The effect of index finger distal interphalangeal joint arthrodesis on muscle forces and adjacent joint contact pressures.

Distal interphalangeal joint arthrodesis is a frequent surgical operation performed to treat severe arthritis. Nevertheless, the angle selected when fusing the joint is arbitrarily chosen without any quantified data concerning its mechanical effects, thus preventing the optimal choice for the patient. In the current study, we realized an experiment and developed a numerical model to investigate the effect of fusion angle on the biomechanics of adjacent non-operated joints.

A Morphometric Fixed-Bearing Unicompartmental Knee Arthroplasty Can Reproduce Normal Knee Kinematics. An In Vitro Robotic Evaluation.

Background: A new morphometric fixed-bearing unicompartmental knee arthroplasty (UKA) system has been introduced to address the anatomical patient-specific challenges. It was our hypothesis that accurate restoration of the patient-specific anatomy would restore normal knee kinematics after UKA. Therefore, we aimed in this cadaveric study to analyze the impact of a medial morphometric UKA on (1) the varus-valgus and anterior-posterior stability of the knee, (2) the knee kinematics during standardized activities of the daily living, and (3) the patellar tracking, measured using a dedicated robotic testing protocol.

ACL surgical trends evolve in the last five years for young European surgeons: results of the survey among the U45 ESSKA members.

Purpose: Although the outcomes of ACL reconstruction are generally satisfying, there are several patients who do not regain their pre-injury sporting level and suffer persistent symptoms. Orthopaedic practice has evolved significantly over the last five years to address these drawbacks. The aim of the present survey was to analyze the changes in the approach to ACL reconstruction among a population of young ESSKA surgeons dedicated to ACL surgery.

Failure analysis of articulating polymethyl methacrylate spacers in two-stage revision total hip arthroplasty.

Aims: Two-stage exchange revision total hip arthroplasty (THA) performed in case of periprosthetic joint infection (PJI) has been considered for many years as being the gold standard for the treatment of chronic infection. However, over the past decade, there have been concerns about its safety and its effectiveness. The purposes of our study were to investigate our practice, collecting the overall spacer complications, and then to analyze their risk factors.

The reliability of the Neer classification for proximal humerus fractures: a survey of orthopedic shoulder surgeons.

Background: The Neer classification is among the most widely used systems to describe proximal humerus fractures (PHF) despite the poor interobserver agreement. The purpose of this study was to verify whether or not blinded shoulder surgeons and trainees agree with the authors of articles published in the highest impact-factor orthopedic journals.

Methods: All articles regarding PHF published between 2017 and 2019 in the top 10 orthopedic journals as rated by impact factor were searched.

An anatomo-functional implant positioning technique with robotic assistance for primary TKA allows the restoration of the native knee alignment and a natural functional ligament pattern, with a faster recovery at 6 months compared to an adjusted mechanical technique.

Purpose: An anatomo-functional implant positioning (AFIP) technique in total knee arthroplasty (TKA) could restore physiological ligament balance (symmetric gap in extension, asymmetric gap in flexion). The purposes were to compare (1) ligament balancing in extension and flexion after TKA in the AFIP group, (2) TKA alignment, implant positioning and patellar tracking between AFIP and adjusted mechanical alignment (aMA) techniques, (3) clinical outcomes between both groups at 12 months.

Methods: All robotic-assisted TKA with an AFIP technique were included (n = 40).

Assessing the Elasticity of Child Cortical Bone.

A better understanding of the mechanical behaviour of child bone is essential to improve the diagnosis of pediatric bone disorders that may influence bone development. Even though the process of bone growth is well described, there are still lacks of knowledge on intrinsic material properties of child bone and particularly on child bone considered as "non-pathological". Geometry, material properties, microstructure and biochemical components are associated with child bone fragility and remain difficult to assess for two main reasons: the scarcity of the bone samples and their small dimensions.

Artificial intelligence in knee arthroplasty: current concept of the available clinical applications.

