Abstract Introduction Postoperative infection remains one of the most devastating complications following inflatable penile prosthesis (IPP) implantation, despite ongoing advancements in surgical techniques and device manufacturing. Infection risk is particularly elevated in revision cases, likely due to bacterial biofilm formation on previously implanted devices. XPERIENCE, a surgical irrigation solution composed of citric acid, sodium citrate, and sodium lauryl sulfate, has been developed to aid in debris and microorganism removal and to disrupt biofilms. Its use has recently expanded to various prosthetic surgeries, including revision IPP procedures, with the aim of reducing infection rates. Objective To evaluate postoperative infection rates following revision IPP surgeries utilizing XPERIENCE surgical irrigation solution at a single institution. Methods We conducted a retrospective review of revision IPP procedures performed by a single surgeon at a single, large academic center with high prosthetic volume between January 2024 and May 2025. Included cases involved explantation and replacement of three-piece Coloplast IPPs with intraoperative use of XPERIENCE both as a dip and irrigation solution. Patient demographics (age, presence of diabetes mellitus, most recent hemoglobin A1C) and procedural characteristics (operative time, number of prior implants, history of prior IPP infection, explanted device brand, implant size, antibiotic regimen, and postoperative complications) were collected. Descriptive statistics were used for analysis. Results Fourteen patients met inclusion criteria. The mean age was 64.1 years, and the average operative time was 1 hour and 33 minutes. Nine patients (64%) had diabetes mellitus, with a mean A1C of 6.8. Only one patient required explantation, which occurred due to wound dehiscence after premature device activation eight days postoperatively. Intraoperatively, no evidence of infection was noted at the time of explantation. Conclusions Infection remains a major concern in revision IPP procedures. The use of XPERIENCE surgical irrigation solution as both a dip and irrigant appears to be associated with low infection rates in this initial cohort. These preliminary findings suggest a potential benefit of XPERIENCE in revision Coloplast IPP cases. Larger, controlled studies are warranted to further evaluate its efficacy in reducing postoperative infections. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific

Abstract Introduction Despite the high reliability and longevity of modern genitourinary prosthetics, revision surgery is common over time. This may be several years later, at a different institution, and/or with a different surgeon. It can be challenging to obtain operative records and/or understand previous implant history by history and physical exam alone. Thus, it is our practice to routinely obtain axial imaging prior to penile implant and artificial urinary sphincter surgery. Objective The objective of this study is to evaluate the yield of preoperative axial imaging on perioperative decision-making during revision prosthetic surgery. Methods A retrospective review was performed of all men who underwent revision surgery (partial or complete device replacement) for either inflatable penile prosthesis or artificial urinary sphincter at our tertiary referral center from July 2019 to August 2024 for two surgeons (MV, SH). It is our routine practice to obtain noncontrast axial imaging before revision prosthetic surgery. Significant findings were defined as any finding (not detectable on physical exam) that changed incision type/location, changed the plan for reservoir/pressure regulating balloon (PRB) management, and/or indicated asymmetric number of rear-tip extenders. Demographic data was obtained on chart review and axial imaging reviewed by one author (AH) with ambiguous results arbitrated by all authors. Results A total of 74 men underwent prosthetic revision surgery during the study period, 55 of whom (74.3%) had preoperative axial imaging available for review. The median patient age was 70 (range 47-89, IQR 10.8), with median device survival being 5 years (range 0-20, IQR 6). Most revisions were for inflatable penile prostheses (38/55, 69.1%) and were performed by a surgeon other than the original surgeon (49/55, 89.1%). Axial imaging altered the operative plan in 22/55 cases (40%). The most common findings were 1) reservoir/PRB in unanticipated location and/or near critical structures (12/22, 54.5%), cylinder complication (4/22, 18.1%), and either multiple or discordant rear tip extenders (3/22, 13.6%). When looking at change in operative plan by surgery type (inflatable penile prosthesis vs artificial urinary sphincter), there was no difference (OR 0.55, 95% CI 0.13-2.13, p= 0.38). Conclusions Axial imaging prior to revision prosthetic surgery is high yield, revealing meaningful and/or unexpected findings in over a third of patients. Routine imaging prior to revision surgery may thus decrease the incidence of unexpected intraoperative findings and potential complications. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific

Abstract Introduction Retained prosthetic fragments are a rare but serious complication in penile implant surgery. Components like rear-tip extenders (RTEs) or tubing connectors can be overlooked during explantation, especially in the setting of infection or fibrosis. When left behind, these fragments may lead to chronic pain, persistent drainage, or infection, often requiring further surgical intervention. A high index of suspicion is critical, particularly in patients with prior explantation or reimplantation procedures. The use of structured intraoperative protocols, such as an implant-specific component checklist, can help mitigate the risk of retained fragments. Complete surgical field inspection and documentation should be emphasized in all prosthetic revisions. Objective This video highlights two challenging cases of retained penile prosthetic components, with a focus on intraoperative decision-making and imaging. The objective is to demonstrate how non-contrast CT and intraoperative radiography can be effectively used to identify and localize retained fragments, and to share practical surgical approaches for safe and complete retrieval. Methods The video presents two cases: In the first case, a rear tip extender was identified to be detached preoperatively via CT imaging and retrieved during corporal exploration. The second case involves intraoperative identification and removal of a metallic tubing cap aided by intraoperative radiography. Results Both fragments were successfully removed without intraoperative or postoperative issues. These cases emphasize the value of preoperative and intraoperative imaging in select cases and demonstrate safe, reproducible techniques for identifying and extracting retained pieces. Conclusions Retained implant components can present subtly and cause significant morbidity if missed. A high index of suspicion is essential. Preoperative CT or intraoperative radiography can aid diagnosis. Just as importantly, surgeons should adopt standardized intraoperative protocols, including component checklists and inspection of all explanted materials, to prevent fragments from being left behind. Disclosure No

