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Poor soft tissue balance in total knee arthroplasty (TKA) often results in patient dissatisfaction and reduced joint longevity. Patella-in-place balancing (PIPB) is a novel technique which aims to restore native collateral ligament behavior without collateral ligament release, while restoring post-operative patellar position. This study aimed to assess the effectiveness of this novel technique through a detailed ex vivo biomechanical analysis by comparing post-TKA tibiofemoral kinematics and collateral ligament behavior to the native condition.

Eight fresh-frozen cadaveric legs (89.2 ± 6 years) were tested on a validated dynamic knee simulator, following computed tomography imaging. Specimens were subjected to passive flexion (10-120°), squatting (35-100°), and varus/valgus laxity testing (10Nm at 0°, 30°, 60°, 90° flexion). An optical motion capture system recorded markers affixed rigidly to the femur, tibia, and patella, while digital extensometers longitudinally affixed to the superficial medial collateduced joint laxity, while restoring collateral ligament strains. The technique also seemed to restore kinematics and strains, especially in passive flexion.

Understanding practice-based differences in treatment of lumbar disc herniations (LDHs) is vital for reducing unwarranted variation in the delivery of spine surgical health care. Identifying factors that influence surgeons' decision-making will offer useful insights for developing the most cost-effective and safest surgical strategy as well as developing surgeon education materials for common lumbar pathologies. This study was to capture any variation in techniques used by surgeons in Australia and New Zealand (ANZ) region, and perceived complications of different surgical procedures for primary and recurrent LDH (rLDH).

Web-based survey study was emailed to orthopaedic and neurosurgeons who routinely performed spinal surgery in ANZ from Decmber 20, 2018 to February 20, 2020. The response data were analyzed to assess for differences based on geography, practice setting, speciality, practice experience, practice length, and operative volume.

Invitations were sent to 150 surgeons; 96 (64%) responded. selleck chemicals llc Most P = 0.023).

Surgeons' annual practice volume and practice setting have significant influences in the selection of surgical procedures and the perception of surgical complications when treating LDHs.

Surgeons' annual practice volume and practice setting have significant influences in the selection of surgical procedures and the perception of surgical complications when treating LDHs.

Elliptical-shaped humeral head prostheses have recently been proposed to reflect a more anatomic shoulder replacement. However, its subsequent effect on micro-motion of the glenoid component is still not understood.

Six fresh-frozen, cadaveric shoulders (mean age 62.7 ± 9.2years) were used for the study. Each specimen underwent total shoulder arthroplasty using an anatomic stemless implant. At 15°, 30°, 45° and 60° of glenohumeral abduction, 50° of internal and external rotations in the axial plane were alternatingly applied to the humerus with both an elliptical and spherical humeral head design. Glenohumeral translation was assessed by means of a 3-dimensional digitizer. Micro-motion of the glenoid component was evaluated using four high-resolution differential variable reluctance transducer strain gauges, placed at the anterior, posterior, superior, and inferior aspect of the glenoid component.

The elliptical head design showed significantly more micro-motion in total and at the superior aspect of glk for glenoid loosening in the long term.

Controlled Laboratory Study.

Controlled Laboratory Study.

Femorotibial alignment is crucial for the outcome of unicompartmental knee arthroplasty (UKA). Robotic-assisted systems are useful to increase the accuracy of alignment in UKA. However, no study has assessed if the femorotibial alignment measured by the image-free robotic system is reliable. The aim of this study was to determine whether measurement of the mechanical femorotibial axis (mFTA) in the coronal plane with handheld robotic assistance during surgery is equivalent to a static measurement on radiographs and to a dynamic measurement during walking.

Twenty patients scheduled for robotic-assisted medial UKA using handheld technology were included in this prospective study. Three measurements of the frontal femorotibial axis were compared intra-operative acquisition by computer assistance (dynamic, non-weightbearing position), radiographic measurements on long leg X-ray (static, weightbearing position), and by gait analysis during walking (dynamic, weightbearing position).

There was no significant difference in the mFTA between computer (174.4 ± 3.4°), radiological (173.9 ± 3.3°), and gait analysis (172.9 ± 5.1°) measurements (p = 0.5). There was a strong positive correlation (r = 0.6577355, p = 0.0016) between robotic-assisted measurements and gait analysis.

There was no significant difference in the femorotibial axis measured by the image-free robotic assistance, from the preoperative radiographs or by gait analysis. The reliability of intra-operative measurements of the frontal femorotibial axis by these robotic-assisted systems is acceptable.

There was no significant difference in the femorotibial axis measured by the image-free robotic assistance, from the preoperative radiographs or by gait analysis. The reliability of intra-operative measurements of the frontal femorotibial axis by these robotic-assisted systems is acceptable.

The aim of the present study was to evaluate if the vancomycin (1mg/ml) is effective for the prevention of septic arthritis after ACL reconstruction. The hypothesis was that local antibiotic prophylaxis by soaking ACL grafts in vancomycin results in significantly less infections than ACL reconstruction without local antibiosis.

In group 1, 636 patients who were operated between 1.9.2014 and 31.8.2016 received no local antibiotic treatment with vancomycin. In group 2, 536 patients who were operated between 1.9.2016 and 31.8.2018 received local antibiotic treatment with vancomycin (1mg/ml). In this group the graft was soaked in the vancomycin solution for 10min prior to graft passage and fixation.

In group 1 (ACL reconstruction without vancomycin application), a postoperative infection was detected in ten patients (infection rate 1.6%). In group 2 (ACL reconstruction with 1mg/ml vancomycin), no postoperative infection was detected (infection rate 0%). The statistical analysis showed a clear significant difference between the two groups (p = 0.