Deep versus Moderate Neuromuscular Blockade During Total Hip Replacement Surgery on Postoperative Recovery and Immune Function: A Randomized Controlled Trial.

Background: Deep neuromuscular blockade (NMB) enhances surgical working conditions in laparoscopic surgery. Whether this accounts for nonlaparoscopic surgery is not known. Additionally, the effect on clinical and patient-reported outcomes remains debated.

Superior Wear Resistance of Highly Cross-Linked Cemented Polyethylene Cups in Young Patients: A Randomized Controlled Trial.

Background: Polyethylene wear of the acetabular component is related to periprosthetic osteolysis and subsequent aseptic loosening, requiring revision surgery. Highly cross-linked polyethylenes (HXLPEs) have been developed to mitigate wear. However, long-term randomized comparative studies focusing on acetabular component wear in young patients are scarce.

Rifampicin combination therapy versus targeted antimicrobial monotherapy in the oral antimicrobial treatment phase of staphylococcal prosthetic joint infection (RiCOTTA-trial): protocol for a randomized, controlled, open-label, non-inferiority trial.

Background: Rifampicin-combination therapy is currently the first-choice oral antimicrobial regimen for staphylococcal prosthetic joint infections (sPJI) treated by debridement, antibiotics and implant retention (DAIR). Lack of high quality evidence to substantiate this recommendation and a high drug discontinuation rate of this regimen warrant investigation of alternative antimicrobial strategies.

Method: The Rifampicin Combination Therapy versus Targeted Antimicrobial Monotherapy in the Oral Antimicrobial Treatment Phase of Staphylococcal Prosthetic Joint Infection (RiCOTTA)-trial is a multicenter, non-inferiority, open-label, randomized controlled trial evaluating monotherapy (without rifampicin) versus rifampicin-combination therapy in the oral treatment phase of sPJI managed with DAIR.

Constrained acetabular liners in total hip arthroplasty: analysis of 265 primary and revision cases from the Dutch Arthroplasty Register (2007-2022).

Introduction: Constrained acetabular liners (CALs) are predominantly used as a salvage procedure in patients with a severe risk for dislocation after total hip arthroplasty (THA). However, the constrained design of CALs bears the risk of impingement with subsequent loosening or failure of the integrity of the implant. We investigated the use and survival of CALs in primary and revision THA in the Dutch Arthroplasty Register (LROI).

The immunomodulatory effect of sugammadex in vitro and after total hip arthroplasty : A randomised controlled pilot and retrospective cohort study.

Background: Postoperative immunosuppression is a well known phenomenon associated with infectious complications. Peri-operative immune dysregulation is likely induced by surgical damage and anaesthetics, but remains far from comprehensively characterised. To address this, the effects of individual drugs on immune function must be explored.

The effect of general versus spinal anesthesia on perioperative innate immune function in patients undergoing total hip arthroplasty.

Background: Increasing evidence shows that postoperative innate immune dysregulation is associated with delayed recovery and infectious complications. The aim of this study was to compare the effects of general versus spinal anesthesia on innate immune function during and after total hip arthroplasty (THA).

Methods: This comparative matched cohort study used data from two single-center randomized-controlled trials.

Bone support of a custom triflange acetabular component over time.

Aims: To investigate the extent of bone development around the scaffold of custom triflange acetabular components (CTACs) over time.

Methods: We performed a single-centre historical prospective cohort study, including all patients with revision THA using the aMace CTAC between January 2017 and March 2021. A total of 18 patients (18 CTACs) were included.

Deep versus moderate neuromuscular blockade during total hip arthroplasty to improve postoperative quality of recovery and immune function: protocol for a randomised controlled study.

Introduction: There is accumulating evidence that deep neuromuscular blockade (NMB) improves intraoperative surgical conditions during laparoscopic surgery. Studies investigating the effects of deep NMB in open surgery are scarce. In theory, by limiting surgical damage through deeper muscle relaxation, postoperative inflammation and concomitant immune suppression can be reduced.

[Decision making in frail patients with a hip fracture].

Background: When an older patient presents herself at the emergency department with a femur fracture different doctors are involved: the geriatrician, the orthopaedic or trauma- surgeon and the anaesthesiologist. Together they form an ad hoc team and are in charge of organising the best medical care for the patient.

Case Description: In this case description we present a patient with cardiovascular comorbidity and dementia.

Thirty years of experience with instrumented femoral impaction bone grafting and a cemented polished Exeter stem : a prospective cohort study of 208 revision arthroplasties performed between 1991 and 2007.

Aims: The aim of this study is to report the long-term outcomes of instrumented femoral revisions with impaction allograft bone grafting (IBG) using the X-change femoral revision system at 30 years after introduction of the technique.

Methods: We updated the outcomes of our previous study, based on 208 consecutive revisions using IBG and the X-change femoral revision system in combination with a cemented polished stem, performed in our tertiary care institute between 1991 and 2007. Kaplan-Meier survival analyses were used to determine the survival rate of the revisions with endpoint revision for any reason and aseptic loosening.

[Arthroscopy for degenerative meniscal tears: from standard to exception].

Osteoarthritis of the knee is often accompanied by degeneration of the meniscus. Worldwide, the arthroscopic partial meniscectomy has been a standard of care for patients with knee pain in the presence a degenerative meniscal tear. However, in recent years, clinical studies have proven that a meniscectomy is not effective in the osteoarthritic knee.

Dual-contrast computed tomography enables detection of equine posttraumatic osteoarthritis in vitro.

To prevent the progression of posttraumatic osteoarthritis, assessment of cartilage composition is critical for effective treatment planning. Posttraumatic changes include proteoglycan (PG) loss and elevated water content. Quantitative dual-energy computed tomography (QDECT) provides a means to diagnose these changes.

