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The present study was aimed at stimulating the growth and yield of Sri Lankan tea cultivar TRI 2025 grown in different climatic regions in the country. The model was developed and calibrated using weather, crop and soil data collected from different climatic zones. The model is designed to simulate shoot replacement cycle, leaf area of a shoot, shoot growth, dry matter partitioning and tea shoot yield. The model was validated using shoot development and growth data not used for model calibration. These validation data were collected from low, mid and high elevations representing temperature and rainfall gradients in the country. Model calibration showed that thermal time required to initiate the fish leaf, 1st, 2nd and 3rd normal leaf in a tea shoot from the time of natural senescence of the scale leaves were 129, 188, 235, 296 °C days, respectively, and a tea shoot reached the harvestable stage after 393 °C days. The model simulated leaf area (cm2) and fresh weight (g/m2) of tea shoots at different developmental stages and locations which were in good agreement with the measured values at the validation stage (R2 > 0.92 and 0.98, respectively). Similarly, simulated shoot yields (g/m2/month) at the validation stage were strongly correlated with the measured values (n = 12, R2 > 0.58, RMSE = 5–17 g/m2/month). Thus, the model can be used to estimate the shoot yield of tea cultivar TRI 2025 grown in different climatic conditions in Sri Lanka. Areas requiring further improvements to the model are also discussed. [ABSTRACT FROM AUTHOR]

Abstract Background In our experience results of the Oxford unicompartmental knee replacement have not been as good as had been expected. A common post operative complaint is of persistent medial knee discomfort, it is not clear why this phenomenon occurs and we have attempted to address this in our study. Methods 48 patients were retrospectively identified at a mean of 4.5 years (range = 3 to 6 years) following consecutive Oxford medial Unicompartmental Knee arthroplasties for varus anteromedial osteoarthritis. The mean age at implantation was 67 years (range 57-86). Of these 48 patients, 4 had died, 4 had undergone revision of their unicompartmental knee replacements and 2 had been lost to follow up leaving 38 patients with 40 replaced knees available for analysis using the 'new Oxford Knee Score' questionnaire. During assessment patients were asked specifically whether or not they still experienced medial knee discomfort or pain. Results The mean 'Oxford score' was only 32.7 (range = 16 to 48) and 22 of the 40 knees were uncomfortable or painful medially. The accuracy of component positioning was recorded, using standard post operative xrays, by summing the angulation or displacement of each component in two planes from the ideal position (according to the 'Oxford knee system radiographic criteria'). No correlation was demonstrated between the radiographic scores and the 'Oxford scores', or with the presence or absence of medial knee discomfort or pain. Conclusion In our hands the functional outcome following Oxford Unicompartmental knee replacement was variable, with a high incidence of medial knee discomfort which did not correlate with the postoperative radiographic scores, pre-op arthritis and positioning of the prosthesis.

Background and Objectives: The management of complex upper limb arthroplasty has received national guidelines supporting the use of a regional network. An upper limb network was established for both elbow and shoulder arthroplasty. This study evaluates the impact of establishing this network over a 5-year period., Methods: Data were collected from network meetings from June 2017 to December 2022. Hospital-level National Joint Registry data were obtained for analysis of case volume., Results: A total of 243 cases were discussed. Network discussion changed the management plan in 53% of cases. Only 8% of cases required transfer to the tertiary center. The proportional caseload at either hub or spoke hospitals did not change after creation of the network., Discussion: Regional network discussion aids decision-making for complex cases, with further management options realized in over half of the cases presented. The discussion allowed every patient to gain the advantage of regional expertise while being managed conveniently at their local hospital., 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.)

Abstract: We previously reported the mean 4-year outcomes of anatomic total shoulder replacement using an all-polyethylene, pegged, hybrid-fixation (bone ingrowth and cement) glenoid component. In the present study, we report on that patient cohort after another 4 years of follow-up (mean, 101 months; range, 77 to 146 months). At that time, the median American Shoulder and Elbow Surgeons (ASES) score was 92 points (interquartile range [IQR], 81.7 to 98.3) and the median Oxford Shoulder Score was 47 points (IQR, 41 to 48). Osseointegration, demonstrated by bone ingrowth between the flanges on the central peg as seen on coronal computed tomography (CT), was complete in 75% of the shoulders, partial in 21%, and absent in 4%. There were radiolucent lines at the bone-prosthesis interface on CT, with a median Yian score of 1 (IQR, 0 to 2; range, 0 to 18). The conclusion in the present study was that shoulder arthroplasty with an all-polyethylene, hybrid-fixation (bone ingrowth and cement) pegged glenoid component has durable clinical and radiographic outcomes at medium-term follow-up., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: Disclosure: Funding for CT scans was provided by the Melbourne Orthopaedic Group Research Fund. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/G223)., (Copyright © 2020 by The Journal of Bone and Joint Surgery, Incorporated.)

