Advancements and Strategies in Robotic Planning for Knee Arthroplasty in Patients with Minor Deformities.

Knee arthroplasty, commonly performed to treat osteoarthritis, necessitates precise surgical techniques for optimal outcomes. The introduction of systems such as the Persona Knee System (Zimmer Biomet, Warsaw, IN, USA) has revolutionized knee arthroplasty, promising enhanced precision and better patient outcomes. This study investigates the application of robotic planning specifically in knee prosthetic surgeries, with a focus on Persona Knee System prostheses.

The use of an imageless robotic system in revision of unicompartmental knee arthroplasty.

Purpose: The application of robotics in revision arthroplasty particularly from unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA), is underexplored. The purpose of this study is to describe the surgical technique of an imageless robotic system used in the revision of UKA to TKA and to evaluate short- to mid-term outcomes.

Methods: This prospective study includes 35 patients treated from May 2020 to July 2023.

Metal-backed versus all-poly tibia in the original cartier unicompartmental knee arthroplasty: outcomes and survivorship at long-term follow-up.

Purpose: Unicompartmental knee arthroplasty (UKA) is a viable option for localized osteoarthritis (OA) or avascular osteonecrosis with several advantages over total knee arthroplasty (TKA). UKA implants may feature a tibial component either all-polyethylene (AP) or metal-backed (MB). This study aims to retrospectively compare the clinical outcomes and survivorship of 74 UKAs over 16 years, focusing on comparing the results and survivorship of MB versus AP tibial tray.

Fractures around the knee in elderly patients: Balancing fixation and arthroplasty approaches, a multicenter experience.

Introduction: In recent years, a discernible shift has occurred in the approach to knee pathologies, specifically in the management of acute fractures. Traditionally, fractures were primarily treated through osteosynthesis, whereas prosthesis replacement was primarily reserved for degenerative issues. Outcomes of this investigation aim to elucidate the potential indications and contraindications for the use of prosthetic interventions in the management of such fractures and to propose a scoring system that can be adopted for the choice between the two different approaches.

Trochleoplasty and à-la-carte procedures for patellar instability in young and active patients: Clinical outcomes at minimum 2 Years follow-up.

Introduction: Patellar instability is a common condition affecting approximately 6 individuals per 100,000, but among adolescents, this incidence is notably higher. Trochlear dysplasia has been recognized as the pathoanatomic risk factor exerting the most significant biomechanical influence. Over time, various surgical techniques have been developed to address trochlear dysplasia.

Bilateral Total Knee Arthroplasty (TKA) in a One-Stage Procedure Versus Two-Stage Procedure: A Retrospective Study.

This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA.

Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFire System within a Time-Dependent and Bacterium-Dependent Protocol: Review and Prosthesis-Saving Protocol.

Despite ongoing efforts to enhance diagnostic and treatment processes, the success rate for eradicating infections, particularly prosthetic joint infections (PJIs), currently stands at around 50%. For acute infections occurring shortly after arthroplasty, guidelines recommend a treatment known as DAIR (debridement, antibiotics, and implant retention). This approach is suggested for infections within 30 days post-arthroplasty or with less than 3 weeks of symptoms, provided that there is a stable implant and adequate soft-tissue mass.

Managing Surgical Risks in Hemophilic Elbow Arthropathy: An In-Depth Case Study and Literature Review.

This study presents a detailed case analysis of a 40-year-old male patient with hemophilia A and severe chronic elbow arthropathy, exploring the surgical challenges and outcomes within the context of the current literature. The patient, with a history of multiple comorbidities including Hodgkin's lymphoma and cardiomyopathy, exhibited significant joint damage and functional impairment. A comprehensive approach was employed, collecting all relevant clinical data, including radiographic and MRI findings, to inform treatment decisions.

Impact of a Novel Antiseptic Lavage Solution on Acute Periprosthetic Joint Infection in Hip and Knee Arthroplasty.

Periprosthetic joint infection (PJI) represents a challenge following hip or knee arthroplasty, demanding immediate intervention to prevent implant failure and systemic issues. Bacterial biofilm development on orthopedic devices worsens PJI severity, resulting in recurrent hospitalizations and significant economic burdens. The objective of this retrospective cohort study is to evaluate the efficacy of this novel antiseptic solution, never previously evaluated in vivo, in managing early post-operative or acute hematogenous PJI following primary hip and knee joint replacements.

A morphometric medial compartment-specific unicompartmental knee system: 5 years follow up results from a pilot center.

Background: Unicompartmental Knee Arthroplasty (UKA) is a valuable solution for the treatment of medial osteoarthritis of the knee. New implants feature designs for the elective substitution of a specific compartment. Aim of this study was to assess the survivorship and functional outcomes at minimum 4 years of the first 60 implanted patients in a pilot center of a new medial UKA as the evolution of a well performing long lasting fixed bearing implant.

Angle-Adjustable Dynamic Hip Screw Plate for Unstable Trochanteric Fractures in Middle-Aged Patients: Mid-Term Outcomes and Return to Sport.

Background: There are conflicting results in the literature regarding the superiority of proximal femoral nails over dynamic hip screw (DHS) plates. The primary aim of this study is to evaluate mid-term post-injury patient-reported outcome measures (PROMs) and return to sport (RTS) in middle-aged patients treated with the DHS plate for unstable trochanteric fractures.

