Predicting periprosthetic joint infection in primary total knee arthroplasty: a machine learning model integrating preoperative and perioperative risk factors.

Background: Periprosthetic joint infection leads to significant morbidity and mortality after total knee arthroplasty. Preoperative and perioperative risk prediction and assessment tools are lacking in Asia. This study developed the first machine learning model for individualized prediction of periprosthetic joint infection following primary total knee arthroplasty in this demographic.

Factors Affecting Successful Restricted Kinematic Alignment With Robotic Assisted Total Knee Arthroplasty in Patients With Severe Varus Preoperative Alignment.

Background: Total knee arthroplasty (TKA) remains challenging in severe varus knees. We evaluated the impact of hip-knee-ankle varus deformity and osteophyte size on achieving restricted kinematic alignment (rKA) in robotic-arm-assisted TKA.

Methods: This retrospective study included 244 knees (194 patients) that underwent robotic-arm-assisted TKA for varus primary knee osteoarthritis at an academic institution.

Current trends of unicompartmental knee arthroplasty (UKA): choosing between robotic-assisted and conventional surgeries and timing of procedures.

Background: With robotic advancements in UKA technology, we sought to explore if robotic-assisted UKA could translate to clinical benefits such as reduced hospital stays and lowered emergency readmissions. Also, current utilization trends of UKA and choice of procedure timing (unilateral [uUKA] vs. one-staged bilateral UKA [biUKA]) could be explored.

Minimally important change on the Columbia Impairment Scale and Strengths and Difficulties Questionnaire in youths seeking mental healthcare.

Background: Evidence-based mental health requires patient-relevant outcome data, but many indicators lack clinical meaning and fail to consider youth perceptions. The minimally important change (MIC) indicator designates change as meaningful to patients, yet is rarely reported in youth mental health trials.

Objective: This study aimed to establish MIC thresholds for two patient-reported outcome measures (PROMs), the Columbia Impairment Scale (CIS) and the Strengths and Difficulties Questionnaire (SDQ), using different estimation methods.

Robotic total knee arthroplasty safely reduces length of stay in an Asian public healthcare system.

Aims: Around the world, the emergence of robotic technology has improved surgical precision and accuracy in total knee arthroplasty (TKA). This territory-wide study compares the results of various robotic TKA (R-TKA) systems with those of conventional TKA (C-TKA) and computer-navigated TKA (N-TKA).

Methods: This is a retrospective study utilizing territory-wide data from the Clinical Data Analysis and Reporting System (CDARS).

The role of navigation services in supporting mental health and addictions care transitions: A qualitative exploration of perspectives from transitional-aged youth, family, and service providers (part 2).

Introduction: Transitional-aged youth (TAY) are at a vulnerable stage of their development in which mental health and/or addiction (MHA) issues tend to manifest and/or increase in severity. These youth also tend to find themselves caught in the gap between child and adult MHA services, often resulting in sub-optimal access to and transition through MHA services. Navigation services may be one way to close this and other system gaps and improve service utilization and supports for TAY.

Experiences of barriers and facilitators in mental health care transitions: A qualitative exploration of perspectives from transitional-aged youth, family, and service providers (part 1).

Introduction: Transitional-aged youth (TAY) are at a vulnerable stage of their development in which mental health and/or addiction (MHA) issues tend to manifest and/or increase in severity. TAY also tend to find themselves subject to multiple care transitions, often resulting in sub-optimal access to MHA services. The objective of this study was to explore the perspectives of TAY, family members, and system providers regarding the supports needed by TAY and their families during transitions through MHA care.

Comparison of the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022.

A substantial proportion of Hong Kong's aging population suffers from osteoarthritis in both knees. Bilateral total knee arthroplasty (BTKA) is a surgical option for addressing this condition and can be performed via two approaches: simultaneous BTKA (SimBTKA) and staged BTKA (StaBTKA). We compared the cost-effectiveness and safety of these two methods in our institution.

Promising short-term outcomes of free-hand burring technique to implant second-generation metaphyseal cone in Asian knees - a case series.

Background: The second-generation metaphyseal cone was useful in managing bone defects in revision knee arthroplasty. However, due to the anatomical constraints in Asian osteometry, the authors utilized a novel free-hand burring technique instead of cannulated reaming for bone preparation. We reported the short-term outcomes of our surgical techniques specific to Asian osteometry.

Reducing edge loading and alignment outliers with image-free robotic-assisted unicompartmental knee arthroplasty: a case controlled study.

Background: Survivorship of medial unicompartmental knee arthroplasty (UKA) is technique-dependent. Correct femoral-tibial component positioning associates with improved survivorship. Image-free robotic-assisted unicompartmental knee arthroplasty enables preoperative and intraoperative planning of alignment and assessment of positioning prior to execution.

Preoperative weight loss interventions before total hip and knee arthroplasty: a systematic review of randomized controlled trials.

Background: The high co-prevalence of obesity and end-stage osteoarthritis requiring arthroplasty, with the former being a risk factor for complications during arthroplasty, has led to increasing interest in employing preoperative weight loss interventions such as bariatric surgery and diet modification. However, the current evidence is conflicting, and this study aimed to investigate the effect of weight loss intervention before arthroplasty in prospective randomized controlled trials.

