Total knee replacement after high tibial osteotomy: Time-to-event analysis and predictors

© 2021 Joule Inc. or its licensors. BACKGROUND: An important aim of high tibial osteotomy (HTO) is to prevent or delay the need for total knee replacement (TKR). We sought to estimate the frequency and timing of conversion from HTO to TKR and the factors associated with it. METHODS: We prospectively evaluated patients with osteoarthritis (OA) of the knee who underwent medial opening wedge HTO from 2002 to 2014 and analyzed the cumulative incidence of TKR in July 2019. The presence or absence of TKR on the HTO limb was identified from the orthopedic surgery reports and knee radiographs contained in the electronic medical records for each patient at London Health Sciences Centre. We used cumulative incidence curves to evaluate the primary outcome of time to TKR. We used multivariable Cox proportional hazards analysis to assess potential preoperative predictors including radiographic disease severity, malalignment, correction size, pain, sex, age, body mass index (BMI) and year of surgery. RESULTS: Among 556 patients who underwent 643 HTO procedures, the cumulative incidence of TKR was 5% (95% confidence interval [CI] 3%–7%) at 5 years and 21% (95% CI 17%–26%) at 10 years. With the Cox proportional hazards multivariable model, the following preoperative factors were significantly associated with an increased rate of conversion: radiographic OA severity (adjusted hazard ratio [HR] 1.96, 95% CI 1.12–3.45), pain (adjusted HR 0.85, 95% CI 0.75–0.96)], female sex (adjusted HR 1.67, 95% CI 1.08–2.58), age (adjusted HR 1.50 per 10 yr, 95% CI 1.17–1.93) and BMI (adjusted HR 1.31 per 5 kng/m2, 95% CI 1.12–1.53). INTERPRETATION: We found that 79% of knees did not undergo TKR within 10 years after undergoing medial opening wedge HTO. The strongest predictor of conversion to TKR is greater radiographic disease at the time of HTO

An Analysis of Collegiate Club-Sport Female Lacrosse Players: Sport-Specific Field Test Performance and the Influence of Lacrosse Stick Carrying

International Journal of Exercise Science 11(4): 269-280, 2018. Lacrosse is a field-based, intermittent sport that requires players to use a stick with a shaft and mesh pocket to manipulate the ball. However, there has been limited analysis of the characteristics of collegiate club-sport players, and whether stick carry influences the sprinting speed of lacrosse players. As a result, this study investigated the field test characteristics of collegiate club-sport female lacrosse players, and the effects of stick carry on linear and change-of-direction speed. Nine players (seven field players, two goalkeepers) volunteered for this study and completed: vertical jump and standing broad jump; 30-meter (m) sprint (0-5, 0-10, and 0-30 m intervals) and modified T-test without and with a stick; and the Yo-Yo Intermittent Recovery Test. Magnitude-based inference analyses via effect sizes (d) compared the field players and goalkeepers. Data was pooled for the 30-m sprint and modified T-test to examine the effect of stick carry via paired samples t-tests (p\u3c0.05) and effect sizes. Field players performed better in most field tests (d=0.93-2.45), although goalkeepers generated greater vertical jump power (d=2.01). With regards to the effects of stick carry, there was a significant difference between the faster 0-5 m sprint interval without a stick compared to with a stick (p=0.02), but this had a small effect (d=0.25). There were no differences between the other sprint intervals and modified T-test (p=0.08-0.39; d=0.06-0.19). When contextualized with comparisons to other female collegiate athletes, the results indicated limitations in training exposure for collegiate club-sport lacrosse players. Furthermore, stick carry generally did not affect speed

An investigation of the mechanics and sticking region of a one-repetition maximum close-grip bench press versus the traditional bench press

The close-grip bench press (CGBP) is a variation of the traditional bench press (TBP) that uses a narrower grip (~95% of biacromial distance (BAD)) and has potential application for athletes performing explosive arm actions from positions where the hands are held close to the torso. Limited research has investigated CGBP mechanics compared to the TBP. Twenty-seven resistance-trained individuals completed a one-repetition maximum TBP and CGBP. The TBP was performed with the preferred grip; the CGBP with a grip width of 95% BAD. A linear position transducer measured lift distance and duration; peak and mean power, velocity, and force; distance and time when peak power occurred; and work. Pre-sticking region (PrSR), sticking region, and post-sticking region distance and duration for each lift was measured. A repeated measures ANOVA was used to derive differences between TBP and CGBP mechanics (p \u3c 0.01); effect sizes (d) were also calculated. A greater load was lifted in the TBP, thus mean force was greater (d = 0.16–0.17). Peak power and velocity were higher in the CGBP, which had a longer PrSR distance (d = 0.49–1.32). The CGBP could emphasize power for athletes that initiate explosive upper-body actions with the hands positioned close to the torso

Shear Modes, Criticality and Extremal Black Holes

We consider a (2+1)-dimensional field theory, assumed to be holographically dual to the extremal Reissner-Nordstrom AdS(4) black hole background, and calculate the retarded correlators of charge (vector) current and energy-momentum (tensor) operators at finite momentum and frequency. We show that, similar to what was observed previously for the correlators of scalar and spinor operators, these correlators exhibit emergent scaling behavior at low frequency. We numerically compute the electromagnetic and gravitational quasinormal frequencies (in the shear channel) of the extremal Reissner-Nordstrom AdS(4) black hole corresponding to the spectrum of poles in the retarded correlators. The picture that emerges is quite simple: there is a branch cut along the negative imaginary frequency axis, and a series of isolated poles corresponding to damped excitations. All of these poles are always in the lower half complex frequency plane, indicating stability. We show that this analytic structure can be understood as the proper limit of finite temperature results as T is taken to zero holding the chemical potential fixed.Comment: 28 pages, 7 figures, added reference

