Impact of time between meniscal injury and isolated meniscus repair on post-operative outcomes:A systematic review

BACKGROUND Meniscal tears are one of the most common knee injuries.After the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical decision-making.The influence of time between injury and isolated meniscus repair on patient outcomes is not well described.Assessing this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education process.We hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative outcomes.AIM To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient outcomes.METHODS PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus repair.Exclusion criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and meniscectomies.Patient demographics,time to injury,and postoperative outcomes from each study were abstracted and analyzed.RESULTS Five studies met all inclusion and exclusion criteria.There were 204(121 male,83 female)patients included.Three of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to surgery.CONCLUSION Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative outcomes.Decision-making primarily based on injury interval is thus not recommended.

Polyethylene glycol fusion repair of severed sciatic nerves accelerates recovery of nociceptive sensory perceptions in male and female rats of different strains

Successful polyethylene glycol fusion(PEG-fusion)of severed axons following peripheral nerve injuries for PEG-fused axons has been reported to:(1)rapidly restore electrophysiological continuity;(2)prevent distal Wallerian Degeneration and maintain their myelin sheaths;(3)promote primarily motor,voluntary behavioral recoveries as assessed by the Sciatic Functional Index;and,(4)rapidly produce correct and incorrect connections in many possible combinations that produce rapid and extensive recovery of functional peripheral nervous system/central nervous system connections and reflex(e.g.,toe twitch)or voluntary behaviors.The preceding companion paper describes sensory terminal field reo rganization following PEG-fusion repair of sciatic nerve transections or ablations;howeve r,sensory behavioral recovery has not been explicitly explored following PEG-fusion repair.In the current study,we confirmed the success of PEG-fusion surgeries according to criteria(1-3)above and more extensively investigated whether PEG-fusion enhanced mechanical nociceptive recovery following sciatic transection in male and female outbred Sprague-Dawley and inbred Lewis rats.Mechanical nociceptive responses were assessed by measuring withdrawal thresholds using von Frey filaments on the dorsal and midplantar regions of the hindpaws.Dorsal von Frey filament tests were a more reliable method than plantar von Frey filament tests to assess mechanical nociceptive sensitivity following sciatic nerve transections.Baseline withdrawal thresholds of the sciatic-mediated lateral dorsal region differed significantly across strain but not sex.Withdrawal thresholds did not change significantly from baseline in chronic Unoperated and Sham-operated rats.Following sciatic transection,all rats exhibited severe hyposensitivity to stimuli at the lateral dorsal region of the hindpaw ipsilateral to the injury.However,PEG-fused rats exhibited significantly earlier return to baseline withdrawal thresholds than Negative Control rats.Furthermore,PEG-fused rats with significantly improved Sciatic Functional Index scores at or after 4 weeks postoperatively exhibited yet-earlier von Frey filament recove ry compared with those without Sciatic Functional Index recovery,suggesting a correlation between successful PEG-fusion and both motor-dominant and sensory-dominant behavioral recoveries.This correlation was independent of the sex or strain of the rat.Furthermore,our data showed that the acceleration of von Frey filament sensory recovery to baseline was solely due to the PEG-fused sciatic nerve and not saphenous nerve collateral outgrowths.No chronic hypersensitivity developed in any rat up to 12 weeks.All these data suggest that PEG-fusion repair of transection peripheral nerve injuries co uld have important clinical benefits.

ANALYSIS ON A TYPE OF SERVICING MACHINES MODEL WITH REPAIRABLE SERVICE STATION

This paper deals with a type of servicing machines model, which service station has a life time of the kth Er-langian distribution and can be repaired just like a new one. The cyclic time and the inefficiency quantities of this system in equilibrium are obtained.

Reliability Analysis of a Cold Standby Repairable System with Repairman Extra Work

This paper deals with a cold standby repairman who can do extra work in idle time. The repairable system with two identical units and one authors are devoted to studying the unique existence and exponential stability of the system solution. C0-semigroup theory is used to prove the existence of a unique nonnegative time-dependent solution of the system. Then by using the theory of resolvent positive operator, the authors derive that dynamic solution of the system exponentially converges to its steady-state one which is the eigenfunction corresponding to eigenvalue 0 of the system operator. Some reliability indices of the system are discussed with a different method from traditional one. The authors also make a profit analysis to determine the optimal service time outside the system to maximize the system profit.

