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Article ; Online: Digital and robotic MSK surgery: is this the moment?

Plastow, R / Beard, D J / Haddad, F S

Annals of the Royal College of Surgeons of England

2021 Volume 104, Issue 1, Page(s) 2–4

MeSH term(s)	Humans ; Musculoskeletal Diseases/surgery ; Musculoskeletal System/surgery ; Robotic Surgical Procedures/methods ; Surgery, Computer-Assisted/methods
Language	English
Publishing date	2021-12-23
Publishing country	England
Document type	Editorial
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2021.0131
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Article ; Online: Anterior cruciate ligament injuries in female athletes: risk factors and strategies for prevention.

Mancino, Fabio / Kayani, Babar / Gabr, Ayman / Fontalis, Andreas / Plastow, Ricci / Haddad, Fares S

Bone & joint open

2024 Volume 5, Issue 2, Page(s) 94–100

Abstract: Anterior cruciate ligament (ACL) injuries are among the most common and debilitating knee injuries in professional athletes with an incidence in females up to eight-times higher than their male counterparts. ACL injuries can be career-threatening and are ...

Abstract	Anterior cruciate ligament (ACL) injuries are among the most common and debilitating knee injuries in professional athletes with an incidence in females up to eight-times higher than their male counterparts. ACL injuries can be career-threatening and are associated with increased risk of developing knee osteoarthritis in future life. The increased risk of ACL injury in females has been attributed to various anatomical, developmental, neuromuscular, and hormonal factors. Anatomical and hormonal factors have been identified and investigated as significant contributors including osseous anatomy, ligament laxity, and hamstring muscular recruitment. Postural stability and impact absorption are associated with the stabilizing effort and stress on the ACL during sport activity, increasing the risk of noncontact pivot injury. Female patients have smaller diameter hamstring autografts than males, which may predispose to increased risk of re-rupture following ACL reconstruction and to an increased risk of chondral and meniscal injuries. The addition of an extra-articular tenodesis can reduce the risk of failure; therefore, it should routinely be considered in young elite athletes. Prevention programs target key aspects of training including plyometrics, strengthening, balance, endurance and stability, and neuromuscular training, reducing the risk of ACL injuries in female athletes by up to 90%. Sex disparities in access to training facilities may also play an important role in the risk of ACL injuries between males and females. Similarly, football boots, pitches quality, and football size and weight should be considered and tailored around females' characteristics. Finally, high levels of personal and sport-related stress have been shown to increase the risk of ACL injury which may be related to alterations in attention and coordination, together with increased muscular tension, and compromise the return to sport after ACL injury. Further investigations are still necessary to better understand and address the risk factors involved in ACL injuries in female athletes.
Language	English
Publishing date	2024-02-05
Publishing country	England
Document type	Journal Article
ISSN	2633-1462
ISSN (online)	2633-1462
DOI	10.1302/2633-1462.52.BJO-2023-0166
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Article: The Value of Computed Tomography Scan in Three-dimensional Planning and Intraoperative Navigation in Primary Total Hip Arthroplasty.

Mancino, Fabio / Fontalis, Andreas / Magan, Ahmed / Plastow, Ricci / Haddad, Fares S

Hip & pelvis

2024 Volume 36, Issue 1, Page(s) 26–36

Abstract: Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional ( ...

