Pharmacological prevention of arthrofibrosis: a systematic review.

Background And Aims: Arthrofibrosis is a complication of intra-articular knee surgery which is caused by intra-articular fibrosis. To date, several preventive therapies for arthrofibrosis have been reported. This systematic review aims to summarize current knowledge about pharmacological arthrofibrosis prevention.

Impact of implant design on the Forgotten Joint Score: a retrospective study comparing two contemporary knee designs.

This retrospective study was designed to assess two fixed bearing total knee design concepts and their clinical outcomes, particularly in Forgotten Joint Score-12 (FJS-12). Patients were assessed clinically using the Knee Society Score (KSS). Participants completed an FJS-12 and a short form of the Knee Injury and Osteoarthritis Outcome Score (KOOS-PS).

Does Unicondylar Knee Arthroplasty Affect Tibial Bone Strain? A Paired Cadaveric Comparison of Fixed- and Mobile-bearing Designs.

Background: Unexplained pain in the medial proximal tibia frequently leads to revision after unicondylar knee arthroplasty (UKA). As one of the most important factors for osteogenic adaptive response, increased bone strain following UKA has been suggested as a possible cause.

Questions/purposes: In this study we: (1) performed a cadaver-based kinematic analysis on paired cadaveric specimens before and after mobile-bearing and fixed-bearing UKA; and (2) simultaneously characterized the strain distribution in the anterior and posterior proximal tibia during squatting.

The forgotten joint score in total and unicompartmental knee arthroplasty: a prospective cohort study.

Purpose: The purpose of this study was to assess whether unicompartmental knee arthroplasty (UKA) results in better patient-reported and clinical outcome than total knee arthroplasty (TKA). The study hypothesis was UKA yields better patient-reported and clinical outcomes than TKA.

Methods: Our prospective cohort study compared patients who underwent medial UKA or TKA from February 2014 through June 2015.

A novel technology for 3D knee prosthesis planning and treatment evaluation using 2D X-ray radiographs: a clinical evaluation.

Purpose:  To present a clinical validation of a novel technology called "3X" which allows for 3D prosthesis planning and treatment evaluation in total knee arthroplasty (TKA) using only 2D X-ray radiographs.

Materials And Methods:  After local institution review board approvals, 3X was evaluated on 43 cases (23 for preoperative planning and 20 for postoperative treatment evaluation). All the patients underwent CT scans according to a standard protocol.

Kinematics of mobile-bearing unicompartmental knee arthroplasty compared to native: results from an in vitro study.

Introduction: Fixed-bearing unicompartmental knee arthroplasty (UKA) closely replicates native knee kinematics. As few studies have assessed kinematics following mobile-bearing (MB) UKA, the current study aimed to investigate whether MB UKA preserves natural knee kinematics.

Materials And Methods: Seven fresh-frozen full-leg cadaver specimens were prepared and mounted in a kinematic rig that allowed all degrees of freedom at the knee.

The influence of polyethylene bearing thickness on the tibiofemoral kinematics of a bicruciate retaining total knee arthroplasty.

Background: The recently reintroduced bicruciate retaining Total Knee Arthroplasty (BCR TKA) is an effort to reproduce kinematics closer to the native knee. However, there is no data on appropriate balancing with this implant. Balancing is crucial and challenging as medial and lateral polyethylene (PE) inlays are modular, which allows for placement of different thicknesses in the medial and lateral compartments.

Kinematics of a bicruciate-retaining total knee arthroplasty.

Purpose: The recently reintroduced bicruciate-retaining Total Knee Arthroplasty (BCR TKA) is an interesting approach in the quest for close replication of knee joint biomechanics and kinematics closer to the native knee. Therefore, this study aimed at providing a detailed biomechanical view on the functional resemblance of BCR TKA to the native knee joint.

Methods: Seven fresh-frozen full leg cadaver specimens (76 ± 10 year) were mounted in a 6 degrees-of-freedom kinematic rig that applied a dynamic squatting motion knee flexion.

Malrotation deformities of the lower extremity and implications on total knee arthroplasty: a narrative review.

Introduction: Total knee arthroplasty (TKA) is a successful procedure for the management of osteoarthritis (OA) of the knee. Axial plane deformities are more common than suspected in patients presenting with osteoarthritis of the knee joint. Recent research has indicated that torsional deformities could play an important role in the development of anterior knee pain (AKP).

Balancing mobile-bearing unicondylar knee arthroplasty in vitro.

Purpose: Balancing mobile-bearing (MB) unicondylar knee arthroplasty (UKA) is challenging. If performed improperly, potential complications include pain, implant loosening, or progression of osteoarthritis in the preserved compartment. The purpose of this study was to document effects of improper balancing on knee kinematics and joint contact stress.

Custom-made lateral femoral hemiarthroplasty for traumatic bone loss: A case report.

We report the case of a 32-year-old male patient involved in a road traffic accident in which he sustained a grade II open supra- and intercondylar fracture of the left distal femur with substantial bone loss of the lateral femoral condyle and trochlea (AO classification type 33 C3). Normal knee function was no longer possible, as the patella was trapped within the bony defect. Existing reconstructive options such as unicondylar osteoarticular allograft, arthrodesis, and arthroplasty were considered.

Cost-effectiveness of unicondylar versus total knee arthroplasty: a Markov model analysis.

Background: Unicondylar knee arthroplasty (UKA) is believed to lead to less morbidity and enhanced functional outcomes when compared with total knee arthroplasty (TKA). Conversely, UKA is also associated with a higher revision risk than TKA. In order to further clarify the key differences between these separate procedures, the current study assessing the cost-effectiveness of UKA versus TKA was undertaken.

Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis.

