving graft survival.