Are running stitches needed in DT4 Single Anteromedial Bundle Biological Augmentation transplant preparation?

Partial running whipstitches are commonly used in DT4 SAMBBA (Single Anteromedial Bundle Biological Augmentation) transplant preparation. We wanted to determine whether or not running whipstitches all over the graft affected the risk of iterative rupture and the overall outcome of the procedure. Two groups of 32 patients comparable in terms of sex, age, sport level and type of sport practiced were recruited in this prospective cohort study. DT4 SAMBBA was performed for all patients by a single surgeon. One cohort was treated with a full length running whipstitches during SAMBBA DT4 transplant preparation (F), the other had a classical SAMBBA DT4 graft preparation (NO F). The ACL RSI, subjective IKDC and KOOS scores were established preoperatively and with a 4 years follow-up. Complication rates (iterative rupture, cyclops syndrome) as well as pre and postoperative score variations were calculated. No statistically significant difference in terms of frequency of iterative rupture or complications could be demonstrated (NO F 9.3% vs F 3.1%, p = 0.61). There was no difference either on score variations compared pre and post operatively. Full running whipstitches of the DT4 SAMBBA transplant does not seem to influence the ligamentoplasty outcomes with a 4 years follow-up.

Kick-off meeting of the TOWWERS showcase project: 1st collaborative value-based healthcare anchored on real-world data involving the 5P.

The COVID-19 pandemic has highlighted the need to modernize healthcare systems to the reality of the 21st century. The first world-wide Strategic Committee to launch Collaborative Value-Based Healthcare (C-VBHC) anchored on populational Real World Data and structured collaboration, took place in Montreal, via TOWWERS showcase project. The meeting covered a broad range of topics from the perspective of each of the various Real-World healthcare actors, the 5P+: Patient, Prescriber, Producer, Policymaker, Payer, including Data and Research stakeholders. Attended by approximately 20 participants from North America and Europe, the meeting provided a valuable opportunity to unit the 5P+ around common goals and exchanging on solutions. TOWWERS Strategic committee identified key elements required to continue the transformation.

Alpha Defensin: A Diagnostic Accuracy Depending on the Infection Definition Used.

BACKGROUND: The purpose of this study was to evaluate the alpha defensin qualitative detection (ADLF) sensitivity and specificity as compared with 3 standard classifications in the diagnostic management of chronic prosthetic joint infections. MATERIALS AND METHODS: A multicenter cohort of 136 patients with a painful arthroplasty was classified into either infected or noninfected according to the Musculoskeletal Infection Society (MSIS) score, Infectious Diseases Society of America (IDSA) score, European Bone and Joint Infection Society (EBJIS) score. The sensitivity and specificity of the ADLF test were calculated for each score. Spearman's correlations between all scores were then analyzed, and multiple logistic regression was applied to identify independent variables strongly connected to the prosthetic joint infection probability. RESULTS: The EBJIS score was positive in 68 patients, IDSA score in 50 patients, MSIS score in 41 patients, and ADLF in 40 patients. The ADLF sensitivity was 87.8% compared with MSIS, 70% compared with IDSA, and 55.8% compared with EBJIS. The ADLF specificity was in the range of 94%-97%. A good correlation was observed between synovial fluid cultures and ADLF (r = 0.73). Low to excellent correlations were recorded between ADLF and the EBJIS (r = 0.58), IDSA (r = 0.68), and MSIS (r = 0.84) scores. The synovial fluid's white blood cell count was proven to be the biological test that most influenced the probability of a positive culture (P value: .005). DISCUSSION: The ADLF sensitivity was variable, whereas its specificity was excellent. The EBJIS score results significantly differed from those obtained via cultures, which possibly explains the ADLF low sensitivity compared with that of the EBJIS score.