Proximal tibial osteotomies for the medial compartment arthrosis of the knee: a historical journey

Several proximal tibial osteotomy techniques for the medial compartment arthrosis of the knee are described and traced in their development. These techniques are of the closed wedge, dome and open wedge types. We detail the differences in planning and surgery as well the need for different fixation devices. This historical and technical description will benefit those surgeons wishing to undertake the procedure as an alternative to joint replacement strategies

Convolutional neural network denoising of focused ion beam micrographs

Most research on deep learning algorithms for image denoising has focused on signal-independent additive noise. Focused ion beam (FIB) microscopy with direct secondary electron detection has an unusual Neyman Type A (compound Poisson) measurement model, and sample damage poses fundamental challenges in obtaining training data. Model-based estimation is difficult and ineffective because of the nonconvexity of the negative log likelihood. In this paper, we develop deep learning-based denoising methods for FIB micrographs using synthetic training data generated from natural images. To the best of our knowledge, this is the first attempt in the literature to solve this problem with deep learning. Our results show that the proposed methods slightly outperform a total variation-regularized model-based method that requires time-resolved measurements that are not conventionally available. Improvements over methods using conventional measurements and less accurate noise modeling are dramatic - around 10 dB in peak signal-to-noise ratio.Accepted manuscrip

The subchondral bone in articular cartilage repair: current problems in the surgical management

As the understanding of interactions between articular cartilage and subchondral bone continues to evolve, increased attention is being directed at treatment options for the entire osteochondral unit, rather than focusing on the articular surface only. It is becoming apparent that without support from an intact subchondral bed, any treatment of the surface chondral lesion is likely to fail. This article reviews issues affecting the entire osteochondral unit, such as subchondral changes after marrow-stimulation techniques and meniscectomy or large osteochondral defects created by prosthetic resurfacing techniques. Also discussed are surgical techniques designed to address these issues, including the use of osteochondral allografts, autologous bone grafting, next generation cell-based implants, as well as strategies after failed subchondral repair and problems specific to the ankle joint. Lastly, since this area remains in constant evolution, the requirements for prospective studies needed to evaluate these emerging technologies will be reviewed