Predictors of outcome following two-stage revision total knee arthroplasty.

Purpose: Two stage revision arthroplasty remains the gold standard for peri-prosthetic joint infections of the knee. However, the functional outcomes of revision surgeries and the factors governing them require further investigation. The purpose of this study was to (a) evaluate impact of early and late stage I surgery and interval between stage I and stage II; (b) understand the impact of infecting organism and resistance; (c) to estimate long term survivorship and causes of failure.

Robotic Assisted TKA achieves adjusted mechanical alignment targets more consistently compared to manual TKA without improving outcomes.

Introduction: Robotic total knee arthroplasty (rTKA), with its purported advantages of more accurate alignment, greater functional outcomes and patient satisfaction, is gaining popularity in patients undergoing TKA. The purpose of our study was to compare these parameters along with gait pattern and kneeling ability in a cohort of patients who underwent simultaneous TKA with manual instrumentation (mTKA) and rTKA in contralateral knees at a 1-year follow-up.

Methods: This was a retrospective review of 135 consecutive patients who underwent simultaneous bilateral TKA using robotic assistance on one side and manual instrumentation on the contralateral side between January 2022 and June 2022.

Phytonutrients in the promotion of healthspan: a new perspective.

Considering a growing, aging population, the need for interventions to improve the healthspan in aging are tantamount. Diet and nutrition are important determinants of the aging trajectory. Plant-based diets that provide bioactive phytonutrients may contribute to offsetting hallmarks of aging and reducing the risk of chronic disease.

A randomized double-blind trial to measure the absorption characteristics of eicosapentaenoic acid and docosahexaenoic acid rich oil blend with natural lipid-based delivery system.

A randomized, double-blinded trial with 65 subjects was conducted to compare the pharmacokinetics between PhytoMarineCelle (PM) that consists of eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) plus a self-emulsifying drug delivery system (SEDDS), and a standard EPA + DHA ethyl ester (SEE) that does not contain SEDDS. PM showed 1.6-fold greater plasma area under the curve (AUC) than SEE at 300 mg, although no significant difference was observed.

Induction of ferroptosis in human keratinocyte HaCaT cells by squalene hydroperoxide: Possible prevention of skin ferroptosis by botanical extracts.

Ever since the proposal of ferroptosis, it has been studied as a nonapoptotic cell death caused by iron ion-dependent phospholipid (PL) peroxidation. We previously showed that treatment of human hepatoma cell line HepG2 with prepared PL hydroperoxide (PLOOH) resulted in ferroptosis. However, in human sebum, the major hydroperoxide is not PLOOH but squalene hydroperoxide (SQOOH), and to our knowledge, it is not established yet whether SQOOH induces ferroptosis in the skin.

Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update.

With a significant rise in the number of arthroplasty procedures performed worldwide, the increasing revision burden posed by periprosthetic joint infection (PJI) is a matter of growing concern. In spite of various attempts to diagnose PJI, there are no defined tests that can be called a gold standard. Given the importance of early diagnosis in PJI, newer tests and biomarkers have been introduced to improve cumulative diagnostic accuracy.

PCL retention demonstrates better functional scores and gait patterns in total knee arthroplasty using a medial congruent insert-a prospective study.

Purpose: Despite Total Knee Arthroplasty (TKA) being one of the most successful procedures for end stage arthritis, nearly 20% of patients undergoing this procedure remain dissatisfied. Various design options have been introduced to reduce this cohort of patients. One such option has been the introduction of the medial congruent (MC) polyethylene design.

'Every patient, every day': a daily ward round tool to improve patient safety and experience.

Introduction: Many essential interventions are required to ensure in-patients receive safe and effective care with a good experience. In addition, healthcare organisations are assessed on numerous performance indicators, including the aforementioned interventions, where underperformance can lead to lower publicly reported ratings, loss of income and reputational damage. Most importantly, underperformance can lead to compromised patient experience and outcomes.

Pharmacokinetic Comparison of Chitosan-Derived and Biofermentation-Derived Glucosamine in Nutritional Supplement for Bone Health.

Glucosamine and chondroitin sulfate have been used as nutritional supplementation for joint tissues and osteoarthritis (OA). Biofermented glucosamine is of great interest in the supplement industry as an alternative source of glucosamine. The purpose of this study is to compare the pharmacokinetics of chitosan-derived glucosamine and biofermentation-derived glucosamine as nutritional supplementation.

Failure modes in malrotated total knee replacement.

Purpose: Achieving normal rotational alignment of both components in total knee arthroplasty (TKA) is essential for improved knee survivorship and function. However, malrotation is a known complication resulting in higher revision rates. Understanding malrotation of the components and its concomitant clinical and functional outcomes are important for early diagnosis and management.

Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts.

Purpose: There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.

