Knee Osteoarthritis Progression after Distal Femur Closing Wedge Osteotomy

Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.

Osteotomy Protocol for Implant Insertion of One Day Biotech: One Drill, One Implant

Background: Four factors determine the quality of an implantology kit: 1) Heat generated by the drills;2) Morphology of the osteotomy according to the diameter of the implant;3) Efficiency of collecting autologous bone;and 4) Osteotomy execution time. Materials and Methods: This article examines the heat produced by drills during osteotomy, focusing on the effect of the following factors: drilling technique;volume of autologous bone harvested;drilling time;implant primary stability;and the percentage of osseointegrated implants after primary healing. Discussion: The four factors mentioned above are analyzed based on the data obtained for sequential, biological, and One Drill milling techniques. Conclusions: 1) One Drill is the fastest technique for performing the osteotomy;2) All techniques stay within the biological temperature range of living bone, with the lowest increase in temperature achieved using One Drill with irrigation;3) The bone harvested showed no statistically significant differences between biological milling and the One Drill technique, both far superior to the sequential technique;and 4) There is no statistically significant difference in the number of osseointegrated implants among the three techniques analyzed.

Clinical outcomes of triceps reflecting anconeus pedicle and olecranon osteotomy approach for distal humerus intercondylar fractures

BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.

Unicompartmental knee arthroplasty vs high tibial osteotomy for knee osteoarthritis:A comparison of clinical and radiological outcomes

BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.

Osteotomy combined with anterior cruciate ligament reconstruction for anterior cruciate ligament injury and biplanar deformity

BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthritis.AIM To evaluate the efficacy of modified high tibial osteotomy(HTO)and anterior cruciate ligament reconstruction(ACLR)in the treatment of anterior cruciate ligament(ACL)injuries with varus deformities and increased posterior tibial slope(PTS)based on clinical and imaging data.METHODS The patient data in this retrospective study were collected from 2019 to 2021.A total of 6 patients were diagnosed with ACL injury combined with varus deformities and increased PTS.All patients underwent modified open wedge HTO and ACLR.The degree of correction of varus deformity and the PTS was evaluated by radiography and magnetic resonance imaging.RESULTS All 6 patients(6 knee joints)were followed up for an average of 20.8±3.7 months.The average age at surgery was 29.5±3.8 years.At the last follow-up,all patients resumed competitive sports.The International Knee Documentation Committee score increased from 50.3±3.1 to 87.0±2.8,the Lysholm score increased from 43.8±4.9 to 86±3.1,and the Tegner activity level increased from 2.2±0.7 to 7.0±0.6.The average movement distance of the tibia anterior translation was 4.8±1.1 mm,medial proximal tibial angle(MPTA)was 88.9±1.3°at the last follow-up,and the PTS was 8.4±1.4°,both of which were significantly higher than those before surgery(P<0.05).CONCLUSION Modified open wedge HTO combined with ACLR can effectively treat patients with ACL ruptures with an associated increased PTS and varus deformity.The short-term effect is significant,but the long-term effect requires further follow-up.

V-Shaped Monopole Antenna with Chichena Itzia Inspired Defected Ground Structure for UWB Applications

Due to rapid growth in wireless communication technology,higher bandwidth requirement for advance telecommunication systems,capable of operating on two or higher bands with higher channel capacities and minimum distortion losses is desired.In this paper,a compact Ultra-Wideband(UWB)V-shaped monopole antenna is presented.UWB response is achieved by modifying the ground plane with Chichen Itzia inspired rectangular staircase shape.The proposed V-shaped is designed by incorporating a rectangle,and an inverted isosceles triangle using FR4 substrate.The size of the antenna is 25 mm×26 mm×1.6 mm.The proposed V-shaped monopole antenna produces bandwidth response of 3 GHz Industrial,Scientific,and Medical(ISM),Worldwide Interoperability for Microwave Access(WiMAX),(IEEE 802.11/HIPERLAN band,5G sub 6 GHz)which with an additional square cut amplified the bandwidth response up to 8 GHz ranging from 3.1 GHz to 10.6 GHz attaining UWB defined by Federal Communications Commission(FCC)with a maximum gain of 3.83 dB.The antenna is designed in Ansys HFSS.Results for key performance parameters of the antenna are presented.The measured results are in good agreement with the simulated results.Due to flat gain,uniform group delay,omni directional radiation pattern characteristics and well-matched impedance,the proposed antenna is suitable for WiMAX,ISM and heterogeneous wireless systems.

