The use of an imageless robotic system in revision of unicompartmental knee arthroplasty.

Purpose: The application of robotics in revision arthroplasty particularly from unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA), is underexplored. The purpose of this study is to describe the surgical technique of an imageless robotic system used in the revision of UKA to TKA and to evaluate short- to mid-term outcomes.

Methods: This prospective study includes 35 patients treated from May 2020 to July 2023.

Metal-backed versus all-poly tibia in the original cartier unicompartmental knee arthroplasty: outcomes and survivorship at long-term follow-up.

Purpose: Unicompartmental knee arthroplasty (UKA) is a viable option for localized osteoarthritis (OA) or avascular osteonecrosis with several advantages over total knee arthroplasty (TKA). UKA implants may feature a tibial component either all-polyethylene (AP) or metal-backed (MB). This study aims to retrospectively compare the clinical outcomes and survivorship of 74 UKAs over 16 years, focusing on comparing the results and survivorship of MB versus AP tibial tray.

Fractures around the knee in elderly patients: Balancing fixation and arthroplasty approaches, a multicenter experience.

Introduction: In recent years, a discernible shift has occurred in the approach to knee pathologies, specifically in the management of acute fractures. Traditionally, fractures were primarily treated through osteosynthesis, whereas prosthesis replacement was primarily reserved for degenerative issues. Outcomes of this investigation aim to elucidate the potential indications and contraindications for the use of prosthetic interventions in the management of such fractures and to propose a scoring system that can be adopted for the choice between the two different approaches.

Trochleoplasty and à-la-carte procedures for patellar instability in young and active patients: Clinical outcomes at minimum 2 Years follow-up.

Introduction: Patellar instability is a common condition affecting approximately 6 individuals per 100,000, but among adolescents, this incidence is notably higher. Trochlear dysplasia has been recognized as the pathoanatomic risk factor exerting the most significant biomechanical influence. Over time, various surgical techniques have been developed to address trochlear dysplasia.

Diagnosis and Treatment of Acute Periprosthetic Infections with the BioFire System within a Time-Dependent and Bacterium-Dependent Protocol: Review and Prosthesis-Saving Protocol.

Despite ongoing efforts to enhance diagnostic and treatment processes, the success rate for eradicating infections, particularly prosthetic joint infections (PJIs), currently stands at around 50%. For acute infections occurring shortly after arthroplasty, guidelines recommend a treatment known as DAIR (debridement, antibiotics, and implant retention). This approach is suggested for infections within 30 days post-arthroplasty or with less than 3 weeks of symptoms, provided that there is a stable implant and adequate soft-tissue mass.

The impact of the European Union emissions trading system on carbon dioxide emissions: a matrix completion analysis.

Despite the negative externalities on the environment and human health, today's economies still produce excessive carbon dioxide emissions. As a result, governments are trying to shift production and consumption to more sustainable models that reduce the environmental impact of carbon dioxide emissions. The European Union, in particular, has implemented an innovative policy to reduce carbon dioxide emissions by creating a market for emission rights, the emissions trading system.

A morphometric medial compartment-specific unicompartmental knee system: 5 years follow up results from a pilot center.

Background: Unicompartmental Knee Arthroplasty (UKA) is a valuable solution for the treatment of medial osteoarthritis of the knee. New implants feature designs for the elective substitution of a specific compartment. Aim of this study was to assess the survivorship and functional outcomes at minimum 4 years of the first 60 implanted patients in a pilot center of a new medial UKA as the evolution of a well performing long lasting fixed bearing implant.

Problems and Opportunities of a Smartphone-Based Care Management Platform: Application of the Wald Principles to a Survey-Based Analysis of Patients' Perception in a Pilot Center.

(1) Background: Mobile health (mHealth) solutions can become a means of improving functional recovery and reducing the peri-operative burden and costs associated with arthroplasty procedures. The aim of this study is to explore the objectives, functionalities, and outcomes of a platform designed to provide personalized surgical experiences to qualified patients, along with the associated problems and opportunities. (2) Methods: A survey-based analysis was conducted on patients who were prescribed the use of a specific care management platform and underwent primary robotic total knee arthroplasty (rTKA) between January 2021 and February 2023.

