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Knee arthroplasty is a widely performed surgical procedure that significantly improves the quality of life for patients with advanced knee joint diseases. However, many multidisciplinary healthcare professionals lack a clear understanding of the types and subtypes of knee arthroplasty, which is essential for effective perioperative care and rehabilitation planning. This narrative review categorises knee arthroplasty into three main types: total knee arthroplasty, partial knee arthroplasty, and revision knee arthroplasty. Total knee arthroplasty remains the most common procedure, with subtypes based on implant constraint, fixation method, bearing surface, alignment philosophy, surgical approach, and technological aids. Partial knee arthroplasty includes unicompartmental and patellofemoral replacements, offering faster recovery and more natural knee kinematics in appropriately selected patients, although with higher revision rates. Revision knee arthroplasty addresses failed implants using one-stage or two-stage procedures with specialised components such as constrained condylar and hinged implants, stem extensions, augments, and megaprostheses, but carries higher surgical complexity and complication risks. This educational framework aims to enhance multidisciplinary understanding of knee arthroplasty procedures, supporting better communication, patient education, and rehabilitation planning. Future research should validate its impact in educational settings and explore ongoing innovations in implant designs and surgical technologies to optimise patient outcomes.

Background Periprosthetic femoral fractures (PFFs) are a growing indication for revision total hip arthroplasty (THA), particularly in elderly patients with complex comorbidities. Surgical management is challenging, with significant morbidity and mortality. This study evaluates outcomes following revision arthroplasty for PFFs at a tertiary trauma centre in the United Kingdom . Methods A retrospective review was conducted of 24 patients who underwent revision arthroplasty for PFFs between February 2021 and January 2022. Data collected included patient demographics, fracture classification, implant history, surgical details, and complications. Follow-up data were extracted from electronic health records up to February 2025. The primary outcome was the need for further revision; secondary outcomes included mortality and postoperative complications. Results The cohort had a mean age of 78.3 years (IQR: 16), with most injuries resulting from low-energy trauma. Vancouver B-type fractures were the most common, and three patients sustained interprosthetic fractures. Surgical strategies included modular fluted stems (n=13), femoral replacement prostheses (n=7), and cemented stems (n=4). Complications included one infection managed with suppressive antibiotics, two recurrent dislocations, and two cases of leg length discrepancy. One patient required further revision for instability. Twelve patients died during follow-up: two within 30 days, three within one year, and seven after one year. Thirteen patients were followed remotely due to frailty or relocation. Conclusion Revision arthroplasty for PFFs involves technically demanding procedures with significant risks. Despite the complexity, outcomes were in line with published data. Multidisciplinary care, timely surgical intervention, and individualised implant selection remain critical to optimise outcomes in this high-risk population.

Background The management of distal clavicle injuries with disruption of the coracoclavicular ligaments (CCLs) is challenging. The aim of this study was to assess the functional results of reconstructing the CCLs with the Infinity-Lock Button System using validated outcome measures, patient satisfaction scores, return to pre-injury activity, and complications. Methods A total of 28 cases of CCL disruption were assessed over a seven-year period, which included 14 lateral end-of-clavicle fractures and 14 acromioclavicular joint (ACJ) dislocations. All patients underwent stabilisation of the CCLs using the Infinity-Lock Button System. Patients were assessed preoperatively and postoperatively using validated outcome measures such as visual analogue scale (VAS), Oxford Shoulder Score (OSS), Quick Disabilities of Arm, Shoulder & Hand (Q-DASH) scores, return to pre-injury level of activities, patient satisfaction scores, and complications were reviewed. Results The mean age of patients was 36.7 years (18-74 years). The mean follow-up was 38.6 months (8-68 months). The mean time to surgery was 75.8 days (3-619 days). There was a statistically significant improvement in postoperative VAS, OSS, and Q-DASH scores compared to the preoperative (p-value <0.001). Out of the 28 participants, 23 (82.1%) returned to pre-injury level of activities, 25 (89.7%) reported 'good' or 'excellent' outcomes following the intervention, and none of the patients reported functional instability postoperatively. None of the patients required revision surgery or implant removal. Conclusion CCL reconstruction is vital in the management of clavicular injuries. This study demonstrates the safe use of the Infinity-Lock Button System in these injuries with statistically significant improvement in early patient-reported outcome measures, return to pre-injury level of activities, and subjective patient satisfaction.

