ACL reconstruction significantly improves clinical results and stability of the knee. Difference in Lysholm score and stability between groups was not significant. Neither group showed higher tendency to graft failure within two years. Graft choice for reconstruction in female patients should be surgeon specific and individualised, as both grafts studied achieved comparable results.

Cyclosporine induces hypertension and widespread vasoconstriction after transplantation in addition to reducing kidney function. We studied hemodynamic, renal, and hormonal effects of monotherapy with nifedipine XL (n=37) in liver transplant recipients within a year after transplant (median, 4.4 months). Systemic hemodynamics were determined with thoracic electrical bioimpedance. Blood pressure before therapy was 172±4/108±2 mm Hg. Sixty-four percent of recipients achieved blood pressures less than 140/90 mm Hg mediated by a fall in systemic vascular resistance index (2427±245 dyne • s • cm" 5 • m" J in responders versus 2905 ±281 in nonresponders, P<.01). Despite the fall in systemic vascular resistance, glomerular filtration rates were not changed during nifedipine therapy, as measured by both creatinine and iothalamate clearances. Urinary prostacyclin (6-ketoprostaglandin F la ) was suppressed below normal from 2468±323 ng/d before transplant to 1103±99 ng/d (P<.01) after transplant and did not change during nifedipine therapy. Urinary thromboxane Bj and plasma renin activity also fell after transplant and remained low during nifedipine. These data demonstrate that nifedipine can reverse systemic vasoconstriction associated with hypertension after transplantation. Systemic effects were not transmitted to the kidney sufficiently to improve glomerular filtration rate or reverse hormonal changes within the kidney. Hence, vascular and functional regulation of the kidney was dissociated from the systemic circulation during nifedipine administration after transplantation. 1 The mechanisms underlying this disorder remain uncertain, although it is characterized by widespread vasoconstriction affecting systemic and regional vessels, including the kidney. The effects of antihypertensive medications on vascular regulation and kidney function after transplantation have not been clearly established. With the use of CSA, glomerular filtration is universally reduced after transplant. Studies in renal transplant recipients indicate that CSA produces intense renal vasoconstriction and loss of glomerular filtration rate (GFR) after each dose, which is associated with elevated urinary endothelin excretion. Calcium channel blocking agents, particularly dihydropyridines, ameliorate experimental nephrotoxicity from CSA 7 and prevent renal vasoconstriction. 8 They may improve GFR in some clinical settings, but this has not been widely examined in conditions other than renal transplantation.Previous results demonstrate that renal vasoconstriction after liver transplant in humans, unlike the rat, is associated with reduced vasodilating prostaglandins (prostacyclin). The relative ratio of thromboxane to From the Departments of Medicine and Transplantation Surgery, Mayo Clinic, Rochester, Minn.Correspondence to Stephen C. Textor, MD, Hypertension and Internal Medicine, Desk W9A, Mayo Clinic, Rochester, MN 55905.prostacyclin favors vasoconstriction. 6 We elected to examine monotherapy with nifedipine XL because of its capacity...

The present article introduces a novel method of characterizing the macromechanical cartilage properties based on dynamic testing. The proposed approach of instrumented impact testing shows the possibility of more detailed investigation of the acting dynamic forces and corresponding deformations within the wide range of strain rates and loads, including the unloading part of stress-strain curves and hysteresis loops. The presented results of the unconfined compression testing of both the native joint cartilage tissues and potential substitute materials outlined the opportunity to measure the dissipation energy and thus to identify the initial mechanical deterioration symptoms and to introduce a better definition of material damage. Based on the analysis of measured specimen deformation, the intact and pathologically changed cartilage tissue can be distinguished and the differences revealed.

The results of the study affirm the relevance of hip preserving surgery, especially in younger-aged groups.

Only ∆E correlated with the condition of the cartilage--the value increased with decreasing quality-and is the most suitable characteristic. This change appears substantial in initial stages of cartilage deterioration.