Methods: Four electronic databases (MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials) were searched for prospective randomized controlled trials that compared weight loss interventions with usual care from inception to October 2023 by following the PRISMA guidelines.

Acetabular component liner exchange with highly crosslinked polyethylene for wear and osteolysis.

Aims: Isolated acetabular liner exchange with a highly crosslinked polyethylene (HXLPE) component is an option to address polyethylene wear and osteolysis following total hip arthroplasty (THA) in the presence of a well-fixed acetabular shell. The liner can be fixed either with the original locking mechanism or by being cemented within the acetabular component. Whether the method used for fixation of the HXLPE liner has any bearing on the long-term outcomes is still unclear.

Exploring Zentangle as a virtual mindfulness-based art intervention for people with serious mental illness.

Introduction: Zentangle is an emerging art intervention that incorporates mindfulness into creative drawing. This pilot study explored Zentangle as a novel adjunct treatment for people with serious mental illness (SMI).

Methods: Six participants with SMI completed an 8-week Zentangle program.

A Health App for Post-Pandemic Years (HAPPY) for people with physiological and psychosocial distress during the post-pandemic era: Protocol for a randomized controlled trial.

Objective: This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress.

Methods: Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase.

Robotic arm-assisted unicondylar knee arthroplasty resulted in superior radiological accuracy: a propensity score-matched analysis.

Introduction: Unicompartmental knee arthroplasty (UKA) is an effective surgical treatment for medial compartment arthritis of the knee, yet surgical outcomes are directly related to surgical execution. Robotic arm-assisted surgery aims to address these difficulties by allowing for detailed preoperative planning, real-time intraoperative assessment and haptic-controlled bone removal. This study aimed to compare the clinical and radiological outcomes between conventional manual mobile bearing and robot arm-assisted fixed bearing medial UKA in our local population.

Prediction of Total Knee Arthroplasty Sizes with Demographics, including Hand and Foot Sizes.

Anticipating implant sizes before total knee arthroplasty (TKA) allows the surgical team to streamline operations and prepare for potential difficulties. This study aims to determine the correlation and derive a regression model for predicting TKA sizes using patient-specific demographics without using radiographs. We reviewed the demographics, including hand and foot sizes, of 1,339 primary TKAs.

The role of telemedicine in joint replacement surgery? An updated review.

The usage of telemedicine and telehealth services has grown tremendously and has become increasingly relevant and essential. Technological advancements in current telehealth services have supported its use as a viable alternative tool to conduct visits for consultations, follow-up, and rehabilitation in total joint arthroplasty. Such technology has been widely implemented, particularly during the coronavirus 2019 (COVID-19) pandemic, to deliver postoperative rehabilitation among patients receiving total joint arthroplasty (TJA), further demonstrating its feasibility with a lower cost yet comparable clinical outcomes when compared with traditional care.

Metal-on-crosslinked polyethylene in total hip arthroplasty - an excellent combination at fifteen to twenty years of follow-up.

Purpose: Cross-linked polyethylene (PE) has been used with great clinical success in total hip arthroplasty (THA) since its debut in the late 1990's. However, reports regarding this bearing couple near the end of its second decade of service are still scant. The aim of this study was to first determine the long term clinical and radiological results and second Investigate what factors affect wear rates using a metal-on-crosslinked PE bearing articulation.

Does knowledge have a half-life? An observational study analyzing the use of older citations in medical and scientific publications.

Objectives: In the process of scientific progress, prior evidence is both relied on and supplanted by new discoveries. We use the term 'knowledge half-life' to refer to the phenomenon in which older knowledge is discounted in favour of newer research. By quantifying the knowledge half-life, we sought to determine whether research published in more recent years is preferentially cited over older research in medical and scientific articles.

Transitions in mental health and addiction care for youth and their families: a scoping review of needs, barriers, and facilitators.

Introduction: Transitional-aged youth (TAY) with mental health and/or addictions (MHA) concerns and their families experience significant challenges finding, accessing, and transitioning through needed MHA care. To develop appropriate supports that assist TAY and their families in navigating MHA care, their experiences of transitions in the MHA care system must be better understood. This scoping review identifies and explores the needs, barriers, and facilitators for TAY and their families when transitioning through MHA care.

Neurexins in serotonergic neurons regulate neuronal survival, serotonin transmission, and complex mouse behaviors.

Extensive serotonin (5-hydroxytryptamine, 5-HT) innervation throughout the brain corroborates 5-HT's modulatory role in numerous cognitive activities. Volume transmission is the major mode for 5-HT transmission but mechanisms underlying 5-HT signaling are still largely unknown. Abnormal brain 5-HT levels and function have been implicated in autism spectrum disorder (ASD).

Editorial: Preventing Relapse in Adolescents With Depression and Anxiety.

Although data from adequately powered, high-quality randomized controlled trials are needed, existing research shows that depression prevention strategies can reduce risk of relapse/recurrence in youth. This includes SSRIs such as fluoxetine (ages 8 years and older) and escitalopram (ages 12 years and older)-the only antidepressants approved for use in the pediatric population by the Food and Drug Administration-and Cognifive-Behavioral Therapy or a combination of the two. Similar studies of relapse prevention are urgently needed in youth with anxiety disorders, as none currently exist.