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Accumulating evidence suggests obesity and its complication are linked to gut microbiota and probiotics can affect the metabolic functions of humans. The goal of this study was to systematically review the effect of probiotic and synbiotic formulations on body mass index (BMI), total body fat, waist circumstance (WC), Waist–hip ratio (WHR), and adiponectin in overweight and obese Participants in randomized trials (RCTs). A comprehensive search performed in PubMed/MEDLINE, Cochrane and SCOPUS by two researchers, independently without language or release date restrictions up to 15th October 2019. PRISMA guidelines followed to perform this meta-analysis. The inclusion criteria were: 1) RCT design, 2) intervention by pro or synbiotic, 3) Anthropometrics and/or adiponectin levels as outcome. DerSimonian and Laird random effect model used to combine results of included studies. Thirty-two studies contained 2105 participants (n = 28–200) were analyzed in this meta-analysis. Average length of intervention in included studies was 10.18 weeks and ranged from 3 to 12 weeks. Combined results showed significant reduction in BMI (WMD: −0.25 kg/m2; 95% CI −0.33, −0.17; I2 = 96%), total body fat (WMD: −0.75%; 95% CI −0.90, −0.61; I2 = 63%), WC (WMD: −0.99 cm; 95% CI −1.33, −0.66; I2 = 92%), and WHR (WMD: −0.01; 95% CI −0.02, 0.01; I2 = 15%) in probiotic group compared to placebo. There was no significant effect on adiponectin levels by probiotic intervention (WMD: −0.01 μg/ml; 95% CI −0.33, 0.32; I2 = 90%). Furthermore, meta-regression showed significant relation between duration of intervention and reduction of BMI (coef = −0.1533, p

Arthroscopic treatment of osteochondral defects is well established but has had mixed results in larger lesions and revision operations. Particulated allograft cartilage transfer may provide an arthroscopic option for lesions that would otherwise have been treated through open approaches or osteotomies. The procedure is performed under noninvasive distraction with standard arthroscopic portals.

Adequate reduction of posterior malleolar fractures leads to better outcomes. Arthroscopic reduction and internal fixation presents an opportunity for excellent reduction with a minimally invasive approach. Herein, we present a technique with some discussion on outcomes.

Subtle syndesmotic instability not evident on radiography can result in chronic ankle pain. The diagnosis is uncommon, and arthroscopic evaluation remains the gold standard for diagnosis. Definitive surgical management can be performed at the time of diagnosis. Patients with 2 to 4 mm of diastasis of the syndesmosis or translation can be treated with debridement alone, and patients with 4 mm or more of diastasis or translation can be treated with arthroscopic debridement and reduction followed by percutaneous stabilization. Percutaneous stabilization is accomplished by a TightRope technique, which involves passing 1 or 2 suture buttons through all 4 cortices of the distal tibia and fibula. This technique is used in lieu of the traditional syndesmotic screw, which requires a subsequent operation for removal.