Risk factors of recurrent periprosthetic joint infection of the knee after two-stage reimplantation.

Introduction: Prosthetic joint infection (PJI) is one of the most common and detrimental complications of total knee replacement arthroplasty (TKA). Despite extensive efforts, including two-stage reimplantation, to eradicate PJI, it still recurs in a substantial number of patients. However, the risk factors of recurrence after two-stage reimplantation of the knee have not been established.

Machine learning-based prediction of contralateral knee osteoarthritis development using the Osteoarthritis Initiative and the Multicenter Osteoarthritis Study dataset.

Having osteoarthritis in one knee is reported as an independent risk factor for developing contralateral knee osteoarthritis (KOA). However, no study has been designed to predict the development of contralateral KOA (cKOA). The authors hypothesized that specific risk factors for cKOA development exist and that it could be accurately predicted with the assistance of machine learning.

Development of the machine learning model that is highly validated and easily applicable to predict radiographic knee osteoarthritis progression.

Many models using the aid of artificial intelligence have been recently proposed to predict the progression of knee osteoarthritis. However, previous models have not been properly validated with an external data set or have reported poor predictive performances. Therefore, the purpose of this study was to design a machine learning model for knee osteoarthritis progression, focusing on high validation quality and clinical applicability.

Accurate, automated classification of radiographic knee osteoarthritis severity using a novel method of deep learning: Plug-in modules.

Background: Fine-grained classification deals with data with a large degree of similarity, such as cat or bird species, and similarly, knee osteoarthritis severity classification [Kellgren-Lawrence (KL) grading] is one such fine-grained classification task. Recently, a plug-in module (PIM) that can be integrated into convolutional neural-network-based or transformer-based networks has been shown to provide strong discriminative regions for fine-grained classification, with results that outperformed the previous deep learning models. PIM utilizes each pixel of an image as an independent feature and can subsequently better classify images with minor differences.

Comparative analysis of gait: Similar coronal but different sagittal effects between closing-wedge and opening-wedge high tibial osteotomy.

Background: High tibial osteotomy is an established surgical option for medial compartment osteoarthritis of the knee with varus alignment. It can be divided into open wedge and closing wedge by operative technique. Although they have fundamental differences, little is known about the biomechanical consequences of the two surgical methods.

Patella Cartilage Status Does Not Affect the Clinical Outcomes of Non-resurfaced Patella in Mobile-Bearing Total Knee Arthroplasty.

Background: During total knee arthroplasty (TKA), patellar retention is performed when the cartilage is fairly well preserved and the thickness of the patella is relatively thin. However, clinical outcomes of the non-resurfaced patella in TKA according to the cartilage status are lacking in the literature. The purpose of this study was to compare patient-reported outcome measures (PROMs) according to the grade and location of the patellar cartilage lesion in TKA patients.

Prediction of postoperative gait speed change after bilateral primary total knee arthroplasty in female patients using a machine learning algorithm.

Background: An important aim of total knee arthroplasty is to achieve functional recovery, which includes post-operative increase in walking speed. Therefore, predicting whether a patient will walk faster or slower after surgery is important in TKA, which has not been studied in previous literatures. Who walks faster and who walks slower after TKA? Can we predict these kinds of patients before surgery?

Hypothesis: Whether or not a patient walk faster after total knee arthroplasty can be predicted with preoperative characteristics.

Rectangular-Tunnel Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Autograft Can Reduce Early Donor Site Morbidity While Maintaining Comparable Short-term Clinical Outcomes.

Background: Rectangular tunnel and graft have been recently designed to closely resemble the native anatomy in anterior cruciate ligament reconstruction (ACLR). This study was performed to compare the short-term clinical outcomes between rectangular and round femoral tunnels in ACLR using quadriceps tendon-patellar bone (QTPB) autografts.

Methods: A total of 78 patients who underwent primary ACLR with QTPB autografts performed by three senior surgeons and had at least 1 year of postoperative follow-up were retrospectively reviewed.

Titanium Alloy Knee Implant Is Associated with Higher Bone Density over Cobalt Chromium: A Prospective Matched-Pair Case-Control Study.

Background: Little is known about the relationship between implant material and periprosthetic bone mineral density (pBMD) in total knee arthroplasty (TKA). The purpose of this study was to investigate the change in pBMD after TKA and to compare pBMD changes between two different implant materials.

Methods: A prospective matched-pair case-control study was conducted on 29 patients who underwent bilateral TKAs.

Automated Detection of Surgical Implants on Plain Knee Radiographs Using a Deep Learning Algorithm.

: The number of patients who undergo multiple operations on a knee is increasing. The objective of this study was to develop a deep learning algorithm that could detect 17 different surgical implants on plain knee radiographs. : An internal dataset consisted of 5206 plain knee antero-posterior X-rays from a single, tertiary institute for model development.

Variability between the trial and final implant measurements during the sensor-guided total knee arthroplasty.

Purpose: Compartmental load-sensing technology has been used in the attempt to achieve optimal soft tissue balance during total knee arthroplasty (TKA). This study was conducted to investigate the validity of such use of intraoperative sensing technology.

Methods: Ninety-three knees scheduled to undergo total knee arthroplasty for knee osteoarthritis with a tibial sensor were prospectively enrolled.

Long-term Outcomes of Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Autograft.

Background: To date, there have been few studies on the outcomes of anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon-patellar bone (QTPB) autograft.

Purpose: To evaluate the long-term clinical outcomes of ACLR using QTPB autograft.

