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Background: Valgus deformity of the knee comprises upwards of 15 % of the deformities in primary total knee arthroplasty (TKA) patients. 1,2 The two implants most commonly used in valgus deformed knees are posterior stabilizing (PS) and cruciate-retaining (CR) implants. CR implants may offer a more advantageous construct due to the retention of the PCL for proprioception and less bony resection compared to PS implants. The purpose of this systematic review is to aggregate findings for cruciate-retaining implants used in primary TKA with valgus deformed knees., Methods: In compliance with PRISMA guidelines, databases were queried for CR TKA studies which met the inclusion criteria. Cochrane ROBINS-I and the GRADE framework assessed bias and quality respectively., Results: There was a statistically significant (p < 0.001) difference between preoperative and postoperative valgus deformity as measured by tibiofemoral angle. The all-cause revision rate was 8.3 % in our sample of 710 total knee arthroplasties., Conclusion: This review of the literature demonstrates that, although scarcely reported, cruciate-retaining implants used in primary total knee arthroplasties in valgus deformed knees provide satisfactory outcomes such as arc of motion and knee score. Our results demonstrate a significant increase in all-cause revision when using CR implants for valgus deformed knee. For this reason, further investigations should be conducted to evaluate modes of failure in this specific patient population., Level of Evidence: IV systematic review., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. AC discloses consultant relationship with Exactech and royalties with Arthrex. All other authors declare that they have no competing interests., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Summary: The distal radioulnar joint (DRUJ) is vital to the stability and function of the wrist and forearm. The osseous morphology is variable and provides little stability. A complex of confluent soft tissues is the primary stabilizer; however, the contribution of each component has yet to be elucidated. It has become increasingly clear that the anatomic fixation of distal radius fractures restores DRUJ stability, obviating the need for additional DRUJ stabilization. This review will describe the anatomy and biomechanics of the DRUJ and discuss injury patterns, treatments, and clinical results., Competing Interests: G. P. Kolovich discloses a consultant relationship with Axogen, Trice Medical, and Ortho Circle and is a shareholder in Oxos Medical. The remaining authors report no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction and Importance: Primary total hip arthroplasty (THA) is a procedure performed in the United States for a variety of indications, with operation rates slated to increase over 275 % by 2040 when compared to 2014 (Thilak et al., 2015). Dual-mobility (DM) implants have gained popularity in the United States since gaining approval in the early 2010s (Heckmann et al., 2020). It has been well reported that DM implants decrease the risk of dislocation after primary and revision THA (Vielpeau et al., 2011; Donovan et al., 2022; Heifner et al., 2023; Foissey et al., 2023; Schmidt et al., 2020; Neri et al., 2019)., Case Presentation: We present the case of a 33-year-old male with a suspected ankylosing spondylitis (AS) diagnosis and bilateral bony ankylosis of the hips who underwent staged THA with modular dual-mobility (MDM) implants. At one year post-operatively, the patient is walking without the use of an assistive device and reports a VAS pain score of 0 at rest and 2 with activity and HHS of 90., Clinical Discussion: Implant selection is important in this patient population due to the increased risk of dislocation. Contemporary reports reveal MDM implants have demonstrated a substantial reduction in dislocation risk compared to fixed-bearing implants in patients with a high risk of dislocation. We opted to place the acetabular component inside the safe zone to improve stability and use the dual-mobility prosthesis to achieve our desired range of motion., Conclusion: The improved stability of DM implants allows for a greater range of acetabular positions in patients who have a highly unpredictable functional outcome at the time of surgery. Our preliminary results contribute to the growing list of indications for MDM total hip arthroplasty., Competing Interests: Conflict of interest statement AC receives royalties or licenses from Arthrex and payment for lectures, presentations, speaker's bureaus, manuscript writing or educational events from Exactech. The other authors have no financial interests or personal relationships to disclose., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Compared to total elbow arthroplasty, elbow hemiarthroplasty (EHA) does not have an ulnar component or a hinge/link which eliminates complication risk due to polyethylene wear and ulnar loosening. There are notable gaps in the existing EHA literature. Patient age is often identified as an important determinant when deciding to treat with EHA; however, there is limited age-based evidence. Our systematic review objectives were (a) to compare EHA outcomes between younger and older adults, and (b) to stratify outcomes for EHA by prosthesis., Methods: In compliance with PRISMA guidelines, databases were searched for EHA studies and 65 years was used to delineate younger and older adults., Results: Older adults (N = 159) had a significantly higher elbow arc of motion compared to younger adults (N = 121) at a mean follow-up of 51 months. There was a significantly increased risk for a MEPS below 75 in younger compared to older adults. Mean Disabilities of the Arm, Shoulder, and Hand scores and rates of revision/removal were comparable between age groups., Conclusion: The current findings suggest that although elbow range of motion may be limited in younger adults following EHA, function is satisfactory and comparable to the function in older adults. Additionally, the risk of revision/removal surgery is similar between younger and older adults across short to mid-terms of follow-up., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

We present two cases of complex metacarpal fractures treated with an intramedullary locking nail. This is an emerging fixation method that minimizes tissue insult, provides sufficient stability, and allows early mobilization. Locking nails accommodate the capture of fractured fragments in complex unstable patterns and provide longitudinal and rotational stability. The described intrafocal technique is intended to improve coaxial placement of the wire into the medullary canal., Competing Interests: Dr Mercer has association/financial involvement with Skeletal Dynamics (speaker’s bureau) and Axogen (speaker’s bureau). No benefits in any form have been received or will be received by the other authors related directly to this article., (© 2024 The Authors.)

Introduction: Curcumin reduces gut barrier damage and plasma cytokine responses to exertional heat stress. However, the role of peripheral blood mononuclear cell (PBMC) in this response remains unclear., Purpose: This work investigated the effect of 3 days of 500 mg/day dietary curcumin supplementation on PBMC responses to exertional heat stress in non-heat acclimated humans., Methods: Eight participants ran (65% VO 2max ) for 60 min in an environmental chamber (37 °C/25% RH) two times (curcumin/placebo). Blood samples were collected pre, post, 1 h post, and 4 h post-exercise. PBMC were isolated from blood samples and the protein content of markers along the TLR4 signaling pathway (TLR4, MyD88, pNF-κB, NF-κB), indicators of cellular energy status (SIRT1 and p-AMPK), and mediators of cellular heat shock response (pHSF-1 and HSP70) were examined with Western blot. Data were analyzed with two-way (condition × time) RM-ANOVAs with Newman-Keuls post hocs., Results: As compared to placebo, curcumin did not alter protein expression in PBMC (p > 0.05). However, in both study conditions at 1 h post-reductions were noted in TLR 4 (- 21.5%; p = 0.03), HSP70 (- 11.0%; p = 0.04), pAMPK (- 48.5%; p < 0.01), and SIRT1 (- 47.8%; p < 0.01). Remarkably, the ratio of pNF-κB to NF-κB was elevated in both conditions at this same timepoint (+ 75.4%; p = 0.02)., Conclusions: Inflammatory protein expression in PBMC did not differ between curcumin and placebo conditions. Downregulation of pAMPK/SIRT1 and release of HSP70 to the bloodstream may compensate for reduced TLR4, allowing PBMC to maintain inflammatory capacity and preventing an "open window" during the hours following hyperthermic exercise.