Fallow deer bone beds in Tabun Cave Layer B: Insights from renewed fieldwork

Tetrapods invaded oceanic environments after the cataclysmic end-Permian mass extinction (EPME), with temnospondyl amphibian to reptile-dominated assemblages succeeding across the Early Triassic [~251.9 to 247.2 million years ago (Ma)]. However, conflicting fossil occurrences, divergence estimates, and stratigraphic time averaging make the tempo of this landmark evolutionary transition uncertain. In this work, we describe an oceanic tetrapod ecosystem from a condensed mid-Early Triassic (early Spathian, ~249 Ma) bone bed on the arctic island of Spitsbergen. Apex predator ichthyosaurians, small-bodied ichthyopterygians, durophagous ichthyosauriforms, semiaquatic archosauromorphs, euryhaline temnospondyls, coelacanths, lungfish, ray-finned fish, and sharks formed an unexpectedly complex trophic network. Comparative diversity analyses further show that heterogeneous marine vertebrate communities were well established by the late-earliest Triassic (Dienerian-Smithian, ~251 Ma) and integrated fully variegate tetrapod niches by ~3 million years after the EPME.

Background: The Siwalik Group of the Himalayan foreland basin preserves a rich record of Late Miocene mammalian evolution, with the Dhok Pathan Formation yielding abundant boselaphine bovids. Deciduous premolars, particularly DP3, are rarely documented in these taxa, limiting understanding of juvenile morphology and taxonomic variability. Objective: To describe and diagnose a rare isolated left DP3 from the Bhandar Bone Bed (Dhok Pathan Formation) and compare it metrically and morphologically to published material for taxonomic assignment. Methods: The specimen was surface-collected, mechanically and chemically cleaned, catalogued as USKT-PC 100923, measured using a digital Vernier caliper, and photographed in standardized views. Qualitative description focused on preservation, enamel texture, cusp development, styles, ribs, median valley, fossettes, and cingulum. Quantitative comparison used length, width, and published DP3 measurements. Results: USKT-PC 100923 is an unworn left DP3 (length 18.60 mm, width 12.00 mm) with shiny smooth enamel, prominent cusps, well-developed labial styles and ribs, deep fossettes, shallow median valley, and anterior cingulum. Metrics fall within the range of published Tragoportax DP3 specimens. Conclusion: The specimen is assigned to Tragoportax punjabicus (Pilgrim, 1910), representing a rare documentation of deciduous dentition that enhances morphological data for Siwalik boselaphines

Abstract The chondrichthyan fauna of the Late Triassic Rhaetian is fairly diverse and has been well-studied in France and the United Kingdom. Conversely, contemporaneous faunas from Germany only were sporadically analyzed. Here, we present a taxonomic and palaeoecological evaluation of a cartilaginous fish assemblage from Bonenburg in NW Germany, which is represented by isolated teeth as well as cephalic and dorsal fin spines. This material includes the first holocephalan record as well as several morphotypes of dorsal fin and cephalic spines. Based on the material from Bonenburg, Rhomphaiodon minor is synonymized with Nemacanthus monilifer and assigned to the Palaeospinacidae. The Bonenburg bone beds differ from other localities across the Rhaetian Sea as Nemacanthus monilifer is present in unprecedented numbers and Lissodus minimus , typically the most common shark species in Rhaetian deposits, is a distant second in abundance. This, as well as other comparative measurements of Rhaetian shark diversity, reveal that neoselachians were a larger component of Rhaetian ecosystems than previously assumed. A food web reconstruction with a focus on the chondrichthyan and actinopterygian taxa present at the locality shows a general partitioning of niches among the chondrichthyans of Bonenburg, and that chondrichthyans inhabited all but the lowest and highest positions in the trophic chain, revealing that they were an important and ecologically diverse part of their ecosystem.

