Single cut distal femoral osteotomy for correction of femoral torsion and valgus malformity in patellofemoral malalignment - proof of application of new trigonometrical calculations and 3D-printed cutting guides.

BACKGROUND: The purpose of this study was to perform a derotational osteotomy at the distal femur, as is done in cases of patellofemoral instability, and demonstrate the predictability of three-dimensional (3D) changes on axes in a cadaveric model by the use of a new mathematical approach. METHODS: Ten human cadaveric femurs, with increased antetorsion, underwent a visually observed derotational osteotomy at the distal femur by 20°, as is commonly done in clinics. For surgery, a single cut osteotomy with a defined cutting angle was calculated and given using a simple 3D-printed cutting guide per specimen, based on a newly-created trigonometrical model. To simulate post-operative straight frontal alignment in a normal range, a goal for the mechanical lateral distal femur angle (mLDFA) was set to 87.0° for five specimens (87-goal group) and 90.0° for five specimens (90-goal group). Specimens underwent pre- and post-operative radiographic analysis with CT scan for torsion and frontal plane x-ray for alignment measurements of mLDFA and anatomical mechanical angle (AMA). RESULTS: Performed derotation showed a mean of 19.69° ±1.08°SD (95% CI: 18.91° to 20.47°). Regarding frontal alignment, a mean mLDFA of 86.9° ±0.66°SD (87-goal-group) and 90.42° ±0.25° SD (90-goal group), was observed (p = 0.008). Overall, the mean difference between intended mLDFA-goal and post-operatively achieved mLDFA was 0.14° ±0.56° SD (95% CI: -0.26° to 0.54°). CONCLUSION: A preoperative calculated angle for single cut derotational osteotomy at the distal femur leads to a clinically precise post-operative result on torsion and frontal alignment when using this approach.

Lasing from individual GaAs-AlGaAs core-shell nanowires up to room temperature.

Semiconductor nanowires are widely considered to be the next frontier in the drive towards ultra-small, highly efficient coherent light sources. While NW lasers in the visible and ultraviolet have been widely demonstrated, the major role of surface and Auger recombination has hindered their development in the near infrared. Here we report infrared lasing up to room temperature from individual core-shell GaAs-AlGaAs nanowires. When subject to pulsed optical excitation, NWs exhibit lasing, characterized by single-mode emission at 10 K with a linewidth <60 GHz. The major role of non-radiative surface recombination is obviated by the presence of an AlGaAs shell around the GaAs-active region. Remarkably low threshold pump power densities down to ~760 W cm(-2) are observed at 10 K, with a characteristic temperature of T(0)=109±12 K and lasing operation up to room temperature. Our results show that, by carefully designing the materials composition profile, high-performance infrared NW lasers can be realised using III/V semiconductors.