Palovarotene in fibrodysplasia ossificans progressiva: review and perspective.

Introduction: Palovarotene is a retinoic acid receptor gamma agonist that was studied in phase-2 and phase-3 clinical trials for the inhibition of new heterotopic ossification (HO) in fibrodysplasia ossificans progressiva (FOP). Despite numerous setbacks and regulatory delays, palovarotene is now the first approved FOP treatment in the U.S.

Nanograin-enhanced surface-layer strengthening of 3D printed intervertebral cage induced by sandblasting.

3D-printed customized titanium alloy (Ti6Al4V, TC4) as load-bearing prostheses and implants, such as intervertebral cages, have been widely used in clinical practice. Native biological inertia and inadequate bone in-growth of porous titanium alloy scaffolds hampered their clinical application efficiency and then extended the healing period. To improve the osseointegration capacity of 3D-printed intervertebral cages, sandblasting was selected to execute their surface treatment.

Enhancements in artificial intelligence for medical examinations: A leap from ChatGPT 3.5 to ChatGPT 4.0 in the FRCS trauma & orthopaedics examination.

Introduction: ChatGPT is a sophisticated AI model capable of generating human-like text based on the input it receives. ChatGPT 3.5 showed an inability to pass the FRCS (Tr&Orth) examination due to a lack of higher-order judgement in previous studies.

Comparative analysis of conventionally and additively manufactured acetabular shells from a single manufacturer.

Background: The Trident II Tritanium acetabular shell is additively manufactured (3D printed), based on the established Trident 'I' Tritanium shell, produced using conventional methods; this study characterised their differences.

Methods: We obtained 5 Trident I (T1) and 5 Trident II (T2) shells sized 52 mm, 54 mm (n = 3) and 60 mm. We measured their: mass, shell-liner engaging surface roughness, roundness, wall thickness, the depth of the bone-facing porous layer, porosity, and the number, volume and location of structural voids.

Surface adhered titanium particles on 3D printed off-the-shelf acetabular cups.

3D printing is a rapidly growing manufacturing method of medical implants. In orthopedics, this method enables the construction of complex porous structures with the aim of improved bone fixation. A known by-product of the 3D printing process is surface adhered particles which are often challenging to remove from the strut surfaces of the porous region.

A Prospective Observational Cohort Study for Newly Diagnosed Osteosarcoma Patients in the UK: ICONIC Study Initial Results.

There has been little change to the standard treatment for osteosarcoma (OS) over the last 25 years and there is an unmet need to identify new biomarkers and novel therapeutic approaches if outcomes are to improve. Furthermore, there is limited evidence on the impact of OS treatment on patient-reported outcomes (PROs). ICONIC (Improving Outcomes through Collaboration in Osteosarcoma; NCT04132895) is a prospective observational cohort study recruiting newly diagnosed OS patients across the United Kingdom (UK) with matched longitudinal collection of clinical, biological, and PRO data.

High Velocity Passive Stretching Mimics Eccentric Exercise in Cerebral Palsy and May Be Used to Increase Spastic Muscle Fascicle Length.

Muscle fascicles are shorter and stiffer than normal in spastic Cerebral Palsy (CP). Increasing fascicle length (FL) has been attempted in CP, the outcomes of which have been unsatisfactory. In healthy muscles, FL can be increased using eccentric exercise at high velocities (ECC).

Fabrication of a Triple-Layer Bionic Vascular Scaffold via Hybrid Electrospinning.

Tissue engineering aims to develop bionic scaffolds as alternatives to autologous vascular grafts due to their limited availability. This study introduces a novel wet-electrospinning fabrication technique to create small-diameter, uniformly aligned tubular scaffolds. By combining this innovative method with conventional electrospinning, a bionic tri-layer scaffold that mimics the zonal structure of vascular tissues is produced.

Periprosthetic tibial fracture as a complication of unicompartmental knee arthroplasty: Current insights.

Periprosthetic fracture following knee arthroplasty is a rare but devastating complication associated with significant morbidity. With unicompartmental knee arthroplasty being performed far less frequently than total knee arthroplasty, periprosthetic fracture following unicompartmental knee arthroplasty presents a particular challenge to orthopaedic surgeons, due to clinical unfamiliarity and sparsity of literature. An up-to-date review of the epidemiology, risk factors, and management strategies for PPF after UKA is presented.

Total Knee Arthroplasty in Patients Who Have Skeletal Dysplasia: A Center's Experience With a Mean 9-Year Follow-Up.

Background: Total knee arthroplasty (TKA) in patients who have skeletal dysplasia (SD) is a technically challenging surgery due to deformity, joint contracture, and associated comorbidities. Patients presenting with this condition have traditionally been treated with conservative measures, leading to poor outcomes. The aim of this study was to follow-up on patients who had SD following TKA, specifically with regards to clinical outcomes.