Background: Artificial intelligence (AI) is defined as the study of algorithms that allow machines to reason and perform cognitive functions such as problem-solving, objects, images, word recognition, and decision-making. This study aimed to review the published articles and the comprehensive clinical relevance of AI-based tools used before, during, and after knee arthroplasty.

Methods: The search was conducted through PubMed, EMBASE, and MEDLINE databases from 2000 to 2021 using the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA).

Staged BiCompartmental Knee Arthroplasty has Greater Functional Improvement, but Equivalent Midterm Survivorship, as Revision TKA for Progressive Osteoarthritis After Partial Knee Arthroplasty.

Background: Progressive arthritis in the unresurfaced compartments of the knee is one failure mode after partial knee arthroplasty (PKA). While progressive arthritis after PKA is typically treated with revision to TKA (rTKA), staged bicompartmental knee arthroplasty (sBiKA) -the addition of another PKA - is an alternative. This study compared outcomes of sBiKA and rTKA for progressive arthritis after PKA.

Implantation of the Femoral Component Relative to the Tibial Component in Medial Unicompartmental Knee Arthroplasty: A Clinical, Radiological, and Biomechanical Study.

Background: Unicompartmental knee arthroplasty (UKA) is a procedure with low morbidity and fast recovery. Anatomic implants or robotic-assisted UKA has been proposed to improve outcomes with precise positioning. Femoral component position (FCP) relative to the tibial insert could be a factor influencing the contact stresses.

Assessment of Bone Microarchitecture in Fresh Cadaveric Human Femurs: What Could Be the Clinical Relevance of Ultra-High Field MRI.

MRI could be applied for bone microarchitecture assessment; however, this technique is still suffering from low resolution compared to the trabecular dimension. A clear comparative analysis between MRI and X-ray microcomputed tomography (μCT) regarding microarchitecture metrics is still lacking. In this study, we performed a comparative analysis between μCT and 7T MRI with the aim of assessing the image resolution effect on the accuracy of microarchitecture metrics.

Coronal and sagittal alignment of the lower limb in Caucasians: Analysis of a 3D CT database.

Introduction: Lower limb alignment is a major determinant of long-term outcomes after osteotomy or total knee replacement. The aim of this paper is to define the mean values of coronal and sagittal lower limb alignment for Caucasians as a function of sex using 3D reconstructions from CT-scans.

Materials And Methods: The analysis involved 586 Caucasian patients (269 males and 317 females) who had their hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior proximal tibial angle (PPTA), lateral and medial proximal posterior tibial angles (LPPTA/MPPTA), posterior distal femoral angle (PDFA), and non-weightbearing joint convergence angle (nwJLCA) measured.

Ethnical Differences in Knee Phenotypes Indicate the Need for a More Individualized Approach in Knee Arthroplasty: A Comparison of 80 Asian Knees with 308 Caucasian Knees.

The purpose of this study was to determine the distribution of functional knee phenotypes in a non-osteoarthritic Asian population. The Stryker Orthopaedic Modeling and Analytics (SOMA) database was searched for CT scans of the lower limb meeting the following inclusion criteria: patient age at time of image >18 and <46 years, no signs of fractures and/or previous surgery and/or degenerative changes, Asian ethnicity. A total of 80 CT scans of 40 patients were included (24 males, 16 females).

A 3-Dimensional Suture Technique for Flexor Tendon Repair: A Biomechanical Study.

Purpose: Flexor tendon injury continues to pose a number of challenges for hand surgeons. Improving mechanical properties of repairs should allow for earlier and unprotected rehabilitation. A 3-dimensional (3D) 4-strand suture technique has been proposed to combine high tensile strength and low gliding resistance without causing suture pullout due to tendon delamination.

Femoral and Tibial Bony Risk Factors for Anterior Cruciate Ligament Injuries Are Present in More Than 50% of Healthy Individuals.

Background: Anterior cruciate ligament (ACL) injuries are multifactorial events that may be influenced by morphometric parameters. Associations between primary ACL injuries or graft ruptures and both femoral and tibial bony risk factors have been well described in the literature.