Abstract	Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional (3D) imaging and computed tomography (CT)-based navigation are valuable tools in both the preoperative planning and intraoperative execution. The aim of this study is to provide a thorough overview on the applications of CT scans in both the preoperative and intraoperative settings of primary THA. Preoperative planning using CT-based 3D imaging enables greater accuracy in prediction of implant sizes, leading to enhancement of surgical workflow with optimization of implant inventory. Surgeons can perform a more thorough assessment of posterior and anterior acetabular wall coverage, acetabular osteophytes, anatomical landmarks, and thus achieve more functional implant positioning. Intraoperative CT-based navigation can facilitate precise execution of the preoperative plan, to attain optimal positioning of the prosthetic components to avoid impingement. Medial reaming can be minimized preserving native bone stock, which can enable restoration of femoral, acetabular, and combined offsets. In addition, it is associated with greater accuracy in leg length adjustment, a critical factor in patients' postoperative satisfaction. Despite the higher costs and radiation exposure, which currently limits its widespread adoption, it offers many benefits, and the increasing interest in robotic surgery has facilitated its integration into routine practice. Conducting additional research on ultra-low-dose CT scans and examining the potential for translation of 3D imaging into improved clinical outcomes will be necessary to warrant its expanded application.
Language	English
Publishing date	2024-02-29
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	3016993-8
ISSN	2287-3279 ; 2287-3260
ISSN (online)	2287-3279
ISSN	2287-3260
DOI	10.5371/hp.2024.36.1.26
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Article ; Online: Basics must improve to reduce the burden of hamstring muscle injuries.

Haddad, Fares S / Paton, Bruce M / Plastow, Ricci / Wilson, Mathew G

British journal of sports medicine

2023 Volume 57, Issue 5, Page(s) 252–253

MeSH term(s)	Humans ; Hamstring Muscles/injuries ; Tendons ; Leg Injuries
Language	English
Publishing date	2023-02-09
Publishing country	England
Document type	Editorial
ZDB-ID	600592-5
ISSN	1473-0480 ; 0306-3674
ISSN (online)	1473-0480
ISSN	0306-3674
DOI	10.1136/bjsports-2021-105387
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Article ; Online: Anterior cruciate ligament injuries in female athletes.

Mancino, Fabio / Gabr, Ayman / Plastow, Ricci / Haddad, Fares S

The bone & joint journal

2023 Volume 105-B, Issue 10, Page(s) 1033–1037

Abstract: The anterior cruciate ligament (ACL) is frequently injured in elite athletes, with females up to eight times more likely to suffer an ACL tear than males. Biomechanical and hormonal factors have been thoroughly investigated; however, there remain unknown ...

Abstract	The anterior cruciate ligament (ACL) is frequently injured in elite athletes, with females up to eight times more likely to suffer an ACL tear than males. Biomechanical and hormonal factors have been thoroughly investigated; however, there remain unknown factors that need investigation. The mechanism of injury differs between males and females, and anatomical differences contribute significantly to the increased risk in females. Hormonal factors, both endogenous and exogenous, play a role in ACL laxity and may modify the risk of injury. However, data are still limited, and research involving oral contraceptives is potentially associated with methodological and ethical problems. Such characteristics can also influence the outcome after ACL reconstruction, with higher failure rates in females linked to a smaller diameter of the graft, especially in athletes aged < 21 years. The addition of a lateral extra-articular tenodesis can improve the outcomes after ACL reconstruction and reduce the risk of failure, and it should be routinely considered in young elite athletes. Sex-specific environmental differences can also contribute to the increased risk of injury, with more limited access to and availablility of advanced training facilities for female athletes. In addition, football kits are designed for male players, and increased attention should be focused on improving the quality of pitches, as female leagues usually play the day after male leagues. The kit, including boots, the length of studs, and the footballs themselves, should be tailored to the needs and body shapes of female athletes. Specific physiotherapy programmes and training protocols have yielded remarkable results in reducing the risk of injury, and these should be extended to school-age athletes. Finally, psychological factors should not be overlooked, with females' greater fear of re-injury and lack of confidence in their knee compromising their return to sport after ACL injury. Both intrinsic and extrinsic factors should be recognized and addressed to optimize the training programmes which are designed to prevent injury, and improve our understanding of these injuries.
MeSH term(s)	Humans ; Male ; Female ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Injuries/complications ; Return to Sport ; Anterior Cruciate Ligament/surgery ; Knee Joint ; Athletes
Language	English
Publishing date	2023-10-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B10.BJJ-2023-0881.R1
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Article ; Online: Quadriceps injuries.