The objective of this research was to biomechanically assess the osseointegration of implants placed in bone sites prepared with diameters smaller than, larger than, or equal to the implant diameter. Twenty–one 6–month–old female Sprague Dawley rats weighing between 250–300 g were used in the study. The rats were divided into three groups and titanium implants, 2.5 mm diameter and 4 mm lenght, were placed in the cortico–cancellous bone structure in the metaphyseal parts of the right tibia bones of all rats included in the study. The study groups were; the group in which a bone bed of 2.2 mm in diameter and 4 mm in length was prepared and the implants were placed very tightly (n=7), the group in which a bone bed of 2.8 mm in diameter and 4 mm in length was prepared and the implants were placed loosely (n=7), and the control group in which a bone bed of 2.5 mm in diameter and 4 mm in length was prepared and the implants were placed. The rats were sacrificed 15 days after the operation. The implants were then subjected to torque analysis to measure biomechanical osseointegration values. Data were analyzed using One–Way Anova and Tukey HSD tests. Statistical significance was accepted as P<0.05. Biomechanical osseointegration values (N·cm-1) of overly tightly placed implants (12.86 ± 3.09) and implants in the control group (12.56 ± 3.58) were found to be significantly higher than those of loosely placed implants (6.56 ± 1.43) (P<0.05). Although the biomechanical osseointegration values of overly tightly placed implants those of implants in the control group were numerically higher, no statistically significant difference was found (P>0.05). As a result of the study, it was determined that tightly implant placement increased biomechanical osseointegration values. Additionally, osseointegration can be achieved without initial placement tightness too.

ABSTRACT Before 2023, excavations at the La Prele site identified three hearth-centered areas associated with mammoth remains. In 2022 and 2023, more than 150 augers across the site suggested the presence of a bone bed and a fourth activity area with the potential for dense archaeological deposits. Here we report preliminary results comparing the expected versus actual artifact densities to evaluate the use of auger surveys for identifying artifact clusters in deep deposits on known sites.

Medial Meniscal Posterior Root Repairs Performed With Modified Mason-Allen Locking Stitches Are Associated With Intact but Lax Repairs in a High Proportion of Second-Look Arthroscopy Cases.

The long-term success of total hip arthroplasty (THA) is dependent on support from the periprosthetic bone bed. We present a randomised study using 18F-fluoride Positron Emission Tomography/Computerised Tomography (F-PET/CT) to analyse bone metabolism in periprosthetic bone adjacent to femoral stems following THA surgery. To compare bone metabolism to cemented Exeter and uncemented SP-CL stems, patients with hip osteoarthritis were randomly assigned for THA with either cemented or uncemented femoral components. The results were analysed with F-PET/CT. In 28 patients (28 cases) with hip osteoarthritis, a THA was performed. The patients received either an uncemented or a cemented femoral stem. The contralateral healthy femur was used as reference for normal bone metabolism. Patients' clinical scores, radiography and F-PET/CT were analysed at 4, 16 and 36 weeks postoperatively. PET results were analysed and presented in 13 regions of interest (ROI) adjacent to the whole stem-bone interface. Clinical results were good in all patients, and no major complications were recorded. At radiography, all stems were stable. PET analyses after 4 weeks showed that bone mineralising activity was significantly higher around the SP-CL stems, both compared to the Exeter group and to the contralateral healthy reference femur group. The SP-CL also had prolonged raised activity compared to the Exeter group. A detailed analysis of bone formation patterns on the implant surface shows that early healing is associated with higher mineral deposition using the uncemented SP-CL stem. The study was registered at ClinicalTrials.gov (identifier NCT02320682).

