Gait comparison of unicompartmental and total knee arthroplasties with healthy controls.

AIMS: To compare the gait of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) patients with healthy controls, using a machine-learning approach. PATIENTS AND METHODS: 145 participants (121 healthy controls, 12 patients with cruciate-retaining TKA, and 12 with mobile-bearing medial UKA) were recruited. The TKA and UKA patients were a minimum of 12 months post-operative, and matched for pattern and severity of arthrosis, age, and body mass index. Participants walked on an instrumented treadmill until their maximum walking speed was reached. Temporospatial gait parameters, and vertical ground reaction force data, were captured at each speed. Oxford knee scores (OKS) were also collected. An ensemble of trees algorithm was used to analyse the data: 27 gait variables were used to train classification trees for each speed, with a binary output prediction of whether these variables were derived from a UKA or TKA patient. Healthy control gait data was then tested by the decision trees at each speed and a final classification (UKA or TKA) reached for each subject in a majority voting manner over all gait cycles and speeds. Top walking speed was also recorded. RESULTS: 92% of the healthy controls were classified by the decision tree as a UKA, 5% as a TKA, and 3% were unclassified. There was no significant difference in OKS between the UKA and TKA patients (p = 0.077). Top walking speed in TKA patients (1.6 m/s; 1.3 to 2.1) was significantly lower than that of both the UKA group (2.2 m/s; 1.8 to 2.7) and healthy controls (2.2 m/s; 1.5 to 2.7; p < 0.001). CONCLUSION: UKA results in a more physiological gait compared with TKA, and a higher top walking speed. This difference in function was not detected by the OKS. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):16-21.

Surgical tip--a novel method of applying fibrin sealant during repair of divarication of the recti via an abdominoplasty incision.

The use of fibrin sealant to secure the mesh after a hernia repair, and to reduce seroma formation after abdominoplasty, is well recognised. However, delivery of the fibrin sealant post-abdominoplasty has proved technically difficult due to the competing demands of: (1) applying instant pressure to the fibrin sealant-containing cavity and (2) accurate suturing of the skin flaps. A new technique is proposed for the application of the fibrin sealant during abdominoplasty.

The use of depot neuroleptic haloperidol decanoate.

Twenty-nine patients were treated with haloperidol decanoate, the dosage ranging from 100 to 300 mg i.m. once a month, with duration of treatment ranging from 3-7 months. It seems that haloperidol decanoate could be useful in schizo-affective disorder/depressed type and also in manic disorder. The investigators were impressed by the relative lack of side effects.