Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial)

In young patients with medial knee osteoarthritis (OA), surgical intervention may not be desirable due to preferences to avoid bone cutting procedures, return to high activity levels, and prolong implant survival. The Atlas Knee System was designed to fill the gap between ineffective conservative treatments and invasive surgery. This single-arm study included 26 patients, aged 25 to 65 years, who completed 12 months of follow-up. All dimensions of the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score significantly improved from baseline to 12 months. About 96.2% and 92.3% of patients experienced a ⩾20% improvement in their KOOS pain and WOMAC pain scores, respectively, at 12 months. This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months

Advanced Anal Squamous Cell Carcinoma -Radiotherapy or Surgery?

Rezumat Carcinom scuamos anal avansat -radioterapie sau chirurgie? Premize: Cancerul rectal aei anal este a treia cauzã de deces în Polonia. Adenocarcinomul este cea mai frecventã tumorã din acest grup. Carcinomul scuamos este relativ rar. Acest tip de carcinom afecteazã mai degrabã anusul decât rectul. Deaei leziunea este perceputã a nu fi foarte malignã aei a fi responsivã la radioterapie, unele cazuri pot necesita tratament chirurgical. grupul pacienåilor operaåi rata medie de supravieåuire a fost de 48 luni (mediana a 14-74 luni) în timp ce pentru grupul de pacienåi tratat conservator rata de supravieåuire medie a depãaeit 55 luni (mediana a 17-82 luni, p=0,23). Rata medie de supravieåuire fãrã boalã la 5 ani a fost similarã cu a grupului general în timp ce complicaåiile postoperatorii au apãrut la 66% din intervenåiile chirurgicale aei la 27% din procedurile de teleradioterapie. Concluzii: asocierea radioterapiei cu chimioterapia poate fi metoda de elecåie în tratamentul carcinomului scuamos anal. Chirurgia este necesarã în cazurile avansate, la care nu se observã regresia completã dupã radiochimioterapie. Rezecåia abdomino-perinealã a rectului este o intervenåie chirurgicalã care poate fi acompaniatã de numeroase complicaåii. Totuaei, aceasta rãmâne o metodã terapeuticã necesarã în cazurile descrise. Material aei Cuvinte cheie: carcinom anal, APR (rezecåie abdominoperinealã a rectului), radioterapie, carcinom scuamos anal avansat Abstract Background: Anal and rectal cancers occupy the third position of death causes in Poland. Adenocarcinoma is the most frequent among the tumours in this group. Squamous cell carcinoma can be relatively less common. This kind of carcinoma may rather affect the anus than the rectum. Although the lesion is perceived as not very malignant and as such responsive to radiant energy therapy, some cases may require surgical treatment. Results: For the total number of 18 patients with anal squamous cell carcinoma the mean observation period was 5.5 years, in the group of the operated patients the mean survival rate was 48 months (the median of 14-74 months) while for the group of the patients treated conservatively the mean survival rate amounted to 55 months (the median of 17-82 months, p=0.23). The mean 5-year disease-free survival rate was rather similar to the same rate of the general group, whereas the post-operative complications occurred in 66% of surgical procedures and 27% of teleradiotherapeutic procedures. Conclusions: Combined radiotherapy and chemotherapy can be the method of choice in treating anal squamous cell carcinoma. Surgery should be used in advanced cases, when complete regression on radiochemotherapy cannot be observed. The abdomino-perineal resection of the rectum is the kind of a procedure that may be accompanied with a vast number of complications. Nevertheless, it still remains a necessary therapeutic method in the described cases