Robotic-Arm-Assisted Total Hip Arthroplasty: A Review of the Workflow, Outcomes and Its Role in Addressing the Challenge of Spinopelvic Imbalance.

Robotic-arm-assisted total hip arthroplasty (RoTHA) offers the opportunity to improve the implant positioning and restoration of native hip mechanics. The concept of individualised, functional implant positioning and how it relates to spinopelvic imbalance is an important yet rather novel consideration in THA. There is mounting evidence that a significant percentage of dislocations occur within the perceived "safe zones"; hence, in the challenging subset of patients with a stiff spinopelvic construct, it is imperative to employ individualised component positioning based on the patients' phenotype. Restoring the native centre of rotation, preserving offset, achieving the desired combined anteversion and avoiding leg length inequality are all very important surgeon-controlled variables that have been shown to be associated with postoperative outcomes. The latest version of the software has a feature of virtual range of motion (VROM), which preoperatively identifies potential dynamic causes of impingement that can cause instability. This review presents the workflow of RoTHA, especially focusing on pragmatic solutions to tackle the challenge of spinopelvic imbalance. Furthermore, it presents an overview of the existing evidence concerning RoTHA and touches upon future direction.

Quantifying the Sustainability of Water Availability for the Water-Food-Energy-Ecosystem Nexus in the Niger River Basin.

Water, food, energy, and the ecosystems they depend on interact with each other in highly complex and interlinked ways. These interdependencies can be traced particularly well in the context of a river basin, which is delineated by hydrological boundaries. The interactions are shaped by humans interacting with nature, and as such, a river basin can be characterized as a complex, coupled socioecological system. The Niger River Basin in West Africa is such a system, where water infrastructure development to meet growing water, food, and energy demands may threaten a productive and vulnerable basin ecosystem. These dynamic interactions remain poorly understood. Trade-off analyses between different sectors and at different spatial scales are needed to support solution-oriented policy analysis, particularly in transboundary basins. This study assesses the impact of climate and human/anthropogenic changes on the water, energy, food, and ecosystem sectors and characterizes the resulting trade-offs through a set of generic metrics related to the sustainability of water availability. Results suggest that dam development can mitigate negative impacts from climate change on hydropower generation and also on ecosystem health to some extent.