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PURPOSE: The reason for graft failure after anterior cruciate ligament reconstruction (ACLR) is multifactorial. Controversies remain regarding the predominant factor and incidence of failure aetiology in the literature. This review aimed to provide a meta-analysis of the literature to evaluate the relative proportion of various failure modes among patients with ACLR failure. METHODS: The PubMed, Embase, Cochrane Library, Web of Science, and EBSCO databases were searched for literature on ACLR failure or revision from 1975 to 2021. Data related to causes for ACLR surgical failure were extracted, and a random effects model was used to pool the results, which incorporates potential heterogeneity. Failure modes were compared between different populations, research methods, graft types, femoral portal techniques, and fixation methods by subgroup analysis or linear regression. Funnel plots were used to identify publication bias and small-study effects. RESULTS: A total of 39 studies were analyzed, including 33 cohort studies and six registry-based studies reporting 6578 failures. The results showed that among patients with ACLR failure or revision, traumatic reinjury was the most common failure mode with a rate of 40% (95% CI: 35-44%), followed by technical error (34%, 95% CI: 28-42%) and biological failure (11%, 95% CI: 7-15%). Femoral tunnel malposition was the most common cause of the technical error (29%, 95% CI: 18-41%), with more than two times higher occurrence than tibial tunnel malposition (11%, 95% CI: 6-16%). Traumatic reinjury was the most common factor for ACLR failure in European populations and in recent studies, while technical errors were more common in Asian populations, earlier studies, and surgery performed using the transtibial (TT) portal technique. Biological factors were more likely to result in ACLR failure in hamstring (HT) autografts compared to bone-patellar tendon-bone (BPTB) autografts. CONCLUSION: Trauma is the most important factor leading to surgical failure or revision following ACLR. Technical error is also an important contributing factor, with femoral tunnel malposition being the leading cause of error resulting in failure.

BACKGROUND AND OBJECTIVE: Osteoarthritis (OA) is a highly prevalent, disabling disease requiring chronic management that is associated with an enormous individual and societal burden. This systematic review provides a global cost-effectiveness evaluation of pharmacological therapy for the management of OA. METHODS: Following Center for Reviews and Dissemination (CRD) guidance, a literature search strategy was undertaken using PubMed, EMBASE, Cochrane Library, Health Technology Assessment (HTA) database, and National Health Service Economic Evaluation database (NHS EED) to identify original articles containing cost-effectiveness evaluation of OA pharmacological treatment published before 4 November 2021. Risk of bias was assessed by two independent reviewers using the Joanna Briggs Institute (JBI) critical appraisal checklist for economic evaluations. The Quality of Health Economic Studies (QHES) instrument was used to assess the reporting quality of included articles. RESULTS: Database searches identified 43 cost-effectiveness analysis studies (CEAs) on pharmacological management of OA that were conducted in 18 countries and four continents, with one study containing multiple continents. A total of four classes of drugs were assessed, including non-steroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, symptomatic slow-acting drugs for osteoarthritis (SYSADOAs), and intra-articular (IA) injections. The methodological approaches of these studies showed substantial heterogeneity. The incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY) were (in 2021 US dollars) US$44.40 to US$307,013.56 for NSAIDS, US$11,984.84 to US$128,028.74 for opioids, US$10,930.17 to US$27,799.73 for SYSADOAs, and US$258.36 to US$58,447.97 for IA injections in different continents. The key drivers of cost effectiveness included medical resources, productivity, relative risks, and selected comparators. CONCLUSION: This review showed substantial heterogeneity among studies, ranging from a finding of dominance to very high ICERs, but most studies found interventions to be cost effective based on specific ICER thresholds. Important challenges in the analysis were related to the standardization and methodological quality of studies, as well as the presentation of results.

