Challenges and Complications in Treating Total Knee Arthroplasty in Morbidly Obese Patients.

The number of total hip and total knee replacements has increased steadily each year. Today, they are routinely performed all over the world. The increasing prevalence of obesity has led to an increase in the number of total knee arthroplasties (TKAs) performed in patients with a higher body mass index (BMI) and also has a higher rate of complications. Possible complications are infection, instability, misalignment, osteolysis, or fracture. Revision arthroplasty can be challenging due to bone defects, ligament instability, and difficulty in fixation. We present the case of a 66-year-old morbidly obese patient who underwent TKA. After the operation, infection and a mechanical complication of periprosthetic fracture of the tibial component occurred. The infection made the treatment more difficult. The patient had to undergo several surgeries in several stages to address the post-surgical complications. TKA in obese patients leads to a higher risk of postoperative complications.

Resting-state frontal, frontlateral, and parietal alpha asymmetry:A pilot study examining relations with depressive disorder type and severity.

Introduction: The search for biomarkers has been central to efforts of improving clinical diagnosis and prognosis in psychopathology in the last decades. The main approach has been to validate biomarkers that could accurately discriminate between clinical diagnoses of very prevalent forms of psychopathology. One of the most popular electrophysiological markers proposed for discrimination in depressive disorders is the electroencephalography (EEG)-derived frontal alpha asymmetry. However, the validity, reliability and predictive value of this biomarker have been questioned in recent years, mainly due to conceptual and methodological heterogeneity. Methods: In the current non-experimental, correlational study we investigated relationship of resting-state EEG alpha asymmetry from multiple sites (frontal, frontolateral, and parietal) with different forms of depressive disorders (varying in type or severity), in a clinical sample. Results: Results showed that alpha asymmetry in the parietal (P3-P4) was significantly higher than in the frontal (F3-F4) and frontolateral sites (F7-F8). However, we did not find significant relations between alpha asymmetry indices and our depressive disorder measures, except for a moderate positive association between frontolateral alpha asymmetry (eyes-closed only) and depressive disorder severity (determined through clinical structured interview). We also found no significant differences in alpha asymmetry between participants, depending on their depression type. Discussion: Based on results, we propose the parietal and frontolateral asymmetry indices to form hypotheses that should not be abandoned in the depression markers research, but worth for further experimental research. Methodological and clinical implications of the current findings are discussed.