Currently, due to the high frequency of dental implantation and targeted bone regeneration of periodontal tissues worldwide, it is particularly important to improve methods for restoring the original volume of alveolar bone tissue. To achieve this goal, various surgical procedures are used, which result in the formation of bone volume necessary to create a complete bone bed for both the tooth and the implant. The review aims to analyze the literature data on the use of barrier membranes in implantology and targeted periodontal tissue regeneration with special emphasis on their chemical structure, as well as to identify their main disadvantages and advantages. As a result of the search, 245 publications were extracted from the PubMed/MEDLINE, Google Scholar and eLibrary databases.EN, after the selection procedure, 30 articles were included in the review. The main task of targeted periodontal tissue regeneration in recent years has been to create a unique type of barrier materials that would be maximally biocompatible and combine the properties of non-absorbable (non-absorbable) and resorbable (absorbable) membranes. Alternatively, polylactide and polyglycolide can act as promising materials for this type of membrane.

Background: The Middle Siwaliks of northern Pakistan preserve one of the most important Late Miocene terrestrial mammal records in Asia, with Bovidae—especially boselaphines—forming a dominant component of Dhok Pathan faunas. Deciduous dentition is rarely recovered and remains under-described despite its taxonomic value. Objective: To describe and diagnose a rare isolated deciduous premolar (DP3) attributed to Tragoportax punjabicus from the Bhandar Bone Bed (Dhok Pathan Formation, Jhelum, Pakistan) and evaluate its systematic significance through comparative morphology and morphometrics. Methods: The specimen (USKT-PC 100923) was collected by surface prospecting, mechanically and chemically cleaned, photographed in standardized views, and measured using digital calipers. Qualitative dental characters and quantitative dimensions were compared with published DP3 datasets and systematic accounts of Siwalik boselaphines. Results: USKT-PC 100923 is a well-preserved left DP3 with smooth to mildly rugose enamel, prominent labial styles and ribs, shallow median valley, deep anterior and posterior fossettes, and an anterior shelf-like cingulum. Measurements (L 18.60 mm; W 12.00 mm; W/L 0.65) align with published Tragoportax DP3 values and support referral to T. punjabicus. Conclusion: This DP3 represents a rare juvenile dental record of T. punjabicus from the Bhandar Bone Bed, refining the Siwalik boselaphine dataset and highlighting the systematic value of deciduous dentition for taxonomic reassessment.