Objective To estimate the global prevalence of hip osteoarthritis (HOA) through a systematic review and meta-analysis, and to determine by regression analysis the respective relationships between age and sex, and sex and prevalence. Methods EMBASE, PubMed, Web of science, CINAHL, and SCOPUS were searched from inception until August 2022. Two authors independently extracted data and assessed the quality of the retrieved literature. Random-effects meta-analysis was performed to derive the pooled prevalence. Variations in the prevalence estimate in different subgroups, including diagnostic methods, region, and patient sex, were examined by subgroup meta-analysis. Meta-regression was used to construct the age-specific prevalence of HOA. Results A total of 31 studies were included in our analysis, involving 326,463 participants. Quality evaluation showed that all studies included in the analysis had a Quality Score of at least 4. The most frequently used method for diagnosing HOA was the Kellgren–Lawrence (K-L) grade classification, accounting for 19/31 (61.3%) studies. The pooled prevalence of HOA diagnosed based on the K-L grade ≥ 2 criterion was 8.55% (95% CI 4.85–13.18) worldwide. The prevalence of HOA was lowest in Africa at 1.20% (95% CI: 0.40–2.38), followed by Asia at 4.26% (95% CI 0.02–14.93) and North America at 7.95% (95% CI 1.98–17.36), and highest in Europe at 12.59% (95% CI 7.17–19.25). There was no statistically significant difference in HOA prevalence between men (9.42%, 95% CI:4.81–15.34) and women at (7.94%, 95% CI: 3.57–13.81). The regression model showed a correlation between age and the prevalence of HOA. Conclusion HOA has high prevalence worldwide and increases with age. The prevalence varies significantly by region but not by patient sex. High-quality epidemiological studies are warranted to more accurately estimate the prevalence of HOA.

Panax notoginseng is an important traditional medicinal plant, but the commercial value is threatened by root-rot disease caused by rhizosphere microbes and a potential health risk caused by plant arsenic (As) accumulation. Whether rhizospheric microbes isolated from P. notoginseng rhizosphere soil could impact As uptake and transport into P. notoginseng is not yet known. Among the three root-rot disease-causing pathogens Fusarium flocciferum (PG 1), Fusarium oxysporum (PG 2), and Fusarium solani (PG 3) and one root-rot disease biocontrol fungus Trichoderma koningiopsis (FC 1) and five biocontrol-exerting bacterial species Bacillus siamensis (BC 1), Delftia acidovorans (BC 2), Brevibacillus formosus (BC 3), Mortierella alpine (BC 4), and Bacillus subtilis (BC 5), one As-resistant pathogen and four biocontrol microorganisms with As-resistant ability were identified. The As-transforming ability of the identified fungi and bacteria was ranked in the order of FC 1 > PG 1 and BC 2 > BC 3 > BC 1, respectively. Then, the As-resistant biocontrol and pathogenic microbes were initiated to colonize the rhizosphere of 1-year-old P. notoginseng seedlings growing in artificially As(V)-contaminated soil to evaluate the impact of microbe inoculation on P. notoginseng As uptake and transport capacity. Concentration of As in P. notoginseng tissues decreased in the order of the sequence stem > root > leaf. Compared to treatment without colonization by microorganism, inoculation with microorganisms increased As root uptake efficiency and root As concentration, especially under treatment of inoculation by BC 2 and PG 1 + BC 2. As transport efficiency from root to stem decreased by inoculation with microorganism, especially under treatment with inoculation of BC 2 and PG 1 + BC 2. However, the impact of microorganism colonization on As stem to leaf transport efficiency was not obvious. In summary, inoculation with rhizosphere microbes may increase As accumulation in P. notoginseng root, especially when using bacteria with high As transformation ability. Therefore, it is necessary to evaluate the As transformation capacity before applying biological control microorganism to the rhizosphere of P. notoginseng.

BACKGROUND: Hip hemiarthroplasty (HA) is a standard surgical procedure for elderly patients with displaced fracture of the femoral neck, where dislocation is a possible complication. This study is a systematic review on the risk factors of implant dislocation in patients with femoral neck fracture following hip hemiarthroplasty (HA), and evaluates the methodological quality of the included studies. METHODS: Studies on risk factor assessment of dislocation following hip HA were sourced from EMBASE, Ovid, PubMed and ScienceDirect databases. The quality of included studies was evaluated using an improved quality evaluation method combined with a best-evidence synthesis method. RESULTS: A total of 130,127 patients were involved in 17 observational studies included in this systematic review, with a dislocation rate that ranged between 0.76 and 12.2% (overall incidence was 4–5% by meta-analysis). According to the applied quality evaluation criteria, eight studies were considered to be of high quality, six to be of medium quality, and three to be of low quality. The posterolateral surgical approach was identified as the only risk factor supported by strong evidence, while patients with small acetabular coverage and low postoperative offset were identified as risk factors supported by moderate evidence, and 11 other risk factors were supported by limited evidence. CONCLUSION: This systematic review provides some evidence in helping surgeons develop optimal prevention strategies for dislocation following hip HA during the perioperative period based on common risk factors identified in the literature. However, conclusive evidence supporting most of these risk factors is lacking and more methodologically rigorous studies are required to increase the confidence of recommendations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s43465-020-00177-5) contains supplementary material, which is available to authorized users.

