Cementless versus cemented fixation in image-based robotic total knee arthroplasty guided by functional knee positioning principles.

Introduction: Under functional knee positioning (FKPos) principles, residual varus or valgus alignment of the tibia and femur may be maintained, resulting in loading conditions that differ from those observed with mechanical alignment. Consequently, there is a need for evidence regarding implant fixation (cemented or cementless) in this context. This study aimed to evaluate the impact of implant fixation type (cemented versus cementless) on clinical outcomes, complications, and implant survival in robotic-assisted total knee arthroplasty (TKA) guided by FKPos principles.

Prolonged passive vibration of Achilles and patellar tendons decreases effort perception during subsequent cycling tasks.

Background: The perception of effort is a key determinant of endurance performance and a barrier to physical activity in inactive populations. From a neurophysiological viewpoint, effort perception is thought to arise from the brain processing of an efference copy of the motor command in sensory areas. However, recent research suggests that feedback from muscle spindles plays a significant role in this perception.

Isokinetic Testing After Anterior Cruciate Ligament Injury Showed a Greater Hamstrings/Quadriceps Ratio at 240°/S Over 6 Months From Injury but No Difference of Limb Symmetry Index.

Purpose: To assess preoperative quadriceps and hamstring strength at various time points after anterior cruciate ligament (ACL) injury but before ACL reconstruction.

Methods: Patients who underwent isokinetic muscle strength testing before planned ACL reconstruction were included. Patients were placed in 1 of the following 3 groups on the basis of time from injury to testing: <3 months, 3 to 6 months, and 6 to 12 months.

Impact of high body mass index on functionally aligned image-based robotic total knee arthroplasty: Comparable functional outcomes but higher mechanical failures.

Objectives: Increased body mass index (BMI) poses challenges in total knee arthroplasty (TKA), including higher complication rates. Functional knee positioning (FKP) with robotic assistance provides a personalized approach to optimize alignment and soft-tissue balance, but its impact on patients with increased BMI remains unclear. This retrospective comparative study aims to evaluate the influence of obesity and its severity on clinical outcomes and complications in TKA performed with an image-based robotic system-guided by FKP principles.

Return to physical activity after revision total knee arthroplasty: Comparative insights with primary procedure.

Introduction: While the return to physical activity (RTPA) after primary total knee arthroplasty (TKA) is well-documented, research on RTPA after revision TKA remains limited. This retrospective study aimed to evaluate the resumption of physical activity following revision TKA by comparing outcomes with a control group of primary TKA patients.

Methods: A total of 110 revision TKA patients were matched 1:1 with 521 primary TKA patients with a minimum of 2 years of follow-up.

Does the change between the native and the prosthetic posterior tibial slope influence the clinical outcomes after posterior stabilized TKA? A review of 793 knees at a minimum of 5 years follow-up.

Introduction: The understanding of the influence of posterior tibial slope (PTS) on knee kinematics has increased. However, the PTS influence on clinical outcomes remains unclear. The study aimed to evaluate whether a significant change between the native and the prosthetic tibial plateau PTS influences functional results and the risk of complications following total knee arthroplasty (TKA).

Lateral approach in robotic total knee arthroplasty for valgus knees: A step-by-step technique.

Total knee arthroplasty (TKA) in valgus knee deformities presents unique challenges, including alignment, soft tissue balance, and implant positioning. The lateral approach offers advantages over the traditional medial approach by improving direct access, patellar tracking, and soft tissue preservation. Robotic-assisted TKA enhances precision, ligament balancing, and patient-specific alignment strategies, such as functional knee positioning (FKP).

Beyond the coronal plane in robotic total knee arthroplasty-Part 2: Combined flexion does not affect outcomes.

Purpose: Personalized alignment in total knee arthroplasty (TKA) is becoming increasingly widespread, driven in part by advancements in robotic-assisted surgery. However, true personalization must extend beyond the coronal plane to include sagittal and axial planes. This study investigates the impact of combined flexion (CF) of the femoral and tibial components in robotic-assisted TKA within functional alignment (FA), also analyzing its variation (ΔCF) from native anatomy and its correlation with functional outcomes and complications.

Tibial implant varus >3° does not adversely affect outcomes or revision rates in functionally aligned image-based robotic total knee arthroplasty in a minimum of 2-year follow-up.

