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Background Several studies have evaluated the outcomes of tantalum cones in revision knee arthroplasty with moderate-to-severe metaphyseal bone defects. However, recent innovations have led to the development of 3-D printed titanium cones to better adapt to host bone, there remains no consensus on their overall performance. Objective We therefore performed a systematic review of the literature to examine short-term survivorship and complication rates of their usage in revision TKAs. Methods A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 7 articles met the inclusion criteria. A total of 687 cones were implanted in 557 revision TKAs. The all-cause revision-free survivorship of the implants was 95.3% (26 revisions), and of the cones was 95.5% (31 cones revised) at mean 24 months follow-up. The cones revision-free survivorship from aseptic loosening was 99.7%. The overall complication rate was 19.7% with infection as the most common complications observed and the most frequent reason for revision with an incidence of 10.4% and 4.1%, respectively. Overall, functional outcomes improved as documented by postoperative knee scores. Conclusion 3-D printed metal cones represent a reliable option in metaphyseal bone defects reconstruction that provides high fixation, good short-term survivorship, and complications rates in line with similar devices. In addition, they are associated with lower intraoperative complications, and higher survivorship from aseptic loosening. [ABSTRACT FROM AUTHOR]

Robotic-assisted total knee arthroplasty (rTKA) has been developed to improve knee kinematics and functional outcomes, expedite recovery, and improve implants long-term survivorship. Robotic devices are classified into active, semi-active, and passive, based on their degree of freedom. Their capacity to provide increased accuracy in implants positioning with reduced radiographic outliers has been widely proved. However, these early advantages are yet to be associated with long-term survivorship. Moreover, multiple drawbacks are still encountered including a variable learning curve, increased setup and maintenance costs, and potential complications related to the surgical technique. Despite recent technologies applied to TKA have failed to prove substantial improvements, robotic-assisted surgery seems to be here to stay and revolutionize the field of TKA. To support its consistent usage on a daily basis, long-term results are still awaited, and further improvements are necessary to reduce the expenses related to it. [ABSTRACT FROM AUTHOR]

The results of a techno-economic model of distributed wind-hydrogen systems (WHS) located at each existing wind farm on the island of Ireland are presented in this paper. Hydrogen is produced by water electrolysis from wind energy and backed up by grid electricity, compressed before temporarily stored, then transported to the nearest injection location on the natural gas network. The model employs a novel correlation-based approach to select an optimum electrolyser capacity that generates a minimum levelised cost of hydrogen production (LCOH) for each WHS. Three scenarios of electrolyser operation are studied: (1) curtailed wind, (2) available wind, and (3) full capacity operations. Additionally, two sets of input parameters are used: (1) current and (2) future techno-economic parameters. Additionally, two electricity prices are considered: (1) low and (2) high prices. A closest facility algorithm in a geographic information system (GIS) package identifies the shortest routes from each WHS to its nearest injection point. By using current parameters, results show that small wind farms are not suitable to run electrolysers under available wind operation. They must be run at full capacity to achieve sufficiently low LCOH. At full capacity, the future average LCOH is 6–8 €/kg with total hydrogen production capacity of 49 kilotonnes per year, or equivalent to nearly 3% of Irish natural gas consumption. This potential will increase significantly due to the projected expansion of installed wind capacity in Ireland from 5 GW in 2020 to 10 GW in 2030. [ABSTRACT FROM AUTHOR]