Patients undergoing robotic arm-assisted total knee arthroplasty have a greater improvement in knee-specific pain but not in function.

Aims: The aim was to assess whether robotic-assisted total knee arthroplasty (rTKA) had greater knee-specific outcomes, improved fulfilment of expectations, health-related quality of life (HRQoL), and patient satisfaction when compared with manual TKA (mTKA).

Methods: A randomized controlled trial was undertaken (May 2019 to December 2021), and patients were allocated to either mTKA or rTKA. A total of 100 patients were randomized, 50 to each group, of whom 43 rTKA and 38 mTKA patients were available for review at 12 months following surgery.

Identifying subgroups of patients that may benefit from robotic arm-assisted total knee arthroplasty: Secondary analysis of data from a randomised controlled trial.

Background: The aims were to assess whether a specific subgroup(s) of patients had a clinically significant benefit in their knee specific outcome or health-related quality of life (HRQoL) when undergoing robotic total knee arthroplasty (rTKA) when compared to manually performed TKA (mTKA).

Methods: One hundred patients were randomised to either rTKA or mTKA, 50 to each group, of which 46 and 41 were available for functional review at 6-months, respectively. Subgroup analysis was undertaken for sex, age (<67-years versus ≥ 67-years), preoperative WOMAC score (<40 versus ≥ 40) and EQ-5D utility (<0.

Robotic Arm-assisted versus Manual (ROAM) total knee arthroplasty: a randomized controlled trial.

Aims: The primary aim was to assess whether robotic total knee arthroplasty (rTKA) had a greater early knee-specific outcome when compared to manual TKA (mTKA). Secondary aims were to assess whether rTKA was associated with improved expectation fulfilment, health-related quality of life (HRQoL), and patient satisfaction when compared to mTKA.

Methods: A randomized controlled trial was undertaken, and patients were randomized to either mTKA or rTKA.

Detection of early-universe gravitational-wave signatures and fundamental physics.

Detection of a gravitational-wave signal of non-astrophysical origin would be a landmark discovery, potentially providing a significant clue to some of our most basic, big-picture scientific questions about the Universe. In this white paper, we survey the leading early-Universe mechanisms that may produce a detectable signal-including inflation, phase transitions, topological defects, as well as primordial black holes-and highlight the connections to fundamental physics. We review the complementarity with collider searches for new physics, and multimessenger probes of the large-scale structure of the Universe.

Robotic- and orthosensor-assisted versus manual (ROAM) total knee replacement: a study protocol for a randomised controlled trial.

Background: Robotic-arm-assisted knee arthroplasty allows for more accurate component positioning and alignment and is associated with better patient-reported outcomes compared to manually performed jig-based knee arthroplasty. However, what is not known is whether the addition of an intra-articular sensor (Verasense) to aid intraoperative balancing of the total knee replacement (TKR) offers improved functional outcomes for the patient. The purpose of this research is to compare the outcomes of patients undergoing a conventional manual knee replacement to those undergoing TKR using robotic-assisted surgery and the Verasense to optimise alignment and balance the knee joint, respectively, and assess the associated cost economics of such technology.

Thermodynamics of a Two-Step Electroweak Phase Transition.

New field content beyond that of the standard model of particle physics can alter the thermal history of electroweak symmetry breaking in the early Universe. In particular, the symmetry breaking may have occurred through a sequence of successive phase transitions. We study the thermodynamics of such a scenario in a real triplet extension of the standard model, using nonperturbative lattice simulations.

Depression Is Not Independently Associated with a Clinically Worse Functional Improvement but Associated with a Lower Reported Satisfaction Rate after Total Knee Arthroplasty.

The aim of this study was to assess whether depression had a clinically significant influence on the functional improvement of total knee arthroplasty (TKA) according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and whether it influences patient satisfaction at 1 year. A retrospective cohort of 3,510 primary TKA was identified from an arthroplasty database. Patient demographics, comorbidities, WOMAC, and Short Form-12 (SF-12) scores were collected preoperatively and 1 year postoperatively.

Vorticity, Kinetic Energy, and Suppressed Gravitational-Wave Production in Strong First-Order Phase Transitions.

We have performed the first three-dimensional simulations of strong first-order thermal phase transitions in the early universe. For deflagrations, we find that the rotational component of the fluid velocity increases as the transition strength is increased. For detonations, however, the rotational velocity component remains constant and small.

Contralateral knee pain reduces the rate of patient satisfaction but does not clinically impair the change in WOMAC score after total knee arthroplasty.

Aims: The primary aim of this study was to assess whether pain in the contralateral knee had a clinically significant influence on the outcome of total knee arthroplasty (TKA) according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Secondary aims were to: describe the prevalence of contralateral knee pain; identify if it clinically improves after TKA; and assess whether contralateral knee pain independently influences patient satisfaction with their TKA.

Methods: A retrospective cohort of 3,178 primary TKA patients were identified from an arthroplasty database.

Is there a Threshold Preoperative WOMAC Score That Predicts Patient Satisfaction after Total Knee Arthroplasty?

The aim of this study was to identify threshold preoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores that were predictive of patient dissatisfaction 1 year after total knee arthroplasty (TKA). A retrospective cohort of 3,324 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, comorbidities, and the WOMAC score were collected preoperatively.