Objectives:Osteochondritis dissecans (OCD) is a pathologic condition in which a portion of subchondral bone and possibly surrounding articular cartilage become either partially or totally separated from the surrounding bone bed due to lack of blood supply, and this injury is distinct from focal articular cartilage defects. OCD lesions occur most commonly on convex weight-bearing joint surfaces, such as on the femoral head or femoral condyle, where convexity leads to greater axial contact loads at the articular surface and likely predisposes the joint to microvascular trauma. Non-weight-bearing convex joint surfaces such as the humeral head and capitellum, when subjected to repetitive microtrauma, have also been described to occasionally sustain OCD lesions. All such reports contain a patient clinical history of either an acute traumatic event or repetitive activities such as overhead throwing or gymnastics. However, OCD of the glenoid is especially rare, and the clinical presentation, surgical treatment, and outcomes are not well-understood. The purpose of our current study was to synthesize and describe clinical presentation, treatment, and patient-reported outcomes within a cohort of glenoid OCD lesions identified amongst baseball athletes treated at a single institution over a 26-year span.Methods:Over a 26-year period at our institution, we retrospectively identified shoulder arthroscopies performed by 3 surgeons within athletes. We reviewed radiographs, contrast-enhanced magnetic resonance imaging (MRI; Figure 1), and arthroscopic images (Figure 2) to identify those with glenoid OCD lesions. Intraoperatively, the glenoid OCD was identified and excised, fragmented or loose bodies were removed, and a burr was used to debride the bony bed to a bleeding surface, followed by microfracture of the lesion (Figure 2), along with surgical treatment of concomitant shoulder pathology as appropriate. All athletes underwent standardized rehabilitation, beginning with range of motion and strengthening immediately postoperatively. We collected data from the electronic health record including patient demographics, clinical presentation, sport-related information, imaging findings, surgical details, and concomitant procedures. We evaluated patient-reported outcomes at a minimum of 1 year post-operatively using the Athletic Shoulder Outcome Scoring System (ASOSS), the Short Form-36 (SF-36) health survey, and a series of questions regarding return to preinjury sport. We calculated summary statistics (means and standard deviations for continuous variables; counts/proportions for categorical variables) for demographic, clinical, surgical, and outcomes data.Results:From a total of 3,940 potential shoulder arthroscopies, we identified 19 (~0.5%) diagnosed cases of glenoid OCD, with a mean age of 22.7 years at surgery. All 19 patients were baseball players, including 14 pitchers, 1 outfielder, 1 second baseman, 1 third baseman, 1 shortstop, and 1 catcher. Regarding clinical presentation, the most common complaint was posterior shoulder pain (13 patients) and decreased performance and/or pitching velocity. Additionally, 17 of 19 patients had a gradual onset of pain, with no antecedent traumatic event, with an average of 18 months of pain (range, 2-36 months) prior to evaluation. Imaging review revealed cystic subchondral changes in 14 of the 19 patients, indicating underlying necrosis of the glenoid consistent with OCD (Figure 1). Isolated OCD lesions were identified in 7 patients, whereas 12 had concomitant shoulder pathology (Table 1). Specific concomitant procedures performed included partial rotator cuff tear debridement (n=7), superior labral repair (n=2), posterior labral repair (n=1), subacromial bursectomy (n=1), or debridement of thrower’s exostosis (n=1). Following surgery, 9 patients were ready to begin an interval throwing program 6 weeks post-operatively; 7 of these patients had isolated OCD lesions and the other 2 had subacromial bursectomy or debridement of thrower’s exostosis. The remaining 10 patients who underwent concomitant procedures during shoulder arthroscopy progressed through rehabilitation programs as indicated and began interval throwing programs between 12 and 20 weeks postoperatively. All 19 (100%) were successfully-contacted for follow-up data collection, at an average of 32 months (range 16-124 months) after surgery. The average ASOSS score was 78 (out of 100). When stratified by concomitant surgery/pathology, the 9 patients with isolated OCD lesions had an average ASOSS score of 85, and the 10 patients with concomitant pathology had an average ASOSS score of 73. For the SF-36 (all subscales scored out of 100), the average social function score was 93, the average pain score was 75, and the average general health score was 83. Fifteen of the 19 (79%) athletes were able to return to the same or higher level of competition postoperatively (Table 1). Conclusions:To our knowledge, this study represents the largest case series of rare OCD lesions of the glenoid fossa in baseball athletes. We found that arthroscopic debridement of glenoid OCD with microfracture of subchondral bone yields good outcomes and a high level of return-to-sport in a group of high-level throwing athletes, especially in athletes with isolated OCD lesions.

Osteoporosis compromises bone quality and impairs implant osseointegration. Since an adequate bone bed is essential for implant stability and success, this study evaluated the effects of implant surface functionalization with zoledronic acid (ZOL), alone or combined with ruterpy (TERPY), on peri-implant bone healing in healthy (SHAM) and osteoporotic (OVX) rats. ZOL has antiresorptive properties, while TERPY exhibits osteoinductive potential. The hypothesis was that ZOL + TERPY would act synergistically by inhibiting bone resorption and promoting new bone formation. Sixty-six female Wistar rats (3 months old) were divided into six groups (n = 11) according to systemic condition (SHAM or OVX) and implant type: conventional (CONV), ZOL, or ZOL + TERPY. Surgeries (sham or bilateral ovariectomy) were performed on day 0, and implants were placed in the tibial metaphysis on day 90. Fluorochromes were administered on days 104 (calcein) and 114 (alizarin), and euthanasia was performed on day 118. Samples were analyzed histologically via confocal microscopy and micro-computed tomography (Micro-CT). The ZOL + TERPY groups demonstrated significantly accelerated peri-implant bone repair, showing greater bone formation and organization; improved BV/TV, Tb.N, and I.S.; and reduced Tb.Sp and Po.Tot compared to CONV and ZOL-alone groups. In conclusion, ZOL + TERPY enhances and speeds bone healing, even under osteoporotic conditions.

