Sweet potato (Ipomoea batatas L.) genotype selection using advanced indices and statistical models: A multi-year approach.

In Bangladesh, sweet potato holds the fourth position as a crucial carbohydrate source, trailing rice, wheat, and potato. However, locally grown sweet potato varieties often display limited stability and yield. To tackle this challenge, diverse selection methods and statistical models were utilized to pinpoint sweet potato genotypes showcasing both stability and superior yield and quality traits. In the initial two years, multiple selection methods were employed to narrow down the collections based on preferences for yield and its contributing traits. Subsequently, a multi-environment trial (MET) was conducted in the following year to pinpoint superior and stable genotypes with desirable yield and quality characteristics. An integrated approach involving the Multi-Trait Genotype Ideotype Distance Index (MGIDI), Factor Analysis and Ideotype-Design (FAI-BLUP), and Smith-Hazel Index (SH) led to the identification of 71 superior sweet potato genotypes out of a total of 351 in the initial growing season. In the subsequent season, the MGIDI selection index was applied to the 71 genotypes, resulting in the selection of 11 top-performing genotypes. This selection process was complemented by a detailed analysis of the strengths and weaknesses of the selected genotypes. In the MET, the mixed effect model, specifically the linear mixed model (LMM), identified significant genotypic and genotype-environment interaction (GEI) variances. This points to elevated heritability and selection accuracy, ultimately boosting the model's reliability. By combining the strengths of LMM and additive main effects and multiplicative interaction (AMMI), the best linear unbiased prediction (BLUP) index identified H20 as the top-performing genotype for marketable root yield (MRY), H37 for dry weight of root (DW), H8 for beta carotene (BC) and H41 for vitamin c (VC). These genotypes surpassed the overall average in the WAAS index. For simultaneous stability and high performance, the WAASBY index selected H37 for MRY, H6 for DW, H61 for BC, and H3 for VC. Finally, genotypes H3 and H20 were selected using multi-trait stability index (MTSI), as they possessed high performance and stability. Based on the selection sense, the objective has been achieved with regards to the trait MRW, which serves as a major criterion for a superior variety of sweet potato.

Role of placental membrane in ACL graft healing - A series of 18 patients.

Introduction: ACL injuries are common and the standard treatment remains to be ACL reconstruction. Controversy still remains around graft ligamentisation and various methods have been experimented to augment this process. In this series we discuss the outcome of using dehydrated umbilical cord derived membrane in ACL reconstruction. Material and method: A prospective Level IV analysis of outcome in 30 consecutive patients of complete isolated ACL tear presenting to us between May 2022 to September 2022 was done. There was no age or sex restriction. Revision cases were excluded from this series. ACL reconstruction was done using standard all inside technique using the ipsilateral semitendinosus graft which was wrapped with dehydrated umbilical cord derived membrane (5*3 cm2) after soaking in normal saline (Cord Thick - Life Cell; LifeCell international private limited, Chennai, Tamil Nadu, India) and secured with Monocryl 3-0 sutures in a continuous manner. Results: 18 patients completed the one year follow up and were analysed for final results. Eleven of the patients followed up were females and seven males, with an average age of 30.3 years.The average VAS score at 6 weeks was 2.2. The mean KOOS score at the follow up visits were 72.3, 82.3, 90.7, 95.8. The mean SANE score reported at 6 weeks, 3 months, 6 months and 1 year were 68.8, 80, 87.5, 95.1.The follow up MRI's confirmed good ligamentisation of the graft even as early as 6 weeks with minimal fluid in the tunnel. Conclusion: The use of dehydrated umbilical cord derived membrane augmentation to potentiate graft integration in ACL reconstruction seems promising and helps improve patient outcomes.

Comparison of Patellofemoral Outcomes between Attune and PFC Sigma Designs: A Prospective Matched-Pair Analysis.

