Does Femoral Stem Design Influence Periprosthetic Fracture Incidence and Morphology in Total Hip Arthroplasty?

Background: As the incidence of total hip arthroplasty (THA) increases, the number of periprosthetic femur fractures (PFFs) will also rise. The surgical approach and stem design have been shown to influence the rate of PFF. This study evaluated PFF in cementless THA done through the posterior approach and described how stem design influences intraoperative and early postoperative fracture incidence and morphology.

Global atmospheric methane uptake by upland tree woody surfaces.

Methane is an important greenhouse gas, but the role of trees in the methane budget remains uncertain. Although it has been shown that wetland and some upland trees can emit soil-derived methane at the stem base, it has also been suggested that upland trees can serve as a net sink for atmospheric methane. Here we examine in situ woody surface methane exchange of upland tropical, temperate and boreal forest trees.

Risk Factors of Failure to Discharge Before "Two Midnights" in Outpatient-Designated Total Hip Arthroplasty.

Introduction: The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only list but continued to classify admissions as inpatient if they include two midnights, complicating care if an outpatient THA requires extended hospitalization. This study evaluates risk factors of patients undergoing outpatient-designated THA with a length of stay (LOS) ≥ 2 days.

Methods: A total of 17,063 THA procedures designated as outpatient in the National Surgical Quality Improvement Program database between 2015 and 2020 were stratified by LOS < 2 days (n = 2,294, 13.

Evaluation of augmented reality training for a navigation device used for CT-guided needle placement.

Purpose: Numerous navigation devices for percutaneous, CT-guided interventions exist and are, due to their advantages, increasingly integrated into the clinical workflow. However, effective training methods to ensure safe usage are still lacking. This study compares the potential of an augmented reality (AR) training application with conventional instructions for the Cube Navigation System (CNS), hypothesizing enhanced training with AR, leading to safer clinical usage.

Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System.

Background: Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes.

Jones Fracture in the National Football League.

Jones fracture, or proximal fifth metatarsal fracture, is a common injury in National Football League (NFL)-caliber athletes. Combine draft performance can greatly impact the long-term success of these athletes, and substantial emphasis has been placed on early return to play (RTP) and the minimization of post-operative complications after Jones fracture in these athletes. To date, no study has specifically described the treatment and outcomes of this injury specifically in NFL-caliber players, considering factors relevant to this unique population.

Gender Trends in Authorship in 6 Major Orthopaedic Journals.

Background: Historically, orthopaedic surgery has had low female representation, with <6% of practicing surgeons identifying as female. Although prior literature has illustrated gender disparities in first and last authorship as well as changes in gender representation over time, less attention has been paid to middle authorship. We hypothesized that trends in female authorship would reflect increasing female participation in orthopaedic surgery and orthopaedic subspecialties coinciding with an overall increase in female authorship.

Structure-function relationship study for sulfated protein therapeutics using hydrophobic interaction chromatography and mass spectrometry.

Protein tyrosine sulfation is a post-translational modification (PTM) that is rarely reported in recombinant therapeutic proteins. However, when sulfation does occur, the additional negative charge from the modification can influence intermolecular interactions and antigen-binding activity, making it a critical quality attribute that necessitates stringent control. In this study, we developed a unique hydrophobic interaction chromatography (HIC) method for the separation and quantification of a therapeutic bispecific antibody with varying degrees of sulfation.

Management of Intraoperative Acetabular Fractures During Total Hip Arthroplasty.

Intraoperative fractures of the acetabulum are a rare but serious complication during total hip arthroplasty. Acute fractures generally require attention with plating, whereas chronic acetabular fractures may be approached with distraction, a Burch-Schneider cage, or a custom implant. It is imperative for arthroplasty surgeons to possess a thorough understanding of how to identify and manage these injuries.

Treating Sleep Disorders After Total Hip and Total Knee Arthroplasty.

Disorders of sleep are common after total hip and knee arthroplasty and may contribute to patient dissatisfaction and poorer outcomes in the early postoperative period. Multiple factors contribute to sleep disorders, including poorly controlled pain, opioid medication, perioperative stress, and anxiety. Both pharmacologic and nonpharmacologic methods have been used for perioperative sleep disorders, but there is no consensus on the optimal treatment.

Biomechanical profile of varying suture button constructs in cadaveric specimens: a systematic review and meta-analysis.

Background: Suture button fixation of syndesmotic injuries allows for more physiologic motion of the ankle joint while maintaining adequate reduction and may avoid the need for additional surgeries, given the lower risk of syndesmotic diastasis and implant failure. Few studies have examined the optimal number and configuration of suture buttons for syndesmotic disruption. The purpose of this systematic review and meta-analysis is to compare different suture button configurations from the cadaveric literature and to assess their relative effect on the stability of the syndesmotic reduction and functional movement of the ankle.

Modern Patellofemoral Arthroplasty.

Introduction: The ideal procedure for isolated patellofemoral arthritis is a controversial topic. Patellofemoral arthroplasty (PFA) is an option that aims to restore normal kinematics to the knee while preserving bone. PFA has been shown to have benefits compared with total knee arthroplasty (TKA) in this patient population but has historically had a high failure rate.

Trends in outcomes following aseptic revision shoulder arthroplasty.

Purpose: As the incidence of anatomic and reverse total shoulder arthroplasty (TSA, RSA) increases, revision procedures will also increase with a corresponding need for counseling patients regarding outcomes. We hypothesized that different revision categories would have different complication profiles depending on both the indication as well as the nature of the prior hardware.