Markov repairable systems with stochastic regimes switching

Compared with the classical Markov repairable system, the Markov repairable system with stochastic regimes switching introduced in the paper provides a more realistic description of the practical system. The system can be used to model the dynamics of a repairable system whose performance regimes switch according to the external conditions. For example, to satisfy the demand variation that is typical for the power and communication systems and reduce the cost, these systems usually adjust their operating regimes. The transition rate matrices under distinct operating regimes are assumed to be different and the sojourn times in distinct regimes are governed by a finite state Markov chain. By using the theory of Markov process, Ion channel theory, and Laplace transforms, the up time of the system are studied. A numerical example is given to illustrate the obtained results. The effect of sojourn times in distinct regimes on the availability and the up time are also discussed in the numerical example.

Availability Analysis of Parallel Repairable System with Omitted Failures

The new model for parallel repairable system is introduced, and it is based on the practice problems of maintenance and the idea of Ion-Channel modeling. In the new model, repair times that are sufficiently short （less than some critical value） do not result in system failure, and such a repair interval is omitted from the downtime record. Usually, the underlying process is Markov process if the durations of working and repair time have the negative-exponential distributions, but the new system has not the Markov properties, which is worth to study. The reliability indexes such as instantaneous availability and steady-state availabilities for the new system are given through probability analysis. A numerical example is given to illustrate the results.

Availability Equivalence Factors of a General Repairable Parallel-Series System

The availability equivalence factors of a general repairable parallel-series system are discussed in this paper considering the availability function of the system. The system components are assumed to be repairable and independent but not identical. The life and repair times of the system components are exponentially distributed with different parameters. Two types of availability equivalent factors of the system are derived. The results derived in this paper generalize those given in the literature. A numerical example is introduced to illustrate how the idea of this work can be applied.

Reliability Evaluation of Two-Stage Directed Semi-Markov Repairable Network Systems

A two-stage directed Semi-Markov repairable network system is presented in this paper to model the performance of many transmission systems, such as power or oil transmission network, water or gas supply network, etc. The availability of the system is discussed by using Markov renewal theory, Laplace transform and probability analysis methods. A numerical example is given to illustrate the results obtained in the paper.

A REPLACEMENT MODEL FOR QUEUEING SYSTEM WITH REPAIRABLE ELECTRICAL EQUIPMENT OF AUTOMATIC STEEL ROLLING

The optimal replacement model for the repairable queueing system con-sisting of single electrical equipment of automatic steel rolling is studied. Assumingthat the equipment after repair is not “as goed as new” , by using geometric pro-cess, we take the n

RELIABILITY ANALYSIS FOR A REPAIRABLE PARALLEL SYSTEM WITH TIME-VARYING FAILURE RATES

To solve a real problem:how to calculate the reliability of a system with time-varying failure rates in industry systems,this paper studies a model for the load-sharing parallel system with time-varying failure rates,and obtains calculating formulas of reliability and availability of the system by solving differential equations.In this paper,the failure rates are expressed in polynomial configuration.The constant,linear and Weibull failure rate are in their special form.The polynomial failure rates provide flexibility in modeling the practical time-varying failure rates.

A Two-Unit Cold Standby Repairable System with One Replaceable Repair Facility and Delay Repair: Some Reliability Problems

This paper considers a two–unit same cold standby repairable system with a replaceable repair facility and delay repair .The failure time of unit is assumed to follow exponential distribution , and the repair time and delay time of failed unit are assumed to follow arbitrary distributions , whereas the failure and replacement time distributions of the repair facility are exponential and arbitrary . By using the Markov renewal process theory, some primary reliability quantities of the system are obtained.

REPAIRABLE SYSTEM AVAILABILITY MODEL WITH RESPECT TO LIFE DISTRIBUTION OF SPARE PARTS

The failed components of repairable systems are replaced with spare parts that may have different failure distributions from those of the components that have failed. The spare parts may be either the same as new, better than new, or worse than new. This is the reality in maintenance engineering. Repair with better spare parts is defined as ＂super repair＂. The failure distributions of the spare parts affect the availability of the components and their systems. A novel model is proposed to describe the availability of repairable systems across their operating time, at the level of their components, on the assumption that the failed components are immediately replaced. The model functions with arbitrary failure distributions of spare parts. It can be used to compute the availability of components and systems not only under perfect and imperfect repair but also under super repair.