A new dinosaur assemblage from the Lower Jurassic at Wande Town, Wuding County, Yunnan Province, China is discovered recently. Here a new sauropodomorph from this site, Wudingloong wui gen. et sp. nov., is described on the basis of a partial skeleton. Wudingloong is different from other non-sauropodiform sauropodomorphs particularly in having an ascending ramus of the maxilla excavated by triangular antorbital fossa, distinct ventral keel on the middle cervical centra, a slender humerus with a flat and low humeral head, a gracile metacarpal V with the proximal end as wide as the distal end, and a large and robust ungual of manual digit I. Wudingloong was excavated from the lowest Lower Jurassic Yubacun Formation, which is the lowest dinosaur bone bed in East Asia. Both the phylogenetic analysis and stratigraphic horizon indicate that Wudingloong represents the earliest-diverging and stratigraphically oldest sauropodomorph dinosaur discovered in East Asia so far. The discovery of this new taxon provides further evidence that the southwestern China sauropodomorph assemblage is one of the most taxonomically diverse and morphologically disparate in the pre-Toarcian Early Jurassic worldwide, represented by various taxa from near the base of the Massopoda to non-sauropodan sauropodiforms.

Temporally constrained microvertebrate bone beds are powerful tools for understanding continent-scale biotic change. Such sites are rare globally in nonmarine settings during the 12 million years (Ma) preceding the end-Triassic extinction (ETE; ~201.5 Ma), obscuring patterns of faunal change across this interval. A vertebrate assemblage from Arizona, USA, provides unique insights into community composition and ecology prior to the ETE. PFV 393 is a macro- and microvertebrate bone bed preserved in a volcaniclastic fluvial channel-fill with a high-precision U-Pb zircon age of 209.187 ± 0.083 Ma. The fossil assemblage consists of three-dimensionally preserved, delicate, and small skeletal elements of known and new taxa that document a local paleocommunity including hybodontiformes, actinopterygians, actinistians, metoposaurids, salientians, synapsids, lepidosaurs, testudinatans, trilophosaurids, Vancleavea, doswelliids, Revueltosaurus, loricatans, phytosaurs, and pterosaurs. The new early-diverging pterosaur is one of the few Triassic pterosaurs found outside of Europe and the only one with a documented precise radioisotopic age. The testudinatan material shows the rapid dispersal of terrestrial stem-turtles across the Pangaean supercontinent in the Norian and refines temporal constraints on the origin of the turtle shell. The presence of vertebrate lineages endemic to the Triassic highlights their persistence in a mesic, fluvial paleocommunity through a prolonged phase of environmental change preceding the ETE. These lineages coexisted with frogs, lepidosaurs, turtles, and pterosaurs- all key elements of post-Triassic Mesozoic communities. The arrival of turtles and pterosaurs in west-central Pangaea therefore may have been driven by the northward drift of Laurentia from humid equatorial conditions into more arid subtropical latitudes.

BackgroundOne of the notable challenges in implant dentistry is the inadequacy of bone dimensions. While guided bone regeneration remains the standard approach for horizontal bone reconstruction, emerging new approaches such as the shell technique offer the potential for significant bone gain through effective space creation. This article presents a modified shell technique as a promising and practitioner-friendly solution for managing horizontal bone deficiencies before and during implant placement. This article aims to introduce a simplified and minimally invasive approach that enhances space maintenance and surgical management and allows for extraoral screw fixation to the disc with just a single screw.MethodologyThis study included six patients with horizontal bone defects that made them candidates for bone augmentation procedures. We employed a newly modified shell technique utilizing a single-screw cortical disc. The cortical discs were fabricated from cortical plates using a trephine drill and Cortico-Cage device. A titanium screw was secured extraorally to the cortical disc. The assembly of the screw and disc was anchored bi-cortically in the appropriate position, and the gap between the cortical disc and the underlying bone bed was filled with a combination of autogenous chips and allograft material. This simplified shell technique is designed to facilitate bone augmentation in areas with horizontal bone deficiencies.ResultsCone-beam computed tomography assessments performed five months postoperatively in five cases demonstrated that the increase in bone width at the crestal area, specifically at the site of cortical discs, ranged from a minimum of 2.03 mm to a maximum of 5.76 mm. Moreover, the initial bone width before reconstruction in the evaluated cases ranged from a minimum of 1.74 mm to a maximum of 4.40 mm. Radiographs before and after the procedure indicated a noteworthy bone formation.ConclusionsThe findings suggest that employing a single screw to secure the cortical disc while connecting it to the disc outside of the patient’s oral cavity can facilitate the surgical process and enhance patient comfort.