RIGID-PLASTIC MECHANICAL MODEL FOR THE FORGING METHOD WITH HORIZONTAL V-SHAPED ANVIL

In order to decrease the anisotropy of mechanical properties, the rigid-plastic mechanical model for the forging method with horizontal V-shaped anvil is presented. The forging method, through the change of anvils shape, is able to control fibrous tissue direction, to improve the anisotropy of mechanical properties of axial forgings, to realize uniform forging. Therefore, the forging method can overcome the defect that conventional forging methods produce. The mechanism of the forging method with horizontal V-shaped anvil and the process of metal deformation are analyzed. The agreement of theoretical analysis with experimental study verifies the fact that the forging method with horizontal V-shaped anvil can control effectively the mechanical properties of axial forgings.

An experimental investigation of the fracturing behaviour of rock-like materials containing two V-shaped parallelogram flaws

The distribution characteristics and evolution law of rock mass fissures induced by mining are a key scientific issue in the study of deep rock mechanics.In this study,a series of uniaxial compression experiments was conducted on rock-like specimens containing double V-shaped prefabricated fissures at dip angles ofα=β=45°,α=45°<b=60°,α=β=60°,andα=60°<β=75°with a rock mechanics servocontrolled testing system.According to the experimental results,the effects of the dip angles of the double V-shaped prefabricated flaws with the same area on the mechanical parameters and fracturing process of the specimens were analysed in detail.Additionally,the crack initiation stress presented a nearly linear growth trend,which is generally similar to that of the crack peak stress with increasing flaw dip angle.By applying photographic monitoring to the crack initiation,propagation,coalescence,and failure modes in rock-like specimens,it was easily seen that the V-shaped flaw properties slightly influence the crack initiation positions but significantly influence the crack trajectories.The crack failure modes can be summarized into two distinct types.The study reported herein can provide a better understanding of the evolution of double V-shaped prefabricated fissures induced by coal mining.

Scattering of SH waves induced by a symmetrical V-shaped canyon: a unified analytical solution

This paper reports a series solution of wave functions for two-dimensional scattering and diffraction of plane SH waves induced by a symmetrical V-shaped canyon with different shape ratios. A half-space with a symmetrical V-shaped canyon is divided into two sub-regions by using a circular-arc auxiliary boundary. The two sub-regions are represented by global and local cylindrical coordinate systems, respectively. In each coordinate system, the wave field satisfying the Helmholtz equation is represented by the separation of variables method, in terms of the series of both Bessel functions and Hankel functions with unknown complex coefficients. Then, the two wave fields are described in the local coordinate system using the Graf addition theorem. Finally, the unknown coefficients are sought by satisfying the continuity conditions of the auxiliary boundary. To consider the phase characteristics of the wave scattering, a parametric analysis is carried out in the time domain by assuming an incident signal of the Ricker type. Surface and subsurface transient responses demonstrate the characteristics and mechanisms of wave propagating and scattering.

Seismic analysis of high-speed railway irregular bridge–track system considering V-shaped canyon effect

To explore the effect of canyon topography on the seismic response of railway irregular bridge-track system that crosses a V-shaped canyon, seismic ground motions of the horizontal site and V-shaped canyon site were simulated through theoretical analysis with 12 earthquake records selected from the Pacific Earthquake Engineering Research Center(PEER) Strong Ground Motion Database matching the site condition of the bridge.Nonlinear seismic response analyses of an existing 11-span irregular simply supported railway bridge-track system were performed under the simulated spatially varying ground motions. The effects of the V-shaped canyon topography on the peak ground acceleration at bridge foundations and seismic responses of the bridge-track system were analyzed. Comparisons between the results of horizontal and V-shaped canyon sites show that the top relative displacement between adjacent piers at the junction of the incident side and the back side of the V-shaped site is almost two times that of the horizontal site, which also determines the seismic response of the fastener. The maximum displacement of the fastener occurs in the V-shaped canyon site and is 1.4 times larger than that in the horizontal site. Neglecting the effect of V-shaped canyon leads to the inappropriate assessment of the maximum seismic response of the irregular high-speed railway bridge-track system. Moreover, engineers should focus on the girder end to the left or right of the two fasteners within the distance of track seismic damage.