Comparison of Different Strategies in Revision Arthroplasty of the Knee with Severe Bone Loss: A Systematic Review and Meta-Analysis of Clinical Outcomes.

Background: In revision total knee arthroplasty large bone lesions can jeopardize correct implant orientation and fixation. Different strategies have been proposed to tackle this issue. The purpose of this review and meta-analysis is to evaluate the midterm clinical and survivorship results of porous cones and porous-coated sleeves compared to morselized and structural grafts.

Evaluating Long Term Outcomes and Survivorship of Cruciate Retaining and Sacrificing Knee Replacements Done for Degenerative Arthritis in Patients Under 55 Years.

Background: Total Knee Arthroplasty (TKA) is the gold standard of treatment for end stage arthritis not responding to conservative treatment. With a recent increase in the younger population presenting with osteoarthritis (OA) we undertook this study to evaluate long-term outcomes and survivorship of TKA in this cohort.

Materials And Methods: Our study cohort included 328 patients, < 55 years, with OA, who underwent TKA using Cruciate Retaining (CR), and Posterior Stabilized (PS) implants with a minimum follow up of 15 years.

Recognizing the Role of the Posterolateral Corner in Patients Undergoing Total Knee Arthroplasty for Fixed Varus Deformity.

Purpose: Varus deformity is the commonest presentation of the arthritic knee requiring surgical intervention. While correctable deformities lend themselves to realignment options like unicompartmental replacement, fixed deformities often need a total knee replacement. Current treatment options for patients with fixed coronal varus malalignment undergoing total knee arthroplasty include varying degrees of medial soft tissue releases, often leading to infringement of the medial collateral ligament complex and increased use of constrained options.

Effect of intestinal dialysis using polyethylene glycol on fluid balance and thirst in maintenance hemodialysis patients: A comparative study.

High inter-dialytic weight gains (IDWG) and Hyperkalemia have been associated with adverse outcomes like poor quality of life and high mortality. Thirst remains an unsolved problem in hemodialysis (HD) patients. The aim of this study was to evaluate the effect of polyethylene glycol (PEG) based intestinal dialysis on IDWG, thirst and biochemical parameters.

Development and internal validation of clinical prediction models for outcomes of complicated intra-abdominal infection.

Background: Complicated intra-abdominal infections (cIAIs) are associated with significant morbidity and mortality. The aim of this study was to describe the clinical characteristics of patients with cIAI in a multicentre study and to develop clinical prediction models (CPMs) to help identify patients at risk of mortality or relapse.

Methods: A multicentre observational study was conducted from August 2016 to February 2017 in the UK.

Midterm Outcomes of Tantalum Metal Cones for Severe Bone Loss in Complex Primary and Revision Total Knee Arthroplasty.

Background: Managing severe periarticular bone loss poses a major challenge in complex primary and revision total knee arthroplasty (TKA). Impaction bone graft, structural allografts, metal augments, and mega prosthesis are some of the methods used to address major bone loss. Tantalum metal (TM) Cones (Zimmer, Warsaw, IN) were introduced as an alternative to address this cohort of patients.

Therapeutic Potential of Cannabidiol (CBD) for Skin Health and Disorders.

Though there is limited research confirming the purported topical benefits of cannabinoids, it is certain that cutaneous biology is modulated by the human endocannabinoid system (ECS). Receptors from the ECS have been identified in the skin and systemic abuse of synthetic cannabinoids, and their analogs, have also been associated with the manifestation of dermatological disorders, indicating the effects of the ECS on cutaneous biology. In particular, cannabidiol (CBD), a non-psychoactive compound from the cannabis plant, has garnered significant attention in recent years for its anecdotal therapeutic potential for various pathologies, including skin and cosmetic disorders.

A Five-Year Comparative Functional and Clinical Evaluation of Two Contemporary Cruciate-Retaining Knee Implants.

Background: The purpose of our study was to compare 2 commonly used highly successful cruciate-retaining knee designs on the basis of patient-reported outcome measures (PROMs), range of motion (ROM), and anterior knee pain (AKP) at a minimum follow-up of 5 years.

Methods: A cohort of 65 patients underwent unilateral total knee arthroplasty, from January 2013 to December 2013, using NexGen Cruciate Retaining (Zimmer Biomet, Warsaw, IN), a nonmorphogenic knee (NMK) system. They were subsequently operated upon for the contralateral knee using Persona Cruciate Retaining (Zimmer Biomet, Warsaw, IN), a morphogenic knee (MK) system between January 2014 and June 2014.

Improvement of Orthopedic Residency Programs and Diversity: Dilemmas and Challenges, an International Perspective.

Background: To date, little has been published comparing the structure and requirements of orthopedic training programs across multiple countries. The goal of this study was to summarize and compare the characteristics of orthopedic training programs in the U.S.