Purpose: To determine values of femoral and tibial bony morphology that have been associated with ACL injuries in a reference population.

Intradiscal oxygen-ozone therapy for the treatment of symptomatic lumbar disc herniation: A preliminary study.

Purpose: To assess safety and effectiveness of computed tomography (CT)-guided intradiscal oxygen-ozone therapy (O-O therapy) for the treatment of symptomatic lumbar disc herniation and radiological changes.

Materials And Methods: This study was conducted in twenty patients presenting lumbar disc herniation with resistant lumbar or lumbar radicular pain They underwent intradiscal oxygen-ozone therapy under CT guidance. They were treated at one- or two-disc levels, representing a total of 24 discs treated.

Validation and Optimization of Proximal Femurs Microstructure Analysis Using High Field and Ultra-High Field MRI.

Trabecular bone could be assessed non-invasively using MRI. However, MRI does not yet provide resolutions lower than trabecular thickness and a comparative analysis between different MRI sequences at different field strengths and X-ray microtomography (μCT) is still missing. In this study, we compared bone microstructure parameters and bone mineral density (BMD) computed using various MRI approaches, i.

Safe and reliable clinical outcomes at 2 years of a fixed-bearing partial knee arthroplasty with a morphometric tibial tray in a large worldwide population.

Purpose: The purpose of this study was to evaluate: (1) improvement of functional and quality of life scores, (2) adverse events, (3) short-term implants survivorship of a newly designed fixed-bearing partial knee replacement (PKR) with a morphometric tibial tray in a large and multicentric population at a minimum follow-up of 2 years.

Methods: From 2017 to 2019, 479 medial PKR were implanted by 16 non-developing surgeons from United States, Europe, and Japan. Eight patients were lost to follow-up (1.

Impact of bone deformities and labral and cartilage lesions on early functional results of arthroscopic treatment of femoroacetabular impingement.

Introduction: Femoroacetabular impingement (FAI) is a frequent cause of inguinal pain. Treatment failure rates range between 2.9% and 13.

The torsion of the proximal femur in cementless total hip arthroplasty: a 3-dimensional evaluation.

Introduction: The anatomy of the proximal femur at the time of total hip arthroplasty has been widely studied but the horizontal plane was never considered, or only limited to the torsion of the femoral neck.

Methods: Using CT-scan images from a group of 178 patients scheduled for cementless total hip arthroplasty (THA), we analysed the evolution of the torsion of the proximal femoral metaphysis, in reference to the posterior bicondylar plane of the femur. The evolution of the torsion, between 20 mm below the centre of the lesser trochanter and 20 mm above, was evaluated.

Patellar height is not modified after isolated open-wedge high tibial osteotomy without change in posterior tibial slope.

Introduction: Open-wedge high tibial osteotomy (OWHTO) corrects coronal deformity and can impact sagittal parameters such as posterior tibial slope and patellar height. The aim of the present study was to analyze change in patellar height after medial OWHTO with respect to tibial and femoral-referenced indices.

Material And Method: This single-center retrospective study included 129 patients undergoing isolated posteromedial OWHTO, without change in tibial slope, using patient-specific cutting-guides.

Intraoperative virtual reality distraction in TKA under spinal anesthesia: a preliminary study.

Introduction: The effect of patient anxiety during the perioperative period has been shown to be of great importance in its influence on post-operative recovery. Over the last 10 years, virtual reality (VR) has been developed in anesthesia for patient's distraction by immersion. The aim of this study was to evaluate post-operative patient anxiety the day after TKA surgery under spinal anesthesia (SA) with or without VR distraction.

Assistive technologies in knee arthroplasty: fashion or evolution? Rate of publications and national registries prove the Scott Parabola wrong.

Purpose: Most opponents of assistive technologies in orthopedic surgery consider them as a marketing ruse or fashion. Our hypothesis was that many innovations in modern knee arthroplasty are not following the Scott Parabola. This parabola represents the visual curve of a procedure or therapy showing great promise at the beginning, becoming the standard treatment after reports of encouraging results, only to fall into disuse due to adverse outcome reports.