Asynchronous Bilateral Total Knee Arthroplasty: Predictors of the Functional Outcome and Patient Satisfaction for the Second Knee Replacement.

Background: The primary aim of this study is to identify independent preoperative predictors of outcome and patient satisfaction for the second total knee arthroplasty (TKA).

Methods: A retrospective cohort of 454 patients undergoing an asynchronous (6 weeks or more apart) bilateral primary TKA were identified from an arthroplasty database. Patient demographics, comorbidities, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Form-12 scores were collected preoperatively and 1 year postoperatively.

Nonperturbative Analysis of the Electroweak Phase Transition in the Two Higgs Doublet Model.

We perform a nonperturbative study of the electroweak phase transition (EWPT) in the two Higgs doublet model (2HDM) by deriving a dimensionally reduced high-temperature effective theory for the model, and matching to known results for the phase diagram of the effective theory. We find regions of the parameter space where the theory exhibits a first-order phase transition. In particular, our findings are consistent with previous perturbative results suggesting that the primary signature of a first-order EWPT in the 2HDM is m_{A_{0}}>m_{H_{0}}+m_{Z}.

Gravitational waves from a first-order electroweak phase transition: a brief review.

We review the production of gravitational waves by an electroweak first-order phase transition. The resulting signal is a good candidate for detection at next-generation gravitational wave detectors, such as LISA. Detection of such a source of gravitational waves could yield information about physics beyond the Standard Model that is complementary to that accessible to current and near-future collider experiments.

Fibroblasts Promote Inflammation and Pain via IL-1α Induction of the Monocyte Chemoattractant Chemokine (C-C Motif) Ligand 2.

Fibroblasts persist within fibrotic scar tissue and exhibit considerable phenotypic and functional plasticity. Herein, we hypothesized that scar-associated fibroblasts may be a source of stress-induced inflammatory exacerbations and pain. To test this idea, we used a human model of surgery-induced fibrosis, total knee arthroplasty (TKA).

A comparative surface topographical analysis of explanted total knee replacement prostheses: Oxidised zirconium vs cobalt chromium femoral components.

It has been proposed that an increased surface roughness of the femoral components of Total Knee Replacements (TKRs) may be a contributing factor to the accelerated wear of the polyethylene (PE) bearing and ultimately prosthesis failure. Oxidised Zirconium was introduced to the orthopaedic market in an attempt to reduce PE wear associated failures and increase the longevity of the prosthesis. In this study, non-contacting profilometry was used to measure the surface roughness of the femoral components of 6 retrieved TKRs (3 Oxidised Zirconium (OxZr) and 3 Cobalt Chromium alloy (CoCr) femoral components) and 2 as-manufactured femoral components (1 OxZr and 1 CoCr).

New Solutions for Non-Abelian Cosmic Strings.

We study the properties of classical vortex solutions in a non-Abelian gauge theory. A system of two adjoint Higgs fields breaks the SU(2) gauge symmetry to Z_{2}, producing 't Hooft-Polyakov monopoles trapped on cosmic strings, termed beads; there are two charges of monopole and two degenerate string solutions. The strings break an accidental discrete Z_{2} symmetry of the theory, explaining the degeneracy of the ground state.

Fibrosis is a common outcome following total knee arthroplasty.

Total knee arthroplasty (TKA) is one of the most successful orthopaedic procedures that alleviates pain and restores function in patients with degenerative knee joint diseases. Arthrofibrosis, abnormal scarring in which dense fibrous tissue prevents normal range of motion, develops in ~3-10% of TKA patients. No prophylactic intervention is available and treatment is restricted to aggressive physiotherapy or revision surgery.

A potential mode of action for Anakinra in patients with arthrofibrosis following total knee arthroplasty.

Arthrofibrosis is a fibroproliferative disease characterised by excessive deposition of extracellular matrix components intra-articularly leading to pain and restricted range of movement. Although frequently observed following total knee arthroplasty (TKA) no therapeutic options exist. A pilot study demonstrated that intra-articular injection of Anakinra, an IL-1R antagonist, improved range of movement and pain in patients with arthrofibrosis however the mechanism of action is unknown.

Gravitational waves from the sound of a first order phase transition.

We report on the first three-dimensional numerical simulations of first-order phase transitions in the early Universe to include the cosmic fluid as well as the scalar field order parameter. We calculate the gravitational wave (GW) spectrum resulting from the nucleation, expansion, and collision of bubbles of the low-temperature phase, for phase transition strengths and bubble wall velocities covering many cases of interest. We find that the compression waves in the fluid continue to be a source of GWs long after the bubbles have merged, a new effect not taken properly into account in previous modeling of the GW source.

Functional outcome following aseptic single-stage revision knee arthroplasty.

Purpose: This study attempts to quantify the influence of constraint and various indications upon functional outcome following aseptic first-time revision knee arthroplasty.

Methods: A single-centre prospective study was performed to examine the outcome for 175 consecutive total revision knee replacements performed between 2003 and 2008 with a minimum follow-up of 2 years. Patient-reported outcome data were used to determine the influence of final level of component constraint, its relationship with primary indication for surgery and the predictor variable for functional outcome at 1 year.