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The article focuses on the functional and radiological outcomes of arthroscopic-assisted reduction and fixation for intra-articular distal radius fractures (DRFs). Topics include the significant improvements in wrist range of motion and reduction in disability and symptoms as measured by DASH and PRWE scores, the impact of chronic conditions on recovery, and the need for further research to validate these findings and compare them with other surgical methods.

The article focuses on the effectiveness of an arthroscopically assisted technique for treating ankle fractures involving a posterior malleolus fragment in adults. Topics include the impact of the technique on functional outcomes as measured by the AOFAS score, improvements in ankle range of motion over time, and the identification and management of intra-articular injuries during the procedure.

The article focuses on evaluating the correlation between component size asymmetry and functional knee outcomes in patients undergoing simultaneous bilateral total knee arthroplasty (simBTKA). Topics include the rate of asymmetry in component sizes, the impact on Knee Society Score (KSS) and range of motion (ROM), and the incidence of complications associated with the procedure.

Simple Summary: Thyroid cancer is the most common endocrine cancer and is becoming increasingly prevalent. Although its prognosis is generally favorable, bone metastasis is a notable complication that significantly decreases survival rates. Currently, there is no definitive cure as most treatments are palliative to relieve patients of any pain or other symptoms. We assessed the incidence and influence of bone metastasis on thyroid cancer patients to understand the risk factors and outcomes which can improve clinical decision making and research endeavors. Bone is the second most common site of metastasis in patients with thyroid cancer (TC) and dramatically impacts overall survival and quality of life with no definitive cure, yet there is no extensive study of the demographic and clinical risk factors in the recent literature. Data regarding 120,754 TC patients with bone metastasis were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analyses were used to identify the risk factors of bone metastasis occurring in various histologies of TC. Cox regression was performed to analyze the influence of bone metastasis on overall survival. Hazard ratios were computed to analyze the association between bone metastasis and the primary outcomes. Of the 120,754 records collected from the SEER database from 2000 to 2019, 976 (0.8%) presented with bone metastasis, with occurrence being the greatest in patients of age ≥ 55 years (OR = 5.63, 95%CI = 4.72–6.71), males (OR = 2.60, 95%CI = 2.27–2.97), Blacks (OR = 2.38, 95%CI = 1.95–2.9) and Asian or Pacific Islanders (OR = 1.90, 95%CI = 1.58–2.27), and single marital status. TC patients presenting with bone metastasis (HR = 2.78, 95%CI = 2.34–3.3) or concurrent bone and brain metastases (HR = 1.62, 95%CI = 1.03–2.55) had a higher mortality risk. Older age, gender, race, and single marital status were associated with bone metastasis and poorer prognosis in TC patients at initial diagnosis. Understanding such risk factors can potentially assist clinicians in making early diagnoses and personalized treatment plans, as well as researchers in developing more therapeutic protocols. [ABSTRACT FROM AUTHOR]

Introduction: Only 70–85% of patients that had total knee arthroplasty (TKA) are satisfied with their knees. The need for a near to normal knee kinematics is crucial and maybe the solution to their needs. Addressing the cruciate ligaments during surgery along with the extent of arthrosis may give a solution to this problem. Material and methods: One hundred consecutive patients in whom a total knee arthroplasty was indicated and performed were prospectively documented. During the knee replacement surgery, the condition of the anterior and posterior cruciate ligaments and the degree of osteoarthritis (OA) in the medial and lateral compartments as well as in the patello-femoral joint were documented using the Outerbridge classification. The patients’ average age was 72.3 years, with the majority being female. In all patients, a total bi-compartmental knee replacement was indicated. Results: Our results showed that in 78% of all patients the anterior, and in 98% the posterior cruciate ligament was still intact. Seventy-one percent of cases suffered from grade 4 medial osteoarthritis, 19% from grade 3 and 10% from grade 2. Thirty-six of patients suffered from grade 4 lateral osteoarthritis, 36% from grade 3, 24% from grade 2 and 4% from grade 1. Grade 4 patello-femoral osteoarthritis was present in 32% of all patients, grade 3 in 60% and grade 2 in 8% of all patients. Discussion: The goal of arthroplasty is to approximate the function of a normal knee. The retention of the anterior cruciate ligament (ACL) allows for better knee, kinematics, improved proprioception, increased flexion and an overall improvement in knee function. The decreased constraint that is possible with retention of both cruciates may decrease implant stresses and improve the implant survivorship. The distribution of OA shows that the medial and patello-femoral compartments of the joint are primarily affected. This could also allow for a more conservative and patient-tailored prosthetic design.