Evaluation of articular cartilage with quantitative MRI in an equine model of post-traumatic osteoarthritis.

Chondral lesions lead to degenerative changes in the surrounding cartilage tissue, increasing the risk of developing post-traumatic osteoarthritis (PTOA). This study aimed to investigate the feasibility of quantitative magnetic resonance imaging (qMRI) for evaluation of articular cartilage in PTOA. Articular explants containing surgically induced and repaired chondral lesions were obtained from the stifle joints of seven Shetland ponies (14 samples).

[Applications of 3D printing in medicine; 5 years later].

5 years ago, we described the emergence of 3D printing in medicine. It was about 3D printing of anatomical structures, patient-specific drilling guides, cutting templates and implants and printing of living cells, growth factors and biomaterials ('bioprinting'). Surgeons are increasingly making use of 3D printing possibilities in preparation of surgeries on patients with complicated anatomies.

Arthroscopic Determination of Cartilage Proteoglycan Content and Collagen Network Structure with Near-Infrared Spectroscopy.

Conventional arthroscopic evaluation of articular cartilage is subjective and insufficient for assessing early compositional and structural changes during the progression of post-traumatic osteoarthritis. Therefore, in this study, arthroscopic near-infrared (NIR) spectroscopy is introduced, for the first time, for in vivo evaluation of articular cartilage thickness, proteoglycan (PG) content, and collagen orientation angle. NIR spectra were acquired in vivo and in vitro from equine cartilage adjacent to experimental cartilage repair sites.

Arthroscopic near infrared spectroscopy enables simultaneous quantitative evaluation of articular cartilage and subchondral bone in vivo.

Arthroscopic assessment of articular tissues is highly subjective and poorly reproducible. To ensure optimal patient care, quantitative techniques (e.g.

Low sensitivity of a-defensin (Synovasure) test for intra-operative exclusion of prosthetic joint infection.

Background and purpose - The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty.

Yield stress determines bioprintability of hydrogels based on gelatin-methacryloyl and gellan gum for cartilage bioprinting.

Bioprinting of chondrocyte-laden hydrogels facilitates the fabrication of constructs with controlled organization and shape e.g. for articular cartilage implants.

Biofabrication of reinforced 3D-scaffolds using two-component hydrogels.

Progress in biofabrication technologies is mainly hampered by the limited number of suitable hydrogels that can act as bioinks. Here, we present a new bioink for 3D-printing, capable of forming large, highly defined constructs. Hydrogel formulations consisted of a thermoresponsive polymer mixed with a poly(ethylene glycol) (PEG) or a hyaluronic acid (HA) cross-linker with a total polymer concentration of 11.

Thermogelling and Chemoselectively Cross-Linked Hydrogels with Controlled Mechanical Properties and Degradation Behavior.

Chemoselectively cross-linked hydrogels have recently gained increasing attention for the development of novel, injectable biomaterials given their limited side reactions. In this study, we compared the properties of hydrogels obtained by native chemical ligation (NCL) and its recently described variation termed oxo-ester-mediated native chemical ligation (OMNCL) in combination with temperature-induced physical gelation. Triblock copolymers consisting of cysteine functionalities, thermoresponsive N-isopropylacrylamide (NIPAAm) units and degradable moieties were mixed with functionalized poly(ethylene glycol) (PEG) cross-linkers.

Reinforcement of hydrogels using three-dimensionally printed microfibres.

Despite intensive research, hydrogels currently available for tissue repair in the musculoskeletal system are unable to meet the mechanical, as well as the biological, requirements for successful outcomes. Here we reinforce soft hydrogels with highly organized, high-porosity microfibre networks that are 3D-printed with a technique termed as melt electrospinning writing. We show that the stiffness of the gel/scaffold composites increases synergistically (up to 54-fold), compared with hydrogels or microfibre scaffolds alone.

Crosslinkable hydrogels derived from cartilage, meniscus, and tendon tissue.

Decellularized tissues have proven to be versatile matrices for the engineering of tissues and organs. These matrices usually consist of collagens, matrix-specific proteins, and a set of largely undefined growth factors and signaling molecules. Although several decellularized tissues have found their way to clinical applications, their use in the engineering of cartilage tissue has only been explored to a limited extent.

Recovery of TES-MEPs during surgical decompression of the spine: a case series of eight patients.

Purpose: This study aimed to illustrate the recovery of transcranial electrical stimulation motor evoked potentials during surgical decompression of the spinal cord in patients with impaired motor function preoperatively. Specific attention was paid to the duration of neurologic symptoms before surgery and the postoperative clinical recovery.

Methods: A case series of eight patients was selected from a cohort of 74 patients that underwent spine surgery.

Endochondral bone formation in gelatin methacrylamide hydrogel with embedded cartilage-derived matrix particles.

The natural process of endochondral bone formation in the growing skeletal system is increasingly inspiring the field of bone tissue engineering. However, in order to create relevant-size bone grafts, a cell carrier is required that ensures a high diffusion rate and facilitates matrix formation, balanced by its degradation. Therefore, we set out to engineer endochondral bone in gelatin methacrylamide (GelMA) hydrogels with embedded multipotent stromal cells (MSCs) and cartilage-derived matrix (CDM) particles.

Decellularized cartilage-derived matrix as substrate for endochondral bone regeneration.

Following an endochondral approach to bone regeneration, multipotent stromal cells (MSCs) can be cultured on a scaffold to create a cartilaginous callus that is subsequently remodeled into bone. An attractive scaffold material for cartilage regeneration that has recently regained attention is decellularized cartilage-derived matrix (CDM). Since this material has shown potential for cartilage regeneration, we hypothesized that CDM could be a potent material for endochondral bone regeneration.