bluuebunny/crossref_metadata_2025_split huggingface dataset:
PROSPECTIVE RANDOMIZED STUDY USING PHARMACOGENETICS TO OPTIMIZE PERIOPERATIVE PAIN MANAGEMENT AFTER TOTAL KNEE ARTHROPLASTY
Authors: Kraus Molly , Bingham Joshua , Kekic Adrijana , Erickson Colby , Grilli Christopher , Seamans David , Upjohn David , Hentz Joseph , Clarke Henry , Spangehl Mark 
Published: August 2023

AbstractIntroductionAdverse reactions to pain medication and pain can delay discharge after outpatient knee arthroplasty (TKA). Pharmacogenomics is an emerging tool that might help reduce adverse events by tailoring medication use based on known genetic variations in the CYP genes determining drug metabolism. This study was undertaken to evaluate whether pre-operative pharmacogenomic testing could optimize peri-operative pain management in patients undergoing total knee arthroplasty (TKA).MethodsThis prospective, randomized study was performed in adults undergoing primary TKA. Patients in the experimental group underwent pre-operative pharmacogenomic evaluation and medication adjustments. Medications were not optimized for control patients. The Overall Benefit of Analgesic Score (OBAS) at 24 hours post-op was the primary outcome. Postoperative pain scores (VAS scale), total opioid use, time in recovery, and time to discharge were also compared.Results76 patients enrolled. 93% of patients had a poor-intermediate phenotype for at least one of four CYP genes. OBAS did not differ significantly between the two groups (4.2 control vs. 4.7 experimental; 95% CI −1.1 to 2.1) and was below the minimum clinically important difference of 2.0 points. Furthermore, there were no differences in any OBAS subscale including pain, satisfaction, or nausea. There were no differences in time in the recovery area or to discharge from hospital, or narcotic use.ConclusionsDespite many patients having a poor-intermediate phenotype for a CYP gene, pharmacogenomic testing prior to TKA and medication adjustment did not improve anesthesia or pain management outcomes, time to discharge or mean total opioid use after surgery.
ITEM RESPONSE THEORY VALIDATION OF THE FORGOTTEN JOINT SCORE FOR PEOPLE UNDERGOING TOTAL KNEE ARTHROPLASTY
Authors: Khatri Chetan , Harrison Conrad , Scott Chloe , Clement Nick , MacDonald Deborah , Metcalfe Andrew , Rodrigues Jeremy 
Published: August 2023

AbstractBackgroundThe Forgotten Joint Score (FJS) is a 12-item patient reported outcome measurement instrument. It was developed with classical test theory, without testing assumptions such as unidimensionality (all items reflect one underlying factor), appropriate weighting of each item, no differential item function (DIF, different groups answer the same way), and monotonicity (people with higher function have higher score). We applied item response theory (IRT) to improve the validity of FJS to contemporary standards to optimise it for ongoing use.Research QuestionsDoes the FJS reflect one latent trait? Can an IRT model be fitted to the FJS to provide interval-scaled measurement?MethodologyParticipants undergoing primary total knee replacement provided pre-operative and post-operative (6-months) responses for FJS. An exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and Mokken analysis were conducted. The data were fitted to a graded response model (GRM).Results1288 response patterns were analysed. EFA showed a one factor model (all 12 items load to one underlying trait). CFA demonstrated excellent model fit (X2 <0.001, Tucker Lewis Index=0.96, Comparative Fit Index=0.96). Items did not have equal weighting. The FJS demonstrated good monotonicity with no differential item functioning by sex, age, or body mass index.ConclusionsThe FJS meets key validity assumptions supporting its use in clinical practice and research. The IRT-adapted FJS provides continuous measurements with greater granularity including individual measurement error. This adapted score has advantages over traditional FJS scoring, being interval scaled (using GRM) and can be retrospectively applied to existing response sets.
EXTRA-ARTICULAR KNEE LIGAMENT RECONSTRUCTIONS USING LARS (LIGAMENT AUGMENTATION AND RECONSTRUCTION SYSTEM) SYNTHETIC GRAFTS IN ELITE ATHLETES
Authors: Ball Simon , Jones Mary , Pinheiro Vitor Hugo , Church Sam , Williams Andy 
Published: August 2023

