Anterolateral approach with tibial tubercle osteotomy versus standard medial approach for primary total knee arthroplasty: does it matter?

The purpose of this prospective consecutive multicenter study was to investigate whether the type of surgical approach (medial parapatellar (MPA) or lateral parapatellar with tibial tubercle osteotomy (TubOT)) influences the early clinical and radiological outcomes of primary total knee arthroplasty (TKA)

Minimally invasive total knee replacement : techniques and results

In this review, we outlined the definition of minimally invasive surgery (MIS) in total knee replacement (TKR) and described the different surgical approaches reported in the literature. Afterwards we went through the most recent studies assessing MIS TKR. Next, we searched for potential limitations of MIS knee replacement and tried to answer the following questions: Are there selective criteria and specific patient selection for MIS knee surgery? If there are, then what are they? After all, a discussion and conclusion completed this article. There is certainly room for MIS or at least less invasive surgery (LIS) for appropriate selected patients. Nonetheless, there are differences between approaches. Mini medial parapatellar is easy to master, quick to perform and potentially extendable, whereas mini subvastus and mini midvastus are trickier and require more caution related to risk of hematoma and VMO nerve damage. Current evidence on the safety and efficacy of mini-incision surgery for TKR does not appear fully adequate for the procedure to be used without special arrangements for consent and for audit or continuing research. There is an argument that a sudden jump from standard TKR to MIS TKR, especially without computer assistance such as navigation, patient specific instrumentation (PSI) or robotic, may breach a surgeon's duty of care toward patients because it exposes patients to unnecessary risks. As a final point, more evidence is required on the long-term safety and efficacy of this procedure which will give objective shed light on real benefits of MIS TKR

Comparison of the modified subvastus and medial parapatellar approaches in total knee arthroplasty

In this paper, we evaluated the difference between the modified subvastus approach and the medial parapatellar approach in total knee arthroplasty(TKA). We assessed the time of active straight-leg raise (SLR) post-operatively and the range of flexion of the operated knee at the tenth post-operative day, 6 weeks and 6 months, 12 months and 3 years. We investigated the degree of the patellar tilt and subluxation 24 months post-operatively. The patients who underwent the modified subvastus approach performed active SLR earlier (mean 0.5 days) than the medial parapatellar approach patients (mean 2.2 days). Knee flexion was better at the tenth post-operative day in the modified subvastus approach group compared to the medial parapatellar approach group. There was no statistical difference between the two groups with regard to the patellar tilt and subluxation. We conclude that the modified subvastus approach is recommendable in primary TKA

V3D enables real-time 3D visualization and quantitative analysis of large-scale biological image data sets

The V3D system provides three-dimensional (3D) visualization of gigabyte-sized microscopy image stacks in real time on current laptops and desktops. Combined with highly ergonomic features for selecting an X, Y, Z location of an image directly in 3D space and for visualizing overlays of a variety of surface objects, V3D streamlines the on-line analysis, measurement, and proofreading of complicated image patterns. V3D is cross-platform and can be enhanced by plug-ins. We built V3D-Neuron on top of V3D to reconstruct complex 3D neuronal structures from large brain images. V3D-Neuron enables us to precisely digitize the morphology of a single neuron in a fruit fly brain in minutes, with about 17-fold improvement in reliability and 10-fold savings in time compared to other neuron reconstruction tools. Using V3D-Neuron, we demonstrated the feasibility of building a 3D digital atlas of neurite tracts in the fruit fly brain. Quantitative analysis of three-, four-, and five-dimensional (3D, 4D, and 5D) microscopic data sets that involve the four dimensions of space and time and a fifth dimension of multiple fluorescent probes of different colors, is rapidly becoming the bottleneck in projects that seek to gain new insights from high-throughput experiments that use advanced 3

Magnetically controlled growing rods in the treatment of early-onset scoliosis: a note of caution.

The MAGnetic Expansion Control (MAGEC) system is used increasingly in the management of early-onset scoliosis. Good results have been published, but there have been recent reports identifying implant failures that may be associated with significant metallosis surrounding the implants. This article aims to present the current knowledge regarding the performance of this implant, and the potential implications and strategies that may be employed to identify and limit any problems. We urge surgeons to apply caution to patient and construct selection; engage in prospective patient registration using a spine registry; ensure close clinical monitoring until growth has ceased; and send all explanted MAGEC rods for independent analysis. The MAGEC system may be a good instrumentation system for the treatment of early-onset scoliosis. However, it is innovative and like all new technology, especially when deployed in a paediatric population, robust systems to assess long-term outcome are required to ensure that patient safety is maintained. Cite this article: Bone Joint J 2017;99-B:708-13