Buckschultz7094

The aim of this study was to trace contacts of coronavirus disease 2019 (COVID-19) hospitalised patients and determine the risk factors of infection in urban areas.

Longitudinal analysis of contacts identified from index cases.

A contact tracing study was carried out in the Northern Metropolitan area of Barcelona, Spain, during the inter-epidemic lapse of May to July 2020, a period of low SARS-CoV-2 incidence. Index cases were notified from the referral hospital. Contacts were traced and followed up for 14 days. Reverse transcription polymerase chain reaction was performed on day 0 and day 14 for contacts.

In total, 368 contacts were identified from 81 index cases (median of seven contacts per index case), from which 308 were traced successfully. The median age of contacts was 28 years, 62% (223 of 368) were men. During the follow-up period, 100 contacts tested positive for COVID-19 (32.5% [95% confidence interval CI=27.3-38.0]), with a secondary infection rate of 48.3% (95% CI=40.8-55.9) among housemates. Clusters of index and respective contacts tended to aggregate within disadvantaged neighbourhoods (P<0.001), and non-national index cases (N = 28, 34.1%) resulted in higher secondary infection rates compared with nationals (51.0% [95% CI=41.0-60.9] vs 22.3% [95% CI=16.8-28.8]; P<0.001).

Disadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.

Disadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.

Mobile-bearing medial-unicompartmental knee arthroplasty (mUKA) has a documented learning curve. New instrumentation has been designed with the aim of reducing the technical challenges of this procedure. The primary aim of this study was to evaluate the technical performance of mUKA using new (Microplasty) versus older (Phase III) instrumentation, performed by expert surgeons and trainees. Secondary aims were to evaluate functional outcome and mid-term survivorship.

A time-based comparative cohort study was performed between 2009 and 2015 at a high-volume centre. 273 patients (273 knees, 49.5% female) of mean age 67.8 (standard deviation 10.1) years underwent mUKA. 153 (56.0%) procedures used Microplasty instruments and 120 procedures (44.0%) used Phase III instruments.

Non-optimal bearing usage was less frequent with Microplasty than Phase III instruments (24 knees [15.7%] versus 33 knees [27.5%], p=0.024), with differences due to improved trainee performance. Femoral component sagittal alignment outliers were less frequent with Microplasty, but this was not statistically significant (9 knees [5.9%] versus 13 knees [10.8%], p=0.18). Post-operative Oxford Knee Scores (OKS) were better with Microplasty (median 42 points [interquartile range 38-44]) compared to Phase III (median 39.5 points [IQR 33-44]), which was statistically significant (p=0.023), but not clinically meaningful. The overall 5-year Kaplan-Meier (KM) survival estimate was 99.3% (95% CI 97.0-99.8%), with no differences between Microplasty and Phase III instrumentation.

New instrumentation improved the reliability of the proximal tibial resection in trainees. Further research is warranted to investigate whether Microplasty instrumentation shortens the learning curve for medial UKA.

New instrumentation improved the reliability of the proximal tibial resection in trainees. Further research is warranted to investigate whether Microplasty instrumentation shortens the learning curve for medial UKA.

A limb symmetry index (LSI) of ≥90% for the quadriceps is recommended for return to sports activity after anterior cruciate ligament reconstruction (ACLR). However, there is no information on differences in muscle fatigability between patients with LSI of <90% and ≥90%. The aim of this study was to assess the difference in quadriceps muscle fatigability on the involved side between post-ACLR patients with LSI of <90% and ≥90%. We hypothesized that there were differences between the two groups in muscle fatigability on the involved side reflecting difference in muscle fiber composition in the vastus medialis (VM) muscle.

The study subjects were 18 adult men who had undergone ACLR followed by rehabilitation therapy. LSI was <90% in 10 and ≥90% in 8 adult men. Surface electromyography (EMG) of the VM muscle was recorded during sustained quadriceps muscle isometric contraction. The median frequency (MF) was computed from the raw EMG signal using fast Fourier transform spectrum analysis. The MF slope was also calculated.

There were no differences in anthropometric characteristics, time since ACLR, anterior tibial translation and peak torque of knee extension on the involved side between the two groups. However, MF slope was significantly lower in the LSI≥90% group than the <90% group.

Our results demonstrated fatigue-resistant vastus medialis in post-ACLR patients with LSI ≥90% compared to those with LSI <90%. The finding adds support to the use of ≥90% as the cutoff value for LSI for return of post-ACLR patients to sports activity.

Our results demonstrated fatigue-resistant vastus medialis in post-ACLR patients with LSI ≥90% compared to those with LSI less then 90%. The finding adds support to the use of ≥90% as the cutoff value for LSI for return of post-ACLR patients to sports activity.

Aseptic loosening (AL) is among the major reasons for revision of failed primary unicompartmental knee arthroplasty (UKA). There is an ongoing temporal increase in the use of UKA with a resultant increase in the revision burden. We aimed to evaluate the incidence of, temporal trends and risk factors for AL.

Longitudinal studies reporting the incidence of AL following primary UKA were sought from MEDLINE, Embase, Web of Science and Cochrane Library up to 6th April 2020. Incidence and relative risks (RR) (with 95% confidence intervals) were calculated.

We identified 62 studies for inclusion. Overall, 96,294 primary UKA procedures accounting for 1752 AL cases were included. 666-15 inhibitor AL incidence ranged from 0.00% to 22.70% over a 7.7 year weighted mean follow-up. The pooled random effects incidence (95% CI) was 1.77% (1.34-2.25) in the same follow-up period. The annual rate of AL was 0.10% (0.02-0.22). AL incidence increased with length of follow-up, but there was a temporal decrease from the 1970s onwards. Tibial loosening was more common than femoral component loosening incidence (95% CI) of 1.