The amount of femorotibial alignment correction through total knee arthroplasty may affect postoperative hindfoot alignment.

Purpose: This study was performed to investigate the relationship between the amount of femorotibial alignment correction and the amount of improvement of hindfoot alignment in total knee arthroplasty (TKA).

Methods: A total of 159 knees undergoing TKA in 120 patients were assessed preoperatively and at 2 weeks, 1 month, 3 months and 6 months postoperatively. Standing hindfoot alignment was evaluated using the leg-heel angle (LHA).

Tumor‑infiltrating CD8 T cells as a biomarker for chemotherapy efficacy in unresectable hepatocellular carcinoma.

Atezolizumab plus bevacizumab and lenvatinib are approved frontline therapies for advanced hepatocellular carcinoma (HCC). Patients with advanced HCC continue to have a poor prognosis despite these therapeutic choices. Previous studies have reported CD8 tumor-infiltrating lymphocytes (TILs) as a biomarker to predict responsiveness to systemic chemotherapy.

Does Augmented Reality-based Portable Navigation Improve the Accuracy of Cup Placement in THA Compared With Accelerometer-based Portable Navigation? A Randomized Controlled Trial.

Background: Previous studies reported good outcomes of acetabular cup placement using portable navigation systems during THA. However, we are aware of no prospective studies comparing inexpensive portable navigation systems using augmented reality (AR) technology with accelerometer-based portable navigation systems in THA.

Questions/purposes: (1) Is the placement accuracy of the acetabular cup using the AR-based portable navigation system superior to that of an accelerometer-based portable navigation system? (2) Do the frequencies of surgical complications differ between the two groups?

Methods: We conducted a prospective, two-arm, parallel-group, randomized controlled trial involving patients scheduled for unilateral THA.

Risk factors for loss to follow-up after the start of direct-acting antiviral treatment for hepatitis C virus infection.

Background And Aim: Direct-acting antivirals (DAAs) have recently been developed to treat hepatitis C virus (HCV) infection. Additionally, interferon-free DAA treatment has improved liver function and reduced the risk of hepatocellular carcinoma (HCC) following HCV eradication. Previous studies on HCV have focused mainly on the treatment rate and the risk of developing HCC, and less attention has been given to loss to follow-up (LTFU) after DAA treatment.

Predeposited Autologous Blood Transfusion in Single-Anesthetic Bilateral Total Knee Arthroplasty with Modern Blood Conservation Strategy.

Unlabelled: This study was performed to examine the hypothesis that the rate of allogeneic blood transfusion in patients who did not predeposit an autologous blood transfusion before single-anesthetic bilateral total knee arthroplasty (TKA) would be noninferior to that in patients who did predeposit blood.

Methods: We assessed the number of allogeneic transfusions required in 338 patients undergoing single-anesthetic bilateral TKA with a preoperative hemoglobin level of ≥11.0 g/dL.

Augmented reality-aided unicompartmental knee arthroplasty.

Purpose: To illustrate a surgical technique for augmented reality (AR)-assisted unicompartmental knee arthroplasty (UKA) and report preliminary data.

Methods: We developed an AR-based navigation system that enables the surgeon to see the tibial mechanical axis superimposed on the patient's leg in addition to the tibial cutting angle. We measured the tibial resection angle in 11 UKAs using postoperative radiographs and calculated the absolute difference between preoperative target angle and postoperative measured angle.

Therapeutic efficacy of atezolizumab plus bevacizumab for hepatocellular carcinoma with WNT/β-catenin signal activation.

Atezolizumab plus bevacizumab therapy has high response rates in patients with advanced hepatocellular carcinoma (HCC). It has been reported that HCC with immune exclusion associated with the signal activation of WNT/β-catenin is resistant to immune checkpoint inhibitors; however, to the best of our knowledge, the effectiveness of atezolizumab plus bevacizumab for HCC with WNT/β-catenin signal activation has not been reported. The present study aimed to analyze the efficacy of atezolizumab plus bevacizumab for HCC with WNT/β-catenin signal activation.

Augmented Reality- vs Accelerometer-Based Portable Navigation System to Improve the Accuracy of Acetabular Cup Placement During Total Hip Arthroplasty in the Lateral Decubitus Position.

Background: There have been no studies regarding the effectiveness of augmented reality (AR)-based portable navigation systems compared with accelerometer-based portable navigation systems in total hip arthroplasty (THA).

Methods: We retrospectively compared THAs performed using an AR-based portable navigation system (n = 45) and those performed using an accelerometer-based portable navigation system (n = 42). All THAs were performed with the patient in the lateral decubitus position.

Augmented Reality-Assisted Femoral Bone Resection in Total Knee Arthroplasty.