AbstractIntroductionThe aim of this study was to determine if elite athletes could return to professional sport after MCL or PLC reconstruction using LARS ligaments and to demonstrate the safety and efficacy of LARS by reporting sport longevity, subsequent surgeries and complications.MethodsA retrospective review of all extra-articular knee ligament reconstructions in elite athletes utilising LARS ligaments by 3 knee surgeons between January 2013 and October 2020 was undertaken. Return to play (RTP) was defined as competing at professional level or national/ international level in amateur sport.ResultsSixty-four (84.2%) MCL and 12 (15.8%) PLC reconstructions utilising LARS in elite athletes were included. 52 (68.4%) underwent concomitant cruciate(s) reconstruction. The mean age was 25.1 years (SD +/− 4.50. Most were football (35, 46.1%) or rugby players (35, 46.1%).Sixty-seven athletes (88.2%) RTP with 65 (97.0%) of these playing at the same or higher Tegner level. 56 (83.6%) and 20 (57.1%) were still playing at 2 and 5 years post-surgery.Six (7.9%) players (5 of whom RTP) required further surgery relating to the LARS / metalwork and there was one case of adverse local inflammatory reaction to the synthetic material. There was one MCL re-rupture, sustained 4 years after RTP.ConclusionUtilising LARS in extra-articular knee ligament reconstructions allows 88.2% of athletes, with a variety of knee ligament injuries, to return to elite sport. The low morbidity rates coupled with 57% of athletes still playing 5 years post-surgery suggests the LARS is safe and effective in these cases.
COMPARISON OF SIMPLIFIED MCL RECONSTRUCTIONS TO CONTROL VALGUS AND ANTEROMEDIAL ROTATORY INSTABILITY (AMRI): BIOMECHANICAL EVALUATION IN VITRO
Authors: Bartolin Petra Bonacic , Shatrov Jobe , Ball Simon V , Holthof Sander R , Williams Andy , Amis Andrew A 
Published: August 2023

AbstractIntroductionPrevious research has shown that, notwithstanding ligament healing, properly selected MCL reconstruction can restore normal knee stability after MCL rupture. The hypothesis of this work was that it is possible to restore knee stability (particularly valgus and AMRI) with simplified and/or less-invasive MCL reconstruction methods.MethodsNine unpaired human knees were cleaned of skin and fat, then digitization screws and optical trackers were attached to the femur and tibia. A Polaris stereo camera measured knee kinematics across 0o-100o flexion when the knee was unloaded then with 90N anterior-posterior force, 9Nm varus-valgus moment, 5Nm internal-external rotation, and external+anterior (AMRI) loading. The test was conducted for the following knee conditions: intact, injured: transected superficial and deep MCL (sMCL and dMCL), and five reconstructions: (long sMCL, long sMCL+dMCL, dMCL, short sMCL+dMCL, short sMCL), all based on the medial epicondyle isometric point and using 8mm tape as a graft, with long sMCL 60mm below the joint line (anatomical), short sMCL 30mm, dMCL 10mm (anatomical).ResultsNo significant changes were found in anterior or posterior translation, or varus at any stage. MCL deficiency caused increased valgus, external rotation and AMRI instabilities. All reconstructions restored valgus stability. The isolated long sMCL allowed residual external rotation and AMRI instability, while the short sMCL did stabilise AMRI. Both 2-strand reconstructions (dMCL+sMCL) restored stability.ConclusionAll tested techniques, except long sMCL, restored valgus and AMRI stability of the knee. The single femoral tunnel is satisfactory for both the dMCL and sMCL grafts.
A WEARABLE SENSING SYSTEM FOR CONTINUOUS MONITORING OF KNEE CONDITION
Authors: Alabdullah Meernah , Liu Aiqin , Xie Shane 
Published: August 2023

AbstractRehabilitation exercise is critical for patients’ recovery after knee injury or post-surgery. Unfortunately, adherence to exercise is low due to a lack of positive feedback and poor self-motivation. Therefore, it is crucial to monitor their progress and provide supervision. Inertial measurement unit (IMUs) based sensing technology can provide remote patient monitoring functions. However, most current solutions only measure the range of knee motion in one degree of freedom. The current IMUs estimate the orientation-angle based on the integrated raw data, which might lack accuracy in measuring knee motion. This study aims to develop an IMU-based sensing system using the absolute measured orientation-angle to provide more accurate comprehensive monitoring by measuring the knee rotational angles.An IMU sensing system monitoring the knee joint angles, flexion/extension (FE), adduction/abduction (AA), and internal/external (IE) was developed. The accuracy and reliability of FE measurements were validated in human participants during squat exercise using measures including root mean square error (RMSE) and correlation coefficient.The RMSE of the three knee angles (FE, AA, and IE) were 0.82°, 0.26°, and 0.11°, which are acceptable for assessing knee motion. The FE measurement was validated in human participants and showed excellent accuracy (correlation coefficient of 0.99°). Further validation of AA and IE in human participants is underway.The sensing system showed the capability to estimate three knee rotation angles (FE, AA, and IE). It showed the potential to provide comprehensive continuous monitoring for knee rehabilitation exercises, which can also be used as a clinical assessment tool.
NOVEL SINGLE-STRAND ‘SHORT ISOMETRIC CONSTRUCT’ (SIC) MEDIAL COLLATERAL LIGAMENT RECONSTRUCTION RESTORES VALGUS AND ROTATIONAL STABILITY THROUGHOUT KNEE RANGE OF MOTION
Authors: Borque Kyle , Han Shuyang , Gold Jonathan , Sij Ethan , Laughlin Mitzi , Amis Andrew , Williams Andy , Noble Philip , Lowe Walter 
Published: August 2023