BACKGROUD: Attune (DePuy Synthes) prosthesis was designed to overcome patellofemoral complications associated with PFC Sigma (DePuy Synthes) prosthesis. The aim of our study was to compare the incidence of anterior knee pain (AKP), patellofemoral crepitus (PCr), and functional outcome between them. METHODS: This prospective matched-pair study was conducted between January 2014 and June 2015, during which 75 consecutive Attune total knee arthroplasties (TKAs) were matched with 75 PFC Sigma TKAs based on age, sex, body mass index, pathology, and deformity. A single surgeon performed all the operations with aid of computer navigation, using a posterior-stabilized prosthesis with patellar resurfacing. Outcome was assessed by new Knee Society Score (NKSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. AKP and PCr were assessed by a patient-administered questionnaire till 2 years of follow-up. Three pairs were lost to follow-up and finally 72 pairs were analyzed. RESULTS: One patient in each group reported AKP and 1 patient from each group had PCr at 2 years postoperatively. None of these patients required additional surgery. The incidence of lateral retinacular release was higher with PFC Sigma (5/72) than Attune (2/72); however, this was statistically not significant (p = 0.4). The Attune group had a significantly greater range of motion (ROM) at 3 months postoperatively (p = 0.049). At final follow-up, ROM was comparable between two prosthesis designs. NKSS and WOMAC scores were also comparable between the groups. CONCLUSIONS: We observed that both Attune and PFC Sigma had a low and comparable incidence of AKP and PCr up to 2 years of follow-up. The Attune group achieved a significantly greater ROM at 3 months postoperatively. At 2 years of follow-up, both prostheses had excellent and comparable clinical and functional results.

Short-Form New Knee Society Score: What Is Its Responsiveness and Convergent Validity with Other Scores?

The short-form version of New Knee Society Score (SF-NKSS) was designed with a purpose to reduce respondent burden. Literature review revealed only one report by Scuderi et al on responsiveness of derived SF-NKSS, but it was evaluated in two separate patient cohorts pre- and postsurgery. Our study had evaluated responsiveness and convergent validity of derived SF-NKSS in a single, large patient cohort followed longitudinally from preoperative status to over 1 year. Our database of 148 knee arthroplasty patients operated by the same surgeon, whose NKSS, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 12-item Short-Form Survey (SF-12) scores were prospectively collected preoperatively and postoperatively at 3 and 12 months for a study published earlier, was analyzed for derived SF-NKSS. Responsiveness was evaluated by determining the effect size, standardized response mean (SRM), and ceiling and floor effects. For convergent validity, Pearson's correlation coefficient was used. SF-NKSS was found to be most responsive with the largest effect size and SRM at 3 months (3.02 and 2.50, respectively) and at 12 months (3.58 and 2.92, respectively) with no ceiling or floor effect. SF-NKSS was followed in responsiveness by original NKSS, WOMAC, and SF-12 in a descending order. Convergent validity showed a strong correlation (r = 0.8-1.0; p < 0.001) of SF-NKSS with NKSS and a moderate to strong correlation (r = 0.5-0.6; p < 0.001) with WOMAC and SF-12. We concluded that SF-NKSS is a reliable, highly responsive tool for post-total knee replacement evaluation. It also has the ability to register improvement in the patient's recovery, which can continue even after 1 year. We found that the SF-NKSS can be used interchangeably with the original NKSS.

Are Stems Redundant in Times of Metaphyseal Sleeve Fixation?

BACKGROUND: Various options exist for implant fixation in revision total knee arthroplasty. One of it is direct cementless metaphyseal sleeve fixation with stems, which has shown excellent short-term and midterm results. Stemless fixation of sleeves is another fixation option for the treatment of specific bone defects; however, so far no data in larger series exist. The objective of this study was, therefore, to analyze the midterm (3-6.5 years) results of stemless sleeve fixation in a larger revision total knee arthroplasty series. METHODS: In this prospective study, 85 patients with 109 stemless sleeves have been assessed with a mean follow-up of 58.2 (36-78) months. An exclusion criterion was uncontained type II and type III defects. Analysis included clinical and radiographic assessment. RESULTS: The results showed a survival rate of sleeves in 96% of the tibia (27/28) and 100% of the femur (81/81). This results in an overall survival rate of sleeves of 99% (108/109). So far, 10 patients (11.8%) underwent rerevision during the follow-up period. The main reason for failure was infection (4/85; 4.7%). Range of motion, Oxford Knee Score, Knee Society Score, and Functional Score improved significantly. Mechanical leg alignment was within the 3° corridor in all patients. CONCLUSIONS: In cases with type I and contained type II defects, sleeves without stems are a promising option, with a survival rate of sleeves of 99% after 5 years. Also, the clinical improvement and reconstruction of leg alignment showed excellent results. In uncontained defects and type III defects, however, we do recommend using stems for additional fixation in the diaphysis. Although the midterm results are very promising, long-term data are needed.

