Shockwave Intravascular Lithotripsy Facilitated Transvenous Lead Extraction.

Background: Dense calcifications encasing pacing leads with long dwell times are common and increase the difficulty of and risks associated with transvenous lead extraction procedures (TLE). Shockwave intravascular lithotripsy (IVL) focuses sound waves to fracture calcified tissue within a narrow radius to the catheter.

Objectives: This study sought to assess the impact of Shockwave IVL pretreatment during extraction of long dwell time pacemaker and defibrillator leads.

Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature.

Context: A strict rehabilitation protocol is traditionally followed after microfracture, including weightbearing restrictions for 2 to 6 weeks. However, such restrictions pose significant disability, especially in a patient population that is younger and more active.

Evidence Acquisition: An extensive literature review was performed through PubMed and Google Scholar of all studies through December 2018 related to microfracture, including biomechanical, basic science, and clinical studies.

Neuropsychological Assessments of Cognitive Aging in Monolingual and Bilingual Older Adults.

Standardized neuropsychological tests are routinely used as diagnostic criteria in aging populations and are an important piece of evidence for the identification of clinical pathology and neurodegenerative conditions such as Alzheimer's disease. Tests include such measures as the Mini Mental Status Exam, Delis-Kaplan Executive Function System, Montreal Cognitive Assessment, and others. These tests cover a range of functions including working memory, verbal fluency, prospective memory, and task switching.

Task-linked Diurnal Brain Network Reorganization in Older Adults: A Graph Theoretical Approach.

Testing older adults in the morning generally improves behavioral performance relative to afternoon testing. Morning testing is also associated with brain activity similar to that of young adults. Here, we used graph theory to explore how time of day (TOD) affects the organization of brain networks in older adults across rest and task states.

Age-related deficits in inhibition in figure-ground assignment.

We assessed age differences in the ability to resolve competition for figural status in stationary displays using small, enclosed, symmetrical silhouettes that participants classified as depicting "novel" or "familiar" shapes. The silhouettes were biased such that the inside was perceived as the shaped figure, and the outside was perceived as a shapeless ground. The critical manipulation was whether a portion of a meaningful object was suggested on the outside of the border of some of the novel silhouettes but not others (M+Ground and M-Ground novel silhouettes, respectively).

The Trapped Medial Meniscus Tear: An Examination Maneuver Helps Predict Arthroscopic Findings.

Background: Numerous clinical examination maneuvers have been developed to identify meniscus tears of the knee. While meniscus injuries vary significantly in type and severity, no maneuvers have been developed that help to distinguish particular tear characteristics.

Purpose: This nonconsecutive case series highlights a distinctive clinical finding that correlates with inferiorly displaced flap tears of the medial meniscus that become trapped in the medial gutter of the knee, as identified through magnetic resonance imaging (MRI) and arthroscopy.

Direct Visualization of Existing Footprint and Outside-In Drilling of the Femoral Tunnel in Anterior Cruciate Ligament Reconstruction in the Knee.

Improper femoral tunnel placement in anterior cruciate ligament (ACL) reconstruction is a significant problem and may be a cause of ACL graft failure and abnormal kinematics, which may lead to late degenerative changes after reconstruction. Recently, there has been concern that the transtibial approach may contribute to nonanatomic placement of the femoral tunnel, resulting in abnormal knee kinematics. Tibial-independent techniques can provide more anatomic placement of the ACL graft, but these can be technically demanding.

FDA regulation of adult stem cell therapies as used in sports medicine.

In sports medicine, adult stem cells are the subject of great interest. Several uses of stem cells are under investigation including cartilage repair, meniscal regeneration, anterior cruciate ligament reconstruction, and tendinopathy. Extensive clinical and basic science research is warranted as stem cell therapies become increasingly common in clinical practice.

Dietary fatty acid content regulates wound repair and the pathogenesis of osteoarthritis following joint injury.

Objective: The mechanisms linking obesity and osteoarthritis (OA) are not fully understood and have been generally attributed to increased weight, rather than metabolic or inflammatory factors. Here, we examined the influence of fatty acids, adipokines, and body weight on OA following joint injury in an obese mouse model.

Methods: Mice were fed high-fat diets rich in various fatty acids (FA) including saturated FAs (SFAs), ω-6 polyunsaturated FAs (PUFAs), and ω-3 PUFAs.

Patient perception of wound photography.

The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult-to-see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress.

Stem cell therapies for knee cartilage repair: the current status of preclinical and clinical studies.

Background: Articular cartilage damage of the knee is common, causing significant morbidity worldwide. Many adult tissues contain cells that are able to differentiate into multiple cell types, including chondrocytes. These stem cells have gained significant attention over the past decade and may become frontline management for cartilage defects in the very near future.

Surgical restoration/repair of articular cartilage injuries in athletes.

