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Abstract Purpose To longitudinally evaluate sockets localization, tunnel morphological changes and graft maturation after the inside‐out tibial tunnel drilling technique for all‐inside Anterior Cruciate Ligament Reconstruction (ACLR). We hypothesized that due the necessary angle for the inside‐out reaming procedure, the described technique could input changes in the tibial socket. Methods Fourteen knees treated with the same all‐inside ACLR technique were randomly assigned for a magnetic resonance evaluation. All patients were operated by the same surgeon and performed the same follow‐up rehabilitation protocol. Socket's localization, shape and widening, as well as graft maturation and integration, were evaluated intraoperatively at 6 months and 4 years after surgery. Results Both femoral and tibial tunnels had an expected increase at 6 months follow‐up. The widening was larger in the tibial tunnel (12.6 ± 10.0% vs. 9.1 ± 8.5%), yet this difference was not statistically different. Tibial tunnel was well centred in the tibial plateau and the integration of the graft was higher in the tibial socket. Four years after surgery, there was a general reduction of diameter in both tunnels. The tunnel occlusion rate was 33.3% for tibia and 16.7% for femur. Conclusions Overall, our results show that within a 4‐year follow‐up period, the inside‐out tibial tunnel drilling technique for all‐inside ACLR represents a safe technique that did not influence the tibial socket position nor tunnel widening or graft maturation in the long term. Level of Evidence Level IV.

Aim: The present systematic review compares the stability, crestal bone levels and efficacy of osseodensification (OD) drilling techniques for dental implant placement to traditional drilling methods. Settings and Design: The Cochrane online library, PubMed, Scopus, and other well-known online resources are used in the research. Using a systematic review design, the current study examines published qualitative studies with an emphasis on analysis. Materials and Methods: Using precise keywords, a thorough search of pertinent databases was carried out in accordance with PRISMA standards. Studies testing dental implant stability, crestal bone levels and clinical results using both OD and traditional procedures were covered by the inclusion criteria. Statistical Analysis Used: The risk of bias and quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomized controlled trials. Results: A total of 170 patients and 334 implants from Egypt, India, and Brazil were included in eight papers that made up the systematic review. In several clinical situations, osseodensification outperformed standard drilling in terms of implant durability, bone development, and torque data. Statistical analysis presented the lowest risks, while blinded outcome assessment, allocation concealment, random sequence generation, incomplete outcome data and experimental technique revealed higher risks. Bias assessment found various risks across different components. Conclusion: The thorough examination of eight papers demonstrates that osseodensification is a technique with great promise in the field of dental implants. It exhibits superior torque values, bone development, and stability when compared to traditional drilling. The overall results highlight the potential of osseodensification to improve clinical outcomes and advance the science of dental implantology, even in the face of variances in bias concerns.

This paper presents a method to improve accuracy of measuring through–thickness residual stress for welds through deep hole drilling (DHD) technique. The focus of this study is the effect of dimensions of the hollow cylinder, which is manufactured by drilling and trepanning processes, on residual stress measurement at the welds. First, stress concentration–induced plastic region around a reference (drilled) hole was theoretically quantified according to value of existing stress. The plastic region around the hole is not negligible for the welds at where high tensile residual stress exists. In order to reduce the influence of the plastic region, it is considered effective to set a large ratio of trepanning diameter to drilling diameter. Another noteworthy thing is that weld residual stress is present in a relatively narrow region along a weld line. Then, DHD technique was applied to measure through–thickness residual stress at the welds of melt–run welded–plate specimens under conditions of various drilling and trepanning diameters. These DHD residual stress measurement results were compared with those measured by X–ray diffraction and contour methods and calculated by weld thermal elastic–plastic analysis. As the results, it was shown that through–thickness residual stresses measured by DHD technique were obviously influenced by dimensions of the hollow cylinder. Measurement accuracy becomes higher with increasing the ratio of trepanning diameter to drilling diameter. Meanwhile, trepanning diameter should not be larger than width of generation area of high tensile residual stress to be measured at the welds. It was concluded that a method for determining appropriate dimensions of the hollow cylinder to be drilled and trepanned was successfully proposed to accurately assess through–thickness residual stress at the welds through DHD technique.