Unlabelled: An augmented reality (AR)-based navigation system allows visualization of the center of the femoral head and femoral mechanical axis superimposed on the surgical field during total knee arthroplasty (TKA) and may help surgeons to improve the accuracy of distal femoral resection.

Methods: First, we resected 10 femoral Sawbones specimens using the AR-based navigation system and performed computed tomography (CT) to measure the resection angle of the distal part of the femur. We calculated the absolute values of the differences between angles measured using CT images and angles displayed on the smartphone screen of the navigation system.

Percutaneous periarticular analgesic injection at one day after simultaneous bilateral total knee arthroplasty: an open-label randomized control trial.

Background: The postoperative pain after total knee arthroplasty (TKA) remains a critical issue. The aim of this study was to assess the clinical effectiveness of percutaneous periarticular injection at 1 day following simultaneous bilateral TKA.

Methods: A total of 88 knees in 44 patients who underwent simultaneous bilateral TKA were randomly assigned to receive a percutaneous periarticular injection at 1 day following surgery (n = 22 patients) or no injection (n = 22 patients).

Direct Observation of the Relationship between Thixotropic Behavior and Shear-Induced Orientation of Clay Particles in Synesthetic Hectorite Suspensions.

A thixotropic characteristics of aqueous gels containing smectite clay minerals were used in various industrial applications such as paint additives, which have been affected by the clay types and clay particle sizes. A model called a house-of-card arrangement of clay particles and anisotropic arrangement in aqueous gels has been proposed. We prepared different sizes of synthetic hectorite and studied them by scanning electron-assisted dielectric microscopy (SE-ADM) and simultaneous small-angle neutron scattering and rheological measurements (Rheo-SANS).

Addition of corticosteroid to periarticular injections reduces postoperative pain following total hip arthroplasty under general anaesthesia: a double-blind randomized controlled trial.

Aims: Although periarticular injection plays an important role in multimodal pain management following total hip arthroplasty (THA), there is no consensus on the optimal composition of the injection. In particular, it is not clear whether the addition of a corticosteroid improves the pain relief achieved nor whether it is associated with more complications than are observed without corticosteroid. The aim of this study was to quantify the safety and effectiveness of cortocosteroid use in periarticular injection during THA.

Intraoperative Intravenous and Intra-Articular Plus Postoperative Intravenous Tranexamic Acid in Total Knee Arthroplasty: A Placebo-Controlled Randomized Controlled Trial.

Background: Combined intraoperative intravenous and intra-articular tranexamic acid (TXA) is 1 of the most effective administration routes to decrease the amount of perioperative blood loss during total knee arthroplasty (TKA). However, the additive effect of postoperative intravenous TXA administration remains unclear. We hypothesized that the postoperative repeated-dose intravenous administration of TXA would provide lower perioperative blood loss.

Comparison of Early-Stage and Late-Stage Periarticular Injection for Pain Relief After Total Hip Arthroplasty: A Double-Blind Randomized Controlled Trial.

Background: No randomized controlled trial has investigated a more optimal timing of periarticular injection for pain relief after total hip arthroplasty.

Methods: The study included 140 patients, and these patients were randomly allocated to the early-stage (periarticular injection was performed just before arthrotomy, and placebo was injected after implantation) or late-stage (placebo was injected just before arthrotomy, and periarticular injection was performed after implantation) injection groups. Other perioperative interventions were similar in all participants.

Does An Augmented Reality-based Portable Navigation System Improve the Accuracy of Acetabular Component Orientation During THA? A Randomized Controlled Trial.

Background: We developed an augmented reality (AR)-based portable navigation system in which the surgeon can view the pelvic plane and placement angle of an acetabular cup on the display of a smartphone during THA.

Questions/purposes: (1) Is acetabular component placement more accurate using the AR-based portable navigation system compared with the conventional freehand technique? (2) Is intraoperative measurement of placement angle more accurate when using the AR-based portable navigation system compared with a goniometer?

Methods: Forty-six patients were randomly assigned to undergo acetabular cup placement during THA using the AR-based portable navigation system (AR navigation group) or placement of a mechanical alignment guide (conventional group). All surgeries were performed with the patient in the lateral decubitus position.

Augmented reality-based navigation system applied to tibial bone resection in total knee arthroplasty.

Background: This pilot study was performed to examine the accuracy of the AR-KNEE system, an imageless navigation system using augmented reality (AR) technology for total knee arthroplasty. The AR-KNEE system enables the surgeon to view information from the navigation superimposed on the surgical field on a smartphone screen in real time.

Methods: Using the AR-KNEE system, one surgeon resected 10 tibial sawbones with viewing the tibial axis and aiming varus/valgus, posterior slope, internal/external rotation angles, and resection level superimposed on the surgical field.