Study Design: Case series; Level of evidence, 4.

A Flexible Intramedullary Guide Can Reduce the Anteroposterior Oversizing of Femoral Components Used in Total Knee Arthroplasty in Patients with Osteoarthritis and Severe Distal Femoral Sagittal Bowing.

Traditionally, a rigid intramedullary rod has been used as the reference guide for femoral cutting in total knee arthroplasty (TKA). However, correct positioning of this rigid rod is difficult, especially in the knees with severe distal femoral sagittal bowing. A flexible intramedullary rod has been developed to address this problem.

Actual long-term survival after resection of stage III soft tissue sarcoma.

Background: Actuarial survival based on the Kaplan-Meier method can overestimate actual long-term survival, especially among those with factors of poor prognosis. Patients with American Joint Committee on Cancer stage III soft tissue sarcoma (STS) represent a subset with a high risk of STS-specific mortality. Therefore, we aimed to characterize the clinicopathological characteristics associated with actual long-term survival in patients with stage III STS.

Residual varus alignment after total knee arthroplasty increases knee adduction moment without improving patient function: A propensity score-matched cohort study.

Background: Targeting residual varus alignment in total knee arthroplasty may be functionally beneficial to preoperative varus patients.

Methods: Bilateral TKA patients were enrolled. According to the postoperative hip-knee-ankle axis, patients were allocated into residual varus (3° ± 1°) alignment group or neutral (0° ± 1°) alignment group.

Effective period of conservative treatment in patients with acute calcific periarthritis of the hand.

Background: Acute calcific periarthritis of the hand is a relatively uncommon painful condition involving juxta-articular deposits of amorphous calcium hydroxyapatite. Although conservative treatments have been generally considered effective, there is little evidence regarding how long they could remain effective.

Methods: We retrospectively reviewed ten patients who were diagnosed with acute calcific periarthritis of the hand from January 2015 to June 2018.

Carbon monoxide regulates glycolysis-dependent NLRP3 inflammasome activation in macrophages.

Low dose of carbon monoxide (CO) has anti-inflammatory role through various signaling pathways. Cellular metabolism has been implicated in the activation of inflammation in immune cells. However, the mechanisms by which CO-dependent metabolic regulation affect the immune response remain unclear.

Anesthetic experience of frontotemporal dementia patient with severe autonomic dysfunction: a case report.

Anesthetic experience in frontotemporal dementia (FTD) with severe hypotension associated autonomic dysfunction has not yet been reported. Here in case, we report on the case of treatment with vasopressin to refractory hypotension in FTD patient. A 54-year-old male presented with a ten-year history of FTD with frequent syncope.

Pretreatmet with 5% lidocaine patch reduces cannula-induced and propofol-induced pain: a randomized, double-blind, placebo-controlled study.

Background: The purpose of this study was to determine the efficacy of 5% lidocaine patch in reducing propofol-induced pain and cannula-induced pain.

Methods: In a randomized, double-blind study, 126 patients were divided into one of three groups: pretreatment with a 5% lidocaine patch (Lidotop®) and premixed 2 ml of normal saline with 1.5 mg/kg of 1% propofol (Group A); pretreatment with a placebo patch and premixed 2 ml of normal saline with 1.

Comparisons of recursive partitioning analysis and conventional methods for selection of uncuffed endotracheal tubes for pediatric patients.

Background: Numerous studies have investigated the best method of selecting the appropriate size of endotracheal tube (ETT) for children. However, none of the methods or formulae for selection of ETT size have shown better prediction over another, and they have required complex formulae calculation or even use of cumbersome equipment. Recursive partitioning analysis creates a decision tree that is more likely to enable clearer and easier visualization of decision charts compared to other data mining methods.

Modeling of safe window for percutaneous thoracic sympathectomy.

Purpose: Despite the many benefits of percutaneous thoracic sympathectomy, it also has serious complications such as pneumothorax. This study was conducted in order to determine the safe percutaneous entering window and angles for the needle during T2 and T3 thoracic sympathectomy avoiding pneumothorax.

Methods: Transverse section of CT images that crosses at the middle of the T2 or T3 vertebral body was selected.

Effect of nitrous oxide inhalation on pain after propofol and rocuronium injection.

Purpose: This prospective, double-blind, placebo-controlled study was designed to determine the efficacy of nitrous oxide (N(2)O) in alleviating the pain that followed sequential injection of propofol and rocuronium.

Methods: A total of 205 adult patients (age, 18-68 years) received one of the following combinations: NaCl and 100 % O(2) (group C); 0.5 mg/kg lidocaine and 100 % O(2) (group L); NaCl and a mixture of 67 % N(2)O/O(2) (group N); or 0.

Scope and Mechanistic Study of the Coupling Reaction of α, β-Unsaturated Carbonyl Compounds with Alkenes: Uncovering Electronic Effects on Alkene Insertion vs Oxidative Coupling Pathways.

The cationic ruthenium-hydride complex [(C(6)H(6))(PCy(3))(CO)RuH](+)BF(4) (-) (1) was found to be a highly effective catalyst for the intermolecular conjugate addition of simple alkenes to α,β-unsaturated carbonyl compounds to give (Z)-selective tetrasubstituted olefin products. The analogous coupling reaction of cinnamides with electron-deficient olefins led to the oxidative coupling of two olefinic C-H bonds in forming (E)-selective diene products. The intramolecular version of the coupling reaction efficiently produced indene and bicyclic fulvene derivatives.