ACL reconstruction using 5- or 6-strand hamstring autograft provides graft's diameter bigger than 8 mm.

PURPOSE: The objective of this study was to measure the diameters of 5- and 6-strand hamstring autografts and to evaluate the predictability of their thickness by other body size indices. METHODS: Data were collected from 122 skeletally mature adult patients, who had undergone arthroscopic anterior cruciate ligament reconstruction using only 5- or 6-strand hamstring autografts. The diameters of tibial and femoral ends of the grafts were measured with the precision of 0.5 mm. Multiple linear regression was performed to determine the relationship between autograft's thickness and body size indices. RESULTS: The diameter of the femoral end of the 5-strand graft in male/female patients on average was 8.9/8.3 mm, while the femoral end of the 6-strand graft-9.3/8.5 mm (respectively). In 98.4% of the cases, 5- or 6-strand hamstring autografts were significantly thicker than 8 mm. In 5-strand group, a significant positive correlation was detected between the diameter of autograft's femoral end and patient's height (r = 0.55; p < 0.001), weight (r = 0.60; p < 0.001) and BMI (r = 0.43; p < 0.01). The 6-strand group had statistically significant correlations between the femoral end of the graft and height (r = 0.53; p < 0.001), and femoral end of the graft and weight (r = 0.50; p < 0.001). CONCLUSIONS: Hamstring autografts were significantly thicker than 8 mm. Taller and heavier persons tended to have greater diameters of hamstring autografts; however, to better predict the diameter of autograft, body composition should be studied in relation to autograft's size. Preparation of 5- or 6-strand graft (using all the length of hamstring tendons) provides almost 100% of probability to obtain graft's diameter bigger than 8 mm. LEVEL OF EVIDENCE: Level III.

Clinical characteristics and overuse patterns of medication overuse headache: Retrospective case-series study.

According to Eurolight project's results, frequency of medication overuse headache in Lithuania is similar to other European countries. However, data on the characteristics of the disorder is lacking. OBJECTIVE: The aim was to analyze clinical characteristics and overuse patterns of patients with medication overuse headache. PATIENTS AND METHODS: Retrospective study was conducted in out-patient department of university hospital. 57.0% of the patients were from Vilnius and 43.0% from other cities and districts of Lithuania. Medical histories of patients consulted by headache specialist on private (86.2%) or public basis from 2008 to 2015 were analyzed. Diagnoses prior to 2013 were revised according to ICHD-III beta criteria. Overuse patterns were calculated only for patients with migraine. RESULTS: 87 patients (90.8% female) with mean age of 43.78 years were included in the study and 67 of them had primary diagnosis of migraine. Mean duration of overuse was 4.00 years. Mean headache frequency was 24.11days per month. Triptans more often were overused by younger patients (p=0.049). 41.8% of migraine patients with MOH overused triptans, 38.8% simple, and 38.8% combination-analgesics. 1 (1.5%) patient overused ergotamines, 7.5% were poly-overusers and no pure opioid overuse was found. Among patients with migraine most common overused medications were sumatriptan (38.8%), caffeine containing combination-analgesics (35.8%) and ibuprofen (20.9%). CONCLUSION: Triptans were most commonly overused drugs among patients with migraine. Fairly frequent overuse of combination-analgesics for migraine should raise concern.