Articular cartilage injuries of the knee are an increasingly common source of pain and dysfunction, particularly in the athletic population. In the athlete, untreated articular cartilage defects can represent a career threatening injury and create a significant obstacle in returning to full athletic participation. The markedly limited healing potential of articular cartilage often leads to continued deterioration and progressive functional limitations.

Up-regulation of neurotrophic factors by cinnamon and its metabolite sodium benzoate: therapeutic implications for neurodegenerative disorders.

This study underlines the importance of cinnamon, a widely-used food spice and flavoring material, and its metabolite sodium benzoate (NaB), a widely-used food preservative and a FDA-approved drug against urea cycle disorders in humans, in increasing the levels of neurotrophic factors [e.g., brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3)] in the CNS.

Ten- to 15-year clinical and radiographic results for a compression molded monoblock elliptical acetabular component.

The aim of this study was to report the long-term results from a previously published midterm follow-up of a titanium monoblock, elliptical acetabular component. A total of 258 primary total hip arthroplasties (212 patients) with a monoblock, acetabular component were followed up for a mean period of 11.1 years (10-15).

Distinct neural correlates for two types of inhibition in bilinguals: response inhibition versus interference suppression.

To examine the effects of bilingualism on cognitive control, we studied monolingual and bilingual young adults performing a flanker task with functional MRI. The trial types of primary interest for this report were incongruent and no-go trials, representing interference suppression and response inhibition, respectively. Response times were similar between groups.

Neural correlates of recognition memory for emotional faces and scenes.

We examined the influence of emotional valence and type of item to be remembered on brain activity during recognition, using faces and scenes. We used multivariate analyses of event-related fMRI data to identify whole-brain patterns, or networks of activity. Participants demonstrated better recognition for scenes vs faces and for negative vs neutral and positive items.

A multivariate analysis of age-related differences in default mode and task-positive networks across multiple cognitive domains.

We explored the effects of aging on 2 large-scale brain networks, the default mode network (DMN) and the task-positive network (TPN). During functional magnetic resonance imaging scanning, young and older participants carried out 4 visual tasks: detection, perceptual matching, attentional cueing, and working memory. Accuracy of performance was roughly matched at 80% across tasks and groups.

An articulating spacer to treat and mobilize patients with infected total knee arthroplasty.

This retrospective study analyzed 25 consecutive patients (25 knees) with chronic deep TKA infection. During 1997-2004, patients underwent two-stage articulating spacer surgery. The original femoral component was removed, autoclaved and replaced and a new polyethylene was utilized.

Patellofemoral function after total knee arthroplasty: a comparison of 2 posterior-stabilized designs.

Knee complications and function were analyzed in patients with 2 different posterior-stabilized total knee arthroplasty (TKA) designs, Optetrak 913 and Insall-Burstein II. Three hundred Insall-Burstein II knees with mean follow-up of 8 years (range: 5-9 years) and 300 Optetrak knees with mean follow-up of 6 years (range: 5-7 years) were studied. Lateral retinacular release was performed in 30% of Insall-Burstein II patients and 16% of Optetrak patients (P = 0.

Surgery for retrocalcaneal bursitis: a tendon-splitting versus a lateral approach.

Unlabelled: For patients with refractory retrocalcaneal bursitis (Haglund's syndrome), the most effective surgical approach has not been defined. We asked whether patients undergoing the tendon-splitting approach and the lateral approach would have comparably effective relief of pain for both types of calcaneal ostectomies. We retrospectively reviewed 30 patients (31 feet) who underwent the tendon-splitting approach and compared their results with 32 previous patients (35 feet) who had a lateral incision.

Wear data and clinical results for a compression molded monoblock elliptical acetabular component: 5- to 9-year data.

Polyethylene wear rates correlate with osteolysis. Modular acetabular components may fail because of backside polyethylene wear or liner/shell dissociation. A monoblock acetabular component avoids these problems, and we report its midterm results.

Patellofemoral evaluation after total knee arthroplasty. Validation of a new weight-bearing axial radiographic view.

Background: Radiographic assessment of the patella after total knee arthroplasty is typically performed with use of static, unloaded views that may not reproduce the in vivo patellofemoral kinematics. The purpose of the present study was to evaluate and validate the reliability and reproducibility of a weight-bearing radiographic assessment of the patellofemoral joint in patients who have undergone total knee arthroplasty.

Methods: Radiographs were made for 100 knees in sixty-nine patients who had undergone total knee arthroplasty.

Constrained condylar knee without stem extensions for difficult primary total knee arthroplasty.

Two hundred forty-eight constrained condylar total knee arthroplasties consecutively implanted without the use of diaphyseal stem extensions were studied in 180 patients. Preoperative deformity was severe (82% Ahlbäck grade 4-5). One hundred ninety-two knees (148 patients) were reviewed at mean 47-month follow-up (range: 24-72 months).