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Knee osteotomies show efficacy in slowing knee osteoarthritis progression and delaying the need for total knee arthroplasty in younger patients. Despite evolutions in indications, techniques, and hardware that have improved outcomes, longitudinal trends demonstrate a decline in high tibial osteotomy (HTO) and distal femoral osteotomy (DFO) use. Unfortunately, knowledge of the current usage and complications associated with HTO and DFO is limited. The purpose of this study was to compare the preoperative demographics and early complication rates of HTO and DFO. We analyzed the HTOs and DFOs performed between 2006 and 2017 using the ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database. We compared both groups for preoperative patient demographics (sex, age, race, body mass index [BMI]) and health status variables including functional scores, ASA (American Society of Anesthesiologists) scores, smoking status, and other comorbidities. Emergency and elective status of the patient case, length of hospital stay, operation time, and 30-day postoperative complications were also analyzed. After the exclusion criteria were applied, 321 HTO and 295 DFO patients were included in the final analysis. The HTO group had higher proportions of younger (p < 0.001) and male (p < 0.001) patients with higher BMI (p = 0.007). Racial profiles were similar between the two groups (p = 0.575). Preoperatively, those in the HTO group had more functional independence, better physical status scores, and fewer chronic conditions (p < 0.05). There were no statistically significant differences between HTO and DFO in operative time, postoperative complications, readmission, and reoperation. HTO patients, however, had shorter hospital stays (p < 0.001). Although there are differences in preoperative and operative characteristics of HTO and DFO, early postoperative complications are similar for both groups. Therefore, HTO and DFO can be considered safe and effective treatment options for younger patients with symptomatic unicompartmental knee osteoarthritis.

Background Force myography (FMG) is a non-invasive technology used to track functional movements and hand gestures by sensing volumetric changes in the limbs caused by muscle contraction. Force transmission through tissue implies that differences in tissue mechanics and/or architecture might impact FMG signal acquisition and the accuracy of gesture classifier models. The aim of this study is to identify if and how user anthropometry affects the quality of FMG signal acquisition and the performance of machine learning models trained to classify different hand and wrist gestures based on that data. Methods Wrist and forearm anthropometric measures were collected from a total of 21 volunteers aged between 22 and 82 years old. Participants performed a set of tasks while wearing a custom-designed FMG band. Primary outcome measure was the Spearman’s correlation coefficient (R) between the anthropometric measures and FMG signal quality/ML model performance. Results Results demonstrated moderate (0.3 ≤|R| < 0.67) and strong (0.67 ≤ |R|) relationships for ratio of skinfold thickness to forearm circumference, grip strength and ratio of wrist to forearm circumference. These anthropometric features contributed to 23–30% of the variability in FMG signal acquisition and as much as 50% of the variability in classification accuracy for single gestures. Conclusions Increased grip strength, larger forearm girth, and smaller skinfold-to-forearm circumference ratio improve signal quality and gesture classification accuracy.

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Although it has become apparent that cutaneous reflexes can be adjusted based on the phase and context of the locomotor task, it is not clear to what extent these reflexes are regulated when locomotion is modified under visual guidance. To address this, we compared the amplitude of cutaneous reflexes while subjects performed walking tasks that required precise foot placement. In one experiment, subjects walked overground and across a horizontal ladder with narrow raised rungs. In another experiment, subjects walked and stepped onto a series of flat targets, which required different levels of precision (large vs. narrow targets). The superficial peroneal or tibial nerve was electrically stimulated in multiple phases of the gait cycle in each condition and experiment. Reflexes between 50 and 120 ms poststimulation were sorted into 10 equal phase bins, and the amplitudes were then averaged. In each experiment, differences in cutaneous reflexes between conditions occurred predominantly during swing phase when preparation for precise foot placement was necessary. For instance, large excitatory cutaneous reflexes in ipsilateral tibialis anterior were present in the ladder condition and when stepping on narrow targets compared with inhibitory responses in the other conditions, regardless of the nerve stimulated. In the ladder experiments, additional effects of walking condition were evident during stance phase when subjects had to balance on the narrow ladder rungs and may be related to threat and/or the unstable foot-surface interaction. Taken together, these results suggest that cutaneous reflexes are modified when visual feedback regarding the terrain is critical for successful walking.

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This event is an accredited group learning activity as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. The Annual Scientific Conference of the Canadian Spine Society provides a yearly review of spine care in Canada. This year the first combined conference widens its perspective to encompass participation by both the Spine Society of Australia and the New Zealand Orthopaedic Spine Society. There is also an increased contribution from paediatric spine. In addition to a review of surgical advances, the agenda covers a range of non-operative innovations and epidemiological studies. Presentations by members of the three societies will highlight the similarities, differences and common problems in three separate health care systems. Of particular interest are the management of neuromuscular spinal deformity and motion preserving surgery for degenerative back pain. A special focus is the development of national spine registries. Parallel efforts in all three countries will be compared and the conference will consider the possibility of international cooperation.