The use of a modern robotic system for the treatment of severe knee deformities.

Background: Robotic-assisted total knee arthroplasty (TKA) have shown promising results in recent years with improved clinical outcomes using standard primary implants.

Objective: The purpose of this study was to assess the experience of a single center in correcting severe coronal deformities with the use of a robotic-assisted TKA system and an increased constrained implant.

Methods: Between July 2020 and December 2022, 30 knees in 28 patients with a major deformity and an associated ligament laxity requiring an increased constrained implant treated using an imageless robotic-assisted TKA were prospectively enrolled.

Radiation Therapy for Gestational Trophoblastic Neoplasia: Forward-Looking Lessons Learnt.

Gestational trophoblastic neoplasia (GTN) includes several rare malignant diseases occurring after pregnancy: invasive moles, choriocarcinoma, placental site trophoblastic tumours, and epithelioid trophoblastic tumours. Multidisciplinary protocols including multi-agent chemotherapy, surgery, and occasionally radiotherapy achieve good outcomes for some high-risk metastatic patients. In this narrative review of the published studies on the topic, we have tried to identify the role of radiotherapy.

Increased accuracy in component positioning using an image-less robotic arm system in primary total knee arthroplasty: a retrospective study.

Background: Robotic-assisted total knee arthroplasty (RTKA) and navigated total knee arthroplasty (NTKA) have shown improved knee alignment and reduced radiographic outliers. Recent studies have proven that conventional mechanical alignment may not be the optimal goal for every patient. The aim of this study was to compare the accuracy of the planned implant positioning of a novel image-less robotic technique with an established navigated technique (NTKA).

PCL preservation or sacrifice does not influence clinical outcomes and survivorship at mid-term follow-up of a J-curve CR total knee replacement with a medial congruent liner and a functional coronal alignment.

Background: In recent years, increasing interest has arisen for medial pivoting TKA implants, designed to mimic the physiological knee kinematics, maximizing the contact area on the medial compartment of the knee, increasing anterior-posterior stability, and contributing to a ball-in-socket effect that allows the posterior cruciate sacrifice without a post-CAM mechanism. The medial congruent liner works with a J-curve cruciate-retaining (CR) femur without a real ball-in-socket design. The aim of this study was to evaluate the clinical outcomes and survival of these implants, with or without PCL sparing, at a medium follow-up.

Uncemented hemiarthroplasty may have a role in the treatment of unstable intertrochanteric fractures in elderly patient. A survival complications and functional outcomes analysis.

Background: Fractures of the proximal femur account for 30% of all fractures requiring surgical treatment. The optimal treatment for per- and intertrochanteric fractures, particularly associated with trochanter instability, is still open to debate. For these reasons, some authors have recently supported the use of bipolar arthroplasty or hemiarthroplasty as a treatment capable of reducing the risk of complications and obtaining a better functional result.

Quantification and characterization of microplastics in the Thermaic Gulf, in the North Aegean Sea.

The abundance and distribution of microplastics has largely increased during last years and the respective implications on the environment and human health is an emerging field in research. In addition, recent studies in the enclosed Mediterranean Sea in Spain and Italy have shown an extended occurrence of microplastics (MPs) in different sediments of environmental samples. This study is focused on the quantification and the characterization of MPs in the Thermaic Gulf in northern Greece.

Alternative Splicing Changes Promoted by NOVA2 Upregulation in Endothelial Cells and Relevance for Gastric Cancer.

Angiogenesis is crucial for cancer progression. While several anti-angiogenic drugs are in use for cancer treatment, their clinical benefits are unsatisfactory. Thus, a deeper understanding of the mechanisms sustaining cancer vessel growth is fundamental to identify novel biomarkers and therapeutic targets.

In Vitro Effects of Photon Beam and Carbon Ion Radiotherapy on the Perineural Invasion of Two Cell Lines of Neurotropic Tumours.

