bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heterogeneous distribution of viscosupplements in vivo is correlated to ex vivo frictional properties of equine cartilage
Authors: Vishwanath Karan , McClure Scott R. , Bonassar Lawrence J. 
Published: June 2024

AbstractIntra‐articular injections of hyaluronic acid (HA) are the cornerstone of osteoarthritis (OA) treatments. However, the mechanism of action and efficacy of HA viscosupplementation are debated. As such, there has been recent interest in developing synthetic viscosupplements. Recently, a synthetic 4 wt% polyacrylamide (pAAm) hydrogel was shown to effectively lubricate and bind to the surface of cartilage in vitro. However, its ability to localize to cartilage and alter the tribological properties of the tissue in a live articulating large animal joint is not known. The goal of this study was to quantify the distribution and extent of localization of pAAm in the equine metacarpophalangeal or metatarsophalangeal joint (fetlock joint), and determine whether preferential localization of pAAm influences the tribological properties of the tissue. An established planar fluorescence imaging technique was used to visualize and quantify the distribution of fluorescently labeled pAAm within the joint. While the pAAm hydrogel was present on all surfaces, it was not uniformly distributed, with more material present near the site of the injection. The lubricating ability of the cartilage in the joint was then assessed using a custom tribometer across two orders of magnitude of sliding speed in healthy synovial fluid. Cartilage regions with a greater coverage of pAAm, that is, higher fluorescent intensities, exhibited friction coefficients nearly 2‐fold lower than regions with lesser pAAm (Rrm = −0.59, p < 0.001). Collectively, the findings from this study indicate that intra‐articular viscosupplement injections are not evenly distributed inside a joint, and the tribological outcomes of these materials is strongly determined by the ability of the material to localize to the articulating surfaces in the joint.
Third‐generation posterior‐stabilised cemented system for total knee arthroplasty: Survivorship and outcomes after 20‐year follow‐up
Authors: Patiño Contreras José Luis , Sebastián Pérez Victoria , Antonio Checa García , Jorge Montejo Sancho , Javier Martínez Martín 
Published: June 2024

AbstractPurposeTotal knee arthroplasty is a common procedure due to increased life expectancy and ageing populations, necessitating implants with long‐term efficacy. After some initial designs, the third‐generation modular posterior‐stabilised NexGen® prosthesis aimed to enhance kinematics and reduce complications. This study evaluates the long‐term outcomes, survivorship, revision rates and complications of this implant. With promising results observed up to 15 years in previous studies, this investigation aims to assess the implant's performance over extended follow‐up periods, aiding in optimal implant selection for improved patient outcomes.MethodsWe carried out a retrospective study on 263 total knee arthroplasties performed in our centre between 1998 and 2002. Statistical analysis of complications was performed and study of survival using the Kaplan–Meier method and competing risk analysis were calculated. Description of reinterventions and complications were also included.ResultsResults show a 20‐year prosthesis survival rate of 90.8% for revision due to any reason, with an estimated survival of 92.3% considering competitive events. Estimated survivorship at 20 years is 98% for aseptic loosening as the end point, and an estimation of 98.80% considering competitive events. Twenty revisions were performed, with 10 cases due to infection and 10 for noninfectious reasons and three of them due to aseptic loosening. Radiographic analysis revealed radiolucent lines, but no clinical evidence of loosening was observed in these cases.ConclusionThis study offers survivorship data from longer follow‐up periods, what is difficult to find in the reported literature and showed excellent results of this implant in terms of survivorship and low rates of revision in our cohort.Level of EvidenceLevel IV.
Chitosan‐based scaffold augmentation to microfractures: Stable results at mid‐term follow‐up in patients with patellar cartilage lesions
Authors: De Marziani Luca , Boffa Angelo , Andriolo Luca , Di Martino Alessandro , Filardo Giuseppe , Zaffagnini Stefano 
Published: June 2024

