No Difference in 10-year Clinical or Radiographic Outcomes Between Kinematic and Mechanical Alignment in TKA: A Randomized Trial.

Background: There is continuing debate about the ideal philosophy for component alignment in TKA. However, there are limited long-term functional and radiographic data on randomized comparisons of kinematic alignment versus mechanical alignment.

Questions/purposes: We present the 10-year follow-up findings of a single-center, multisurgeon randomized controlled trial (RCT) comparing these two alignment philosophies in terms of the following questions: (1) Is there a difference in PROM scores? (2) Is there a difference in survivorship free from revision or reoperation for any cause? (3) Is there a difference in survivorship free from radiographic loosening?

Methods: Ninety-nine patients undergoing primary TKA for osteoarthritis were randomized to either the mechanical alignment (n = 50) or kinematic alignment (n = 49) group.

Is Cementless Total Knee Arthroplasty Safe in Women Over 75 Y of Age?

Background: Cementless total knee arthroplasty (TKA) is the subject of renewed interest. Previous concerns about survivorship have been addressed and there is an appeal in terms of biological fixation and surgical efficiency. However, even surgeon advocates have concerns about the risk of marked subsidence when using this technology in older patients at risk for osteoporosis.

Hand dominance and experience improve bimanual performance on arthroscopic simulator task.

Purpose: The aim of this study was to identify if experience in arthroscopy confers ambidexterity to the operator and the role of baseline characteristics in arthroscopic simulator performance.

Methods: A prospective comparative study was carried out across four regional Orthopaedic training centres. Participants were divided into novice, intermediate or experienced groups based on arthroscopic experience.

Revision of total knee replacement (TKR) secondary to raised cobalt levels: should this be considered in the painful TKR patient?

A 63-year-old woman was referred to the specialised knee revision clinic with ongoing knee pain after total knee replacement. She incidentally had cobalt and chromium levels measured. These were seen to be elevated.

Knowledge of face masks and attitudes to re-sterilisation among healthcare workers.

Introduction: COVID-19 was declared a pandemic in March 2020. With the sudden surge in demand for personal protective equipment (PPE), significant concerns regarding the ongoing availability emerged. One solution proposed is re-sterilisation of respirator masks and this has been commenced in some parts of the world.

Custom solution for personal protective equipment (PPE) in the orthopaedic setting: retrofitting Stryker Flyte T5 PPE system.

The coronavirus disease 2019 pandemic has meant that there is growing pressure on hospital resources, not least the availability of appropriate personal protective equipment (PPE), particularly face masks and respirator masks. Within the field of orthopaedic surgery, it is a common sight to see surgeons wearing 'space suits' (SSs) which comprise a helmet, hood and surgical gown. In this study, the authors made modifications to two different SS systems to incorporate a high-efficiency particulate air (HEPA) filter into the fan inlet to assess their potential as re-usable PPE systems for surgeons with regard to protection from a virus spread via respiratory droplets.

Crisis change management during COVID-19 in the elective orthopaedic hospital: Easing the trauma burden of acute hospitals.

Introduction: With the emergence of the 2019 novel coronavirus and its resulting pandemic status in March 2020 all routine elective orthopaedic surgery was cancelled in our institution. The developing picture in Italy, of acute hospitals becoming overwhelmed with treating patients suffering with severe and life-threatening symptoms from the disease, prompted the orthopaedic surgeons to formulate a plan to transfer trauma patients requiring surgery to the elective hospital to unburden the acute hospital system.

Methods: Under the threat of this pandemic; protocols and algorithms were established for referral, acceptance and care of trauma patients from acute hospitals in the region.

Regional trauma patterns during the COVID-19 pandemic.

Background: The current pandemic has impacted heavily on health systems, making unprecedented demands on resources, and forcing reconfiguration of services. Trauma and orthopaedic units have cancelled elective surgery, moved to virtual based clinics and have been forced to reconsider the provision of trauma. Our national elective orthopaedic centre has been re-designated as a trauma centre to allow tertiary centres re-direct triaged trauma.

Peri-operative outcomes for ORIF of acetabular fracture in the elderly: Comparison with displaced intracapsular hip fractures in a national pelvic and acetabular referral centre over 5 years.

Introduction: The increasing incidence of acetabular fractures in the elderly and the fracture complexity seen in this cohort represents one of the greatest challenges faced by trauma orthopaedic surgeons today. There are no formal guidelines of best practice in the treatment of these patients. Management options vary from non-operative, acute ORIF, and/or total joint replacement.

Total hip replacement-the cause of failure in patients under 50 years old?

Aim: To establish the mode of failure of primary total hip replacement in patients under 50 years old.

Methods: A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) failures from the index procedure.

Comparison of measured electron energy spectra for six matched, radiotherapy accelerators.

Unlabelled: This study compares energy spectra of the multiple electron beams of individual radiotherapy machines, as well as the sets of spectra across multiple matched machines. Also, energy spectrum metrics are compared with central-axis percent depth-dose (PDD) metrics.

Methods: A lightweight, permanent magnet spectrometer was used to measure energy spectra for seven electron beams (7-20 MeV) on six matched Elekta Infinity accelerators with the MLCi2 treatment head.