The proliferation of computer 3D simulation and computer-generated guides is aimed at minimizing perforation of the glenoid vault by glenoid pegs in shoulder arthroplasty, based on assumptions that perforation leads to worse outcomes by component loosening and potential failure. We evaluated outcomes of glenoid peg perforation testing the assumption that perforation produces worse results. Eighty-three shoulders underwent shoulder arthroplasty with pegged hybrid fixation (bone-ingrowth flanged central glenoid peg and peripheral cemented pegs) without precision signal injector guides or use of 3D planning software. Outcomes were determined by American Shoulder and Elbow Score and Oxford Shoulder Score. Fine slice CT determined the presence of vault perforation and the extent of lucent lines at the prosthesis-bone interface and bony morphology of the vault perforation. Follow-up was 46.7 months (24-99). Seven shoulders (8%) demonstrated perforation of glenoid vault. Bony ingrowth and cortical overgrowth occurred despite perforation, with no clinically significant differences in clinical or radiological outcomes in shoulders with and without glenoid vault perforation. None of these patients underwent revision surgery. Despite not utilizing computer planning and/or guides, 92% of implants did not perforate the glenoid vault. However, glenoid vault perforation in our series produced excellent outcomes with no increased risk of revision as a result of glenoid vault perforation., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2019 The British Elbow & Shoulder Society.)

Background: Loosening of the glenoid component continues to be the main cause of medium and long-term failure of shoulder replacements. The purpose of this study was to evaluate the early clinical and radiographic results following use of an all-polyethylene pegged glenoid component designed for hybrid (biological and cement) fixation., Methods: Eighty-three shoulders in 77 patients (mean age, 68.6 years) underwent total shoulder arthroplasty with a pegged hybrid-fixation component (bone-ingrowth glenoid and cemented peg). Outcomes were determined with the American Shoulder and Elbow Surgeons (ASES) score and the Oxford shoulder score. A detailed analysis of radiographs and fine-slice computed tomography (CT) images was performed to determine the extent of bone ingrowth between the flanges and the extent of radiolucent lines at the prosthesis-bone interface., Results: The mean duration of follow-up was 46.7 months (range, 24 to 99 months). At the time of final follow-up, the median ASES score was 97 points (range, 43 to 100 points) and the median Oxford score was 48 points (range, 24 to 48 points). The median active forward elevation was 130° (range, 65° to 170°), median external rotation was 45° (range, 5° to 80°), and median internal rotation was to T11 (range, buttock to T4). Seventy-eight shoulders demonstrated a perfect Lazarus score for radiolucency (0, indicating no radiolucency). Sixty-eight shoulders demonstrated complete osseointegration, with bone ingrowth between all of the flanges seen on coronal CT; 5 demonstrated partial osseointegration; and 10 demonstrated osteolysis around the central peg. Most radiolucent lines were in the inferior Yian zones. There were no correlations between the Yian CT scores and either the ASES or Oxford score (rho = 0.13 and 0.07, respectively)., Conclusions: Total shoulder arthroplasty with an all-polyethylene pegged glenoid component, utilizing hybrid fixation, demonstrated excellent clinical and radiographic results at the time of early follow-up. Radiolucent lines were seen most commonly around the inferior pegs of the prosthesis, and this may represent an incipient mode of failure., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence., (Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.)

Purpose: This study describes a case series of 15 patients with radial head fractures who underwent radial head excision using an arthroscopic technique., Methods: Over a four year period, 15 patients (average age 49.6 years) who had sustained a radial head or radial neck fracture underwent an arthroscopic excision of the radial head. Four patients had an unreconstructable comminuted fracture (early group; EG) and 11 patients had pain and loss of motion with an associated non- or malunion (late group; LG)., Results: The mean time to surgery following injury was three weeks (one to five) for the EG and 27 weeks (eight-58) for the LG. The average visual analogue scale (VAS) was 1.7 (zero to four), and the average Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score was 24.7 (16-44). At final follow-up, average supination was 62.0° (range 45-75°) and pronation was 63.3° (range 45-75°). There were no complications., Conclusion: This series demonstrates that arthroscopic excision of fractures of the radial head and neck is reliable, reproducible and safe, with similar results to open excision. There may also be additional benefits in the short term with regards to speed of healing and rehabilitation.

Purpose: The diagnosis of hip osteoarthritis is often complicated by co-existing pathology in the knee and spine, and mismatch between clinical and radiological signs. Temporary pain relief from a local anaesthetic injection into the hip joint has been reported to help localise symptoms, reducing the risk of unnecessary surgery being performed. We hypothesize that good surgical outcome is predicted by good analgesia following diagnostic injection, and that alternative pathology is present when there is no response to injection., Methods: Data were analysed from a prospective database of 163 consecutive patients who underwent diagnostic hip injection for possible osteoarthritis. We recorded result of injection and whether hip arthroplasty was performed. A good outcome to surgery was defined as subsequent pain relief without significant residual symptoms., Results: A total of 138 patients were suitable for inclusion in the study. Fifty-eight patients had hip arthroplasty following a good response to diagnostic injection. Of these 54 had a good outcome following surgery (93%). There was also a quantitative improvement in pain and function in these patients as measured by 1 year post-operative and pre-operative Harris hip scores (P < 0.0001). A total of 44/49 patients had no surgery following no response to injection. A clear alternative diagnosis to hip osteoarthritis was made in 40 of these patients (91%)., Conclusion: Diagnostic ultrasound-guided local anaesthetic injection of the hip joint is a useful test in confirming hip pathology. Complete relief of hip pain following intracapsular injection of local anaesthetic is associated with good surgical outcome following joint replacement.