AbstractIntroductionPersistent medial laxity increases the risk of failure for ACL reconstruction. To address this, multiple reconstruction techniques have been created. To date, no single strand reconstruction constructs have been able to restore both valgus and rotational stability. In response to this, a novel single strand Short Isometric Construct (SIC) MCL reconstruction was developed.MethodsEight fresh-frozen cadaveric specimens were tested in three states: 1) intact 2) after sMCL and dMCL transection, and 3) after SIC MCL reconstruction. In each state, four loading conditions were applied at varying flexion angles: 90N anterior drawer, 5Nm tibial external rotation torque, 8Nm valgus torque, and combined 90N anterior drawer plus 5Nm tibial external rotation torque.ResultsTransection of the sMCL and dMCL resulted in increased laxity with external rotation torque, valgus torque, and combined anterior drawer plus external rotation. SIC MCL reconstruction restored external rotation and valgus stability to intact levels throughout all degrees of flexion. In the combined test SIC MCL reconstruction also restored stability to intact levels for both anterior distraction and external rotation throughout the range of motion. No significant differences were noted between intact and SIC reconstruction.ConclusionThe single-limb short isometric construct (SIC) MCL reconstruction restored native valgus and rotatory stability to a sMCL- and dMCL-deficient knee in biomechanical testing.
FIXATION OF OSTEOCHONDRITIS DISSECANS AND TRAUMATIC OSTEOCHONDRAL FRACTURE OF THE KNEE WITH BIODEGRADABLE HEADLESS COMPRESSION SCREWS
Authors: Houston James , Everett Samuel , Choudhary Awais , Middleton Simon , Mandalia Vipul 
Published: August 2023

AbstractIntroductionSymptomatic osteochondritis dissecans (OCD) and traumatic osteochondral fractures (OCF) are treated with fixation with either metal or bioabsorbable device. We performed a comparative review of patients with OCD and traumatic OCF stabilised with Bio-Compression screws which are headless absorbable compression screws. Our aim was to determine whether there was a difference in outcomes between presentations.MethodsRetrospective single-centre cohort study of all patients with OCD and OCF treated with Bio-Compression screw between July 2017 and September 2022. All patients followed up until discharge with satisfactory clinical outcome. Primary outcome was return to theatre for ongoing pain or mechanical symptoms. Secondary outcome was evidence of fixation failure on follow-up MRI scan.Results20 patients included; 8 OCF and 12 OCD. Average age 21 (OCF), 24 (OCD). The most common location was patella (58%) in OCF or the medial femoral condyle (75%) in OCD. Traumatic defects were smaller (2.6cm2 vs 3.3cm2) although this was not statistically significant (p=0.28). In the OCF group one patient went on to have further surgery. There were no re-operations in the OCD group. Both groups had good outcomes and similar times to discharge. There was no evidence of fixation failure of Bio-Compression screws on MRI scans.ConclusionsWithin the limits of this relatively small cohort there is no significant difference between outcomes for OCD or traumatic OCF fixation with Bio-Compression screws. Both groups demonstrate good outcomes irrespective of the location or the aetiology of the fragment.
POLYACRYLAMIDE HYDROGEL VERSUS HYALURONIC ACID IN KNEE OSTEOARTHRITIS: A SUBGROUP ANALYSIS OF A RANDOMIZED STUDY
Authors: Bliddal Henning , Beier Jannie , Hartkopp Andreas , Conaghan Philip , Henriksen Marius 
Published: August 2023