The Sarcoma Assessment Measure (SAM): Preliminary Psychometric Validation of a Novel Patient-Reported Outcome Measure.

The Sarcoma Assessment Measure (SAM) was developed as a sarcoma-specific patient-reported outcome measure to be used in clinical practice. We have reported in detail how SAM has been developed in collaboration with patients and healthcare professionals. The aim of this paper is to report the preliminary validation of SAM.

The failure of subcategorization of cauda equina syndrome.

The diagnostic sub-categorization of cauda equina syndrome (CES) is used to aid communication between doctors and other healthcare professionals. It is also used to determine the need for, and urgency of, MRI and surgery in these patients. A recent paper by Hoeritzauer et al (2023) in this journal examined the interobserver reliability of the widely accepted subcategories in 100 patients with cauda equina syndrome.

Osteosynthesis, hemiarthroplasty, total hip arthroplasty in hip fractures: All I need to know.

Recent data from the UK's National Hip Fracture Database (NHFD) demonstrate an upward trajectory in the incidence of hip fractures, a trend which is expected to persist. In 2023 alone, the NHFD reported 72,160 cases, underscoring the prevalence of these injuries. These fractures are associated with significant morbidity, mortality, and economic costs.

Conformationally regulated "nanozyme-like" cerium oxide with multiple free radical scavenging activities for osteoimmunology modulation and vascularized osseointegration.

Given post-operative aseptic loosening in orthopedic disease treatment, osteointegration occurs at the bone-implant interface as a holistic process, including immunoregulation (e.g., macrophage polarization), angiogenesis and osteogenesis in sequence.

Frequent microbiological profile changes are seen in subsequent-revision hip and knee arthroplasty for prosthetic joint infection.

A proportion of patients with hip and knee prosthetic joint infection (PJI) undergo multiple revisions with the aim of eradicating infection and improving quality of life. The aim of this study was to describe the microbiology cultured from multiply revised hip and knee replacement procedures to guide antimicrobial therapy at the time of surgery. : Consecutive patients were retrospectively identified from databases at two specialist orthopaedic centres in the United Kingdom between 2011 and 2019.

Cemented or uncemented fixation: Which allows a more acceptable prosthetic femoral version in total hip arthroplasty?

Background: Three-dimensional computed-tomography (3D-CT) planning for primary Total Hip Arthroplasty (THA) typically uses the external femoral surface; as a result, it is difficult to predict the prosthetic femoral version (PFV) for uncemented femoral stems that press-fit to the internal surface of the bone. Cemented fixation allows the surgeon to adjust the version independent of the internal femoral anatomy. We aimed to better understand the effect of the fixation type on PFV.

Periprosthetic acetabular fractures as a complication of total hip arthroplasty.

Periprosthetic acetabular fractures are rare but potentially devastating complications of total hip arthroplasty. As the number of total hip arthroplasties performed annually increases, so has the incidence of periprosthetic fractures, with the topic being spotlighted more frequently in the orthopaedic community. There is a particular sparsity of literature regarding periprosthetic acetabular fractures, with periprosthetic femoral fractures after total hip arthroplasty being traditionally far more commonly reported.

A Geometric Analysis of Polyethylene Liners Exposed to Acrylic-based Bone Cement.

Background: Acrylic-based bone cement (polymethyl methacrylate [PMMA]) is a material commonly used in orthopaedic surgeries; however, during PMMA polymerization, a highly exothermic reaction occurs. The heat released in polymerization can damage nearby materials including poorly heat-resistant cross-linked polyethylene (XLPE). Both PMMA and XLPE are used in total hip arthroplasty and could interact during femoral stem fixation.

Patients' Experiences of a Sarcoma Diagnosis: A Process Mapping Exercise of Diagnostic Pathways.

Unlabelled: Patients with sarcoma often report prolonged time to diagnosis, which is attributed to the rarity of sarcoma and the low awareness of pre-diagnostic signs and symptoms.

Aims: To describe patients' experiences of pre-diagnostic signs/symptoms and pathways to diagnosis, including where help was sought, and the processes involved.

Methods: Mixed methods involving quantitative, qualitative and inductive thematic analyses using novel process mapping of patient journey data, as reported by the patients.

Hip Resurfacing Arthroplasty: Past, Present and Future.

The history of hip resurfacing arthroplasty (HRA) has faced numerous challenges and undergone decades of evolution in materials and methods. These innovations have been translated to the successes of current prostheses and represent a surgical and mechanical achievement. Modern HRAs now have long term outcomes with excellent results in specific patient groups as demonstrated in national joint registries.