Notes

[LGI1 ENCEPHALITIS: The 1st HUNGARIAN PATIENT].
To summarise the literature on 3rd-condyle total knee arthroplasty (TKA) designs and compare their survival rates to those of post-cam TKA designs. The null hypothesis was that 3rd-condyle TKAs would have equivalent survival rates compared to contemporary post-cam TKAs.

An electronic literature search for Level I-V studies was independently conducted by two researchers using Medline
and Web of Science for studies published between January 1984 and October 2020 that specifically reported on rates of implant survival and complications, joint kinematics, clinical outcomes, and radiographic outcomes of 3rd-condyle TKA. The methodological quality of clinical studies was assessed according to the Downs and Black Quality Checklist for Health Care Intervention Studies, and for in vitro and in silico studies according to the Joanna Briggs Institute (JBI) tool for assessing analytical cross-sectional studies. Findings extracted for each TKA design were presented as reported and synthesised narratively. Survival rates at 5, 10 and > 10years of 3rd-condyle TKA designs were graphically compared to rates of post-cam TKA designs published in joint registries.

A total of 38 studies were identified that reported on kinematics, clinical outcomes, radiographic alignment, and rates of complications and survival. Mean survival rates ranged from 96 to 98% at 5years, 78-100% at 5-10years, and 86-99% at > 10years for 3rd-condyle PS TKAs. Mean survival rates ranged from 93 to 98% at 5years, 89-99% at 5-10years, and 88-95% at > 10years for post-cam PS TKAs.

Implant survival rates of 3rd-condyle TKAs are comparable to those of post-cam TKAs at follow-up > 10years. When compared to post-cam PS TKA, 3rd-condyle designs offer an alternative for younger and more active patients when considering the added benefits of a lowered point-of-contact and larger congruent contact area at the intercondylar tibial sulcus, that reduce risks of loosening and component wear.

V.
V.
To compare the clinical results of meniscal allograft transplantation (MAT) between patients with discoid lateral meniscus (DLM) and non-DLM (NDLM) and to analyse whether anatomical deformities cause worse clinical results in DLM patients.

Patients who underwent unilateral MAT from 2005 to 2017, including 115 patients with DLMs or NDLMs, were included in this study. Clinical outcomes [International Knee Documentation Committee (IKDC) scores, Lysholm scores, Tegner scores, and visual analogue scale (VAS) scores] and radiographic and MRI data were assessed. Clinical outcomes and anatomical knee variables were analysed by multivariate stepwise regression.

After more than 2years of follow-up, 9 patients were lost to follow-up, and 59 patients with DLM and 47 patients with NDLM were included. The mean postoperative results were significantly better than the preoperative data (P < 0.05) in both the DLM and NDLM groups. Belinostat In addition, postoperative IKDC, Lysholm, and VAS scores but not Tegner scores were better in the NDLM group than in the DLM group. Several anatomical knee variables differed significantly between the NDLM and DLM groups and were associated with MAT outcomes. The condylar prominence ratio of the lateral and medial femoral condyles adjacent to the intercondylar notch and squaring of the lateral femoral condyle (the distance of the straight articular condylar surface) were independent factors significantly correlated with the Lysholm scores for MAT at last follow-up.

MAT improved knee function in both patients with DLM and patients with NDLM, but patients NDLM had better clinical outcomes than patients with DLM. The condylar prominence ratio and squaring of the lateral femoral condyle may underlie this result.

III.
III.
To assess whether the neuromuscular activation pattern following Achilles tendon rupture and repair may contributes to the observable functional deficits in this severe and increasingly frequent injury.

In this study, the neuromuscular activation using surface EMG of n = 52 patients was assessed during a battery of functional performance tasks to assess potential alterations of muscular activation and recruitment. We analyzed the injured legvs. the contralateral healthy leg at a mean of 3.5years following open surgical repair. The testing battery included isokinetic strength testing, bipedal and single-legged heel-rise testing as well as gait analysis.

During isokinetic testing, we observed a higher activation integral for all triceps surae muscles of the injured sideduring active dorsiflexion, e.g., eccentric loading on the injured leg, while concentric plantarflexion showed no significant difference. Dynamic heel-rise testing showed a higher activation in concentric and eccentric loading for all posterior muscles on the injured side(not significant); while static heel-rise for 10sec. revealed a significantly higher activation. Further analysis of frequency of fast Fourier-transformed EMG revealed a significantly higher median frequency in the injured leg. Gait analysis revealed a higher pre-activation of the tibialis anterior before ground contact, while medial and lateral gastrocnemius muscles of the injured legshowed a significantly higher activation during push-off phase.

The results of this study provide evidence on the neuromuscular changes 3.5years following open surgical Achilles tendon repair. These complex neuromuscular changes are manifested to produce the maximum force output whilst protecting the previously injured tendon. The observed alterations may be related to an increased recruitment of type II muscle fibers which couldmake the muscles prone to fatigue.

III.
III.
To evaluate the role and possible complications of tumor resection in the management of glioblastoma (GBM) in a series of patients 80 years of age and older with review of literature.

The authors retrospectively analyzed cases involving patients 80 years or older who underwent biopsy or initial resection of GBM at their hospital between 2007 and 2018. A total of 117 patients (mean age 82 years) met the inclusion criteria; 57 had resection (group A) and 60 had biopsy (group B). Functional outcomes and survival at follow-up were analyzed.

Group A differed significantly from group B at baseline in having better WHO performance status, better ASA scores, more right-sided tumors, and no basal ganglia or "butterfly" gliomas. Nevertheless, 56% of group A patients had an ASA score of 3. Median survival was 9.5 months (95% CI 8-17 months) in group A, 4 months (95% CI 3.5-6 months) in group B, and 17.5 months (95% CI 12-24 months) in the 56% of group A patients treated with resection and Stupp protocol. Rates of postoperative neurologic and medical complications were almost identical in the 2 groups, but the rate of surgical site complications was substantially greater in group A (12% vs 5%).
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