Validation of the Clavien-Dindo classification and Comprehensive Complication Index as measures of morbidity following total hip and knee arthroplasty.

Aims: The Clavien-Dindo (CD) classification and Comprehensive Complication Index (CCI) have been validated primarily among general surgical procedures. To date, the validity of these measures has not been assessed in patients undergoing arthroplasty.

Methods: This retrospective cohort study included patients undergoing primary total hip and knee arthroplasty between April 2013 and December 2019.

Clinical and cost-effectiveness of earlier discharge from acute hospital after total joint arthroplasty.

Background: Reducing length of stay has been proposed as a key component of policies that aim to meet demand and minimize costs associated with total joint arthroplasty. However, few studies explore shifting of healthcare utilization when length of stay is shortened.

Methods: This retrospective cohort study examined patients undergoing primary, total hip and knee arthroplasty for osteoarthritis to simulate a policy-level institutional reduction in acute hospital stay by 1 day.

Willingness to participate in placebo-controlled surgical trials of the knee.

Aims: Surgeon and patient reluctance to participate are potential significant barriers to conducting placebo-controlled trials of orthopaedic surgery. Understanding the preferences of orthopaedic surgeons and patients regarding the design of randomized placebo-controlled trials (RCT-Ps) of knee procedures can help to identify what RCT-P features will lead to the greatest participation. This information could inform future trial designs and feasibility assessments.

Does admission to intensive care post total joint arthroplasty result in poorer outcomes 12-months after surgery?

Background: It is unknown if total joint arthroplasty (TJA) patients admitted to the intensive care unit (ICU) benefit from the surgery. This impedes clinical decision-making, resource allocation and patient informed consent. This study aims to identify whether admission to ICU post-TJA surgery is associated with poorer quality of life, pain and function, compared to those not requiring ICU admission.

Feasibility study of a game-based virtual reality intervention for functional prosthesis use training: A preclinical assessment.

Objective: This paper presents a preclinical feasibility study to investigate the efficacy of a game-based virtual reality (VR) intervention in the functional training of upper-limb prosthesis use.

Methods: The study compared the skill of 2 able-bodied groups (intervention and control, 5 participants in each group) using a surface electromyography controlled self-experience prosthetic hand and wrist through the Box and Blocks Test (BBT). The Intervention Group followed the game-based VR intervention for 4 weeks and underwent real-life (RL) BBT assessments before and after the intervention using the self-experience prosthesis.

Feasibility and barriers to rapid establishment of patient-derived primary osteosarcoma cell lines in clinical management.

Osteosarcoma is a highly aggressive primary bone tumor that has seen little improvement in survival rates in the past three decades. Preclinical studies are conducted on a small pool of commercial cell lines which may not fully reflect the genetic heterogeneity of this complex cancer, potentially hindering translatability of results. Developing a single-site laboratory protocol to rapidly establish patient-derived primary cancer cell lines (PCCL) within a clinically actionable time frame of a few weeks will have significant scientific and clinical ramifications.

Discrete-Target Prosthesis Control Using Uncertainty-Aware Classification for Smooth and Efficient Gross Arm Movement.

Current control approaches for gross prosthetic arm movement mainly regulate movement over a continuous range of target poses. However, these methods suffer from output fluctuation caused by input signal variations during gross arm movements. Prosthesis control approaches with a finite number of discrete target poses can address this issue and reduce the complexity of the pose control process.

Influence of particle parameters on deposition onto healthy and damaged human hair.

Objective: This research investigates how particle parameters, such as zeta potential, size, functional group, material composition, and hydrophobicity affect their affinity and deposition of particles onto hair.

Methods: Streaming potential was used as the technique for analysis. The streaming potential data obtained was then converted to surface coverage data.

Association Between Pharmacologic Treatment of Depression and Patient-Reported Outcomes Following Total Hip and Knee Arthroplasty.

Background: Depression is associated with inferior outcomes following hip or knee arthroplasty, though it remains unclear if this relationship is modifiable. This study examined the association between pharmacologic treatment of depression and patient-reported outcomes.

Methods: This retrospective cohort study of 1,651 total hip arthroplasty (THA) and 1,792 total knee arthroplasty (TKA) procedures between October 2012 and June 2019 used institutional registry data linked to nationwide pharmaceutical claims.

Evidence-Based Physiotherapeutic Interventions Enhancing Hand Dexterity, Activities of Daily Living and Quality of Life of Parkinson's Disease Patients: A Systematic Review.

Objectives: This systematic review primarily aims to identify the optimal physiotherapeutic intervention to improve hand dexterity in Parkinson's Disease (PD) patients. The secondary objectives were to identify the hand dexterity physiotherapeutic interventions available for PD patients, and to determine the quality of these interventions.

Review Methods: Eight electronic databases were systematically searched to identify relevant randomized controlled trial full-text articles using the established search strategy.

Finite element analysis of patient-specific additive-manufactured implants.

Bone tumors, characterized by diverse locations and shapes, often necessitate surgical excision followed by custom implant placement to facilitate targeted bone reconstruction. Leveraging additive manufacturing, patient-specific implants can be precisely tailored with complex geometries and desired stiffness, enhancing their suitability for bone ingrowth. In this work, a finite element model is employed to assess patient-specific lattice implants in femur bones.