What is the Responsiveness and Respondent Burden of the New Knee Society Score?

BACKGROUND: Although the new Knee Society score (NKSS) has been validated by a task force, a longitudinal study of the same cohort of patients to evaluate the score's responsiveness and respondent burden has not been reported, to our knowledge. QUESTIONS/PURPOSES: We analyzed the NKSS for (1) responsiveness; (2) respondent burden; and (3) convergent validity in 148 patients studied longitudinally during more than 1 year. METHODS: During an 8-month period, 165 patients underwent TKA by the same surgeon at our institution, of whom 148 (90%) completed this study; the others were excluded because of distance to travel or loss to followup at the specified time. The NKSS, WOMAC, and SF-12 were completed by each patient 1 day before surgery and at 3 and 12 months postoperatively. At the same times, the original KSS (OKSS) which is designed as an observer's assessment, was completed by the same orthopaedic fellow for all patients. Responsiveness of the NKSS was assessed by determining effect size, standardized response mean (SRM), and ceiling and floor effects. Respondent burden was assessed through time to completion recorded in minutes and ease of completion which was measured objectively on a Likert scale of 1 to 5 by the patients. Convergent validity was assessed by correlating the NKSS with the WOMAC, SF-12, and OKSS (current, widely used scales) by Pearson's correlation coefficient. RESULTS: Effect size was largest (2.83 and 3.38) and SRM was highest (2.29 and 2.68) for the NKSS at 3 and 12 months respectively, indicating the NKSS to be the most-responsive score followed by the OKSS, WOMAC, and SF-12. The NKSS exhibited no ceiling and floor effects. The NKSS took a longer time to complete (5.49 ± 3.56 minutes) compared with the WOMAC (4.64 ± 3.19 minutes) and SF-12 (4.35 ± 3.27 minutes). The mean difference in time taken for the NKSS versus the WOMAC was 0.85 minutes (95% CI, 0.54-1.17 minutes; p < 0.001) and the mean difference for the NKSS versus the SF-12 was 1.14 minutes (95% CI, 0.76-1.15 minutes; p < 0.001). Its ease of completion generally was comparable to that of the WOMAC and SF-12. Convergent validity showed a strong correlation (r > 0.6; p < 0.001) of the NKSS with the WOMAC at all times and moderate to strong correlation (r = 0.4-0.6; p < 0.001) with the SF-12 and OKSS at the first two assessments, which became strong (r > 0.6; p < 0.001) at 12 months. CONCLUSIONS: The NKSS exhibited greater responsiveness than the WOMAC, SF-12, and OKSS scales and showed no ceiling effect, indicating adequate potential for recording future improvement. The NKSS also showed reliable convergent validity when correlated with these other scores. However, it posed a greater respondent burden in terms of time to completion. CLINICAL RELEVANCE: As independent nondevelopers of the NKSS, we found it to be a responsive tool for assessment of TKA outcomes. We have confirmed that the NKSS can be used interchangeably for this purpose with the WOMAC scale and that it correlates positively with other established scales of the SF-12 and OKSS. Further study of the short-form version will establish whether it also can be used effectively while reducing the respondent burden.

Giant cell tumor of the metacarpal bones.

Giant cell tumor (GCT) of hand bones is rare. We present two cases of GCT of metacarpal bone. One case was treated successfully with ray amputation. The second patient underwent wide resection and tricortical iliac crest bone grafting. Till the last follow-up (at 26 and 70 months respectively) both patients have been recurrence free and have returned to their previous occupational activities.