Corporate sustainability and environmental reporting: triggers and consequences.

This paper explores the triggers and consequences of sustainability reporting in the developing economy of Pakistan. Moreover, the study examines whether the corporate factors have any indirect and conditional indirect effects on financial performance through sustainability reporting where sector-affiliation acts as a moderator. An explanatory sequential mixed-methods approach has been applied for the data collection and analysis. The study uses secondary data collected from annual reports of 178 companies listed on the Pakistan Stock Exchange for 2010-2018. The quantitative results reveal that size, age, leverage, earnings, sustainability awards, CEO duality, and board independence significantly influence sustainability reporting. In contrast, foreign ownership, ownership concentration, women on board, and media visibility do not determine sustainability reporting. Mediation results indicate significant indirect effects of each corporate factor on financial performance through sustainability reporting. Similarly, except for a few, conditional indirect effects in all the models were also seen to exist. Subsequently, interviews with prominent players in the field helped validate and understand the quantitative results. This study has implications for regulators, corporate managers, investors, NGOs, and academic researchers.

Has the modern design of Attune total knee replacement improved outcome in patients with isolated patellofemoral arthritis?

INTRODUCTION AND AIM: Modern knee replacements aim to improve patient function in arthritis affecting different compartments of the knee. This study evaluates the Patient Reported Outcome Measure (PROM) and functional outcome of a modern total knee replacement (Attune, DePuy) in patients with isolated patellofemoral arthritis. METHODS: A total of 50 consecutive patients with isolated unilateral patellofemoral arthritis having had Attune total knee replacements at a single institution between 2010 and 2016 were prospectively studied. Five patients who developed symptoms on the opposite side during the study and two patients lost to follow-up were excluded. One patient needed early revision for loosening, leaving a total of 42 patients to be followed up over a period of 4 years. The Oxford Knee score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) recorded pre-operatively and at follow-up was compared. A Functional assessment at around 8 months after operation was undertaken. RESULTS: At average follow-up of 24 months the mean OKS score improved by 15 points and the KOOS score improved by 20 points. Final KOOS sub-score for Pain was 80, Symptom 80, and ADL 82, Sports & Recreation 32 and QOL 60. Functional assessment at mean 8 months showed that a significant number of patients were able to Kneel (50%); Sit cross legged (23%); sit on their heel (23%) and were able do a single leg dip test (86%). CONCLUSION: This unique study of a modern design total knee replacement (Attune) in patients with isolated unilateral patellofemoral arthritis shows good PROM scores at 2 years and good functional assessment results at 8 months. The PROM scores are marginally better than the published results with Attune's predecessor, in a similar cohort of patients, but falls short of the published results of patellofemoral replacement implants. Large randomised comparative studies between traditional and the modern implant design is recommended to answer the question if design modification has influenced clinical outcome in patients with patellofemoral arthritis.

Conventional versus 'all-inside' anterior cruciate ligament reconstruction: a randomized controlled trial comparing hamstring strength and functional outcome.

Cite this article: Bone Joint Open 2020;1-11:706-708.