Purpose: Functional alignment (FA) aims to restore knee kinematics by balancing laxities and adapting implant positioning. This study evaluates safety and outcomes of >3° varus tibial positioning in patients with varus deformity undergoing robotic-assisted total knee arthroplasty (TKA).

Methods: This retrospective study included 337 patients with varus deformity undergoing robotic-assisted TKA with FA principles with a minimum of 2-year follow-up.

Beyond the coronal plane in robotic total knee arthroplasty-Part 1: Variations in tibial slope and distal femoral flexion do not affect outcomes.

Purpose: Robotic-assisted total knee arthroplasty (TKA) and new alignment principles are transforming traditional implant positioning, not only in the coronal plane but also in the sagittal and axial planes. The impact of differences between a patient's native tibial slope (TS) and distal femoral flexion (DFF) compared to the final implant positioning remains unclear. This study aims to evaluate whether variations in TS (ΔTS) and DFF (ΔDFF) play a role in clinical outcomes and implant survival.

Use of Ankle-GO to Assess and Predict Return to Sport After Lateral Ankle Reconstruction for Chronic Ankle Instability.

Background: Chronic ankle instability (CAI) develops in 20% to 40% of patients after ankle sprains because of inappropriate management or a premature return to sports (RTS). Patients become candidates for surgery when nonoperative treatment fails. The results of arthroscopic lateral ligament reconstruction have been shown to be excellent.

Proprioceptive acuity, proprioceptive weighting and balance in individuals with chronic ankle instability.

Background: Joint position sense (JPS), balance assessments, and proprioceptive weighting tests offer insights into different dimensions of proprioception to evaluate deficits associated with chronic ankle instability (CAI). However, it remains unclear whether the outcomes of one test can be extrapolated to others.

Research Question: Is proprioception measured by various tests impaired, and can the result obtained in one test be extrapolated to others in CAI and control participants?

Methods: Thirteen CAI and fifteen control participants were assessed on 1) JPS in dorsiflexion and plantarflexion by calculating absolute and constant repositioning errors.

A new parameter in the era of robotic total knee arthroplasty: Coronal alignment at 90° of flexion impacts clinical outcomes.

Purpose: Alignment strategies in total knee arthroplasty (TKA) have predominantly emphasized coronal alignment in extension, with minimal focus on dynamic alignment during flexion. This study aims to identify the predictors of the intraoperative robotic hip-knee-ankle angle at 90° of flexion (rHKA-90F) and assess its clinical significance in postoperative outcomes, proposing that rHKA-90F may be a critical factor in enhancing functional results in TKA.

Methods: A retrospective analysis was conducted on 180 patients with varus deformity undergoing robotic-assisted TKA under the functional alignment principles.

The Rate of Torque Development as a Determinant of the Torque-Velocity Relationship.

We investigate the contribution of isometric rate of torque development (RTD) and maximal voluntary torque (MVT) to the dynamic force production capacities of knee extensors obtained from the torque-velocity (TV) relationship, that is, the theoretical maximal velocity (V), torque (T), and maximal power (P). Single-leg knee extensors were tested in 64 young adults (31 females). RTD and root mean square (RMS) of electromyographic signals from the knee extensors were recorded during isometric and incremental load dynamic (nonisokinetic) contractions.

Comparable outcomes between cruciate-substituting and posterior-stabilized inserts in robotic total knee arthroplasty under the functional alignment principles.

Purpose: Functional alignment (FA) has emerged as a personalized strategy in total knee arthroplasty (TKA) to optimize outcomes by accounting for patient-specific anatomical and soft tissue characteristics. Limited evidence exists on how polyethylene insert type, specifically cruciate-substituting (CS) versus posterior-stabilized (PS), impacts clinical outcomes and complications in this context.

Methods: This retrospective comparative study included 329 patients who underwent robotic-assisted TKA with FA principles with a minimum 2-year follow-up.

Hemoglobin Mass Determination: Exploring Carboxyhemoglobin Stability and Analyzer Interchangeability.

Carbon monoxide (CO) rebreathing is frequently used to determine hemoglobin mass (Hb) during hypoxic or heat training and high-altitude research. Accurate and reliable carboxyhemoglobin (HbCO) determination is crucial for reliable Hb measurements. The aim was therefore to explore the stability of HbCO and interchangeability of two Radiometer analyzers in the determination of Hb.

