Distributed Coordination for Optimal Energy Generation and Distribution in Cyber-Physical Energy Networks.

This paper proposes three coordination laws for optimal energy generation and distribution in energy network, which is composed of physical flow layer and cyber communication layer. The physical energy flows through the physical layer; but all the energies are coordinated to generate and flow by distributed coordination algorithms on the basis of communication information. First, distributed energy generation and energy distribution laws are proposed in a decoupled manner without considering the interactive characteristics between the energy generation and energy distribution. Second, a joint coordination law to treat the energy generation and energy distribution in a coupled manner taking account of the interactive characteristics is designed. Third, to handle over- or less-energy generation cases, an energy distribution law for networks with batteries is designed. The coordination laws proposed in this paper are fully distributed in the sense that they are decided optimally only using relative information among neighboring nodes. Through numerical simulations, the validity of the proposed distributed coordination laws is illustrated.

Intraoperative Templating in Lateral Meniscal Allograft Transplantation.

Recently, studies have emphasized the importance of anatomical placement of the lateral meniscal allograft to decrease postoperative extrusion. However, it is infeasible to identify the exact rotation of the allograft during transplantation. We present a patient who underwent a lateral meniscal transplantation using a wire for correct positioning of the allograft. The use of a wire intraoperatively shaped to resemble the contour of the lateral meniscal allograft will aid in more accurate and anatomical graft placement.

The Accuracy of the Lateral Tibial Spine as a Landmark for Lateral Meniscal Allograft Transplantation.

PURPOSE: To determine a relationship between the direction of the guide pin for the keyhole in the lateral meniscus (LM) transplantation and the line connecting the centers of both horns of the LM. METHODS: Forty-four resected tibial plateaus during total knee arthroplasty were used for anatomical and radiological evaluations. The inclusion criterion was medial compartment osteoarthritis. Exclusion criteria were osteoarthritic changes, meniscal tear, and previous fracture in the lateral compartment. Resected tibial plateaus were positioned so that the anterior and posterior parts of the lateral tibial spine (LTS) were overlapped accurately on fluoroscopic anteroposterior view. A wire (Pin-F) was drilled along the peak of the LTS. The insertion area of anterior and posterior horns of the LM was dissected carefully. The periphery and the center of the insertion area of both horns were marked. Another wire (Pin-A) was drilled along a line connecting the centers of both horns. An axial radiograph was taken for each prepared tibial plateau. A longitudinal line was drawn along each wire, and the angle between the 2 wires was measured using the imaging software. If the Pin-F was externally rotated relative to the Pin-A, the angle was designated as positive, and if the Pin-F was internally rotated, the angle was designated as negative. RESULTS: The mean angle between Pin-F and Pin-A was -7.4° ± 9.6°. Thirty-three (75%) Pin-Fs were fixed in an internally rotated position, and 11 (25%) were fixed in an externally rotated position. CONCLUSIONS: The direction of most guide pins drilled along the LTS was not coincident with the line connecting the centers of both horns of the LM. CLINICAL RELEVANCE: The axis of the LTS is not a reliable marker for the trough in the LM allograft transplantation.

Suture versus FasT-Fix all-inside meniscus repair at time of anterior cruciate ligament reconstruction.

PURPOSE: To compare meniscal healing and functional outcomes after all-inside meniscal repair between sutures and meniscal fixation devices. METHODS: Sixty patients with a tear within the red-red or red-white zones of the posterior horn of the medial or lateral meniscus in conjunction with an anterior cruciate ligament (ACL) tear were included in this study. Meniscal repairs were performed with sutures in 35 patients and the FasT-Fix device (Smith & Nephew Endoscopy, Andover, MA) in 25 patients concomitantly with hamstring ACL reconstruction. Postoperative evaluations included Lysholm knee score, Tegner activity scale, Lachman and pivot-shift tests, and KT-1000 arthrometer (MEDmetric, San Diego, CA) testing. Follow-up magnetic resonance imaging (MRI) scans were obtained postoperatively for all patients to evaluate meniscal healing. RESULTS: The mean follow-up period was 47.2 months. In the suture group, 31 patients (86.1%) were asymptomatic and 4 (13.9%) were symptomatic. In the FasT-Fix group, 20 patients (80%) were asymptomatic and 5 (20%) were symptomatic. Postoperative functional evaluation and knee stability showed no statistically significant difference between the 2 groups. Follow-up MRI showed that 26 menisci (74.3%) were healed, 3 menisci (8.6%) were partially healed, and 6 menisci (17.1%) were not healed in the suture group. In the FasT-Fix group, 15 menisci (64%) were healed, 7 menisci (24%) were partially healed, and 3 menisci (12%) were not healed. Follow-up MRI showed no statistically significant difference between the 2 groups. In the FasT-Fix group, follow-up MRI showed a newly developed cyst posterior to the medial meniscus in 2 patients. A new tear anterior to the previous tear was found in 1 patient. In the suture group, follow-up MRI showed no cysts or new tears. CONCLUSIONS: All-inside meniscal repairs using either sutures or the FasT-Fix device showed satisfactory results in patients with concomitant hamstring ACL reconstruction. There was no statistically significant difference in meniscal healing evaluated by MRI and functional outcomes between the 2 techniques. LEVEL OF EVIDENCE: Level III, retrospective comparative study.