Repairable Configuration Optimization Model under Two-Echelon Inventory

Spares inventory configuration optimization is an effective way to improve readiness and reduce life cycle cost of equipment.Through analyzing two-echelon spares support system,the METRIC model basic theory was used.An inventory configuration optimization model of two-echelon spares support system was proposed which took the spares expected shortfall as the object and made the minimum repairable parts expected shortfall instead of the maximum spares supportability as the objective function.Marginal efficiency analysis algorithm was applied to optimizing the spares configuration and generating a rational spares inventory configuration.Finally,several examples are given to verify the model.

Existence and Uniqueness of the Dynamic Solution of a Series-Parallel Repairable System Consisting of Three-Unit with Multiple Vacations of a Repairman

We investigate a series-parallel repairable system consisting of three-unit with multiple vacations of a repairman. By using C0-semigroup theory of linear operators in the functional analysis, we prove that the system is well-posed and has a unique positive dynamic solution.

The Linear Stability of a Solution of a Parallel Redundant Repairable System

In this paper,the solution of a parallel redundant repairable system is investigated.by using the method of functional analysis.Especially,the linear semigroups of operator theory on Banach space,we prove the existence of the strictly dominant eigenvalue,and show the linear stability of solution.

Warranty Cost Model Based on Optimal Preventive Maintenance Operations for Repairable Products

Most warranty cost models based on preventive maintenance operations are assumed that products improve at each preventive maintenance （PM） operation and the failure rate is reduced to the failure rate of new products or to some specified level. To make warranty cost models more suitable to real operations, a modeling method of the PM warranty cost was proposed with the situation where each PM operation slowed the rate of product degradation. A warranty cost model was built on PM operations. On the basis of the cost model, both without and with reliability limit PM warranty policy, algorithms were presented to derive the optimal PM number and the optimal PM interval with an objective of minimizing expected total warranty cost over a t＇mite warranty period. Finally, to demonstrate the feasibility of the presented modeling method, Weibuil distribution cases were tested by numerical simulations. The simulation results indicate that the proposed modeling method is feasible and valid for resolving the optimal solution of the product warranty cost.

Model for Failure Point Process of a Repairable System and Application

A engineering system is usually repairable, and failure process of a repairable by a failure point process. The power law model is a commonly used approach to model syst the em is often described failure point process. This paper introduces the concept and model for the failure process of repairable system. The method of parameter estimation is developed, and failure observations are fitted into a power-law model by using the least square method. Two applications of the pressent model are discussed according to the practical failure data of the central cooling system of a nuclear power plant. One application is determining the optimal overhaul time, and the other is evaluating the quality of maintenance. This paper provides references for the overhaul decision making and maintenance quality evaluation in reality.

Reliability Analysis of Repairable Systems Using Stochastic Point Processes

In order to analyze the failure data from repairable systems, the homogeneous Poisson process (HPP) is usually used. In general, HPP cannot be applied to analyze the entire life cycle of a complex, re-pairable system because the rate of occurrence of failures (ROCOF) of the system changes over time rather than remains stable. However, from a practical point of view, it is always preferred to apply the simplest method to address problems and to obtain useful practical results. Therefore, we attempted to use the HPP model to analyze the failure data from real repairable systems. A graphic method and the Laplace test were also used in the analysis. Results of numerical applications show that the HPP model may be a useful tool for the entire life cycle of repairable systems.

Reliability Analysis of Some Typical Repairable Systems with Arbitrary Repair-Time Distribution

In this paper, reliability of some typical non-Markov repairable systems, including series systems, m-out-of- n or majority vote systems, and n : m cross-strapping standby redundant systems with general repair-time distribution, are studied by applying the generalized Markov renewal process (GMRP). The stochastic behavior of the typical systems is analyzed here. Formulas for mean time to first system failure, MTBF, MTTR, and availability are then developed.

Analysis of Stochastic Reliability Characteristics of a Repairable 2-out-of-3 System with Minimal Repair at Failure

In this paper, we study the reliability and availability characteristics of a repairable 2-out-of-3 system. Failure and repair times are assumed exponential. The explicit expressions of reliability and availability characteristics such as mean time to system failure (MTSF), steady-state availability, busy period and profit function are derived using Kolmogorov’s forward equations method. Various cases are analyzed graphically to investigate the impact of system parameters on MTSF, availability, busy period and profit function.