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To identify the factors associated with JHEQ score, the patients were divided into lower ( less then 55 score) and higher (≥55) JHEQ score groups. Spearman rank correlation coefficient (r) showed significant difference between the total number of preoperative medications and postoperative JHEQ movement subscale (r = -0.37, p less then 0.01), mental subscale (r = -0.29, p less then 0.01), and JHEQ (r = -0.30, p less then 0.01) scores. In the multiple logistic regression analysis, only the total number of preoperative medications was identified as a risk factor for lower JHEQ score (p less then 0.01). This study clarified an inverse correlation between the total preoperative medication count and postoperative outcomes and found that larger total count of preoperative medications is a risk factor of poor postoperative patient-reported outcomes of THA.<br /><br /> This study compared the effects of symmetric and asymmetric designs for mobile bearing polyethylene insert for total knee arthroplasty (TKA), both clinically and biomechanically through experimental cadaver tests.<br /><br /> 303 patients implanted with a mobile bearing TKA were retrospectively analyzed up to 2-year follow-up with relative scores. The same femoral and tibial components were used for all the patients; 151 patients received a Symmetric Design (SD) insert and 152 an Asymmetric Design (AD). A biomechanical experimental test was performed to improve the comprehension of the clinical results, analyzing passive squat on 5 cadaveric knee specimens internal-external rotations of femur and tibial insert respect to the tibia tray were analyzed in native and implanted configurations (with both symmetrical and asymmetrical inserts for each specimen).<br /><br /> After surgery, patients' average flexion improved from 105° (with preoperative extension deficit of 5°), to 115° (SD-group) and 120° (AD-group) at the 2-year follow-up. There was no postoperative extension deficit. AD-group presented better ability to perform certain routines and wasn't affected by any pain, while antero-lateral pain was reported in some SD-group patients. The experimental tests returned no statistically relevant difference in tibio-femoral flexion-extension and internal-external rotations among all the three configurations tested; a statistically significant difference is found for insert-tray internal-external rotations between SD and AD configurations; in details, the AD insert showed insert-tray angles comparable to the ones found for femoral component-tibial tray, while the SD insert returned lower angular values.<br /><br /> Clinically and biomechanically, an asymmetric mobile bearing insert could represent a valid alternative to symmetric mobile bearing insert.<br /><br /> III, Case-control study Retrospective comparative study.<br /><br />III, Case-control study Retrospective comparative study.With an ever-increasing number of revisions, the surgeons will be faced with the dilemma of choosing the right implant for the revision knee. The soft tissue viability governs the choice of an implant at the time of revision. The selection ranges from the cruciate-retaining to the rotating/fixed hinge implants. The surgeon needs to plan preoperatively, but usually, the final decisions are made intraoperative. As determining the amount of constraint necessary can be challenging, we have tried to lay down a few pointers, which would help to make that choice. The posterior stabilized implants can manage most revision knees; in certain situations where they cannot accommodate the flexion-extension gap imbalance, a varus-valgus constrained implant should be used. The rotating hinge implants are used for severe instabilities or loss of soft tissue or bone around the knee. The use of a higher constraint implant has its consequences like reduced life span and reduced function. Thus it is crucial to use the least amount of constraint as necessary - however, as much as required.Due to the compromised bone situation revision implants need extended fixation options in order to achieve good long-term survival. Over decades this has been achieved with stems, either cemented or uncemented. In the last decade additional fixation options in terms of cementless metaphyseal sleeves or metaphyseal cones have been introduced and widely accepted. Revision of such implants is challenging, in particular if those porous coated parts are well integrated. Therefore, partial revision leaving the well-fixed parts in place can be an option if the indication is allowing it. This can help to preserve bone. In this study we show 2 cases with metaphyseal sleeves, in which we demonstrate when and how revision can be performed leaving sleeves in place. [https://www.selleckchem.com/products/AZD2281(Olaparib).html AZD2281 mouse] Meticulous pre-Op analysis of the failure mechanism is mandatory to find those few cases in which a partial revision can be recommended. In our cases, it was one patient with persistent tibia stem pain and another patient with secondary instability. In both casible. If it is possible, a specific surgical technique is recommended and described in this study.<br /><br /> We describe a novel morphological ratio, the Femoral Access Ratio, in the preoperative femur to investigate the predictors of femoral stem malalignment.<br /><br /> We reviewed 70 cemented femoral stems. Preoperative 'FAR' score was measured. Postoperative coronal stem alignment was measured and ten year survivorship and functional outcomes investigated.<br /><br /> There were three predictors of varus stem malalignment-BMI, GT-height and 'FAR' score. Increasing BMI led to higher rates of malalignment (p=0.048). 'FAR' score &lt;1 lead to 68.4% of varus stems. GT height contributed most to the prediction of varus stem malalignment (p=0.013).<br /><br /> FAR score is a simple preoperative radiographic measurement that can predict the likelihood of femoral stem varus malalignment in cemented femoral stems.<br /><br />FAR score is a simple preoperative radiographic measurement that can predict the likelihood of femoral stem varus malalignment in cemented femoral stems.<br /><br /> The ongoing COVID 19 pandemic brought about a sudden disruption to the way medical services are rendered in our country. Management of maxillofacial injuries, especially isolated mandibular fractures by surgical methods, became near impossibility because of the restrictions and other concerns related to the pandemic.<br /><br /> The individuals who suffered isolated mandibular fracture because of trauma were included, to undergo conservative treatment methods with adaptations for the pandemic. Individuals with multiple bone fractures were excluded, and the selected patients were given the choice to opt out from this treatment plan. We followed a more conservative approach with adaptations, which we have discussed in this article.<br /><br /> The fracture healing for all the patients was as expected, and none of our team members got infected with this virus from exposure to patients.<br /><br /> The adaptations helped in limiting the possible exposure of patients, relatives and health care providers to the virus and addressed other pressing concerns related to this pandemic.