By means of statistical analysis, the deformation mechanisms taking place in elastic loading and plastic shearing stages during serrated flows on the stress-strain curves for bulk metallic glasses were studied comprehensively. Normalized serration number presented a linear increasing tendency with the decrease of applied strain rates due to the reduction of free volumes. An excellent plastic deformation was illustrated from the influences of structure arrangement with activation energy. By using mean-field theory (MFT), maximum elastic-energy density at different strain rates could be predicted by MFT besides maximum stress drops during serrations. These results were helpful for understanding the serrated flow behavior or designing decent schemes to improve the plasticity of bulk metallic glasses at room temperature.

Intermittent serrated flows of a novel ductile Fe60Ni20P13C7 bulk metallic glass (BMG) at variant strain rates were investigated by statistics analysis. Peak and clutter distribution of slip-avalanche magnitudes are displayed during stable plastic flows at strain rates of 2×10−4 s−1 and 5×10−5 s−1, respectively, which means that serration behavior depends on the strain rate. However, the remarkable agreement between measured slip-avalanche magnitudes and the scaling behavior, i. e. a universal complementary cumulative distribution function (CCDF) predicted by mean-field theory (MFT) model, indicates that the plasticity of the present Fe-based BMGs can be tuned by imposed strain rates: $${S_{\max }} \sim {\dot \varepsilon ^{ - \lambda }}$$ . This tuned plasticity is elucidated with expended free-volume model. Moreover, the scaling behavior of serrated flows for other strain rates can be predicted as well.

Osseointegration has emerged over the past two decades as a dramatically different approach for the treatment of lower limb amputations, which involves direct attachment of the prosthesis to the skeletal residuum. This approach can address many of the socket–interface issues associated with socket prostheses which represent the current standard of care for amputees. The Osseointegrated Prosthetic Limb (OPL) is an osseointegration implant with a new design and improved features compared to other available implant systems. To report on the experience and outcomes of using the OPL for osseointegrated reconstruction of lower limb amputations. This is a retrospective study of 22 patients who received the OPL implant between December 2013 and November 2014. Clinical outcomes were obtained pre- and post-operatively, with results reported at the 1‑year follow-up. Outcome measures included the Questionnaire for persons with a Trans-Femoral Amputation (Q-TFA), Short Form Health Survey 36 (SF-36), Six-Minute Walk Test (6MWT), and Timed Up and Go (TUG). Adverse events were also recorded. Compared to the mean pre-operative values obtained while patients were using socket prostheses or were wheelchair-bound, the mean post-operative values for all four validated outcome measures were significantly improved. There were 15 episodes of minor infections in 12 patients, all of which responded to antibiotics. Soft tissue refashioning was performed electively on 6 patients. No other adverse events were recorded. The results demonstrate that osseointegration surgery using the OPL is a relatively safe and effective procedure for the reconstruction and rehabilitation of lower limb amputees.

The metallic glass matrix composites (MGMCs) and bulk metallic glasses (BMGs) were studied by statistical analysis during plastic deformation at the strain rates of 2×10–2 2×10–3 and 2×10–4 s-1 respectively. No serration events occur in both MGMCs and BMGs during compression tests at the strain rate of 2×10–2 s-1. When deformed at the strain rate of 2×103 s-1 the BMG displays a larger plasticity, which is due to the larger serration events followed by a series of small serrations caused by the continuous movement of free volume. The amplitudes and elastic-energy densities increase with increasing the strain rates owing to many serrations in MGMCs. It is deduced that the Young s modulus decreases from the normalized stress drop and fluctuations are observed on stress-strain curves, which is attributed to a lower coefficient according to the stick-slip model.