Intra-articular tranexamic acid as an adjunct to intravenous tranexamic acid for simultaneous bilateral total knee arthroplasty: a randomized double-blind, placebo-controlled trial.

Background: Intra-articular tranexamic acid (TXA) as an adjunct to intravenous TXA was reported to decrease perioperative blood loss during unilateral total knee arthroplasty (TKA). However, there have been no randomized controlled trials comparing intravenous versus combined intravenous and intra-articular TXA administration in patients undergoing simultaneous bilateral TKA.

Methods: We randomly assigned 77 patients with 154 involved knees undergoing simultaneous bilateral TKA to the intravenous TXA group (intra-articular placebo for each knee) or combined TXA group (1000 mg of intra-articular TXA for each knee) with 1:1 treatment allocation.

A Strategy of Continued Antiplatelet Agents, Vitamin K Antagonists, and Direct Oral Anticoagulants Throughout the Perioperative Period of Total Knee Arthroplasty in Patients Receiving Chronic Antithrombotic Therapy.

Unlabelled: Although continuing antithrombotic therapy is desirable to prevent perioperative cardiovascular and cerebrovascular diseases, perioperative blood loss remains a concern in patients undergoing total knee arthroplasty. The purpose of this study was to assess the impact of continuing chronic antithrombotic therapy on blood loss and major bleeding events.

Methods: We classified 201 consecutive patients undergoing total knee arthroplasty into 2 groups: (1) patients taking antiplatelet agents, vitamin K antagonists, and/or direct oral anticoagulants, referred to as the continuing antithrombotic therapy group (n = 32); and (2) patients not receiving these agents, referred to as the no antithrombotic therapy group (n = 169).

Intraoperative loose flexion gap may restrict postoperative knee flexion after J-curve design posterior-stabilized total knee arthroplasty.

Introduction: Although soft tissue tension during total knee arthroplasty (TKA) has been targeted to achieve equal flexion and extension gaps, such a perfect gap is not always obtained. This study was performed to investigate the impact of difference between flexion and extension gaps on postoperative knee flexion angle.

Materials And Methods: We reviewed 107 consecutive TKAs using a J-curve design posterior-stabilized prosthesis.

Percutaneous periarticular multi-drug injection at one day after total knee arthroplasty as a component of multimodal pain management: a randomized control trial.

Background: Although intraoperative periarticular multi-drug injection has been used for postoperative pain control after total knee arthroplasty (TKA), the injection has the inherent shortcoming of limited acting time. This randomized controlled trial was performed to assess whether adding percutaneous periarticular multi-drug injection at the day following TKA would improve the postoperative pain relief.

Methods: A total of 43 participants were randomly assigned to receive additional periarticular injection at 08:30, postoperative day 1 or no additional injection.

Early stage periarticular injection during total knee arthroplasty may provide a better postoperative pain relief than late-stage periarticular injection: a randomized-controlled trial.

Purpose: This study was performed to determine whether periarticular injection performed in the early stage of total knee arthroplasty (TKA) could provide a better postoperative pain relief than periarticular injection performed in the late stage of TKA. The hypothesis was based on the concept that analgesic intervention before the onset of noxious stimuli would be associated with less postoperative pain.

Methods: A total of 105 participants were randomly assigned to receive superficial injection just prior to arthrotomy (early stage periarticular injection group) or superficial injection after implanting the prosthesis (late-stage periarticular injection group) in patients undergoing unilateral TKA with 1:1 treatment allocation.

Time-resolved magnetic resonance angiography as a follow-up method for visceral artery aneurysm treated with coil-embolisation.

Purpose: The purpose of this study is to assess the feasibility and usefulness of time-resolved magnetic resonance angiography (TR-MRA) for follow-up of visceral artery aneurysms (VAAs) after embolotherapy.

Material And Methods: Twenty-one VAAs (11 splenic, six renal, three internal iliac, and one superior pancreaticoduodenal artery aneurysms) in 18 patients (median age, 64 years; range, 36-88 years) previously treated by embolisation with platinum coils, were evaluated. The mean size of the aneurysm was 10.

Cutaneous Hypesthesia and Kneeling Ability After Total Knee Arthroplasty: A Randomized Controlled Trial Comparing Anterolateral and Anteromedial Skin Incision.

Background: Anterolateral skin incision can preserve the skin sensory of the anterior aspect of the knee and may improve kneeling ability after total knee arthroplasty (TKA).

Methods: This is a prospective, 2-arm, parallel-group, randomized, controlled trial involving patients scheduled for TKA. A total of 118 patients (162 knees) were randomly assigned to receive anterolateral skin incision or anteromedial skin incision with 1:1 treatment allocation.