Introduction

In total knee arthroplalsties, there are risks of revision surgeries because of aseptic loosening, polyethylene wear, and metal component breakage. The data such as model, type, size, and manufacturing companies are required at the time of revision surgeries. However, it is sometimes difficult to acquire such data due to patient's change of address and the elimination and consolidation of hospitals in the long-term. Therefore, we try to use the Radio Frequency IDentification (RFID) in the total knee joint system.

PROBLEM. Since the COVID-19 pandemic of 2020, there has been a marked rise in the use of telemedicine to evaluate patients following total knee arthroplasty (TKA). Telemedicine is helpful to maintain patient contact, but it cannot provide objective functional TKA data. External monitoring devices can be used, but in the past have had mixed results due to patient compliance and data continuity, particularly for monitoring over numerous years. This novel stem is a translational product with an embedded sensor that can remotely monitor patient activity following TKA. SOLUTION. The Canturio™ TE∗ System (Canary Medical) functions structurally as a tibial extension for the Persona® cemented tibial plate (Zimmer Biomet). The stem is instrumented with internal motion sensors (3-D accelerometer and gyroscope) and telemetry that collects and transmits kinematic data. Raw data is converted by analytics into clinically relevant gait metrics using a proprietary algorithm. The Canturio™ TE∗ will monitor the patient's gait daily for the first year and then with lower frequency thereafter to conserve battery power enabling the potential for 20 years of longitudinal data collection and analysis. A base station in the OR activates the device and links the stem and data to the patient. A base station in the patient's home collects and uploads data to the Cloud Based Canary Data Management Platform (Canary Medical). The Canary Cloud is structured as an FDA regulated and HIPPA-compliant database with cybersecurity protocols integrated into the architecture. A third base station is an accessory used in the health care professional's office to perform an on-demand gait analysis of a patient. A dashboard allows the health care professional and patient to monitor objective data of the patient's activity and progress post treatment. MARKET. The early target market for this device includes total joint surgeons who are early adopters of technology and currently utilize technology in their practice. The kinematic data provided by the Canturio™ TE∗ System will enable clinicians to augment patient care by reviewing their objective gait metrics. In the future, this data has the potential to be integrated with other Zimmer Biomet technologies, such as the Rosa™ Knee robotic platform, mymobility™, and sensored devices like iAssist™, to provide the surgeon with a complete pre-surgical functional assessment, intraoperative data, and post-operative functional data. PRODUCT. Persona IQ will be the combination of the proven Persona personalized total knee system with the Canary Medical Canturio™ TE∗. TIMING AND FUNDING. The Canturio™ TE is currently under De Novo FDA review for market clearance; it is not yet available for commercial distribution. The plan is to launch the product in 2021 pending regulatory De Novo grant. This effort is a partnership between Zimmer Biomet and Canary Medical. ∗ The Canturio™ - TE is currently under De Novo FDA review for market clearance; it is not yet available for commercial distribution

Aims

It is well described that patients with bone and joint infections (BJIs) commonly experience significant functional impairment and disability. Published literature is lacking on the impact of BJIs on mental health. Therefore, the aim of this study was to assess health-related quality of life (HRQoL) and the impact on mental health in patients with BJIs.

Despite increasing use of vena cava filters (VCFs) for pulmonary embolism (PE) prophylaxis after major trauma, there is continued debate regarding their safety and efficacy. We aimed to evaluate the impact of prophylactic VCFs on the incidence of PE after major trauma and to describe VCF related complications. Prospectively collected data from The Alfred Hospital Trauma Registry were used to identify all major trauma patients admitted between 1 July 2001 and 1 July 2008. Data for each patient was collated from the registry. This included patient demographics, injury specific data, management details (including prophylactic VCF use) and clinical outcomes (including the occurrence of PE). Medical record and radiology chart review was used to verify all PEs. Potential PE risk factors were assessed as covariates in a univariate analysis, with PE as the dependent variable. A multivariate analysis was then performed using multiple logistic regression adjusting for baseline imbalances and known covariates. During this period, 6,344 major trauma patients were treated, with 73.2% male, mean age of 44.2 +/− 21.0 SD, 90.2% with a blunt mechanism of injury and mean ISS of 24.3 +/− 12.0 SD. Of these patients, 511 (8.1%) received prophylactic VCFs, (inserted in absence of PE) at the discretion of the treating clinician. There were 45 PE (incidence of 0.71%), of which two were fatal. Three variables were independently associated with the occurrence of PE in the multivariate analysis: (i) presence of prophylactic VCF (OR 0.28; 95%CI 0.09 - 0.89); (ii) number of injuries to the AIS body region lower limb (OR 1.31; 95%CI 1.17 - 1.47) and (iii) central venous catheterisation (OR 1.87; 95%CI 1.88 - 6.17). Data was available on the VCF database for 429 of the 511 patients with VCFs (84.0%). The mean time to prophylactic VCF insertion was 3.6 +/− 0.2 SEM days after admission. The VCF major complication rate was 2.6% (n=11), including four non-fatal PE. The technical success rate for retrieval was 92.4% (279 retrievals from 302 attempts) and the overall retrieval rate was 65.0% (279 retrievals from 429 placements). Prophylactic VCFs are associated with a reduced rate of PE when used in selected major trauma patients. In addition, prophylactic VCFs have a low major complication rate and high rate of technical success for retrieval

Pelvic fractures in children are rare and potentially disastrous injuries. Using medical records and radiographs over a three year period from January 2008 to March 2011 at an academic hospital we retrospectively analysed the incidence, the associated data and management of these injuries. Results. During this time period 633 paediatric patients where admitted with trauma related injuries; only 19 had pelvic fractures, an incidence of 0.03%. The majority of these patients (13) were involved in PVA's; while MVA (3), fall from height (1) and sports injuries (1) made up the rest. Males (13) were injured more commonly and the average age of the patients was 9 years (3–14). There is debate of over the ideal paediatric pelvic fracture classification system in the literature. However, 13 pelvic fractures were classified stable; 3 were unstable fractures with disruption of the pelvic ring. In addition 2 iliac wing fractures and 1 avulsion (apophyseal) fracture were found. 58% of the patients had associated injuries, however, only 2 of the 19 had associated abdominal viscus injuries. Neither of these required exploratory laparotomy and were managed conservatively. The treatment of these pelvic fractures in our unit was patient specific and largely conservative. 17 patients' pelvic fractures were treated with bed rest, analgesia and mobilisation as pain allowed while the remaining 2 had pelvic external fixators. No ORIF's were performed. Associated orthopaedic injuries were managed accordingly. The average hospital stay of a patient with a pelvic fracture was 15 days (3–48 days). There were no mortalities during this time period