Background: Polyethylene thickness in total knee arthroplasty (TKA) can affect outcomes and the need for revision surgery. The thickness of polyethylene is dependent on the level of the proximal tibial cut. Computer-assisted techniques can accurately determine the level of tibial cut and help in bone preservation. Objective: The aim was to compare the thickness of the polyethylene inserts in patients who have undergone TKA using patient-specific templating (PST) versus conventional instrumentation. Patients and Methods: We prospectively collected TKA data from the Egyptian Community Arthroplasty Register (ECAR), with controlled age, sex, BMI, deformities, and preoperative knee society score (KSS). The total number included was 315 knees (150 conventional TKA knees and 165 PST knees). All TKAs were done by one surgeon. Statistical analysis was done using Microsoft Excel and R programming language. Results: The average polyethylene thickness in the conventional and PST groups were 11.6 (SD=2.9) and 11.1 (SD=2.1) mm, respectively, which was not statistically significant. However, there was a significant difference in outliers in favor of PST (maximum thickness was 14 and 20 mm in the PST and conventional groups, respectively). The PST group had more improvement in the KSS (p=0.023). Conclusion: This study showed that PST reduced the outliers in polyethylene thickness, which helps in the preservation of bone stock and subsequently may improve implant survival. This study may not be representative as the operations were done by one surgeon. Therefore, further studies are required. [ABSTRACT FROM AUTHOR]

Background: Complex Ankle fractures are a serious condition due to their significant morbidity. Open reduction/internal fixation (ORIF) is the standard technique for managing such types of fractures. In spite of the anatomical reduction, the patient may still suffer from some residual symptoms. Recently, arthroscopic-assisted reduction and internal fixation (ARIF) have given promising results as it can identify and manage concomitant intraarticular injuries. Objective: This review article aimed to assess the role of ARIF in treating ankle fractures. Methods: Ankle, Fracture and Arthroscopy were all searched by Science Direct, Google Scholar, and PubMed. The writers also assessed references from pertinent literature, although they only included the most recent or comprehensive study, which ran from January 2006 to February 2023. Documents in languages other than English were not included since there were insufficient sources available for translation. Excluded papers included dissertations, conference abstracts, unpublished publications, oral presentations, and other works not included in longer scientific investigations. Conclusion: ARIF did not show superiority to ORIF in relieving pain and improving the function in those with ankle fractures. However, it provides a reliable tool for diagnosis and treats intra-articular pathology. Finally, the choice between ARIF and ORIF should be dependent upon the specific case and surgeon's evaluation of patients' needs and goals. [ABSTRACT FROM AUTHOR]

OBJECTIVESpinal cord injury (SCI) has been investigated in various animal studies. One promising therapeutic approach involves the transfer of peripheral nerves originating above the level of injury into those originating below the level of injury. The purpose of the present study was to evaluate the feasibility of nerve transfers for reinnervation of lower limbs in patients suffering SCI to restore some hip and knee functions, enabling them to independently stand or even step forward with assistive devices and thus improve their quality of life.METHODSThe feasibility of transferring intercostal to gluteal nerves and the ilioinguinal and iliohypogastric nerves to femoral nerves was assessed in 5 cadavers. Then, lumbar cord hemitransection was performed below L1 in 20 dogs, followed by transfer of the 10th, 11th, and 12th intercostal and subcostal nerves to gluteal nerves and the ilioinguinal and iliohypogastric nerves to the femoral nerve in only 10 dogs (NT group). At 6 months, clinical and electrophysiological evaluations of the recipient nerves and their motor targets were performed.RESULTSThe donor nerves had sufficient length to reach the recipient nerves in a tension-free manner. At 6 months postoperatively, the mean conduction velocity of gluteal and femoral nerves, respectively, increased to 96.1% and 92.8% of the velocity in controls, and there was significant motor recovery of the quadriceps femoris and glutei.CONCLUSIONSIntercostal, ilioinguinal, and iliohypogastric nerves are suitable donors to transfer to the gluteal and femoral nerves after SCI to restore some hip and knee motor functions.