Methods: Fifty-seven middle-aged patients (35-64 years) treated for proximal femoral fractures of type 31-A2 and 31-A3 according to the AO/OTA classification with the DMS Dynamic Martin Screw (KLS Martin Group, Jacksonville, FL, USA) between January 2017 and December 2019 were enrolled.

Problems and Opportunities of a Smartphone-Based Care Management Platform: Application of the Wald Principles to a Survey-Based Analysis of Patients' Perception in a Pilot Center.

(1) Background: Mobile health (mHealth) solutions can become a means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. The aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to provide personalized surgical experiences to qualified patients, along with the associated problems and opportunities. (2) Methods: A survey-based analysis was conducted on patients who were prescribed the use of a specific care management platform and underwent primary robotic total knee arthroplasty (rTKA) between January 2021 and February 2023.

The use of a modern robotic system for the treatment of severe knee deformities.

Background: Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants.

Objective: The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant.

Methods: Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled.

Lateral UKA can be a safe solution in a young patients' population: a 10-year follow-up report.

Background: This study aimed to assess the long-term survivorship and functional outcomes of fixed-bearing lateral unicompartmental knee arthroplasty (UKA) in a young patients' population with osteoarthritis limited to the lateral compartment.

Methods: The study included a cohort of consecutive patients who underwent lateral UKA between January 2008 and December 2014 at a single high-volume surgical center. The surgical procedures were performed by experienced surgeons using a lateral parapatellar approach and fixed-bearing implants.

Collecting Physicians' Preferences on Medical Devices: Are We Doing It Right? Evidence from Italian Orthopedists Using 2 Different Stated Preference Methods.

Objectives: Physician preference items (PPIs) are high-cost medical devices for which clinicians express firm preferences with respect to a particular manufacturer or product. This study aims to identify the most important factors in the choice of new PPIs (hip or knee prosthesis) and infer about the existence of possible response biases in using 2 alternative stated preference techniques.

Methods: Six key attributes with 3 levels each were identified based on a literature review and clinical experts' opinions.

Increased accuracy in component positioning using an image-less robotic arm system in primary total knee arthroplasty: a retrospective study.

Background: Robotic-assisted total knee arthroplasty (RTKA) and navigated total knee arthroplasty (NTKA) have shown improved knee alignment and reduced radiographic outliers. Recent studies have proven that conventional mechanical alignment may not be the optimal goal for every patient. The aim of this study was to compare the accuracy of the planned implant positioning of a novel image-less robotic technique with an established navigated technique (NTKA).

PCL preservation or sacrifice does not influence clinical outcomes and survivorship at mid-term follow-up of a J-curve CR total knee replacement with a medial congruent liner and a functional coronal alignment.

Background: In recent years, increasing interest has arisen for medial pivoting TKA implants, designed to mimic the physiological knee kinematics, maximizing the contact area on the medial compartment of the knee, increasing anterior-posterior stability, and contributing to a ball-in-socket effect that allows the posterior cruciate sacrifice without a post-CAM mechanism. The medial congruent liner works with a J-curve cruciate-retaining (CR) femur without a real ball-in-socket design. The aim of this study was to evaluate the clinical outcomes and survival of these implants, with or without PCL sparing, at a medium follow-up.

Uncemented hemiarthroplasty may have a role in the treatment of unstable intertrochanteric fractures in elderly patient. A survival complications and functional outcomes analysis.

Background: Fractures of the proximal femur account for 30% of all fractures requiring surgical treatment. The optimal treatment for per- and intertrochanteric fractures, particularly associated with trochanter instability, is still open to debate. For these reasons, some authors have recently supported the use of bipolar arthroplasty or hemiarthroplasty as a treatment capable of reducing the risk of complications and obtaining a better functional result.

Do age, gender, and region affect tibial slope? A multi-center study.

Introduction: Tibial slope is a parameter that is important to recognize in knee kinematics and knee surgery. A very wide range of values governing posterior tibial slope exist in the literature. This study is based on the hypothesis that age, gender and region may have an effect on the tibial slope.

Introduction of innovations in joint arthroplasty: Recommendations from the 'EFORT implant and patient safety initiative'.

With the implementation of the new MDR 2017/745 by the European Parliament, more robust clinical and pre-clinical data will be required due to a more stringent approval process. The EFORT Implant and Patient Safety Initiative WG1 'Introduction of Innovation', combined knowledge of orthopaedic surgeons, research institutes, orthopaedic device manufacturers, patient representatives and regulatory authorities to develop a comprehensive set of recommendations for the introduction of innovations in joint arthroplasty within the boundaries of MDR 2017/745. Recommendations have been developed to address key questions about pre-clinical and clinical requirements for the introduction of new implants and implant-related instrumentation with the participation of a steering group, invited by the EFORT Board in dialogue with representatives from European National Societies and Speciality Societies.

Individualized alignment and ligament balancing technique with the ROSA® robotic system for total knee arthroplasty.

Purpose: Higher patient's expectations and dissatisfaction following total knee arthroplasty are well-documented phenomena. Despite the implications of different patients' related factors both modifiable and nonmodifiable, in the last decade a lot of emphasis has been focused on surgical technique, implant alignment and stability both as a cause and a potential solution of several problems.

Methods: Different alignment and balancing techniques have been recently described and the introduction of new technologies such as computer and robotic-assisted surgery have been the basis for their optimization.