AbstractPurposePatellar cartilage lesions are a frequent and challenging finding in orthopaedic clinical practice. This study aimed to evaluate a chitosan‐based scaffold's mid‐term clinical and imaging results patients with patellar cartilage lesions.MethodsThirteen patients (nine men, four women, 31.3 ± 12.7 years old) were clinically evaluated prospectively at baseline, 12, 24 and at a final minimum follow‐up of 60 months (80.2 ± 14.7) with International Knee Documentation Committee (IKDC) subjective, Knee Injury and Osteoarthritis Outcome Score and Tegner scores. A magnetic resonance analysis was performed at the last follow‐up using the Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) 2.0 score.ResultsAn overall significant clinical improvement in the scores was observed from baseline to all follow‐ups, with stable clinical results from 24 months to the mid‐term evaluation. The IKDC subjective score passed from 46.3 ± 20.0 at baseline to 70.1 ± 21.5 at the last follow‐up (p = 0.029). Symptoms' duration before surgery negatively correlated with the clinical improvement from baseline to the final follow‐up (p = 0.013) and sex influenced the improvement of activity level from the preoperative evaluation to the final follow‐up, with better results in men (p = 0.049). In line with the clinical findings, positive results were documented in terms of cartilage repair quality with a mean MOCART 2.0 score of 72.4 ± 12.5.ConclusionsOverall, the use of this chitosan‐based scaffold provided satisfactory results with a stable clinical improvement up to mid‐term follow‐up, which should be confirmed by further high‐level studies to be considered a suitable surgical option to treat patients affected by patellar cartilage lesions.Level of EvidenceLevel IV, prospective case series.
Are transmembrane 6 superfamily member 2 gene polymorphisms associated with steatohepatitis after pancreaticoduodenectomy?
Authors: Mori Tomotaka , Ozawa Eisuke , Sasaki Ryu , Shimakura Akane , Takahashi Kosuke , Kido Yoko , Kanda Yasuko , Matsuo Satoshi , Tajima Kazuaki , Beppu Asami , Nakao Yasuhiko , Fukushima Masanori , Haraguchi Masafumi , Miuma Satoshi , Miyaaki Hisamitsu , Adachi Tomohiko , Eguchi Susumu , Okano Shinji , Nakao Kazuhiko 
Published: June 2024

AbstractAimAfter pancreaticoduodenectomy, 20–40% of patients develop steatotic liver disease (SLD), and steatohepatitis can be a problem. Although patatin‐like phospholipase domain‐containing 3 protein (PNPLA3) and transmembrane 6 superfamily member 2 (TM6SF2) polymorphisms are involved in SLD and steatohepatitis development, whether this is the case after pancreaticoduodenectomy is unclear.Methods and ResultsForty‐three patients with pancreatic cancer who underwent pancreaticoduodenectomy at our hospital between April 1, 2018, and March 31, 2021, were included. We extracted DNA from noncancerous areas of residual specimens after pancreaticoduodenectomy and determined PNPLA3 and TM6SF2 gene polymorphisms using real‐time polymerase chain reaction. SLD was defined as a liver with an attenuation value of ≤40 HU or a liver‐to‐spleen ratio of ≤0.9 on computed tomography. We defined high hepatic fibrosis indexes (HFI) instead of steatohepatitis as a Fibrosis‐4 index of ≥2.67 or nonalcoholic fatty liver disease fibrosis score of ≥0.675 in patients with SLD. The cumulative incidence of SLD (P = 0.299) and high HFI (P = 0.987) after pancreaticoduodenectomy were not significantly different between the PNPLA3 homozygous and minor allele groups. The incidences of high HFI at 1 year after pancreaticoduodenectomy were 16.8% and 27.0% in the TM6SF2 major homozygous and minor allele groups, respectively, with a significant difference in the cumulative incidence (P = 0.046).ConclusionThe TM6SF2 minor allele may contribute to steatohepatitis development after pancreaticoduodenectomy.
Adherence to therapeutic gastroscopy guidelines for acute esophageal food bolus impaction: Impact on adverse outcomes and length of stay
Authors: Pan Fei Yang , Duong Tuan Anh , Davis Kimberley J. , Smale Matthew , Kapoor Sahil , Rogge Claudia 
Published: June 2024

AbstractBackground and AimAccording to the European Society of Gastrointestinal Endoscopy (ESGE), gastroscopy should be conducted within 6 h for complete obstruction and 24 h for incomplete obstruction due to food bolus impaction. This study explores whether adults with acute esophageal food bolus (FB) impaction experience adverse outcomes when their time to esophagogastroduodenoscopy (EGD) deviates from the recommended guidelines.MethodsA retrospective review was performed on the records of 248 patients who presented at the study site between 2015 and 2022 with symptoms of FB impaction.ResultsTwo hundred and forty‐eight patients underwent EGD for FB impaction. Grade 1 (erosion, ulceration), Grade 2 (tear), and Grade 3 (perforation) complications were present in 31.6%, 6.9%, and 0.8% of cases, respectively. Of the 134 (54.0%) patients with complete obstruction, 51 (38.1%) received EGD within the recommended 6 h. Of the 114 (46%) patients with incomplete obstructions, 93 (81.6%) received EGD within the recommended 24 h. There was no statistically significant correlation between length of stay (LOS) post‐EGD and any of ingestion to presentation time, presentation to EGD time, or ingestion to EGD time. Age and complication level were greater predictors of longer LOS than presentation to EGD time. Patients who presented in hours were significantly more likely to receive EGD within the 6‐ and 24‐h guidelines than those who presented out of hours (50.7% vs 22.0%).ConclusionNeither time to EGD from ingestion of food bolus nor time to EGD from hospital presentation correlated with complication rate, complication severity, or length of stay post‐EGD.
Oxidative balance score and associations with dyslipidemia and mortality among US adults: A mortality follow‐up study of a cross‐sectional cohort
Authors: Kong Xiufang , Gao Xinghui , Wang Wei 
Published: June 2024

