Yilmazmontgomery9130
The thickness of the polyethylene bearing in medial unicondylar knee arthroplasty (UKA) is determined by the depth of the tibial resection, degree of correctable deformity, and balance of the knee. The purpose of this study is to evaluate whether polyethylene thickness in medial mobile-bearing UKA impacts clinical outcomes and survivorship.
A retrospective review from 2004 to 2017 identified patients who underwent a primary mobile-bearing medial UKA with 2-year minimum follow-up or revision. A total of 2305 patients (3030 knees) met inclusion criteria. Patients were divided in 2 groups thin bearing (group 1) 3-mm or 4-mm bearing and thick bearing (group 2) ≥ 5 mm. The thin group consisted of 2640 knees (87%), whereas the thick group had 390 knees (13%). Preoperative and postoperative demographics, range of motion, Knee Society scores, complications, and reoperations were evaluated.
Mean follow-up was 5.2 years (range, 0.5 to 12.6). There was no significant difference between groups in postoperative range of motion or Knee Society scores (P > .05). Manipulations were performed in 1.3% of patients and not significantly different between groups. The all-cause revision rate for group 1 was 4.02% and group 2 was 4.58% (P= .6). Revision rates for tibial aseptic loosening were significantly higher in group 2 (1.8%) than those in group 1 (0.7%) (P= .04). There was no significant difference in failure rates between groups for tibial collapse or fracture, femoral aseptic loosening, arthritic progression, bearing dislocation, or other cause of revision.
This study demonstrated that thicker bearings in medial UKA increased the risk of tibial aseptic loosening, but not all-cause failures or clinical outcomes.
This study demonstrated that thicker bearings in medial UKA increased the risk of tibial aseptic loosening, but not all-cause failures or clinical outcomes.
The clinical benefits of robotic-assisted technology in total joint arthroplasty are unclear, but its use is increasing. This study employed online crowdsourcing to explore public perceptions and beliefs regarding robotic-assisted orthopedic surgery.
A 30-question survey was completed by 588 members of the public using Amazon Mechanical Turk. Participants answered questions regarding robotic-assisted orthopedic surgery, sociodemographic factors, and validated assessments of health literacy and patient engagement. Multivariable logistic regression modeling was used to determine population characteristics associated with preference for robotic technology.
Most respondents believe robotic-assisted surgery leads to better results (69%), fewer complications (69%), less pain (59%), and faster recovery (62%) than conventional manual methods. About half (49%) would prefer a low-volume surgeon using robotic technology to a high-volume surgeon using conventional manual methods. The 3 main concerns regarding robots to be a powerful marketing tool for surgeons and hospitals.
Endoscopic laser-puncture or electrosurgical incision are the most commonly used minimaly invasive approaches for the treatment of the ureterocele. Both techniques are mainly successful in decompressing of ureteroceles, but the consequence of such treatment may be formation of de novo vesicoureteral reflux and febrile urinary tract infection which could impact the final results.
To compare outcomes of treatment of two endoscopic techniques used in management of neonatal patients with intravesical ureterocele.
A case records of 64 neonates who underwent endoscopic procedures for intravesical ureterocele, performed at our institution from January 2005 to January 2021, were retrospectively reviewed. The patients were divided in two groups depending on used endoscopic procedure. The first group (n=41) consisted of patients who underwent electrosurgical incision of the ureterocele, while the second group (n=23) consisted of patients in whom 6 to 8 laser-punctures of the ureterocele were performed. The groups electrosurgical incision and laser-puncture endoscopic techniques are safe and effective in relieving the obstruction. Laser-puncture technique is associated with significantly lower incidence of de novo vesicoureteral reflux and accordingly fewer invasive procedures for neonatal patients.
Both electrosurgical incision and laser-puncture endoscopic techniques are safe and effective in relieving the obstruction. Laser-puncture technique is associated with significantly lower incidence of de novo vesicoureteral reflux and accordingly fewer invasive procedures for neonatal patients.Risk of sudden unexpected death in epilepsy (SUDEP) in children is influenced by different factors such as etiology, seizure type and frequency, treatment, and environment. A greater severity of epilepsy, in terms of seizure frequency, seizures type, especially with nocturnal generalized tonic-clonic seizures (GTCS), and resistance to anti-seizure medication are predisposing factors to SUDEP. GS-4224 molecular weight Potential mechanisms of SUDEP might involve respiratory, cardiovascular, and central autonomic dysfunctions, either combined or in isolation. Patients with epilepsy carrying mutations in cardiac channelopathy genes might be disposed to seizure-induced arrhythmias. Other than in channelopathies, SUDEP has been reported in further patients with genetic epilepsies due to mutations of genes such as DEPDC5, TBC1D24, FHF1, or 5q14.3 deletion. Age-related electro-clinical differences in GTCS may therefore be relevant in explaining differences in SUDEP between adults and children. Typical GTCS represent a rare seizure type in infants and toddlers, they are characterized by a shorter tonic phase and, in direct proportion, by shorter postictal generalized EEG suppression (PGES). The presence of night-time supervision has been found to reduce SUDEP risk, likely reducing SUDEP incidence in children. Reconsideration of safety protocols in epilepsy monitoring units with the aim of reducing the risk of SUDEP, and the use of devices for seizure detection, might contribute to reduce the risk of death in patients affected by epilepsy. This article is part of the Special Issue "Severe Infantile Epilepsies".