Primary mucosal melanoma (PMM) and pancreatic ductal adenocarcinoma (PDAC) are two aggressive malignancies, characterized by intrinsic radio-chemoresistance and neurotropism, a histological feature resulting in frequent perineural invasion (PNI), supported by neurotrophic factors secreted in the tumour microenvironment (TME), such as neurotrophin-3 (NT-3). Carbon-ion radiotherapy (CIRT) could represent an effective option in unresectable PMM and PDAC. Only a few data about the effects of CIRT on PNI in relation to NT-3 are available in the literature, despite the numerous pieces of evidence revealing the peculiar effects of this type of radiation on tumour cell migration.

Self-assessment of empathy uncovers defective self-awareness in mild cognitive impairment.

Objective: Self-assessment scales are broadly used to evaluate empathy in neurological patients, but it is conceivable that some discrepancy with caregiver evaluation may emerge as consequence of reduced self-awareness. The aim of the present study was to verify the presence of discrepancies in the self-assessment of empathy in subjects with mild cognitive impairment (MCI) and to explore their neural correlates.

Method: Twenty MCI patients and 38 healthy controls (HCs) underwent the Interpersonal Reactivity Index (IRI), exploring the following four aspects of empathy: perspective taking (PT), fantasy, empathic concern, and personal distress.

An exposome connectivity paradigm for the mechanistic assessment of the effects of prenatal and early life exposure to metals on neurodevelopment.

The exposome paradigm through an integrated approach to investigating the impact of perinatal exposure to metals on child neurodevelopment in two cohorts carried out in Slovenia (PHIME cohort) and Greece (HERACLES cohort) respectively, is presented herein. Heavy metals are well-known neurotoxicants with well-established links to impaired neurodevelopment. The links between in and early-life exposure to metals, metabolic pathway dysregulation, and neurodevelopmental disorders were drawn through urinary and plasma untargeted metabolomics analysis, followed by the combined application of and biostatistical methods.

Individualized alignment and ligament balancing technique with the ROSA® robotic system for total knee arthroplasty.

Purpose: Higher patient's expectations and dissatisfaction following total knee arthroplasty are well-documented phenomena. Despite the implications of different patients' related factors both modifiable and nonmodifiable, in the last decade a lot of emphasis has been focused on surgical technique, implant alignment and stability both as a cause and a potential solution of several problems.

Methods: Different alignment and balancing techniques have been recently described and the introduction of new technologies such as computer and robotic-assisted surgery have been the basis for their optimization.

A new robotically assisted technique can improve outcomes of total knee arthroplasty comparing to an imageless navigation system.

Background: Robotic assisted total knee arthroplasty (RTKA) has shown improved knee alignment and reduced radiographic outliers. However, there remains debate on functional outcomes and patient-reported outcomes (PROMs). This study compares the 1-year clinical outcomes of a new imageless robotically assisted technique (ROSA Knee System, Zimmer Biomet, Warsaw, IN) with an imageless navigated procedure (NTKA, iAssist Knee, Zimmer, Warsaw, IN).

A well performing medial fixed bearing UKA with promising survivorship at 15 years.

Background: Unicompartmental knee arthroplasty (UKA) accounts for 10% of knee arthroplasty procedures in Europe. Fixed bearing UKA designs have shown favorable survivorship in registries when compared with mobile bearings. This study analyses long-term follow-up of patients with a medial fixed bearing metal backed tibial UKA and reports 15 years survivorship and clinical outcomes.

Primary TKA in patients with major deformities and ligament laxities: promising results of an intermediate constrained implant at mid-term follow-up.

Background: Total knee arthroplasty (TKA) in major deformities with ligament insufficiency may require a higher constraint, with bone sacrifice and concerns about long-term survivorship. Mid-level constraint liners have been recently introduced, but few studies described their outcomes. The aim of this study is to evaluate the short to mid-term outcomes of a constrained postero-stabilized (CPS) insert for primary TKA in moderate to severe deformities.