Optimizing Total Knee Arthroplasty With ROSA® Robotic Technology.

A new robotic platform (ROSA® Knee system, Zimmer Biomet, Warsaw, Indiana) for total knee arthroplasty (TKA) has been created to increase precision of bony resections and knee balancing while maintaining surgeon autonomy. Our aim is to discuss: (1) the background of robotic technology in orthopedics, (2) current literature and potential benefits of the ROSA® Knee system, and the (3) optimal surgical technique for this specific robotic TKA platform. Early literature regarding this robotic system is promising as studies have shown precision of its bony resections, accuracy of overall limb alignment, and low early revision rates.

The Effectiveness of Closed-Incision Negative-Pressure Therapy Versus Silver-Impregnated Dressings in Mitigating Surgical Site Complications in High-Risk Patients After Revision Knee Arthroplasty: The PROMISES Randomized Controlled Trial.

Background: Revision total knee arthroplasty (rTKA) is associated with significant risk of wound-related morbidity. The present study aimed to evaluate the 1) efficacy of closed-incision negative-pressure therapy (ciNPT) vs silver-impregnated antimicrobial dressing (AMD) in mitigating postoperative surgical site complications (SSCs), 2) the effect of ciNPT vs AMD on certain postoperative health utilization parameters, and on 3) patient-reported outcomes (PROs) improvement at 90-day postoperative follow-up.

Methods: This multicenter randomized controlled trial was conducted between December 2017 and August 2019.

Blood loss and transfusion rates following patellofemoral arthroplasty.

Patellofemoral arthroplasty (PFA) is a viable treatment option of the patient with isolated patellofemoral arthritis. Some of the purported advantages of PFA compared with total knee arthroplasty (TKA) include less invasive approach, less bone resection and tissue destruction, decreased operative time, shorter rehabilitation, better knee kinematics, and decreased blood loss. This study compared the blood loss associated with PFA with that of a cohort of patients with TKA.

Postoperative pain management.

Although the long-term results following traditional total joint arthroplasty are excellent, postoperative pain management has been suboptimal. Under-treatment of pain is a focus of growing concern to the orthopedic community. Poorly controlled postoperative pain leads to undesirable outcomes, including immobility, stiffness, myocardial ischemia, atelectasis, pneumonia, deep venous thrombosis, anxiety, depression, and chronic pain.

Novel oscillatory mechanisms in the cholinergic control of Guinea pig sino-atrial node discharge.

Unlabelled: Oscillatory Mechanisms in Sinus Node Cholinergic Control. 

Introduction: The role of the oscillatory after-potential V(os) and pre-potential ThV(os) in cholinergic control of discharge was studied in sino-atrial node (SAN).

Methods And Results: A microelectrode technique was used in isolated guinea-pig SAN superfused in vitro in high [K(+) ](o) to visualize V(os) and ThV(os) .

Unanswered questions, unmet needs in venous thromboprophylaxis.

Although significant progress has been made over the past 25 years in preventing thromboembolic disease in patients undergoing total hip and total knee arthroplasty, important questions remain unanswered. Few would debate the need to seek a balance between maximal antithrombotic efficacy and minimal bleeding in choosing a thromboprophylactic strategy, but there is less agreement as to how efficacy should be defined, and whether efficacy and safety (however each is defined) are intrinsic to the thromboprophylactic agent chosen or depend as well on exogenous factors, ranging from the timing of drug administration to surgical technique. Differences between recent guidelines from the American Academy of Orthopaedic Surgeons (AAOS) and the American College of Chest Physicians (ACCP) illustrate these unanswered questions.

Essential role of diastolic oscillatory potentials in adrenergic control of guinea pig sino-atrial node discharge.

Background: The diastolic oscillatory after-potential Vos and pre-potential ThVos play an essential role in the pacemaker mechanism of sino-atrial node (SAN). The aim of this study was to investigate whether these oscillatory potentials are also involved in adrenergic control of SAN discharge.

Methods: Vos and ThVos were visualized by superfusing guinea pig SAN in high [K+]o.

Magnetic resonance imaging of acute "wiiitis" of the upper extremity.

We present the first reported case of acute "wiiitis", documented clinically and by imaging, of the upper extremity, caused by prolonged participation in a physically interactive virtual video-game. Unenhanced magnetic resonance imaging (MRI) demonstrated marked T2-weighted signal abnormality within several muscles of the shoulder and upper arm, without evidence of macroscopic partial- or full-thickness tearing of the muscle or of intramuscular hematoma.

On the mechanisms underlying diastolic voltage oscillations in the sinoatrial node.

Aim: The study of the mechanisms underlying the oscillatory afterpotential (V(os)) and prepotential (ThV(os)).

Background: It has been recently shown that V(os) and ThV(os) play an obligatory role in the dominant sinoatrial node (SAN) discharge.

Methods: Guinea pig isolated SAN was studied in vitro by means of a microelectrode technique.

Obligatory role of diastolic voltage oscillations in sino-atrial node discharge.

The role of diastolic voltage oscillations in the initiation and maintenance of pacemaker discharge was studied in guinea pig-isolated sino-atrial (SA) node by means of a microelecrode technique. When [K(+)](o) is suitably increased, the maximum diastolic potential decreases and all action potentials (APs) assume the characteristics of dominant pacemakers (slow responses with U-shaped diastolic depolarization). Subsequently, as the slope and amplitude of diastolic depolarization (DD) decreases, the threshold is missed, unmasking the fused oscillatory potentials V(os) and ThV(os).