Surface Terms as Counterterms in the AdS/CFT Correspondence

We examine the recently proposed technique of adding boundary counterterms to the gravitational action for spacetimes which are locally asymptotic to anti-de Sitter. In particular, we explicitly identify higher order counterterms, which allow us to consider spacetimes of dimensions d<=7. As the counterterms eliminate the need of ``background subtraction'' in calculating the action, we apply this technique to study examples where the appropriate background was ambiguous or unknown: topological black holes, Taub-NUT-AdS and Taub-Bolt-AdS. We also identify certain cases where the covariant counterterms fail to render the action finite, and we comment on the dual field theory interpretation of this result. In some examples, the case of vanishing cosmological constant may be recovered in a limit, which allows us to check results and resolve ambiguities in certain asymptotically flat spacetime computations in the literature.Comment: Revtex, 18 pages. References updated and few typo's fixed. Final versio

Are we missing the target? Are we aiming too low? What are the aerobic exercise prescriptions and their effects on markers of cardiovascular health and systemic inflammation in patients with knee osteoarthritis? A systematic review and meta-analysis

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Objectives We systemically reviewed published studies that evaluated aerobic exercise interventions in patients with knee osteoarthritis (OA) to: (1) report the frequency, intensity, type and time (FITT) of exercise prescriptions and (2) quantify the changes in markers of cardiovascular health and systemic inflammation. Data sources PubMed, CINAHL, Scopus; inception to January 2019. Eligibility criteria Randomised clinical trials (RCT), cohort studies, case series. Design We summarised exercise prescriptions for all studies and calculated effect sizes with 95% CIs for between-group (RCTs that compared exercise and control groups) and within-group (pre-post exercise) differences in aerobic capacity (VO 2), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and inflammatory markers (interleukin-6 (IL-6), tumour necrosis factor-alpha). We pooled results where possible using random effects models. Results Interventions from 49 studies were summarised; 8% (4/49) met all FITT guidelines; 16% (8/49) met all or most FITT guidelines. Fourteen studies (10 RCTs) reported at least one marker of cardiovascular health or systemic inflammation. Mean differences (95% CI) indicated a small to moderate increase in VO 2 (0.84 mL/min/kg; 95% CI 0.37 to 1.31), decrease in HR (-3.56 beats per minute; 95% CI -5.60 to -1.52) and DBP (-4.10 mm Hg; 95% CI -4.82 to -3.38) and no change in SBP (-0.36 mm Hg; 95% CI -3.88 to 3.16) and IL-6 (0.37 pg/mL; 95% CI -0.11 to 0.85). Within-group differences were also small to moderate. Conclusions In studies of aerobic exercise in patients with knee OA, very few interventions met guideline-recommended dose; there were small to moderate changes in markers of cardiovascular health and no decrease in markers of systemic inflammation. These findings question whether aerobic exercise is being used to its full potential in patients with knee OA. PROSPERO registration number CRD42018087859

Geons with spin and charge

We construct new geon-type black holes in D>3 dimensions for Einstein's theory coupled to gauge fields. A static nondegenerate vacuum black hole has a geon quotient provided the spatial section admits a suitable discrete isometry, and an antisymmetric tensor field of rank 2 or D-2 with a pure F^2 action can be included by an appropriate (and in most cases nontrivial) choice of the field strength bundle. We find rotating geons as quotients of the Myers-Perry(-AdS) solution when D is odd and not equal to 7. For other D we show that such rotating geons, if they exist at all, cannot be continuously deformed to zero angular momentum. With a negative cosmological constant, we construct geons with angular momenta on a torus at the infinity. As an example of a nonabelian gauge field, we show that the D=4 spherically symmetric SU(2) black hole admits a geon version with a trivial gauge bundle. Various generalisations, including both black-brane geons and Yang-Mills theories with Chern-Simons terms, are briefly discussed.Comment: 26 pages, 1 figure. LaTeX with amssymb, amsmath. (v2: References and a figure added.

Expressions 1988

https://openspace.dmacc.edu/expressions/1031/thumbnail.jp

Towards a derivation of holographic entanglement entropy

We provide a derivation of holographic entanglement entropy for spherical entangling surfaces. Our construction relies on conformally mapping the boundary CFT to a hyperbolic geometry and observing that the vacuum state is mapped to a thermal state in the latter geometry. Hence the conformal transformation maps the entanglement entropy to the thermodynamic entropy of this thermal state. The AdS/CFT dictionary allows us to calculate this thermodynamic entropy as the horizon entropy of a certain topological black hole. In even dimensions, we also demonstrate that the universal contribution to the entanglement entropy is given by A-type trace anomaly for any CFT, without reference to holography.Comment: 42 pages, 2 figures, few new ref's and comments adde

Holographic Calculations of Renyi Entropy

We extend the approach of Casini, Huerta and Myers to a new calculation of the Renyi entropy of a general CFT in d dimensions with a spherical entangling surface, in terms of certain thermal partition functions. We apply this approach to calculate the Renyi entropy in various holographic models. Our results indicate that in general, the Renyi entropy will be a complicated nonlinear function of the central charges and other parameters which characterize the CFT. We also exhibit the relation between this new thermal calculation and a conventional calculation of the Renyi entropy where a twist operator is inserted on the spherical entangling surface. The latter insight also allows us to calculate the scaling dimension of the twist operators in the holographic models.Comment: 71 pages, 6 figure