AbstractBackgroundOxidative stress has been implicated in the pathogenesis and progression of dyslipidemia. We aimed to investigate the association between the oxidative balance score, and dyslipidemia, as well as to assess the mortality risk associated with oxidative balance score in patients with dyslipidemia.MethodsWe performed a mortality follow‐up study of a cross‐sectional cohort of 26,118 adults from the National Health and Nutrition Examination Survey 1999–2018. The total oxidative balance score was calculated by 16 dietary nutrients (dietary oxidative balance score) and four lifestyle factors (lifestyle oxidative balance score). Weighted Cox proportional hazard model was applied to determine the relationship between oxidative balance score and all‐cause or cardiovascular disease (CVD) mortality within the dyslipidemia group.ResultsDuring a median follow‐up of 118 months, 2448 all‐cause deaths (766 CVD‐related) occurred. A significant negative correlation was observed between total oxidative balance score, dietary oxidative balance score, lifestyle oxidative balance score, and dyslipidemia. The multivariable‐adjusted odds ratios and 95% CIs for dyslipidemia were 0.86 (0.77–0.97), 0.80 (0.72–0.91), and 0.63 (0.56–0.70), respectively, when comparing the second, third, and fourth quartiles of total oxidative balance score to the reference lowest quartile (P for trend <0.0001). Increasing total oxidative balance score was inversely associated with all‐cause (hazard ratio [HR] = 0.98, 95% CI 0.98–0.99) and CVD‐specific mortality (HR = 0.98, 95% CI 0.97–0.99) in participants with dyslipidemia.ConclusionsOxidative balance score is inversely associated with dyslipidemia and linked to all‐cause and CVD‐related mortality, highlighting the potentially protective role of an antioxidant‐rich diet against dyslipidemia.
Association between chronic intestinal failure etiology and eGFR trajectory in adults receiving home parenteral nutrition: A retrospective longitudinal cohort study
Authors: Kopczynska Maja , Miller Bethany , White Katherine L. , Green Darren , Barrett Maria , Ahmed Saadat , Cloutier Anabelle , Taylor Michael , Teubner Antje , Abraham Arun , Carlson Gordon , Lal Simon 
Published: June 2024

AbstractBackgroundPatients with chronic intestinal failure (CIF) are at increased risk of developing renal impairment. The aim of this study was to evaluate the occurrence of chronic kidney disease (CKD) in patients dependent on home parenteral nutrition (HPN) and assess risk factors for renal impairment, including patients with all mechanisms of CIF.MethodsThis was a cohort study of patients initiated on HPN between March 1, 2015, and March 1, 2020, at a national UK IF Reference Centre. Patients were followed from their first discharge with HPN until HPN cessation or the end of follow‐up on December 31, 2021.ResultsThere were 357 patients included in the analysis. Median follow‐up time was 4.7 years. At baseline, >40% of patients had renal impairment, with 15.4% fulfilling the criteria for CKD. Mean estimated glomerular filtration rate (eGFR) decreased significantly during the first year after initiation of HPN from 93.32 ml/min/1.73 m2 to 86.30 ml/min/1.73 m2 at the first year of follow‐up (P = 0.002), with sequential stabilization of renal function. Increased age at HPN initiation and renal impairment at baseline were associated with decreased eGFR. By the end of follow‐up, 6.7% patients developed renal calculi and 26.1% fulfilled the criteria for CKD.ConclusionThis is the largest study of renal function in patients receiving long‐term HPN. After the first year following HPN initiation, the rate of decline in eGFR was similar to that expected in the general population. These findings should reassure patients and clinicians that close monitoring of renal function can lead to good outcomes.
The role of the most cranial trochlear orientation in patellar maltracking to better characterise trochlear morphology
Authors: Giovannetti de Sanctis Edoardo , Toanen Cecile , Guarino Amedeo , Pineda Tomas , Deroche Etienne ,   Resurg, Dejour David H. 
Published: June 2024