Plastow, Ricci / Raj, Rhody D / Fontalis, Andreas / Haddad, Fares S

The bone & joint journal

2023 Volume 105-B, Issue 12, Page(s) 1244–1251

Abstract: Injuries to the quadriceps muscle group are common in athletes performing high-speed running and kicking sports. The complex anatomy of the rectus femoris puts it at greatest risk of injury. There is variability in prognosis in the literature, with ... ...

Abstract	Injuries to the quadriceps muscle group are common in athletes performing high-speed running and kicking sports. The complex anatomy of the rectus femoris puts it at greatest risk of injury. There is variability in prognosis in the literature, with reinjury rates as high as 67% in the severe graded proximal tear. Studies have highlighted that athletes can reinjure after nonoperative management, and some benefit may be derived from surgical repair to restore function and return to sport (RTS). This injury is potentially career-threatening in the elite-level athlete, and we aim to highlight the key recent literature on interventions to restore strength and function to allow early RTS while reducing the risk of injury recurrence. This article reviews the optimal diagnostic strategies and classification of quadriceps injuries. We highlight the unique anatomy of each injury on MRI and the outcomes of both nonoperative and operative treatment, providing an evidence-based management framework for athletes.
MeSH term(s)	Humans ; Athletic Injuries/diagnosis ; Athletic Injuries/surgery ; Quadriceps Muscle/surgery ; Prognosis ; Anterior Cruciate Ligament Injuries/surgery ; Return to Sport ; Athletes
Language	English
Publishing date	2023-12-01
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.105B12.BJJ-2023-0399.R1
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Article ; Online: Is it time to revisit cementless total knee arthroplasty?

Haddad, Fares S / Plastow, Ricci

The bone & joint journal

2020 Volume 102-B, Issue 8, Page(s) 965–966

MeSH term(s)	Arthroplasty, Replacement, Knee ; Humans ; Knee Prosthesis ; Osteoarthritis, Knee/surgery
Language	English
Publishing date	2020-08-26
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.102B8.BJJ-2020-0962
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Article ; Online: Factors associated with decreased length of stay following robotic arm-assisted and conventional total hip arthroplasty.

Fontalis, Andreas / Wignadasan, Warran / Mancino, Fabio / The, Crystallynn S / Magan, Ahmed / Plastow, Ricci / Haddad, Fares S

The bone & joint journal

2024 Volume 106-B, Issue 3 Supple A, Page(s) 24–30

Abstract: Aims: Postoperative length of stay (LOS) and discharge dispositions following arthroplasty can be used as surrogate measurements for improvements in patients' pathways and costs. With the increasing use of robotic technology in arthroplasty, it is ... ...

Abstract	Aims: Postoperative length of stay (LOS) and discharge dispositions following arthroplasty can be used as surrogate measurements for improvements in patients' pathways and costs. With the increasing use of robotic technology in arthroplasty, it is important to assess its impact on LOS. The aim of this study was to identify factors associated with decreased LOS following robotic arm-assisted total hip arthroplasty (RO THA) compared with the conventional technique (CO THA). Methods: This large-scale, single-institution study included 1,607 patients of any age who underwent 1,732 primary THAs for any indication between May 2019 and January 2023. The data which were collected included the demographics of the patients, LOS, type of anaesthetic, the need for treatment in a post-anaesthesia care unit (PACU), readmission within 30 days, and discharge disposition. Univariate and multivariate logistic regression models were used to identify factors and the characteristics of patients which were associated with delayed discharge. Results: The multivariate model identified that age, female sex, admission into a PACU, American Society of Anesthesiologists grade > II, and CO THA were associated with a significantly higher risk of a LOS of > two days. The median LOS was 54 hours (interquartile range (IQR) 34 to 78) in the RO THA group compared with 60 hours (IQR 51 to 100) in the CO THA group (p < 0.001). The discharge dispositions were comparable between the two groups. A higher proportion of patients undergoing CO THA required PACU admission postoperatively, although without reaching statistical significance (7.2% vs 5.2%, p = 0.238). Conclusion: We found that among other baseline characteristics and comorbidities, RO THA was associated with a significantly shorter LOS, with no difference in discharge destination. With the increasing demand for THA, these findings suggest that robotic assistance in THA could reduce costs. However, randomized controlled trials are required to investigate the cost-effectiveness of this technology.
MeSH term(s)	Humans ; Female ; Infant, Newborn ; Arthroplasty, Replacement, Hip/methods ; Length of Stay ; Robotic Surgical Procedures ; Costs and Cost Analysis ; Comorbidity
Language	English
Publishing date	2024-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2697156-2
ISSN	2049-4408 ; 2049-4394
ISSN (online)	2049-4408
ISSN	2049-4394
DOI	10.1302/0301-620X.106B3.BJJ-2023-0569.R2
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Article: Short term outcomes following robotic arm-assisted lateral unicompartmental knee arthroplasty.

