Utilizing 3d-printed patient-specific porous titanium cones in complex primary and revision total knee arthroplasty.

Introduction: Effective management of bone defects is crucial in revision total knee arthroplasty (rTKA) to ensure implant stability in low-density bone environments, especially following prosthesis removal. While various reinforcement techniques exist, such as allografts, augments, metal cones, sleeves, or combinations thereof, metal cones are increasingly favored for their ability to reconstruct significant bone defects. A prominent challenge with off-the-shelf (OTS) cones is their unsuitability for Asian and specifically Iranian anatomies due to mismatched sizes and smaller medullary canals.

The Impact of Cementing Techniques on Implant Longevity in Relation to Keel Length in Persona and NexGen Knee Arthroplasty: A Comprehensive Study.

Background: The aim of this study was to investigate the efficacy of our modified cementing technique in reducing the rate of aseptic tibial loosening focusing on its relationship with keel length.

Methods: Every participant who underwent primary total knee arthroplasty (TKA) between August 2014 and September 2022 with a minimum of 4-year follow-up using 1 of 3 implants were included: Persona + conventional cementing technique; Persona + modified cementing technique; and NexGen LPS-Flex. The modifications applied include better preparation of the bone surfaces and the cancellous bone cavities, pressurizing the cement and interstitial fluid suction at the same time, applying a layer of cement on the surfaces of the tibia and implant, and immobilizing the limb.

TAK-242 (Resatorvid) inhibits proinflammatory cytokine production through the inhibition of NF-κB signaling pathway in fibroblast-like synoviocytes in osteoarthritis patients.

Background: Fibroblast-like synoviocytes (FLSs) are involved in osteoarthritis (OA) pathogenesis through pro-inflammatory cytokine production. TAK-242, a TLR4 blocker, has been found to have a significant impact on the gene expression profile of pro-inflammatory cytokines such as IL1-β, IL-6, TNF-α, and TLR4, as well as the phosphorylation of Ikβα, a regulator of the NF-κB signaling pathway, in OA-FLSs. This study aims to investigate this effect because TLR4 plays a crucial role in inflammatory responses.

Subtrochanteric fracture of the femur following knee replacement surgery: A case series and review of the literature.

Introduction And Importance: Knee arthroplasties as an effective intervention is primarily performed in patients with primary osteoarthritis and rheumatoid arthritis. Risk of hip fracture may be either decreased or increased in patients with Knee arthroplasties. There is conflicting evidence in this regard.

Ipsilateral Concurrent Knee Arthroplasty and Tibial Osteotomy with 3D-Printed Patient-Specific Instrumentation: A Case Report.

Case: A 70-year-old woman presented with knee pain and instability and was diagnosed with advanced knee osteoarthritis and bifocal tibial deformities. The complexity of the case challenged our team to perform a significant sagittal correction (>60°) and restore her ability to walk independently. We performed ipsilateral total knee arthroplasty and anterior closed wedge tibial osteotomy using virtual planning and 3D-printed patient-specific instrumentation.

Management of tibial nonunion and osteoarthritis using a 3D-printed titanium cone: A case report.

The use of customized 3D-printed structures has been gaining popularity in non-union management, as it allows for bypassing the defect while promoting osseointegration. Additionally, porous titanium implants minimize stress shielding due to their stiffness and elastic modulus being closer to that of bone. The interconnected channels increase the surface area and provide space for cell adhesion and proliferation.

Overview of posterior knee arthroscopy in the medial meniscal repair: Technical note.

Preservation of the meniscus in bucket handle medial meniscal tears (BHMMTs) and posterior meniscocapsular (ramp) lesions is challenging. Current efforts are being made in the scientific community to (1) introduce new ways of gaining easier and better field of view over the repair site and (2) increase the chance of meniscal healing through effective augmentation procedures. The current note introduces a way to achieve good exposure of posterior knee compartments and proposes an augmentation technique that involves exposing the local non-articulating subchondral cancellous bone and making in situ clots.

The functional impact of home-based self-rehabilitation following arthroscopic meniscus root repair.

Background: Corona virus infectious pandemic makes outdoors rehabilitation a potential hazard. Patient education to perform simple home-based exercises seems to be an interesting and sometimes a mandatory option. This study provides a comparison between the conventional and home-based virtual rehabilitation after surgical repair of medial meniscus root tears.

Practical approach to the native distal femur fractures in the elderly: A rapid review over the recent trends.

Significant work has been done in recent years on treatment strategies for distal femur fractures. Inclusive reviews on periprosthetic fractures of distal femur have been carried out recently, but there is a lack of such reviews on the subject of native distal femur fractures in the recent literature. In this narrative review, we are set out to address the latest updates on geriatric non-periprosthetic distal femur fractures, and perform a rapid review over different treatment options, arriving at a summarized proposed treatment algorithm.

Transformation of fibroblast-like synoviocytes in rheumatoid arthritis; from a friend to foe.

Swelling and the progressive destruction of articular cartilage are major characteristics of rheumatoid arthritis (RA), a systemic autoimmune disease that directly affects the synovial joints and often causes severe disability in the affected positions. Recent studies have shown that type B synoviocytes, which are also called fibroblast-like synoviocytes (FLSs), as the most commonly and chiefly resident cells, play a crucial role in early-onset and disease progression by producing various mediators. During the pathogenesis of RA, the FLSs' phenotype is altered, and represent invasive behavior similar to that observed in tumor conditions.

Sonography: a sensitive and specific method for detecting trochlear cartilage pathologies.

Purpose: MRI is now the modality of choice for evaluating articular cartilage. Nevertheless, it has some general drawbacks. Some patients cannot undergo MRI, and in others US scan could be the first examination and cartilage should be evaluated.

Liver transplant listing for hepatitis C-associated cirrhosis and hepatocellular carcinoma has fallen in the United Kingdom since the introduction of direct-acting antiviral therapy.

Following the introduction of direct-acting antivirals (DAA), there have been reports of declining incidence of hepatitis C (HCV)-related liver disease as a liver transplantation indication. In this study, we assessed the impact of DAA on liver transplant indications in the UK and waiting list outcomes for patients with HCV. We assessed UK adult elective liver transplant registrants between 2006 and 2017.

Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature.

A rare and devastating complication following anterior cruciate ligament (ACL) revision reconstruction is femoral fracture. A 35-year old male soccer player with a history of ACL tear from one year ago, who underwent arthroscopic ACL reconstruction and functioned well until another similar injury caused ACL re-rupture. Revision of ACL reconstruction was performed and after failure of graft tension during the pumping, a fluoroscopic assessment showed a femoral condyle fracture.

The bronze kidney: membranous glomerulonephritis associated with iron overload.

A 55-year-old man with a history of diabetes mellitus, hypertension and hypercholesterolaemia developed increasing peripheral oedema over the course of several months. He was found to have nephrotic range proteinuria (15.7 g/24 h).

Evidence-based status of osteochondral cylinder transfer techniques: a systematic review of level I and II studies.

Purpose: Our purpose was to examine the Level I and II evidence for the use of osteochondral cylinder transfer technique (OCT) for cartilage repair.

Methods: A literature search was carried out for Level I and II evidence studies on cartilage repair using the PubMed database. All the studies that involved OCT were identified.

Are we setting about improving the safety of computerised prescribing in the right way? A workshop report.

Background: Prescribing errors are common and costly. Technology should enable safer prescribing. The two main current methods of doing so are computer initiated clinical support software (CDSS) and the user initiated information retrieval (IR) systems.