Emergency Aeromedical Services in Ireland: A Single-Centre Study in 2014.

This retrospective analysis includes patients requiring Emergency Aeromedical Services (EAS) in 2014. The aim of this paper is to evaluate the HEMS service in a single centre and to accurately assess whether certain internationally validated criteria can predict admission rates better than the currently used criteria. Using the American College of Surgeons (ACS) trauma-related dispatch criteria, each case was retrospectively evaluated.

A dosimetric comparison of copper and Cerrobend electron inserts.

The purpose of this work was to evaluate differences in dose resulting from the use of copper aperture inserts compared to lead-alloy (Cerrobend) aperture inserts for electron beam therapy. Specifically, this study examines if copper aperture inserts can be used clinically with the same commissioning data measured using lead-alloy aperture inserts. The copper inserts were acquired from .

The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management.

The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process.

Emergency aeromedical services in Ireland: a retrospective study for "MEDEVAC112".

Aim: This is a retrospective analysis of all consecutive patients requiring emergency aeromedical services (EAS) to a level II trauma centre. This analysis was performed to evaluate the new service to Tallaght Hospital in terms of: the criteria used for dispatch, an estimate of baseline efficiency of time critical management of patients, the cross-catchment transfer of patients.

Methods: Data were provided by the EAS with respect to the patients brought to Tallaght Hospital not including inter-facility transfers for the calendar year 2013.

Permanent-magnet energy spectrometer for electron beams from radiotherapy accelerators.

Purpose: The purpose of this work was to adapt a lightweight, permanent magnet electron energy spectrometer for the measurement of energy spectra of therapeutic electron beams.

Methods: An irradiation geometry and measurement technique were developed for an approximately 0.54-T, permanent dipole magnet spectrometer to produce suitable latent images on computed radiography (CR) phosphor strips.

Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy - A quality of life and cost effectiveness analysis.

Aim: To estimate cost-effectiveness of botulinum toxin therapy for axillary hyperhidrosis compared to the standard surgical intervention of endoscopic thoracic sympathectomy (ETS).

Methods: The validated dermatology life quality index questionnaire was given to patients attending for treatment over a 4 month period, to assess their quality of life (QoL) over the preceding week (n = 44). Follow-up was performed 4-6 weeks later by telephone using the same questionnaire to validate the effectiveness of the treatment.

Human plasma protein adsorption onto alumina nanoparticles relevant to orthopedic wear.

Purpose: Wear of ceramic orthopedic devices generates nanoparticles in vivo that may present a different biological character from the monolithic ceramic from which they are formed. The current work investigated protein adsorption from human plasma on alumina nanoparticles and monolithic samples representative of both wear particles and the ceramic components as implanted.

Materials And Methods: A physicochemical characterization of the particles and their dispersion state was carried out, and the protein adsorption profiles were analyzed using 1D SDS-PAGE and mass spectrometry.

Implementation of a surgical handover tool in a busy tertiary referral centre: a complete audit cycle.

Background: The implementation of the European work-time directive has created increased transitions of care during weekends as doctors adhere to a shift-work structure. This raises concerns over continuity of care and patient safety. To address this, doctors must develop a time efficient yet safe system of handover of patients to the team on-call.

Intra- and intervariability in beam data commissioning among water phantom scanning systems.

Accurate beam data acquisition during commissioning is essential for modeling the treatment planning system and dose calculation in radiotherapy. Although currently several commercial scanning systems are available, there is no report that compared the differences among the systems because most institutions do not acquire several scanning systems due to the high cost, storage space, and infrequent usage. In this report, we demonstrate the intra- and intervariability of beam profiles measured with four commercial scanning systems.

Medical Physics Residency Consortium: collaborative endeavors to meet the ABR 2014 certification requirements.

In 2009, Mary Bird Perkins Cancer Center (MBPCC) established a Radiation Oncology Physics Residency Program to provide opportunities for medical physics residency training to MS and PhD graduates of the CAMPEP-accredited Louisiana State University (LSU)-MBPCC Medical Physics Graduate Program. The LSU-MBPCC Program graduates approximately six students yearly, which equates to a need for up to twelve residency positions in a two-year program. To address this need for residency positions, MBPCC has expanded its Program by developing a Consortium consisting of partnerships with medical physics groups located at other nearby clinical institutions.

Accuracy and precision of cone-beam computed tomography guided intensity modulated radiation therapy.

Purpose: To assess the accuracy and precision of cone-beam computed tomography (CBCT)-guided intensity modulated radiation therapy (IMRT).

Methods And Materials: A 7-field intensity modulated radiation therapy plan was constructed for an anthropomorphic head phantom loaded with a custom cassette containing radiochromic film. The phantom was positioned on the treatment table at 9 locations: 1 "correct" position and 8 "misaligned" positions along 3 orthogonal axes.

Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71.

A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement.

Evaluation of volumetric modulated arc therapy for postmastectomy treatment.

Purpose: To examine the feasibility of volumetric modulated arc therapy (VMAT) for post mastectomy radiotherapy (PMRT).

Methods And Materials: Fifteen PMRT patients previously treated at our clinic with helical tomotherapy (HT) were identified for the study. Planning target volumes (PTV) included the chest wall and regional lymph nodes.