Functional knee positioning in patients with valgus deformity undergoing image-based robotic total knee arthroplasty: Surgical technique.

Background: Functional knee positioning (FKP) represents an innovative personalized approach for total knee arthroplasty (TKA) that reconstructs a three-dimensional alignment based on the optimal balance of soft tissue and bony structures, but it has mostly been described for varus knee deformity.

Surgical Technique: Valgus deformities present specific challenges due to altered bone remodeling and soft tissue imbalances. Using robotic assistance, FKP enables precise intraoperative assessment and correction of compartmental gaps, accommodating each individual's unique anatomy and laxities.

Ankle supports enhance only psychological aspects of the Ankle-GO score in patients with chronic ankle instability.

CONTEXT: Chronic ankle instability (CAI) is the most serious long-term complication following an ankle sprain. Taping and bracing are frequently employed in the return to sport (RTS) continuum to avoid injury recurrence and to maximize post-injury performance. The Ankle-GO score is a valid and reliable objective RTS criteria, but the influence of ankle supports on this score in CAI patients remains unknown.

Robotic Assistance in Simultaneous Bilateral Medial Unicompartmental Knee Arthroplasty: A Retrospective Cohort Study of 126 Knees Demonstrating Enhanced Radiographic Accuracy and Comparable Safety to Conventional Methods.

Background: One-stage bilateral unicompartmental knee arthroplasty (BUKA) is a promising option for patients with bilateral medial knee osteoarthritis. This study aims to compare the safety, early clinical and functional outcomes, and radiological results of conventional vs robotic-assisted medial BUKA.

Methods: A retrospective cohort study was conducted involving patients who underwent medial BUKA as a single-stage procedure between April 2016 and January 2022.

Glycopyrronium 320 μg/mL in children and adolescents with severe sialorrhoea and neurodisabilities: An open-label study extension of the SALIVA trial.

Aims: To test the long-term efficacy, safety, and impact on quality of life (QoL) of an oral paediatric formulation of 320 μg/mL glycopyrronium in the 36-week SALIVA (Sialanar plus orAl rehabiLitation against placebo plus oral rehabilitation for chIldren and adolescents with seVere sialorrhoeA and neurodisabilities) trial.

Method: In the initial 12-week blinded period, 87 children with neurodisabilities and severe sialorrhoea were randomized to 320 μg/mL glycopyrronium versus placebo. In the subsequent 24-week open-label study extension, 74 children received 320 μg/mL glycopyrronium (37 continued glycopyrronium, 37 switched from placebo).

Differential effect of three types of exoskeletons and handling height on muscular activity, postural control and perceived effort during simulated bedside mobilization task.

Home care workers are affected by musculoskeletal disorders caused by biomechanical factors. This study investigated the effect of three exoskeletons devices (HAPO, HAPO FRONT and Japet.W) during load mobilization tasks at three bed heights in order to reduce physical risk factor.

Inferior outcome of stand-alone short versus long tibial stem in revision total knee arthroplasty. A retrospective comparative study with minimum 2 year follow-up.

Introduction: Revision Total Knee Arthroplasty (RTKA) is complex, and induced bone loss might endanger implant fixation and joint stability. Intramedullary stems improve fixation throughout stress redistribution. The current study aims to compare the performance of short tibial stems with long tibial stems, investigating their intermediate-term radiographic and survival outcomes in RTKA.

Functional alignment in robotic-assisted total knee arthroplasty for valgus deformity achieves safe coronal alignment and excellent short-term outcomes.

Purpose: Functional alignment (FA) in total knee arthroplasty (TKA) prioritizes soft tissue balancing and anatomical restoration without systematic correction to neutral alignment. Most studies have focused on varus deformity, with little evidence available about FA in valgus deformity. The hypothesis of the present study was that FA in robotic-assisted TKA for valgus deformity would demonstrate correction of the coronal alignment and yield satisfactory short-term outcomes.

Muscle composition is not a prognostic factor for muscle strength recovery after anterior cruciate ligament surgery by hamstring tendon autograft.

Purpose: For the athlete, anterior Cruciate Ligament (ACL) rupture and its surgical management are often a turning point in their career. Success and time to return to sport are essential parameters for athletes and their support staff, so it is critical to understand the prognostic factors influencing return to sport after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to determine the influence of hamstring muscle composition on muscle power following ACLR with autogenous hamstring grafts.