Purpose: Two design concepts are currently used for unicondylar knee arthroplasty (UKA) prostheses: fixed bearing (FB) and mobile bearing (MB). While MB prostheses have theoretical advantages over their FB counterparts, it is not clear whether they are associated with better outcomes. A systematic review was conducted to examine survivorship differences and differences in failure modes of between FB and MB designs.

Endoscopic decompression for chronic compartment syndrome of the forearm in motocross racers.

Purpose: Sporting activities that involve repetitive stress to muscle compartments can elicit chronic exertional compartment syndrome. Its occurrence in the lower leg muscle compartments is most common, but other locations are less well known and the pathophysiology is not completely understood. In motocross racers, chronic exertional compartment syndrome can occur in the muscles of the lower arm.

Identifying structural barriers to an effective HIV response: using the National Composite Policy Index data to evaluate the human rights, legal and policy environment.

Introduction: Attention to the negative effects of structural barriers on HIV efforts is increasing. Reviewing national legal and policy environments with attention to the international human rights commitments of states is a means of assessing and providing focus for addressing these barriers to effective HIV responses.

Methods: Law and policy data from the 171 countries reporting under the Declaration of Commitment from the 2001 United Nations General Assembly Special Session on HIV/AIDS were analyzed to assess attention to human rights in national legal and policy environments as relevant to the health and rights of key populations such as people who inject drugs, men who have sex with men and sex workers.

Evaluating HIV prevention effectiveness: the perfect as the enemy of the good.

There is a need to better understand the effectiveness of HIV-prevention programs. Cluster randomized designs have major limitations to evaluate such complex large-scale combination programs. To close the prevention evaluation gap, alternative evaluation designs are needed, but also better articulation of the program impact pathways and proper documentation of program implementation.

Survivorship of UKA in the middle-aged.

Background: Unicompartmental knee arthroplasty (UKA) is known to be a viable procedure allowing for preservation of the intact compartments and delivering excellent function at long-term follow-up. The primary purpose of this single-surgeon study was to analyse the survivorship of a fixed bearing UKA in patients younger than 60 years.

Methods: From all UKAs implanted between 1993 and 2005 at the senior authors' centre, 223 patients <60 years at operation with a minimum follow-up of 5 years were identified including all-poly and metal-backed tibiae.

Increasing civil society participation in the national HIV response: the role of UNGASS reporting.

Background: The 2001 Declaration of Commitment on HIV/AIDS provided impetus for strengthening collaboration between government and civil society partners in the HIV response. The biennial UNGASS reporting process is an opportunity for civil society to engage in a review of the implementation of commitments.

Methods: Descriptive analyses of the National Composite Policy Index from 135 countries; a debriefing on UNGASS reporting with civil society in 40 countries; and 3 country case studies on the UNGASS process.

Are the investments in national HIV monitoring and evaluation systems paying off?

Background: Concerted efforts and substantial financial resources have gone toward strengthening national monitoring and evaluation (M&E) systems for HIV programs. This article explores whether those investments have made a difference in terms of data availability, quality and use for assessing whether national programs are on track to achieve the 2015 Millennium Development Goal (MDG) of halting and reversing the HIV epidemic.

Methods: Descriptive analyses, including trends, of the National Composite Policy Index data and M&E expenditures were conducted.

Human rights in the global response to HIV: findings from the 2008 United Nations General Assembly Special Session Reports.

Background: Every country in the world has made human rights-related commitments in relation to HIV, yet assessment of the extent to which HIV-related rights are indeed respected, protected and fulfilled remains relatively new. Civil society has, in some places, highlighted the strengths and shortcomings of government action, but attention to governments' own reports of their performance vis-à-vis their HIV-related human rights obligations offers an important and inadequately explored data source.

Methods: We reviewed National Composite Policy Index data from 133 United Nations General Assembly Special Session Country Progress Reports and examined their narrative reports for text relating to human rights.

Chronic exertional compartment syndrome of the forearm in motocross racers: findings on MRI.

Introduction: The purpose of this prospective study was to demonstrate the findings of MRI in motocross racers with chronic exertional compartment syndrome (CECS) of the forearm.

Materials And Methods: Racers with proven CECS and without CECS and male individuals not involved in strenuous activities with the forearm were included. Signal intensity (SI) and signal-to-noise ratio (SNR) obtained before and after exercise were compared (D-SNR).

Is oral vitamin D a risk factor for prosthetic loosening?

High counts of wear particles and activated macrophages are strong predictors of prosthetic loosening in total joint arthroplasty patients. The tissue response, dominated by macrophages, with production of inflammatory mediators and matrix-degrading enzymes, triggers a self-accelerating cycle of osteolysis, ultimately resulting in failure of the arthroplasty, high treatment cost and poor patient outcome. Vitamin D is frequently used as a treatment for osteoporosis, but might also contribute to osteolysis in inflammatory joints.

Prolonged operative time correlates with increased infection rate after total knee arthroplasty.

Risk stratification has proven to be a useful tool in surgical site infection prevention. The duration of the surgical procedure has been recommended for use in surgical site infection (SSI) risk stratification (Infect Control Hosp Epidemiol 20:247-248, 1999). A retrospective analysis of 6489 patients who underwent total knee replacement (TKR) between 1993 and 1999 assessed the association between the duration of the surgical procedure and the risk of postoperative infection.

ASA physical status classification is not a good predictor of infection for total knee replacement and is influenced by the presence of comorbidities.

The American Society of Anesthesiologists Physical Status Classification System (ASA) ranks patients for risk of adverse events during a surgical procedure. The ASA classification is used as a surrogate for the patient's underlying severity of illness and has been recommended for use in Surgical Site Infection (SSI) and risk stratification. We assessed the predictive power of the ASA score for total knee replacement surgery infection, and compared it to a comorbidity score.