ObjectivesThe objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.BackgroundThe indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO).MethodsPart I: A literature review was performed on the basis of the PubMed library search. Publications were screened for damage control interventions in the following anatomic regions: “Spine”, “Pelvis”, “Extremities” and “Soft Tissues”. A standardized questionnaire was developed including a list of damage control interventions and associated indications. Part II: Development of the expert opinion survey: experienced trauma and orthopaedic surgeons participated in the consensus process.ResultsPart I: A total of 646 references were obtained on the basis of the MeSH terms search. 74 manuscripts were included. Part II: Twelve experts in the field of polytrauma management met at three consensus meetings. We identified 12 interventions and 79 indications for DCO. In spinal trauma, percutaneous interventions were determined beneficial. Traction was considered harmful. For isolated injuries, a new terminology should be used: “MusculoSkeletal Temporary Surgery”.ConclusionThis review demonstrates a detailed description of the management consensus for abbreviated musculoskeletal surgeries. It was consented that early fixation is crucial for all major fractures, and certain indications for DCO were dropped. Authors propose a distinct terminology to separate local (MuST surgery) versus systemic (polytrauma: DCO) scenarios.

The management of acute mid-substance Achilles tendon ruptures has shifted towards minimally invasive techniques to reduce soft tissue complications. However, many percutaneous repair methods require expensive, dedicated instrumentation or reusable devices with reprocessing needs. This study describes a novel percutaneous Achilles tendon repair technique using readily available disposable standard instruments (Achilles-tendon Soft Tissue Augmentation Regenerative Repair (A-STARR)) and evaluates its clinical outcomes. A retrospective case series was conducted involving 21 patients (18 male, 3 female) with confirmed acute mid-substance Achilles tendon ruptures. All underwent percutaneous repair using the A-STARR technique between July 2017 and May 2018. Patients were followed up for a minimum of 12 months (range: 12-25 months). Primary outcomes included complication rates, time to return to work, return to sport, and the Achilles Tendon Total Rupture Score (ATRS) at one year. No wound infections, re-ruptures, or sural nerve injuries were observed. The mean time to return to work was 40 days (range: 30-92 days). 18 patients (85.7%) returned to their pre-injury sport at a mean of 6.5 months (range: 4-12 months). The mean ATRS at one-year follow-up was 83.1 (range: 70-95). The A-STARR percutaneous Achilles tendon repair using disposable standard instruments was safe and effective in this series, with no complications and good functional recovery. It may provide a practical and cost-efficient alternative for treating acute mid-substance ruptures, particularly where specialized equipment is unavailable.

Drastic changes in the climate and ecosystem due to natural or anthropogenic activities have severely affected crop production globally. This concern has raised the need to develop environmentally friendly and cost-effective strategies, particularly for keeping pace with the demands of the growing population. The use of nanobiofertilizers in agriculture opens a new chapter in the sustainable production of crops. The application of nanoparticles improves the growth and stress tolerance in plants. Inoculation of biofertilizers is another strategy explored in agriculture. The combination of nanoparticles and biofertilizers produces nanobiofertilizers, which are cost-effective and more potent and eco-friendly than nanoparticles or biofertilizers alone. Nanobiofertilizers consist of biofertilizers encapsulated in nanoparticles. Biofertilizers are the preparations of plant-based carriers having beneficial microbial cells, while nanoparticles are microscopic (1–100 nm) particles that possess numerous advantages. Silicon, zinc, copper, iron, and silver are the commonly used nanoparticles for the formulation of nanobiofertilizer. The green synthesis of these nanoparticles enhances their performance and characteristics. The use of nanobiofertilizers is more effective than other traditional strategies. They also perform their role better than the common salts previously used in agriculture to enhance the production of crops. Nanobiofertilizer gives better and more long-lasting results as compared to traditional chemical fertilizers. It improves the structure and function of soil and the morphological, physiological, biochemical, and yield attributes of plants. The formation and application of nanobiofertilizer is a practical step toward smart fertilizer that enhances growth and augments the yield of crops. The literature on the formulation and application of nanobiofertilizer at the field level is scarce. This product requires attention, as it can reduce the use of chemical fertilizer and make the soil and crops healthy. This review highlights the formulation and application of nanobiofertilizer on various plant species and explains how nanobiofertilizer improves the growth and development of plants. It covers the role and status of nanobiofertilizer in agriculture. The limitations of and future strategies for formulating effective nanobiofertilizer are mentioned.