AbstractIntroductionThe effectiveness of single intra-articular injections of polyacrylamide hydrogel (iPAAG) and hyaluronic acid (HA) was compared in subgroups of participants from an RCT based on baseline age, BMI or Kellgren-Lawrence (KL) grade.Methodology239 participants were randomised to 6 mL iPAAG (Arthrosamid; n=119) or 6 mL HA (Synvisc-One; n=120). Participants continued analgesics (except 48 hours prior to visits) and non-pharmacological therapy. Topical therapies and intra-articular corticosteroids were not allowed. Pre-specified subgroup analyses (age: <70 years, ≥70 years; BMI: normal, overweight, obese; KL grade: 2, 3, 4, 2–3) of change from baseline in WOMAC pain subscale at 52 weeks were based on the least squares means for the treatment-by-week interaction effect using a mixed model for repeated measurement with a restricted maximum likelihood-based approach.ResultsAcross all patients, change from baseline in WOMAC pain subscale in the iPAAG group was non-inferior to HA at 26 weeks and approached superiority (p=0.0572) at 52 weeks. Treatment differences for change from baseline in WOMAC pain subscale in favour of iPAAG over HA were statistically significant for the age <70 years (p=0.019), BMI normal (p=0.011) and KL grade 2–3 (p=0.033) subgroups. Treatment differences for all other subgroups favoured iPAAG, except for KL grade 4 which favoured HA, without reaching statistical significance.ConclusioniPAAG approached superiority to HA across all participants at 52weeks, but demonstrated statistical superiority in participants with normal BMI, participants <70 years old or participants with KL score 2–3. iPAAG represents a useful alternative to HA for the treatment of knee OA.
COMPARISON OF OPEN VERSUS CLOSED REDUCTION AND FIXATION WITH LOCKING PLATES OF SUPRACONDYLAR PERIPROSTHETIC FEMORAL FRACTURES WITH STABLE PROSTHESES
Authors: Sidhu Gur Aziz Singh 
Published: August 2023

AbstractINTRODUCTIONThe anatomic distal femoral locking plate (DF-LCP) has simplified the management of supracondylar femoral fractures with stable knee prostheses. Osteoporosis and comminution seem manageable, but at times, the construct does not permit early mobilization. Considerable soft tissue stripping during open reduction and internal fixation (ORIF) may delay union. Biological plating offsets this disadvantage, minimizing morbidity.MaterialsThirty comminuted periprosthetic supracondylar fractures were operated from October 2010 to August 2016. Fifteen (group A) were treated with ORIF, and fifteen (group B) with closed (biological) plating using the anatomical DF-LCP. Post-operatively, standard rehabilitation protocol was followed in all, with hinged-knee-brace supported physiotherapy. Clinico-radiological follow-up was done at 3 months, 6 months, and then yearly (average duration, 30 months), and time to union, complications, failure rates and function were evaluated.ResultsAverage time to union was 4.5 months (range, 3–6 months) in group A, and 3.5 months (range, 2.5–5 months) in group B. Primary bone grafting was done in twelve patients (all group A). At final follow-up, all fractures had healed, and all (but two) patients were walking unsupported, with no pain or deformity, with average knee range of motion (ROM) of 90° (range, 55 to 100°). Two patients had superficial infection (group A), two had knee stiffness (group A), one had shortening of 1.5cm (group B) and one had valgus malalignment of 10 degrees (group B).ConclusionBiological plating in comminuted supracondylar fractures about stable TKA prostheses is an excellent option, may obviate need for bone grafting, and reducing complications.
LONG-TERM SURVIVAL RATES ARE SIMILAR WITH OR WITHOUT PATELLAR RESURFACING AFTER TOTAL KNEE ARTHROPLASTY, HOWEVER, HIGHER REVISION RATE WITHOUT PATELLAR RESURFACING CAN BE PROSTHETIC-SPECIFIC: A NATIONAL JOINT REGISTRY ANALYSIS
Authors: Chrastek David , Boddu Krishna 
Published: August 2023

AbstractIntroductionThe role of patellar resurfacing in total knee arthroplasty remains controversial. We questioned the effect of patellar resurfacing on the early and late revision rates after total knee arthroplasty.Materials and MethodsWe analysed the data of cumulative revisions of primary knee replacement from the NJR 19th Annual Report. NJR included secondary patellar resurfacing as a revision. We compared differences in the 3-year and 15-year revision rates between the patellar resurfacing and non-resurfacing for the different combinations of total knee replacements using a paired t-test. We performed subgroup analysis for the five combinations with the highest volumes.ResultsTwenty-seven implant combinations had the 15-year revision rates reported. Patellar resurfacing group had lower mean 3-year revision rate of 1.68 (SD 0.7) compared to 2.02 (SD 0.9) in non-resurfacing group (p=0.05). However, 15-year revision rate was similar between the two groups (mean 5.7, SD 2.1 vs. mean 5.7, SD 2.2; p = 0.46).High volume implants showed that two combinations (NexGen CR and PS) had similar revision rates at 3 and 15 years between resurfacing and non-resurfacing groups. Three combinations (PFC Sigma CR and PS and Genesis 2 CR) had higher revision rate in non-resurfacing group at 3 years (p=0.01) and the difference persisted at 15 years (p=0.05).ConclusionsAlthough revision rate in total knee arthroplasty was higher without patellar resurfacing at 3 years, at 15 years the difference was not significant. However, the higher revision without patellar resurfacing can be prosthetic combination specific which surgeons need to be aware of.
OUTCOME OF TREATMENT FOLLOWING ARTHROSCOPIC REPAIR OF BUCKET HANDLE MENISCUS TEARS IN ADULTS
Authors: Nanjundaiah Raghavendra , Guro Randy , Chandratreya Amit , Kotwal Rahul 
Published: August 2023

