Closing-Wedge Posterior Tibial Slope-Reducing Osteotomy in Complex Revision ACL Reconstruction

Background: A posterior tibial slope (PTS) >12° has been shown to correlate with failure of anterior cruciate ligament (ACL) reconstruction (ACLR). PTS-reducing osteotomy has been described to correct the PTS in patients with a deficient ACL, mostly after failure of primary ACLR. Purpose: To report radiologic indices, clinical outcomes, and postoperative complications after PTS-reducing osteotomy performed concurrently with revision ACLR (R-ACLR). Study design: Case series; Level of evidence, 4. Methods: A review of medical records at 3 institutions was performed of patients who had undergone PTS-reducing osteotomy concurrently with R-ACLR between August 2010 and October 2020. Radiologic parameters recorded included the PTS, patellar height according to the Caton-Deschamps Index (CDI), and anterior tibial translation (ATT). Patient-reported outcomes (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]), reoperations, and complications were evaluated. Results: Included were 23 patients with a mean follow-up of 26.7 months (range, 6-84 months; median, 22.5 months). Statistically significant differences from preoperative to postoperative values were found in PTS (median [range], 14.0° [12°-18°] vs 4.0° [0°-15°], respectively; P < .001), CDI (median, 1.00 vs 1.10, respectively; P = .04) and ATT (median, 8.5 vs 3.6 mm, respectively; P = .001). At the final follow-up, the IKDC score was 52.4 ± 19.2 and the KOOS subscale scores were 81.5 ± 9.5 (Pain), 74 ± 21.6 (Symptoms), 88.5 ± 8 (Activities of Daily Living); 52.5 ± 21.6 (Sport and Recreation), and 48.8 ± 15.8 (Quality of Life). A traumatic ACL graft failure occurred in 2 patients (8.7%). Reoperations were necessary for 6 patients (26.1%) because of symptomatic hardware, and atraumatic recurrent knee instability was diagnosed in 1 patient (4.3%). Conclusion: Tibial slope-reducing osteotomy resulted in a significant decrease of ATT and can be considered in patients with a preoperative PTS ≥12° and ≥1 ACLR failure. In highly complex patients with multiple prior surgeries, the authors found a reasonably low graft failure rate (8.7%) when utilizing PTS-reducing osteotomy. Surgeons must be aware of potential complications in patients with multiple previous failed ACLRs

Taming the Dragon: Outlining an African Response to Growing Chinese Engagement

Steering scholarship away from a dichotomously aligned debate betweenapologists and critics of Chinese engagement in Africa, this article redirectsattention to the policy-oriented question of ‘what practical steps can Africans take to seize the opportunities Chinese emergence presents?’ The authors recommend that regional organisations coordinate intraregional trade, economic and industrial policies to forge a path towards sustainable region-wide development and implement a code of conduct based on the 1977 Sullivan Principles; aimed at removing the structural impedimentsaverage Africans are faced with

To stay or switch: breaking the habit of status quo through imagery perspective

Purpose: When consumers imagine themselves in various consumption scenarios, they can do so from the actor or the observer perspective. These different vantage points are known as imagery perspectives. This paper aims to investigate how imagery perspectives can influence consumers’ decisions to stay with the status quo (default option) or to switch to an alternative. Design/methodology/approach: A series of four experimental design studies were conducted in both lab and online settings to study consumers’ switching tendency and choice. The empirical testing involved products, brands and services, including cameras (Study 1), vacation hotels (Study 2), toilet paper (Study 3) and food (Study 4). Findings: The authors demonstrate that compared with actor imagery that tends to perpetuate the default product and brand choice, observer imagery increases consumers’ tendency to change and switch to new products and brands. Research limitations/implications: Due to the methods used in empirical testing, the research results may lack generalizability. Practical implications: Marketers spend a considerable amount of resources in an attempt to get consumers to switch products and brands. The results of this paper shed light on how marketers can promote switching behaviors through imagery perspective. Originality/value: The research contributes to the streams of research in mental imagery, de-biasing and status quos, which have progressed in isolation from one another to date. This research is one of the first to investigate imagery perspective in the context of choice architecture

Microcirculatory effects of landiolol: a double-blind, randomised, controlled study after cardiac surgery

International audienceNo abstract availabl