Early Learning Curve in Robotic-Assisted Total Knee Arthroplasty: A Single-Center Experience.

: This study evaluated the learning curve for robotic-assisted total knee arthroplasty (RA TKA) performed by three experienced surgeons, focusing on procedure duration, surgeon satisfaction, and confidence. A prospective study was conducted with three senior arthroplasty surgeons, each performing 15 RA TKA procedures using the Triathlon Knee System with the Robotic Arm Interactive Orthopedic (RIO) System. Data on preparation, cut-to-suture, and breakdown times were collected.

Microarchitectural properties of compacted cancellous bone allografts: A morphology micro-computed tomography analysis.

Massive bone loss poses a significant challenge in defect reconstruction. The use of compacted allografts is a valuable technique to reconstruct bone stock. This study aimed to assess the impact of compression on the microstructure of native cancellous bone chips with a micro-CT analysis.

Does the Addition of Low-Dose Antibiotics Compromise the Mechanical Properties of Polymethylmethacrylate (PMMA)?

The increasing numbers of total joint replacements and related implant-associated infections demand solutions, which can provide a high-dose local delivery of antibiotics. Antibiotic-loaded bone cement (ALBC) is an accepted treatment method for infected joint arthroplasties. The mechanical properties of low-dose gentamicin-loaded bone cement (BC) in medium- and high-viscosity versions were compared to unloaded BC using a vacuum mixing system.

Acetabular defect management and revision arthroplasty via the direct anterior approach.

Objective: Acetabular revision arthroplasty and osseous defect management through the direct anterior approach (DAA) with or without proximal extension.

Indications: Aseptic or septic component loosening, periacetabular osseous defects, pelvic discontinuity, intrapelvic cup protrusion, anterior pseudotumors, iliopsoas tendonitis, polyethylene wear or iliopsoas abscess.

Contraindications: Clinically relevant gluteal tendon lesions, active infection, morbid obesity, large abdominal pannus, ASA (American Society of Anesthesiologists) score > III, inguinal skin infection.

Femoral revision with the direct anterior approach.

Objective: The advantages of the direct anterior approach (DAA) in primary total hip arthroplasty as a minimally invasive, muscle-sparing, internervous approach are reported by many authors. Therefore, the DAA has become increasingly popular for primary total hip arthroplasty (THA) in recent years, and the number of surgeons using the DAA is steadily increasing. Thus, the question arises whether femoral revisions are possible through the same interval.

Aerosol morphology and particle size distribution in orthopaedic bone machining: a laboratory worst-case contamination simulation. Is high-speed bone machining potentially harmful by pollution and quality schemes and what measures could be taken for prevention?

Aim Of The Study: High-speed bone machining devices with irrigation fluid were used in surgery to spread aerosols and toss tissue particles of varying morphology into the operating room. Based on measurements taken on a phantom object, the shape, size, and spatial contamination distribution of such particles were assessed.

Method: Cadaveric femoral heads were continuously machined with a spherical bur, manually held at a fixed attack angle.

A Prospective Assessment of Knee Arthroscopy Skills Between Medical Students and Residents-Simulator Exercises for Partial Meniscectomy and Analysis of Learning Curves.

Background: The Covid-19 pandemic has created the largest disruption of education in history. In a response to this, we aimed to evaluate the knee arthroscopy learning curve among medical students and orthopaedic residents.

Methods: An arthroscopy simulator was used to compare the learning curves of two groups.

Hemiarthroplasty of the hip using the direct anterior approach.

Objective: Minimally invasive approach in total hip arthroplasty for the treatment of femoral neck fractures with a hemiarthroplasty.

Indications: Femoral neck fractures of patients without hip osteoarthritis where the acetabulum is still intact.

Contraindications: Lesions and infections of the skin in the approach area; hip osteoarthritis; surgeon's lack of experience with the technique.

Subsidence of a metaphyseal-anchored press-fit stem after 4-year follow-up: an EBRA-FCA analysis.

Purpose: Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analyse) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless metaphyseal-anchored press-fit stem after 4-year follow-up.

Methods: Applying a retrospective study design, we reviewed all consecutive patients who between 2012 and 2017 received a cementless Accolade II press-fit stem at our Department.

Influence of Nutrient Media Compared to Human Synovial Fluid on the Antibiotic Susceptibility and Biofilm Gene Expression of Coagulase-Negative In Vitro.

Bacterial antibiotic resistance and biofilm formation are mechanisms usually involved in the pathogeny of implant-related infections. Worldwide, antibiotic susceptibility tests are usually carried out using nutrient-rich media. Clinical routine laboratories and even research centers use for example EUCAST or CLSI for guidelines.

Antibacterial and Anti-Biofilm Activity of Omega-3 Polyunsaturated Fatty Acids against Periprosthetic Joint Infections-Isolated Multi-Drug Resistant Strains.

Implantable medical devices, such as prosthetics, catheters, and several other devices, have revolutionized medicine, but they increase the infection risk. In previous decades, commercially available antibiotics lost their activity against coagulase-negative (CoNS) and several other microorganisms. Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are the two major omega-3 polyunsaturated fatty acids (ω-3 PUFAs) with antimicrobial properties.

Mechanical and Morphological Assessment of an Innovative Textile for Patient Positioning Applications: Comparison to Two Standard Bandage Systems.

