Jakub Pobideł

Background. Rupture of the anterior cruciate ligament (ACL) is one of the most common and devastating injuries in sports orthopaedics. Its incidence rate is approximately 68.6 per 100,000 person-years and it represents over 50% of all knee injuries. The risk is exceptionally high among athletic populations, with female athletes facing disproportionately higher injury rates. Given the high and increasing volume of ACL reconstructions performed annually, optimizing surgical strategies is critical for successful athletic recovery. Aim. The aim of this literature review is to compare graft choices in ACL reconstruction to guide the clinical decision-making process in athletic populations. Material and methods. A comprehensive literature search was conducted in the PubMed database for articles published between 2021 and 2026. The search strategy was used to identify relevant clinical studies and reviews published on ACL reconstruction in athletes. Results. The literature indicates that autografts provide superior clinical outcomes compared to allografts. Bone-patellar tendon-bone (BPTB), hamstring tendon (HT). quadriceps tendon (QT), peroneus longus tendon (PLT) autografts should be taken into consideration in the ACL reconstruction surgery. Conclusions. Graft selection in ACL reconstruction cannot be a universal approach and must be highly individualized. Orthopedic surgeons must consider multiple variables including athlete’s specific sport demands, and concomitant injuries.

Background: Urothelial carcinoma (UC) is a significant clinical problem, especially in locally advanced and metastatic stages, where the prognosis remains poor despite advances in immunotherapy. Enfortumab vedotin (EV), an antibody–drug conjugate (ADC) targeting Nectin-4, extends beyond direct cytotoxicity by actively modulating the immunosuppressive tumor microenvironment (TME) in preclinical models, creating a strong rationale for combination strategies. This systematic review aimed to evaluate the clinical efficacy, safety, and hypothesized immune-modulating potential of EV in the treatment of UC, particularly in combination with immunotherapy. Materials and Methods: The review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, and ClinicalTrials.gov databases were searched to identify interventional clinical studies published between 2020 and 2026. Studies evaluating EV used as monotherapy or in combination with immunotherapy in adult patients with UC were analyzed. ORR, PFS, OS, and the incidence of treatment-related adverse events were evaluated. Individual publications originating from the same clinical trial programs were treated as linked records and analyzed collectively. Results: The analysis was primarily based on key clinical trial programs, including EV-103, EV-301, and EV-302, along with their subgroup analyses, follow-up reports, and patient-reported outcomes. EV demonstrated significant clinical efficacy in the treatment of locally advanced UC (laUC). In the EV-301 study, EV therapy significantly prolonged overall survival compared to chemotherapy (12.88 vs. 8.97 months). In the EV-302 study, EV combination therapy with pembrolizumab showed a significant improvement in progression-free survival and overall survival compared to platinum-based chemotherapy. Conclusions: EV represents a significant therapeutic advance not only as a cytotoxic agent but as a potent immune modulator with clinical efficacy that may be enhanced by its biologically hypothesized immunomodulatory mechanisms in mUC. Its clinical development reflects a critical shift from later-line monotherapy toward earlier-line combination strategies designed to target both tumor cells and the microenvironment. Further studies are needed to better define its role in the context of alternative treatment approaches and across different stages of disease.

Introduction and objective: Spinal muscular atrophy (SMA) is an autosomal recessive inherited disease that leads to the atrophy or weakening of skeletal muscles and changes in the brainstem. It is the second most common cause of infant mortality worldwide, with a prevalence ranging from about 1...