Background: The current literature comparing femoral tunnel techniques often reports on short-term outcomes after anterior cruciate ligament reconstruction (ACLR), but only a few studies have analyzed long-term outcomes. In addition, many studies have compared transtibial to anteromedial portal techniques without differentiating whether rigid or flexible reaming is used, making it difficult to infer how the techniques truly compare to one another., Purpose: This study aimed to detect differences in patient-reported outcome scores in those treated with three different femoral tunnel drilling techniques., Study Design: This study is a prospective cohort study., Methods: Of 650 patients treated for anterior cruciate ligament (ACL) injuries with ACLR, 350 were 5+ years out from surgery. Of these patients, 111 completed patient-reported outcome surveys (PROs). The Kruskal-Wallis H test was used to detect differences between patients treated with either of the three femoral tunnel drilling techniques: transtibial (TT), anteromedial portal with rigid reaming (AMP-RR), or anteromedial portal with flexible reaming (AMP-FR). Bonferroni correction was applied to the p-values to reduce the risk of making a type 1 error., Results: No differences were found between the three groups in demographics or postoperative PROs. However, there was a significant change between pre-surgery and post-surgery PROs. TT, when compared to AMP-RR, had a greater increase in satisfaction and greater improvement in a patient's ability to go up and down the stairs from pre-surgery to post-surgery. AMP-FR, when compared to TT, had greater improvement of the patient's knee stiffness/swelling. AMP-FR, when compared to AMP-RR, had greater improvement in knee pain during stairs and the ability to go down the stairs. No differences in return to sport, additional procedures on the affected knee (meniscal surgeries or cyclops lesion excisions), or revision surgery rates were found., Conclusion: Overall, postoperative PROs did not show statistically significant differences between the three femoral tunnel drilling techniques. Differences, however, were identified in the responses to specific questions on PRO surveys, which may have otherwise been overlooked. It is important to recognize the differences between TT, AMP-RR, and AMP-FR in the improvement of stair climbing and swelling/stiffness as these likely directly affect a patient's satisfaction from pre-ACLR to post-ACLR., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. University of Cincinnati Institutional Review Board issued approval 2020-0116. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kurkowski et al.)

Background: Retrograde Drilling (RD) is a surgical technique employed for osteochondral lesions of the talus (OCLTs) to reach the subchondral bone lesion from behind, thus preserving cartilage integrity. The aim of the present pilot study was to set up an in vitro model of OCLTs to evaluate the regenerative potential of biological approaches that could be associated with the RD technique. Methods: For this purpose, an OCLT was created in human osteochondral specimens, to try to mimic the RD technique, and to compare the regenerative potential of two biological treatments. For this purpose, three groups of treatments were performed in vitro: (1) no treatment (empty defect); (2) autologous bone graft (ABG); (3) hyaluronic membrane enriched with autologous bone marrow cells. Tissue viability; production of Collagen I and II, Vascular Endothelial Growth Factor, and Aggrecan; and histological and microCT evaluations were performed after 30 days of culture in normal culture conditions. Results: It was observed that Group 3 showed the highest viability, and Group 2 showed the highest protein production. From a histological and microtomographic point of view, it was possible to appreciate the structure of the morcellized bone with which the defect of Group 2 was filled, while it was not yet possible to observe the deposition of mineralized tissue in Group 3. Conclusions: To conclude, this pilot study shows the feasibility of an alternative in vitro model to evaluate and compare the regenerative potential of two biological scaffolds, trying to mimic the RD technique as much as possible. The tissues remained vital for up to 4 weeks and both ABG and hyaluronic acid-based scaffolds stimulated the release of proteins linked to regenerative processes in comparison to the empty defect group.

Purpose: To longitudinally evaluate sockets localization, tunnel morphological changes and graft maturation after the inside‐out tibial tunnel drilling technique for all‐inside Anterior Cruciate Ligament Reconstruction (ACLR). We hypothesized that due the necessary angle for the inside‐out reaming procedure, the described technique could input changes in the tibial socket. Methods: Fourteen knees treated with the same all‐inside ACLR technique were randomly assigned for a magnetic resonance evaluation. All patients were operated by the same surgeon and performed the same follow‐up rehabilitation protocol. Socket's localization, shape and widening, as well as graft maturation and integration, were evaluated intraoperatively at 6 months and 4 years after surgery. Results: Both femoral and tibial tunnels had an expected increase at 6 months follow‐up. The widening was larger in the tibial tunnel (12.6 ± 10.0% vs. 9.1 ± 8.5%), yet this difference was not statistically different. Tibial tunnel was well centred in the tibial plateau and the integration of the graft was higher in the tibial socket. Four years after surgery, there was a general reduction of diameter in both tunnels. The tunnel occlusion rate was 33.3% for tibia and 16.7% for femur. Conclusions: Overall, our results show that within a 4‐year follow‐up period, the inside‐out tibial tunnel drilling technique for all‐inside ACLR represents a safe technique that did not influence the tibial socket position nor tunnel widening or graft maturation in the long term. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]