Effect of Er:YAG laser bone bed milling, with or without photobiomodulation, on the bone repair process of additive manufacturing implants in rats

The evolution of treatments for edentulous ridges in Implantology is driven by the pursuit of suitable solutions aimed at improving patients' quality of life. Scholars have built on this premise to develop the All-on-Four technique, a gold-standard method for complete arch rehabilitation using only four implants to support a fixed prosthesis. This work explores the application of this technique in the mandible, examining the surgical procedures, clinical outcomes, and possible complications associated with the aforementioned technique. This review discusses the theoretical principles and indications for the All-on-Four technique, emphasizing its suitability for patients with total tooth loss and atrophic bone structures. The technique involves maximizing bone utilization so that prosthetic rehabilitation adheres to the biomechanical principle of the “Roy's Polygon.” The patient in question was carefully evaluated, considering her main complaint and clinical conditions. Therefore, this clinical case report details the surgical protocol, implant selection, planning, and execution of the procedure. The work presents the diagnostic criteria of three- dimensional images (computed tomography) for case planning, and the stages of the surgical procedure, from bone bed preparation to implant insertion and the fixation of a temporary prosthesis.

There are several techniques to increase keratinized tissue, and free gingival grafting (FGG) is one of the most predictable methods. One of the main disadvantages of this method is the significant tissue shrinkage of the graft, so it is desirable to find a method that is associated with less shrinkage. The purpose of the present study was to compare graft shrinkage rates and postoperative pain intensity following FGG augmentation on periosteal beds and denuded alveolar bone. A total of 22 FGGs with a thickness of 1 to 1.5mm were placed in the area between the mandibular premolars. The recipient site for FGG was a periosteal bed in the control group and denuded alveolar bone in the experimental group. Dimensions of the grafts were recorded clinically by a periodontal probe as well as taking photographs, and the pain intensity was assessed with VAS scale, 1, 2, 4 and 8 weeks after surgery. The percentage of tissue shrinkage was calculated, and the two groups were compared. A total of 22 patients (7 males and 15 females) completed the study and of these, 10 patients were in the experimental group (denuded bone bed), and 12 patients were in the control group (periosteal bed). At all times, the percentage of shrinkage in length, width and area in the control group (periosteum) was higher than the test group (bone). The highest percentage of shrinkage in all 3 parameters occurred in the control group related to the time between baseline and 1st week. In the experimental group, the highest percentage of length changes occurred between baseline and the 1st week and the highest percentage of width and area changes occurred between weeks 1 and 2. Changes in length, width and area between baseline and the first week and between baseline and week 8 were significant between the two groups. The mean pain in the control group (periosteum) was higher than the experimental group and only in the first week this difference was statistically significant. It can be concluded that epithelialized gingival graft placed on the denuded bone bed is associated with less pain and discomfort in the recipient area at one week postoperatively and was associated with less tissue shrinkage during 8 weeks of follow-up compared to FGG placement on the periosteal bed.