Near-source topographic effect on seismic responses of a multi-span continuous railway bridge crossing a symmetrical V-shaped canyon

Past earthquakes have revealed that topographic features have significant impacts on the characteristics of ground motions,which may cause the amplification and de-amplification of input seismic waves.The topographic effect with the assumption of plane seismic waves on the seismic responses of bridges has been investigated in the existing literature;however,the influence of near-source topographic effects has not been thoroughly understood.The objective of this study is to numerically explore the near-source topographic effects on the seismic behaviors of an existing railway bridge crossing a symmetrical V-shaped canyon.The influence of the source of incident waves is estimated.Numerical results demonstrate that the topographic effects can noticeably amplify the seismic responses of the bridge.Compared to the bridge without crossing a canyon,the peak displacements of the girder,pier,and bearing in the case of the canyon crossing bridge increase by 15.2%,2.9%−14.5%,and 24.2%−229.6%,respectively.The piers at the illuminated side of the canyon experience larger seismic responses compared to the piers at the shaded side of the canyon due to the unequal motion amplitudes at each support.As the source-to-canyon distance increases,the seismic responses of the piers show an increasing trend.

Controlling deflection of long steel I-shaped girder bridge using two V-shaped pre-tensioning cables

Despite appropriate design of girder under bending and shear,the deflection of long steel girders usually exceeds the allowable range,and therefore the structural designers encounter challenges in this regard.Considering significant features of the cables,namely,low weight,small cross section,and high tensile strength,they are used in this research so as to control the deflection of long girder bridges,rather than increasing their heights.In this study,theoretical relations are developed to calculate the increase in pre-tensioning force of V-shaped steel cables under external loading as well as the deflection of steel girder bridges with V-shaped cables and different support conditions.To verify the theoretical relations,the steel girder bridge is modeled in the finite element ABAQUS software with different support conditions without cable and with V-shaped cables.The obtained results show that the theoretical relations can appropriately predict the deflection of girder bridge with V-shaped cables and different support conditions.In this study,the effects of the distance from support on the deflection of mid span are studied in both simply supported and fixed supported girder bridge so as to obtain the appropriate distance from support causing the minimum deflection.

Effects of different pelvic osteotomies on acetabular morphology in developmental dysplasia of hip in children

Developmental dysplasia of hip seriously affects the health of children,and pelvic osteotomy is an important part of surgical treatment.Improving the shape of the acetabulum,preventing or delaying the progression of osteoarthritis is the ultimate goal of pelvic osteotomies.Re-directional osteotomies,reshaping osteotomies and salvage osteotomies are the three most common types of pelvic osteotomy.The influence of different pelvic osteotomy on acetabular morphology is different,and the acetabular morphology after osteotomy is closely related to the prognosis of the patients.But there lacks comparison of acetabular morphology between different pelvic osteotomies,on the basis of retrospective analysis and measurable imaging indicators,this study predicted the acetabular shape after developmental dysplasia of the hip pelvic osteotomy in order to help clinicians make reasonable and correct decisions and improve the planning and performance of pelvic osteotomy.

New Methods of Determining the Mixed Mode Stress Intensity Factors for V-Shaped Notch

In this paper, on the basis of the stress field given by D.H.Chen, three new photoelastic methods are developed for determining the stress intensity factors K1 and K2 of V-shaped notch. Some photoelastic experiments are performed on a skew -symmetric 45° notch. Measurements of the coordinates components of r,θand fringe order N are made for progressively smaller fringes and used in the proposed methods to solve K1 and K2.Plots of apparent K vs. r/l are made and extrapolated to the notch tip to yield the true values of K1 and K2.The results obtained by the three methods are very close to each other. When the notch problem is simplified as a crack problem, the corresponding equation is identical to the one proposed by D.G. Smith, which shows that the proposed methods are applicable for both notch and crack problems.

Light-extraction efficiency and forward voltage in GaN-based light-emitting diodes with different patterns of V-shaped pits

We present a new method of making a textured V-pit surface for improving the light extraction efficiency in GaN- based light-emitting diodes and compare it with the usual low-temperature method for p-GaN V-pits. Three types of GaNbased light-emitting diodes （LEDs） with surface V-pits in different densities and regions were grown by metal-organic chemical vapor deposition. We achieved the highest output power and lowest forward voltage values with the p-InGaN V-pit LED. The V-pits enhanced the light output power values by 1.45 times the values of the conventional LED owing to an enhancement of the light scattering probability and an effective reduction of Mg-acceptor activation energy. Moreover, this new technique effectively solved the higher forward voltage problem of the usual V-pit LED.

