Improving disease prevention, diagnosis, and treatment using novel bionic technologies.

Increased human life expectancy, due in part to improvements in infant and childhood survival, more active lifestyles, in combination with higher patient expectations for better health outcomes, is leading to an extensive change in the number, type and manner in which health conditions are treated. Over the next decades as the global population rapidly progresses toward a super-aging society, meeting the long-term quality of care needs is forecast to present a major healthcare challenge. The goal is to ensure longer periods of good health, a sustained sense of well-being, with extended periods of activity, social engagement, and productivity. To accomplish these goals, multifunctionalized interfaces are an indispensable component of next generation medical technologies. The development of more sophisticated materials and devices as well as an improved understanding of human disease is forecast to revolutionize the diagnosis and treatment of conditions ranging from osteoarthritis to Alzheimer's disease and will impact disease prevention. This review examines emerging cutting-edge bionic materials, devices and technologies developed to advance disease prevention, and medical care and treatment in our elderly population including developments in smart bandages, cochlear implants, and the increasing role of artificial intelligence and nanorobotics in medicine.

Pediatric Trigger Digits.

Pediatric trigger thumb (PTT) and finger (PTF) are upper extremity deformities that frequently go unrecognized by providers. Early recognition by pediatricians and caregivers is vital because PTT is successfully treated nonoperatively in more than 95% of patients if diagnosed early. Similarly, PTF can be successfully treated nonoperatively in 67% of patients. Although PTT is typically benign and 10 times more common, PTF may be associated with underlying concurrent medical conditions, such as juvenile rheumatoid arthritis, diabetes, mucopolysaccharide and lysosomal disorders, and trisomy 18. Routine examinations consisting of full hand range of motion should be performed in all children. Clinicians should be aware of the importance of conservative treatment options for PTT and PTF and the value of screening for underlying medical conditions associated with PTF.

Incidence of Osteolysis and Aseptic Loosening Following Metal-on-Highly Cross-Linked Polyethylene Hip Arthroplasty: A Systematic Review of Studies with Up to 15-Year Follow-up.

BACKGROUND: This study compared the incidence of osteolysis, aseptic loosening, and revision following use of highly cross-linked polyethylene (HXLPE) or conventional polyethylene (CPE) at medium to long-term (>5 to 15 years) follow-up in primary total hip arthroplasty (THA). Incidences were quantified and compared with regard to age and method of implant fixation. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, 12 randomized controlled trials and 18 cohort studies were investigated for evidence-based outcomes following HXPLE and CPE use in 2,539 hips over a 5 to 15-year follow-up. RESULTS: Lower rates of osteolysis, aseptic loosening, and implant revision were reported following use of HXLPE liners. Osteolysis was reduced from 25.4% with CPE to 4.05% with HXLPE in young patients, and from 29.7% to 6.6% in the older patient cohort. Similarities in osteolysis rates were observed when cemented (24.9% for CPE and 6.5% for HXLPE) and uncemented components (32.8% for CPE and 7.1% for HXLPE) were compared. No clear advantage in the type of HXLPE used was observed. CONCLUSIONS: Over a follow-up period of up to 15 years, when compared with CPE, use of HXLPE liners reduced the incidence of osteolysis, aseptic loosening, and implant revision, regardless of the fixation method and including in younger and potentially more active patients. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.