Methods: A retrospective review of 1773 cases performed at a single tertiary health system utilized case postings and diagnoses to identify revision shoulder arthroplasty cases.

Robotic Technology in Foot and Ankle Surgery: A Comprehensive Review.

Recent developments in robotic technologies in the field of orthopaedic surgery have largely been focused on higher volume arthroplasty procedures, with a paucity of attention paid to robotic potential for foot and ankle surgery. The aim of this paper is to summarize past and present developments foot and ankle robotics and describe outcomes associated with these interventions, with specific emphasis on the following topics: translational and preclinical utilization of robotics, deep learning and artificial intelligence modeling in foot and ankle, current applications for robotics in foot and ankle surgery, and therapeutic and orthotic-related utilizations of robotics related to the foot and ankle. Herein, we describe numerous recent robotic advancements across foot and ankle surgery, geared towards optimizing intra-operative performance, improving detection of foot and ankle pathology, understanding ankle kinematics, and rehabilitating post-surgically.

Outcomes after bilateral shoulder arthroplasty: a systematic review.

The purpose of this systematic review was to report outcomes after bilateral shoulder arthroplasty including bilateral total shoulder arthroplasty (TSA), bilateral reverse shoulder arthroplasty (RSA), and ipsilateral TSA with contralateral RSA (TSA/RSA). Two reviewers independently performed a PRISMA-guided systematic search using MEDLINE/PubMed, Embase, and Cochrane Database of Systematic Reviews up to May 11, 2021. The databases were queried using the following search terms: (["bilateral" OR "contralateral"] AND "shoulder" AND ["arthroplast∗" OR "replacement"]).

Unraveling, contributing factors to the severity of postprandial hypoglycemia after gastric bypass surgery.

Background: Despite the increasing prevalence of postbariatric hypoglycemia (PBH), a late metabolic complication of bariatric surgery, our understanding of its diverse manifestations remains incomplete.

Objectives: To contrast parameters of glucose-insulin homeostasis in 2 distinct phenotypes of PBH (mild versus moderate hypoglycemia) based on nadir plasma glucose.

Setting: University Hospital (Bern, Switzerland).

Multiplexed Assay to Quantify the PP-Fold Family of Peptides in Human Plasma Using Microflow Liquid Chromatography-Tandem Mass Spectrometry.

Background: Peptide Tyr-Tyr (PYY1-36), pancreatic polypeptide (PP1-36) and neuropeptide Y (NPY1-36) constitute the PP-fold family of peptides that is involved in metabolic regulation. Very low plasma concentrations and cleavage into active 3-36 fragments challenge bioanalytical assays used for the quantification of these peptides.

Methods: We developed a multiplexed isotopic dilution assay to quantify PYY1-36, PP1-36, and NPY1-36 and their dipeptidyl peptidase-4 (DPP4)-derived metabolites PYY3-36, PP3-36 and NPY3-36.

Non-flooded riparian Amazon trees are a regionally significant methane source.

Inundation-adapted trees were recently established as the dominant egress pathway for soil-produced methane (CH) in forested wetlands. This raises the possibility that CH produced deep within the soil column can vent to the atmosphere via tree roots even when the water table (WT) is below the surface. If correct, this would challenge modelling efforts where inundation often defines the spatial extent of ecosystem CH production and emission.

Recurrent nonbacterial thrombotic endocarditis and stroke on anticoagulation.

We present a rare case of recurrent nonbacterial thrombotic endocarditis (NBTE) and stroke despite anticoagulation. A 48-year-old man with history of antiphospholipid syndrome, prior nonbacterial aortic valve endocarditis status post valve replacement and prior stroke was found to have acute ischemic stroke while on apixaban and nonbacterial thrombotic endocarditis of mitral valve. This was initially managed conservatively with therapeutic dose of enoxaparin, but the patient later underwent mitral valve replacement.

Effect of fully automated closed-loop insulin delivery using faster aspart versus standard aspart on gluco-regulatory hormones in type 2 diabetes.

We retrospectively assessed gluco-regulatory hormones over 10 h (including two meals) of fully automated closed-loop insulin delivery using faster (FA) versus standard insulin aspart (IAsp) in adults with type 2 diabetes [n = 15, age 59 ± 10 years, body mass index 34.5 ± 9.1 kg/m , glycated haemoglobin 7.

Publisher Correction: Implications of the strain irreversibility cliff on the fabrication of particle-accelerator magnets made of restacked-rod-process NbSn wires.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Implications of the strain irreversibility cliff on the fabrication of particle-accelerator magnets made of restacked-rod-process NbSn wires.

The strain irreversibility cliff (SIC), marking the abrupt change of the intrinsic irreversible strain limit ε as a function of heat-treatment (HT) temperature θ in NbSn superconducting wires made by the restacked-rod process (RRP), is confirmed in various wire designs. It adds to the complexity of reconciling conflicting requirements on conductors for fabricating magnets. Those intended for the high-luminosity upgrade of the Large Hardon Collider (LHC) at the European Organization for Nuclear Research (CERN) facility require maintaining the residual resistivity ratio RRR of conductors above 150 to ensure stability of magnets against quenching.

Precipitous change of the irreversible strain limit with heat-treatment temperature in NbSn wires made by the restacked-rod process.

The intrinsic irreversible strain limit ε of NbSn superconducting wires, made by the restacked-rod process and doped with either Ti or Ta, undergoes a precipitous change as a function of temperature θ of the final heat-treatment for forming the A15 phase. NbSn transitions from a highly brittle state where it cracks as soon as it is subjected to an axial tensile strain of any measurable amount, to a state more resilient to tensile strain as high as 0.4%.