Electronic and transport properties of V-shaped defect zigzag MoS_2 nanoribbons

Based on the nonequilibrium Green＇s function （NEGF） in combination with density functional theory （DFT） calcu- lations, we study the electronic structures and transport properties of zigzag MoS2 nanoribbons （ZMNRs） with V-shaped vacancy defects on the edge. The vacancy formation energy results show that the zigzag vacancy is easier to create on the edge of ZMNR than the armchair vacancy. Both of the defects can make the electronic band structures of ZMNRs change from metal to semiconductor. The calculations of electronic transport properties depict that the currents drop off clearly and rectification ratios increase in the defected systems. These effects would open up possibilities for their applications in novel nanoelectronic devices.

Wave Pressure Acting on V-Shaped Floating Breakwater in Random Seas

Wave pressure on the wet surface of a V-shaped floating breakwater in random seas is investigated. Considering the diffraction effect, the unit velocity potential caused by the single regular waves around the breakwater is solved using the finite-depth Green function and boundary element method, in which the Green function is solved by integral method. The Response-Amplitude Operator(RAO) of wave pressure is acquired according to the Longuet-Higgins' wave model and the linear Bernoulli equation. Furthermore, the wave pressure's response spectrum is calculated according to the wave spectrum by discretizing the frequency domain. The wave pressure's characteristic value corresponding to certain cumulative probability is determined according to the Rayleigh distribution of wave heights. The numerical results and field test results are compared, which indicates that the wave pressure calculated in random seas agrees with that of field measurements. It is found that the bigger angle between legs will cause the bigger pressure response, while the increase in leg length does not influence the pressure significantly. The pressure at the side of head sea is larger than that of back waves. When the incident wave angle changes from 0? to 90?, the pressure at the side of back waves decreases clearly, while at the side of head sea, the situation is more complicated and there seems no obvious tendency. The concentration of wave energy around low frequency(long wavelength) will induce bigger wave pressure, and more attention should be paid to this situation for the structure safety.

Construction of a 3D Co(Ⅱ) Framework Based on Two Types of V-shaped Bidentate Ligands

A three-dimensional （3D） coordination polymer {[Co（bdc）（dpb）]·H2O}n （1） was prepared by solvothermal reaction of 1,3-dipyridyl benzene （dpb） with deprotonated 1,3-benzene- dicarboxylate （H2bdc）, and was characterized by elemental analysis, IR spectroscopy, and X-ray single-crystal diffraction. It crystallizes in the monoclinic system, space group C2/c with α = 15.478（6）, b = 12.865（5）, c = 24.091（10） ？, β = 95.599（5）°, V = 4774（3） ？3, C24H18CoN2O5, Mr = 473.34, Dc = 1.267 g/cm3, F（000） = 1864.0, μ = 0.748 mm-1 and Z = 8. Each Co（II） ion links three bdc2- anions to form an infinitely 1D ladder-shaped chain containing binuclear [（COO）Co]2 cluster, and dpb links adjacent 1D chains to form a 3D pcu framework. In addition, the UV-vis of 1 was also studied.

Carrier transport via V-shaped pits in InGaN/GaN MQW solar cells

Carrier transport via the V-shaped pits （V-pits） in InGaN/GaN multiple-quantum-well （MQW） solar cells is numer- ically investigated. By simulations, it is found that the V-pits can act as effective escape paths for the photo-generated carriers. Due to the thin barrier thickness and low indium composition of the MQW on V-pit sidewall, the carriers entered the sidewall QWs can easily escape and contribute to the photocurrent. This forms a parallel escape route for the carries generated in the fiat quantum wells. As the barrier thickness of the fiat MQW increases, more carriers would transport via the V-pits. Furthermore, it is found that the V-pits may reduce the recombination losses of carriers due to their screening effect to the dislocations. These discoveries are not only helpful for understanding the carrier transport mechanism in the InGaN/GaN MQW, but also important in design of the structure of solar cells.

Study on a W-band modified V-shaped microstrip meander-line traveling-wave tube

The study on a miniaturized, low-voltage, wide-bandwidth, high-efficiency modified V-shaped microstrip meander-line slow-wave structure is presented. This structure is evolved from the original U-shaped microstrip meander-line slow-wave structure, combining the advantages of a traditional microstrip and a rectangular helix. In this paper, simulations of the electromagnetic characteristics and the beam-wave interaction of this structure are carried out. Our study shows that when the design voltage and the current of a sheet electron beam are set to be 4700 V and 100 mA, respectively, this miniature millimeter-wave power amplifier is capable of delivering 160-W output power with a corresponding gain of 37.3 dB and a maximum interaction efficiency of 34% at 97 GHz.