AbstractPurposeThe purpose of our study is to describe a magnetic resonance imaging quantitative parameter to assess the morphology of the trochlea that could be measurable from normal to high‐grade trochlear dysplasia while evaluating the most proximal slice with trochlear cartilage.MethodsTwo groups of patients have been compared: patients with no patellofemoral pain, no previous trauma and undergoing surgery for a suspected isolated meniscal tears (group A) and patients with objective patellar instability (group B). The cranial trochlear orientation (CTO) angle is defined as the angle between the posterior bicondylar line and the most lateral and most medial points on the subchondral bone covered by cartilage digitised on the first and most cranial image with the trochlear cartilage clearly visible.ResultsThe final cohort included 253 patients (109 in group A and 144 in group B). CTO was significantly higher in group B (−2.5 ± 8.4 vs. −10.8 ± 5,1; p < .001). Moreover, 75% of knees in group B had a CTO > −7°, while 75% of knees in group A had a CTO < −7°. CTO was measurable in all 253 knees, whereas the lateral trochlear inclination and the sulcus angle were measurable in only 202 knees. The entire cohort was also divided into knees with CTO ≤ 0° and CTO > 0°. All knees with a CTO > 0 were in group B, and 49% of knees with CTO < 0 were in group B. CTO was positively correlated with lateral patellar tilt.ConclusionsCTO is the only parameter that can be measured on the most cranial slice, in every patient, even in high‐grade trochlear dysplasia. According to this new system, the axial trochlear shape may be divided into two types: a positive CTO and a negative CTO, with the trochlea serving, respectively, as a medial and lateral barrier.Level of EvidenceLevel III.
Clinical outcomes following transtibial medial meniscal root repair are maintained at long‐term follow‐up
Authors: Moore Michael , Levitt Sarah , Lin Charles C. , Wolfe Isabel , Alaia Erin , Meislin Robert , Strauss Eric J. , Jazrawi Laith , Alaia Michael J. , Kaplan Daniel 
Published: June 2024

AbstractPurposeTo evaluate long‐term outcomes of patients treated with posterior medial meniscal root tear (PMMRT) repair through assessment of functional outcome scores and to identify patient surgical and magnetic resonance imaging (MRI) characteristics associated with improved outcomes.MethodsThis was a single‐centre, retrospective study evaluating patients who had undergone a PMMR repair using a transtibial suture pullout technique with two locking cinch sutures. This was performed as a follow‐up to previously published 2‐year and 5‐year outcome studies, using the same cohort. All patients from the prior short‐term and midterm studies were invited to participate. Patient‐reported outcome (PROs) scores, including the International Knee Documentation Committee (IKDC) and Lysholm scores, were collected. Previously collected demographic data were updated based on review of the electronic medical record. Patient outcomes were assessed preoperatively, as well as at 2‐year, 5‐year and 8‐year postoperatively. MRI outcome measurements were assessed at 2‐year and 5‐year follow‐ups. All statistical analysis was performed using SPSS version 26.ResultsSeventeen patients of the original 18 patients (94.4%) were included in the final analysis. Additionally, three patients who had additional ipsilateral surgery were excluded from the analysis of PROs. The IKDC score significantly increased from 44.7 ± 11.6 at preoperative baseline to 71.2 ± 21.3 at 8‐year post‐operation (p = 0.001). There were no significant differences in IKDC score between 2‐year and 8‐year follow‐ups (p = n.s.) or 5‐year and 8‐year follow‐ups (p = n.s.). The Lysholm score significantly increased from 49.6 ± 7.3 at preoperative baseline to 76.4 ± 17.2 at 8‐year follow‐up (p < 0.001). There was no significant difference in Lysholm scores between 2‐year and 8‐year follow‐ups (p = n.s.) or 5‐year and 8‐year follow‐ups (p = n.s.). A linear regression analysis found that 5‐year IKDC scores were significantly correlated with 8‐year IKDC scores (β = 0.681, p = 0.038). At 8‐year follow‐up, four (23.5%) patients required additional procedures on their operative knee (one total knee arthroplasty conversion).ConclusionPatients treated with repair of PMMRT had maintenance of clinical outcome improvements at long‐term follow‐up despite worsening MRI outcomes at short‐term and medium‐term follow‐ups. While a high proportion of patients required additional procedures on their operative knee at 8‐year follow‐up, few of these patient's additional procedures were related to failure of their primary surgery. Providers and patients may expect durable clinical outcomes following the repair of PMMRT, irrespective of radiographic appearance.Level of EvidenceLevel IV.
Combined ACLR and lateral extra‐articular tenodesis with a continuous iliotibial band autograft is a viable option in a population of athletes who participate in pivoting sports
Authors: Lutz Christian , Casin Charles , Pioger Charles , Jacquot Xavier , Jaeger Jean‐Henri , Van Hille William 
Published: June 2024