To investigate the effect of femoral condyle sliding osteotomy (FCSO) on the flexion gap and external rotation of the prosthesis in balancing coronal instability during initial total knee arthroplasty (TKA). Between November 2021 and October 2024, FCSO technique was applied to balance the coronal medial and lateral spaces during initial TKA in 3 patients, including medial condyle sliding osteotomy (MCSO) and lateral condyle sliding osteotomy (LCSO). There were 1 male and 2 females with the age of 81, 68, and 68 years old. The affected knee has varus or valgus deformity, with tibia-femoral angles of 169.7°, 203.3°, and 162.2°, respectively. The hip-knee-ankle angle (HKA), range of motion (ROM), knee society scoring system (KSS), and pain visual analogue scale (VAS) score were used to evaluate joint function and pain relief. Based on model bone, the thickness and bone bed area of the medial and lateral femoral condyle osteotomy blocks in FCSO were measured. During TKA in 12 patients, the range of osteotomy block movement was evaluated. By simplifying the upward and forward movement of the osteotomy block into a geometric model, the impact of movement on the flexion gap and external rotation of the prosthesis was calculated. After application of FCSO during TKA, the limb alignment and medial and lateral balance at extension and flexion positions were restored in 3 patients. Three patients were followed up 23, 11, and 3 months, respectively. Postoperative HKA, pain VAS score, KSS score, and ROM all showed significant improvement compared to preoperative levels. The maximum thickness of osteotomy blocks by MCSO and LCSO was 17 and 12 mm, respectively. The simple upward movement of the osteotomy block mainly affected the extension gap, and had little effect on the flexion gap and external rotation of the prosthesis. Moving the osteotomy block forward at the same time had a significant impact on the flexion gap and external rotation of the prosthesis, especially on LCSO. Mild forward movement leaded to a decrease in external rotation of more than 3°, which had a serious impact on the patellar trajectory. FCSO can effectively solve the problem of imbalance between the medial and lateral spaces during initial TKA, avoiding knee joint instability caused by excessive loosening and limiting the use of constrained condylar prosthesis. The distance for the downward movement of the osteotomy block in MCSO and LCSO was 3-5 mm and 6-8 mm, respectively, with 10-15 mm of space for forward movement and almost no space for backward movement. For MCSO, the upward and forward movement of the osteotomy block will increase the external rotation of the prosthesis, which is beneficial for improving the patellar trajectory and suitable for valgus knee. LCSO is suitable for varus knee, and the osteotomy block only slides vertically up and down without moving forward and backward.

The Osia 2 System is an active transcutaneous bone conduction hearing device. From 2022 to 2024, an FDA-approved, prospective, multi-center, open-label clinical trial was run through seven US-based centers. This trial sought to demonstrate the safety and efficacy of the Osia2 system in children aged 5-11 to expand indications. Fifty children aged 5-11 years (mean 7.4 years), presenting with conductive/mixed hearing loss (N = 37) or single-sided deafness (N = 13) were enrolled prospectively and followed to 12 months post-surgery. Intraoperative findings were collected via surgeon questionnaire. Safety outcomes included adverse events/complications tracked out to 12 months post-surgery. Efficacy outcomes included hearing sensitivity, speech perception in quiet and noise, hours of use, retention, and a parental questionnaire. Fifty subjects were implanted. Forty-nine subjects completed the trial through the 12-month post-implantation endpoint. Surgical bone stock was good in all subjects. Bone bed polishing was required in 36%. 34% (N = 17/50) reported a procedure and/or device-related adverse event. The majority of these were minor and expected issues postoperatively. No patients required explant. Patients experienced statistically significant improvements in word scores (CNC), speech in noise testing (BKB-SIN), and pure tone averages at 6 months post-implantation compared to the pre-surgical unaided condition. Retention scores were good at the study endpoint. Mean daily use was 9.8 +/- 3.2 h/day. The data from this trial suggest the Osia 2 system is safe and effective to use in children aged 5-11. FDA clearance for this new age indication was approved in spring 2024. This study was part of a Multi-center prospective trial, submitted to and approved by the FDA (Clinicaltrials.gov number: NCT05000931; FDA IDE number: G2000325).