In the healthcare environment, bandage systems are versatile medical devices to position and fix patients' torsos or extremities. In this study, the mechanical and morphological properties of an innovative patient position system, iFix, were assessed and compared to two commercially available bandages. Morphological properties were investigated using a scanning electron microscope (SEM).

The spatial distribution of aerosols in high-speed bone burring with external irrigation.

It is well-known that the use of high-speed burring devices with irrigation used in bone surgery produces aerosols, and can toss tissue particles into space. The aim of this study was to assess the spatial vertical contamination in the sterile operation field while using a high-speed cutting device at various locations. A fresh porcine knee was resected for 10 min with a high-speed burring device.

The effect of gastrocnemius resection on knee flexion in a total knee arthroplasty model.

Introduction: Flexion contracture in knee arthritis and total knee arthroplasty (TKA) is a common and significant problem. An improvement in knee extension in patients with TKA and mild flexion contractures has been observed clinically when a gastrocnemius recession was performed for other concomitant conditions. The goal of this study was to quantify the effect of gastrocnemius recession on knee flexion in TKA cadaver model.

Variation of BMP2 Concentration and Its Activity in Bone Grafts Obtained from Patients Undergoing Hip Replacement Surgery.

Aim: Bone morphogenetic protein 2 (BMP2) is a member of a subgroup of the transforming growth factor beta superfamily and triggers various signaling events which in turn stimulate chondrogenesis, osteogenesis, angiogenesis and extracellular matrix remodeling leading to fracture healing. In this study, we quantified the concentration of BMP2 in fresh human bone grafts obtained from 40 patients undergoing hip replacement surgery. Besides the concentration, the activity of the detected BMP2 was also investigated.

Femoral Revision Total Hip Arthroplasty Performed through the Interval of the Direct Anterior Approach.

Background: we report the clinical outcomes for femoral revision total hip replacement (THR) using the Direct Anterior Approach (DAA) interval.

Methods: 149 patients (165 hips) with a mean age of 68.9 years (range, 33.

Outcome and EBRA migration analysis of a reconstruction cage in acetabular revision arthroplasty: a clinical and radiological study.

Purpose: Restoration cages and bone allografts have been proposed to manage severe acetabular bone defects. We aimed to investigate the migration behaviour of a restoration cup and impacted allograft bone in severe acetabular defects with Einzel-Bild-Röntgen-Analyse (EBRA).

Methods: Applying a retrospective study design, 64 cases treated between 2009 and 2016 were reviewed.

An intraoperative assessment of bacterial contamination on surgical helmets and gloves during arthroplasty surgeries.

Introduction: Infection is a devasting complication after primary and revision arthroplasty. Therefore, identifying potential sources of infection can help to reduce infection rates. The aim of this study was to identify the impact and potential risk of contamination for glows and surgical helmets during arthroplasty procedures.

Material modifications enhancing the antibacterial properties of two biodegradable poly(3-hydroxybutyrate) implants.

The aim of this study was to evaluate the antimicrobial efficacy of adding a gentamicin palmitate (GP) coating and zirconium dioxide (ZrO) to biodegradable poly(3-hydroxybutyrate) (PHB) to reduce biofilm formation. Cylindrical pins with and without a coating were incubated in Müller-Hinton broth inoculated with 2 × 10 colony-forming units (CFU) ml-1 of Staphylococcus aureus for 2 d or 7 d, then sonicated to disrupt biofilms. Pure PHB (PHB + GP) and PHB pins with ZrO added (PHBzr + GP) were coated with GP and compared with PHB pins lacking a coating (PHB).

Increased Staphylococcus aureus Biofilm Formation on Biodegradable Poly(3-Hydroxybutyrate)-Implants Compared with Conventional Orthopedic Implants: An In Vitro Analysis.

Objective: To compare the biofilm formation on a biodegradable material, poly(3-hydroxybutyrate) (PHB), with that on conventional titanium (Ti) and steel (St) implant material.

Methods: Pins made of the different materials were incubated in Müller-Hinton broth inoculated with 2 × 10 colony-forming units (CFU)·mL of Staphylococcus aureus for 2 and 7 days and then sonicated for the disruption of the biofilms. CFU were counted to quantify the number of bacteria in the biofilm, and the cell proliferation assay 2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H- tetrazolium-5-carboxanilid salt was used to evaluate their metabolic activity.

Mid-term Follow-up of the Direct Anterior Approach in Acetabular Revision Hip Arthroplasty Using a Reconstruction Cage With Impaction Grafting.

Background: Severe acetabular bone loss is often treated with reconstruction cages and impaction grafting using allograft bone. Accurate implant positioning is crucial for successful clinical and radiological outcomes. The direct anterior approach (DAA) is a standard approach for primary total hip arthroplasty (THA) that is being used more frequently for revision THA.

The direct anterior approach: treating periprosthetic joint infection of the hip using two-stage revision arthroplasty.

Background: Either one- or two-stage revision arthroplasties can be used for the treatment of chronic periprosthetic joint infection (PJI) after total hip arthroplasty (THA). We report our results following two-stage revision surgery performed through the direct anterior approach (DAA) interval using a custom-made articulating spacer.

Methods: Between 2009 and 2014, 49 patients (49 consecutive procedures) had surgery through either a DAA or extended DAA approach.