AbstractPurposeThe aim of this study was to evaluate the clinical results, return to sport and complications after anterior cruciate ligament reconstruction (ACLR) associated with lateral extra‐articular tenodesis using continuous plasty with an iliotibial band.MethodsThis was a prospective multicentre study involving 186 patients who had surgery for anterior cruciate ligament (ACL) rupture. Patients with multiligament ruptures and revision surgery were excluded from the study. All patients included were involved in pivoting sports and wished to resume their activity after surgery. Patients were assessed at a minimum 2‐year follow‐up using functional and psychological questionnaires (subjective International Knee Documentation Committee [IKDC], Tegner, Lysholm and ACL‐RSI scores), ligament assessment including instrumented laxity measurement (Rolimeter), Lachman test and pivot shift and isokinetic testing. Return to sport was assessed using a questionnaire, and complications and repeat surgeries were recorded.ResultsAt a mean follow‐up of 43.1 months, the subjective IKDC, Lysholm, ACL‐RSI and objective IKDC scores were significantly improved (59.8 vs. 94.5 p < 0.0001, 75 vs. 99 p < 0.0001, 60 vs. 93 p < 0.0001, IKDC A 0% vs. 72%, B 12% vs. 27%, C 60% vs. 1% D 28% vs. 0% p < 0.0001). The Tegner activity level was 9 (3–10) before the accident and 9 (3–10) at the last review. Seventy‐six percent of the patients had returned to sports at the same level. The differential laxity was 6.6 mm (±1.7) preoperatively and 1.1 mm (±1.4) postoperatively. Additionally, 97% were equal in pivot shift at the last follow‐up. At the 6‐month isokinetic assessment, the muscle strength recovery for the quadriceps and hamstring was over 85% compared with the healthy side for 79% and 70% of the patients, respectively. Ten patients had graft rupture (5.6%). Four (2.4%) patients had a contralateral ACL rupture, and seven (4%) underwent a reoperation with meniscectomy.ConclusionAnterior ligament reconstruction with lateral extra‐articular tenodesis using a continuous strip of iliotibial band enables 76% of patients in a population with a high demand for sports to resume their activities at the same level. The clinical results and complication rates, particularly reruptures (5.6%), were similar to those of other techniques involving lateral extra‐articular tenodesis.Level of EvidenceLevel II.
Comparable results in total knee arthroplasty using the ROSA knee system versus the conventional technique: A retrospective propensity‐matched cohort study
Authors: Hax Jakob , Leuthard Louis , Baumann Gregor , Preiss Stefan , Stadelmann Vincent A. , Worlicek Michael 
Published: June 2024

AbstractPurposeRobotic‐assisted total knee arthroplasty (RA‐TKA) is an increasingly popular alternative that may increase the accuracy of conventional TKA techniques. This study aims to evaluate RA‐TKA accuracy and compare its radiographic and clinical outcomes to conventional TKA (cTKA).MethodsA retrospective examination of patients with bi‐ or tricompartmental knee osteoarthritis who underwent RA‐TKA (RObotic Surgical Assistant system) or cTKA and were prospectively documented in the TKA registry. Accuracy was assessed using standardized radiographic implant position evaluations, namely femoral and tibial coronal angles and femoral and tibial sagittal angles. Baseline demographics, surgery details and 6‐ and 12‐month post‐TKA patient‐reported outcomes (PROMs; e.g., Oxford Knee Score [OKS] and Core Outcome Measures Index) were compared between RA‐TKA and propensity score‐matched cTKA patients.ResultsOverall correlation between preset and 6‐week postoperative angle measurements for RA‐TKA was low with significant differences noted only for mean tibial sagittal angles (84.6° [RA‐TKA] vs. 82.3° [cTKA]) (p < 0.001). The study groups were demographically similar, although RA‐TKA patients had slightly longer operative times and higher blood loss but shorter inpatient stays. There were sustainable improvements in all PROMs already at 6 months, yet RA‐TKA patients had significantly higher OKS values over their conventional counterparts at this time point.ConclusionRadiological and clinical outcomes were comparable between RA‐TKA and cTKA. The robotic‐assisted system demonstrated higher accuracy in the coronal than sagittal plane and RA‐TKA patients achieved better short‐term outcomes for pain and disability. While both methods are similar in the hands of a skilled surgeon, long‐term studies are necessary to establish clear method superiority.Level of EvidenceLevel III, therapeutic study.