Wignadasan, Warran / Chang, Justin / Fontalis, Andreas / Plastow, Ricci / Haddad, Fares S

Frontiers in surgery

2023 Volume 10, Page(s) 1215280

Abstract: Introduction: Robotic-arm assisted medial unicompartmental knee arthroplasty (RA-UKA) is associated with improved accuracy of implant positioning and excellent early functional outcomes. However, there is paucity of evidence regarding outcomes following ...

Abstract	Introduction: Robotic-arm assisted medial unicompartmental knee arthroplasty (RA-UKA) is associated with improved accuracy of implant positioning and excellent early functional outcomes. However, there is paucity of evidence regarding outcomes following RA-UKA for isolated lateral compartment osteoarthritis. The purpose of this study was to assess the short-term clinical and patient reported outcomes of lateral compartment UKA, utilising robotic-arm assistance. Methods: This was a retrospective study of prospectively collected data of 21 consecutive patients who underwent lateral RA-UKA. The study included 9 (42.9%) males and 12 (57.1%) females with a mean age of 63.4 ± 9.2 years. The Oxford Knee Score (OKS) was measured pre-operatively and at 1-year post-operatively, while range of motion (ROM) and complications were also recorded. Results: There was significant improvement of OKS at 1 year's follow up compared with the baseline score (21.8 ± 5.6 vs. 45.2 ± 2.8 respectively; Conclusion: In our study, lateral RA-UKA resulted in significant improvements in clinical and patient reported outcomes with low complications rates. Further long-term comparative studies are needed to assess the utility of lateral RA-UKA vs. conventional UKA.
Language	English
Publishing date	2023-12-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1215280
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Article ; Online: Troubleshooting Robotics During Total Hip and Knee Arthroplasty.

Fontalis, Andreas / Hansjee, Shanil / Giebaly, Dia Eldean / Mancino, Fabio / Plastow, Ricci / Haddad, Fares S

The Orthopedic clinics of North America

2023 Volume 55, Issue 1, Page(s) 33–48

Abstract: The introduction of new surgical technology highlights appreciable concerns; robotic arthroplasty is no exception. Acquiring comprehensive understanding of the robotic technology to avoid complications during surgery and devising troubleshooting ... ...

Abstract	The introduction of new surgical technology highlights appreciable concerns; robotic arthroplasty is no exception. Acquiring comprehensive understanding of the robotic technology to avoid complications during surgery and devising troubleshooting strategies to overcome potential difficulties is of paramount importance. Troubleshooting algorithms depend on the stage of the procedure and problem encountered, such as loosening of the pins or array, registration or verification problems, or malfunctioning of the device, which is rare. This article aims to outline reproducible workflows and solutions for troubleshooting during robotic-arm assisted total hip arthroplasty and total knee arthroplasty.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee/methods ; Robotic Surgical Procedures/methods ; Arthroplasty, Replacement, Hip/adverse effects ; Knee Joint/surgery
Language	English
Publishing date	2023-07-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	417389-2
ISSN	1558-1373 ; 0030-5898
ISSN (online)	1558-1373
ISSN	0030-5898
DOI	10.1016/j.ocl.2023.06.004
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