Sirtuins (SIRT) are a class of histone deacetylases that regulate important metabolic pathways and play a role in several disease processes. Of the seven mammalian homologs currently identified, sirtuin 1 (SIRT1) is the best understood and most studied. It has been associated with several neurodegenerative diseases and cancers. As such, it has been further investigated as a therapeutic target in the treatment of disorders such as Parkinson's disease (PD), Huntington's disease (HD), and Alzheimer's disease (AD). SIRT1 deacetylates histones such as H1 lysine 26, H3 lysine 9, H3 lysine 56, and H4 lysine 16 to regulate chromatin remodeling and gene transcription. The homolog has also been observed to express contradictory responses to tumor suppression and tumor promotion. Studies have shown that SIRT1 may have anti-inflammatory properties by inhibiting the effects of NF-κB, as well as stimulating upregulation of autophagy. The SIRT1 activators resveratrol and cilostazol have been shown to improve Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores in AD patients. In this review, we aim to explore the various roles of SIRT1 with regard to neuroprotection and neurodegeneration.

Background Corticosteroid injection (CI) is one of the first-line treatments for trigger finger (TF) before escalation to surgical procedures such as percutaneous A1 pulley (PAP) release. This systematic review compares outcomes of concurrent PAP and CI for trigger finger release (TFR). Methods A systematic search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted in PubMed, Embase, and Cochrane Library. Study variables included the number of patients, mean age, mean follow-up, affected finger, Quinnell grading, return to activity, pre-and post-operative patient-reported outcomes (PROs), and complications. Results Seven studies were included, with 685 patients with a mean age of 52.0 years (range of 38.0 to 58.9) and a mean follow-up time of 22 weeks (range 1 week to 52 weeks). Throughout these studies, PAP and CI were performed on 243 thumbs, 115 index fingers, 189 middle fingers, 138 ring fingers, and 10 small fingers. PAP and CI reported satisfaction and pain resolution for 96.2% (five studies) of patients. Additionally, all patients returned to activity, sports, or work (three studies). Conclusion Concurrent PAP and CI positively affect clinical outcomes, PROs, and is a well-tolerated procedure with a low rate of complications.

Water stress affects the growth, development, and yield of crops. The objective of this study is to evaluate the positive effects of nutrients (calcium, potassium, and boron) on durum wheat facing drought stress. Two treatments of calcium, potassium, and boron were used under drought and well-watered conditions on two varieties of durum wheat (V1—Preco; V2—Kronos). The data depict that the exogenous application of these nutrients gave significantly different (p < 0.05) results. The percentage increase in shoot length and root length was 29% and 35% compared to the untreated, drought-facing plants. There is also an increase in the synthesis of photosynthetic pigments and osmolytes. The foliar spray of nutrients enhances the synthesis of antioxidants, including superoxide dismutase, catalase, and peroxidase, which reduce the production of free radicals. It also helps to maintain the stability of membranes and other cell organelles. The spray application enhances the yield of durum wheat, i.e., the percentage increase in the number of grains per spike and 1000-grain weight was 23% and 25% compared to the untreated, drought-facing plants. The use of these nutrients considerably improves the functioning of antioxidant machinery, helping combat the adverse effects of drought. Additionally, they improve the growth- and yield-related parameters. Hence, these sprays can be used as a plant growth regulator.

Water scarcity, exacerbated by climatic variability and human activities, poses a significant challenge in northern Bangladesh. This study presents a comprehensive water scarcity map by integrating drought and groundwater potential maps using advanced deep learning techniques. A deep learning model with optimizer is employed to predict current and future water scarcity under shared socioeconomic pathways (SSP1-2.6, SSP2-4.5, and SSP5-8.5). The primary focus is on how integrating these datasets with deep learning and climate projections enhances the prediction and management of water scarcity, enabling innovative resource planning. Findings reveal that SSP1-2.6 significantly reduces water scarcity and drought risks, particularly during Kharif-1 and Rabi seasons, while SSP5-8.5 intensifies water scarcity, especially in Rabi. Model validation using total operating characteristic and area under the curve metrics confirms strong predictive performance. This study advances water scarcity assessment, offering a detailed and actionable framework for sustainable water resource management and climate adaptation strategies.