Predictive Tool Use and Willingness for Surgery in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.

Importance: Despite the increasing number of tools available to predict the outcomes of total knee arthroplasty (TKA), the effect of these predictive tools on patient decision-making remains uncertain.

Objective: To assess the effect of an online predictive tool on patient-reported willingness to undergo TKA.

Design, Setting, And Participants: This parallel, double-masked, 2-arm randomized clinical trial compared predictive tool use with treatment as usual (TAU).

Influences on clinical trial participation: Enhancing recruitment through a gender lens - A scoping review.

Background: Suboptimal clinical trial recruitment contributes to research waste. Evidence suggests there may be gender-based differences in willingness to participate in clinical research. Identifying gender-based differences impacting the willingness of trial participation may assist trial recruitment.

The impact of infection on length of stay in adult burns: A scoping review.

Background: The disruption to the immune system and profound metabolic response to burn injury gives rise to a unique susceptibility to infection. Indeed, infection is one of the most frequently encountered post-burns complications placing significant burden on patients and healthcare system. Advancements in burn care have led to marked improvements in burn-related mortality and morbidity; however, scarce hospital resources hamper adequate burn-related care, and patient length of stay (LOS) in hospital is an important drain on such resources.

Hybrid peripheral nerve sheath tumours: MRI features with pathological correlation in 24 cases.

Objectives: To describe the MRI features of histologically proven hybrid peripheral nerve sheath tumours (HPNST).

Methods: A retrospective analysis of the MRI features of 24 histologically proven cases of HPNST over 7 years. Demographic data obtained from clinical records included age, gender, and date of diagnosis.

Radiotherapy versus limb-sparing surgery alone in low-grade soft-tissue sarcoma of the extremity and trunk wall: a systematic review and meta-analysis.

Current guidelines recommend the use of radiotherapy in the management of intermediate and high-grade soft-tissue sarcoma of the extremity and trunk wall. Its use in low-grade sarcoma is less clear. To date there have been no pooled data analyses regarding its role in this context.

A Systematic Review of the Quality of Clinical Practice Guidelines for Chronic Limb-Threatening Ischemia.

Background: To assess the quality of clinical practice guidelines (CPGs) for chronic limb-threatening ischemia (CLTI) using the Appraisal of Guidelines for Research and Evaluation II instrument.

Methods: A systematic review of Medline, Embase, and online CPG databases was carried out. Four CPGs on CLTI were identified: Global Vascular Guidelines (GVG), European Society of Cardiology (ESC), American College of Cardiology, and National Institute for Health and Care Excellence guidelines on lower limb peripheral arterial disease.

Feasibility Evaluation of Online Classification-based Control for Gross Movement in a 2-DoF Prosthetic Arm.

Regression and classification models have been extensively studied to exploit the myoelectric and kinematic input information from the residual limb for the control of multiple degree-of-freedom (DoF) powered prostheses. The gross movement control of above-elbow prostheses is mainly based on regression models which map the available inputs to continuous prosthetic poses. However, the regression output is sensitive to the variation in the input signal.

A case of rotenone poisoning from ingesting Derris trifoliata Lour. (Tuba fruit/pod) in Malaysia.

Derris trifoliata is mainly found in mangrove area in tropical regions and the plant extract is traditionally used for fishing by poisoning. This is the first case report of rotenone poisoning in a child from ingesting Derris trifoliata seed. The child developed altered consciousness, vomiting, hypotension, metabolic acidosis, and acute kidney injury.

The long-term impacts of opioid use before and after joint arthroplasty: matched cohort analysis of New Zealand linked register data.

Background: Opioids are commonly used both before and after total joint arthroplasty (TJA).

Objective: The objective of this study was to estimate the long-term effects of pre- and perioperative opioid use in patients undergoing TJA.

Methods: We used linked population datasets to identify all (n =18,666) patients who had a publicly funded TJA in New Zealand between 2011 and 2013.

Patient perspectives of quality of life in chronic limb-threatening ischemia: a qualitative study.

Background: Quality of life (QOL) is an outcome that matters to patients with chronic limb-threatening ischemia (CLTI). However, we identified the lack of and need for a CLTI-specific QOL instrument. Our group is developing this instrument which requires a deep understanding of patient perspectives of QOL in CLTI.

Hybrid CNN-transformer network for interactive learning of challenging musculoskeletal images.

Background And Objectives: Segmentation of regions of interest (ROIs) such as tumors and bones plays an essential role in the analysis of musculoskeletal (MSK) images. Segmentation results can help with orthopaedic surgeons in surgical outcomes assessment and patient's gait cycle simulation. Deep learning-based automatic segmentation methods, particularly those using fully convolutional networks (FCNs), are considered as the state-of-the-art.

Does a consumer co-designed infographic increase knowledge of physical activity after total knee joint replacement? A randomised controlled trial.

Purpose: To determine if a consumer co-designed infographic increased knowledge of physical activity and self-efficacy for exercise after total knee joint replacement surgery.

Methods: Forty-four adults with primary knee joint replacement surgery were recruited from a public and a private hospital in Melbourne, Australia. Participants were randomly allocated to an experimental or control group.