AbstractAimsWe studied the outcomes following arthroscopic primary repair of bucket handle meniscus tears to determine the incidence of re-tears and the functional outcomes of these patients.MethodologyProspective cohort study. Over a 4-year period (2016 to 2020), 35 adult patients presented with a bucket handle tear of the meniscus. Arthroscopic meniscal repair was performed using either the all inside technique or a combination of all-inside and inside-out techniques. 15 patients also underwent simultaneous arthroscopic anterior cruciate ligament reconstruction. Functional knee scores were assessed using IKDC and Lysholm scores.ResultsMean patient age at surgery was 27 years (range, 17 to 53years). Medial meniscus was torn in 20 and lateral in 15 cases. Zone of tear was white on white in 19, red on white in 9 and red on red in 7 cases. Average delay from injury to surgery was 4 months. At a mean follow-up of 4.5 years, the meniscus repair failed in 3 patients (8.5 %). Outcome following re-tear was meniscus excision. Average IKDC scores in patients with intact repair were 74.04 against 56.67 in patients with a failed repair (p< 0.0001). Similarly, Lyshlom scores were 88.96 and 67.333, respectively (p<0.0001).ConclusionThe survivorship of primary repair of bucket handle meniscus tears in our series was 91.5% at medium term follow-up. Functional outcomes were significantly poor in patients with a failed repair compared to those with an intact repair.
Ultra-large near-infrared omnidirectional photonic bandgaps in cascaded one-dimensional photonic crystals containing all-dielectric metamaterials
Authors: Cheng Zhaoming , She Yuchun , Panda Abinash , Feng Mingku , Li Jiaosheng , Wu Feng 
Published: August 2023

In conventional one-dimensional (1-D) photonic crystals (PCs) consisting of isotropic dielectrics, photonic bandgaps (PBGs) substantially shift toward shorter wavelengths as incident angle increases. This strong blueshift characteristic of PBGs significantly reduces the widths of near-infrared omnidirectional photonic bandgaps (OPBGs). Recently, researchers achieved a kind of special PBG called angle-insensitive PBGs in 1-D PCs containing all-dielectric elliptical metamaterials (EMMs). The emergence of angle-insensitive PBGs provides us a possibility to achieve ultra-large near-infrared OPBGs. Herein, we design two 1-D PCs containing all-dielectric EMMs with near-infrared angle-insensitive PBGs in different wavelength ranges. By cascading two 1-D PCs containing all-dielectric EMMs together, we achieve an ultra-large near-infrared OPBG with a width up to 1.004 µm (relative bandwidth of 63.9%). In addition, the width of the near-infrared OPBG demonstrates robustness against the layer thickness. Our work not only provides a feasible route to achieving ultra-large near-infrared OPBGs, but also facilitates the design of broadband omnidirectional mirrors.
Large lateral photovoltaic effect with ultrafast optical relaxation time in SnS2/n-Si junctions
Authors: Zhu Ziyao , Ouyang Zining , Hu Junbei , Qi Hongkai , Pei Yujuan , Zhang Lingli , Wang Xianjie 
Published: August 2023

A large lateral photovoltaic effect (LPE) with a fast optical response time is necessary to develop high-performance position-sensitive detectors. In this paper, we report an LPE with a high self-powered position sensitivity and ultrafast optical relaxation time in SnS2/n−Si junctions prepared using pulsed laser deposition. A large built-in electric field was generated at the SnS2/Si interface, which resulted in a large LPE with a positional sensitivity of up to 116 mV/mm. Furthermore, the measurement circuit with multiple parallel resistors had a strong influence on the ultrafast optical response time of the LPE and the fastest optical relaxation time observed was ∼0.44µs. Our results suggest that the SnS2/Si junction would be a promising candidate for a wide range of optoelectronic device applications.