Explore the vast range of titles available.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Tibiotalar Fusion (TF) and total ankle arthroplasty (TAA) are both viable choices for addressing tibiotalar osteoarthritis. Nevertheless, a definitive agreement on the most effective approach to restore optimal function, particularly in terms of safe emergency braking during car driving, is yet to be established. The primary aim of this investigation was to evaluate the break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) in individuals who underwent TF and TAA using a validated driving simulator. Secondary outcomes encompassed patient-reported measures of pain and functional outcomes. Methods: This observational study assesses the emergency braking capabilities of individuals undergoing either total ankle arthroplasty (TAA) or tibiotalar fusion (TF) in simulated driving scenarios. The participants were categorized into three groups: 1) TAA, 2) TF, and 3) Healthy Elderly (HE) aged 75 years and older, deemed still fit for driving. To be eligible for evaluation on the driving simulator, patients in the TAA and TF groups were required to have a minimum of a 1-year follow-up. Break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) were recorded with and without distraction during a single visit to the research center. Additionally, Ankle Osteoarthritis Scale (AOS) results were collected for all participants in TF and TAA. Results: This study, conducted between 2018 and 2022, included a total of 84 participants, with 21 TF, 21 TAA, and the remaining 42 serving as healthy elderly controls (HE). There was no significant difference between the TF and TAA groups with respect to MBF (p=0.4921), BRT (p=0.8734) or TBT (p= 0.7989). The TAA group and the TF group were significantly faster than the HE regarding TBT with a distraction (p=0.0463 and p=0.0049 respectively). The AOS score was significantly better in the TAA group compared to the TF group (p=0.002). Conclusion: The emergency braking capacity in total ankle arthroplasty (TAA) patients is not inferior to that in tibiotalar fusion (TF) patients. Both groups also performed better than elderly drivers meeting a minimally acceptable braking safety threshold. Thus, both treatment options appear to have a similar impact on braking capacity.

Category: Ankle Arthritis Introduction/Purpose: Ankle arthritis (OA) is a frequent and debilitating disease with the two primary surgical options being ankle arthrodesis or total ankle arthroplasty (TAA). TAA has the advantages maintenance of range of motion (ROM), a more normalized gait and potentially improved functional outcome over arthrodesis. Malaligned protheses have been demonstrated to have increased peak component pressures, potentially leading to component loosening, failure and overall worse outcomes. One TAA system uses pre-op CT to build patient-specific surgical instrumentation, with purported benefit of more reliable and accurate component positioning. The goal of this study is to evaluate reproducibility and accuracy of this system by surgeons without affiliation with the prosthesis design team. Methods: A retrospective radiological study was performed including two centers with four fellowship-trained foot and ankle surgeons using the patient-specific TAA system. All patients operated on between 2015-2018 were included. The primary outcome was alignment of the tibial implant in coronal and sagittal orientation relative to the tibia anatomic axis. All measurements were performed in duplicate an orthopaedic foot and ankle fellow and a musculoskeletal fellowship-trained radiologist. Secondary outcomes included accuracy of prediction of tibial and talar component size implanted compared to the engineered pre-operative plan, rate of prosthesis revision (at least one component) and overall re-operation rate. Results: 79 patients were included in the final review. The mean absolute deviation of the tibial component from tibial anatomical axis was 1.31° +/- 1.14in the coronal plane and 2.68°+/- 1.74 in sagittal alignment. 94.7 % of the implants were implanted within 3°of varus or valgus and 73.7% within 3°of dorsiflexion or plantiflexion. 86 % of the implanted tibial component were of the size predicted by the pre-op plan whereas it was found to be the case in 63 % of the talar component.At a mean follow-up of 22 months(3-52), two TAA (2.5%) have been revised due to aseptic tibial implant loosening. Conclusion: The patient-specific guide has been found to be a reliable system for coronal tibial implant alignment but less in the sagittal plane in the hand of surgeons not involved in the design of any TAA system. Accuracy of prediction of the tibial component size is high, moderate on the talar side. In this series there was a low rate of early component revision (2.5 %).

Considering the literary dimension of the earliest text history of Samuel, this volume asks the question if the comparative analysis of the textual witnesses permit proving the existence of distinct literary editions and identifying the ideological motives that governed the possible modification of the text.

La crise climatique à l'aube d'un monde incertain dresse un état des lieux du monde pré-COVID-19 que nous venons de quitter et offre des clés de compréhension des principaux enjeux climatiques et énergétiques actuels. Il analyse les bouleversements dans l'économie politique mondiale générés par les mesures de réduction des émissions de GES et passe en revue les objectifs de l'Accord de Paris, la montée des énergies renouvelables, la détérioration de l'environnement d'affaire des industries fossiles, la mise en place de grandes politiques publiques et les nombreuses incohérences et incompatibilités entre les engagements politiques et les réalités sur le terrain. S'adressant aux étudiants, aux professionnels et aux gestionnaires de domaines variés, le présent ouvrage conclut finalement par une question au coeur des réflexions critiques actuelles: et si l'économie de marché que nous connaissons était l'une des causes profondes de la crise climatique?.