Abstract Introduction The process for board certification necessitates case logging, which provides a useful source for practice patterns among early-career urologists. Trends in case mix by fellowship training can be predictive of future practice patterns and may reveal changes over time. Objective We sought an inquiry into early practice patterns in the field of penile prosthetics, as this is lacking in the literature and may be illustrative. Methods American Board of Urology Certifying Exam case log data was queried for CPT-code instances of penile prosthetic surgery from 2003 to 2022, including insertions, removals, repairs and exchanges, of all types (multi-component inflatable and non-inflatable semi rigid). Procedures performed by surgeons who self-described as fellowship-trained in andrology, men’s health, sexual medicine, infertility, or genitourinary reconstructive surgery were identified and compared to procedures performed by surgeons who did not identify as fellowship-trained in these areas. Linear regression was used to compute trend over time for years with complete data. Results 4,893 cases were identified, comprising of 3,539 insertions (72.3%); multi-component inflatable prosthesis procedures accounted for 86.8% (4,249) of cases. 87.0% of surgeons identified themselves as male. 43.0% of cases were performed by fellowship-trained physicians. Identified fellowship institutions consisted of training across 17 states. Cases performed in urban areas (population >1 million population) (p<0.001) and academic centers (p<0.001) were more likely to be performed by fellowship-trained physicians (see Table). Over time, the number of logged prosthetics cases increased (see Figure; linear trend p<0.001) and the proportion of cases performed by fellowship trained providers increased (p=0.003). Conclusions Early career practice patterns reveal significant differences in fellowship training among surgeons performing procedures in the field of prosthetics. These differences appear to become amplified over time. With an increase in the number of formal fellowships in prostatic urology and an increasing desire by urologists to have fellowship training, penile prosthesis surgery is becoming a sub-specialized focused procedure. Disclosure No

Increased life expectancy increases the risk of osteoarthritis and sustaining fractures. Prosthetic surgery is the primary treatment for such conditions. Periprosthetic joint infections (PJI) are the principal cause of failure of arthroplasty. This study aimed to mitigate the incidence of PJI by identifying the predominant risk factors and causative microorganisms associated with PJI at our institution. Surgeries for total hip arthroplasty (THA) and total knee arthroplasty (TKA) conducted at the Orthopedic and Traumatology Clinic were retrospectively reviewed. Patient’ demographic data, reproductive factors, and antibiotic resistance profiles were evaluated. Categorical variables are expressed as frequencies and percentages, while continuous variables with non-normal distributions are presented as median values. Within a span of 7 years, 300 THA and TKA procedures were performed, resulting in 18 patients developing surgical site infections attributed to 24 discrete factors. Of these patients, 15 (83.3%) were female and 3 (16.7%) were male. The age range of the affected individuals was 23 to 93 years, with a median age of 74 years. Sixteen patients underwent THA (89%), whereas the others underwent TKA. The mean duration of hospitalization was 46 days. The predominant risk factors identified were advanced age, female sex, and use of peripheral venous catheters. Microbial cultures revealed an 83.4% prevalence of Gram-negative bacteria and a 16.6% prevalence of Gram-positive bacteria. Escherichia coli and Acinetobacter baumannii were the most frequently isolated microorganisms. PJIs present a diagnostic challenge and often require prolonged treatment. Importantly, the prevention of PJIs is not only more straightforward but also significantly more cost-effective than treatment. Establishing laminar airflow in the operating room, limiting personnel traffic, implementing institution-specific infection prevention protocols, and providing feedback to staff can reduce the incidence of PJIs. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Adverse reactions to metal debris are inflammatory-necrotic changes that can occur in individuals with joint prostheses, particularly hips. They are triggered by the release of metal debris at both the periprosthetic tissue level and systemically. This was internationally recognised by 2012: several recommendations followed. Patients were advised to undergo careful clinical, laboratory and radiological follow-up with the potential need for prosthetic revision surgery. Concurrently, the primary manufacturers issued safety notifications and began recalling some prosthetic devices from the market. Notwithstanding, prosthetic implants with metal components continue to be widely used due to their favourable risk-benefit profile. We examined the cases of three patients whose hip arthroplasty had metal-type implants. Following the development of adverse reactions to metal debris, they underwent early prosthetic revision and even surgery to remove the prosthesis and clean up metal debris. Consequently, the patients requested a medico-legal evaluation to obtain compensation for the damage suffered. The investigations conducted in these three cases resulted in different allocations of liability: one to the manufacturing company, one to the healthcare professionals who treated the patients, one shared by both. This illustrates that, even after the risk has been identified, it remains a pertinent issue and provides insight into potential future scenarios regarding professional liability cases of a similar nature.

Is patient weight a risk factor for breakage of smaller cementless femoral stems in total hip arthroplasty? A prospective monocentric cohort study of 251 femoral stems at risk with a mean follow-up of six years.

To investigate the outcome of combined anterior corneal elastic sublaminectomy, conjunctival flap, and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body (FCVB) implantation in severe trauma. This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery. Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVB-implanted atrophic eyes. Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal. Corneal irritation, eyeball protrusion, axial length, lid height, cosmetic satisfaction, and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery. The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively, with the difference being statistically significant (Z=-5.459, P<0.001). The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group, showing a statistically significant difference (t=-20.207, P<0.05). The lid height was 6 mm in the experimental group and 9 mm in the control group, a difference that was statistically significant (Z=-5.326, P<0.001). The appearance satisfaction score was 1 in the experimental group and 4 in the control group, with this difference being statistically significant (Z=-5.447, P=0.001). Regarding the pain numerical rating scale score, the ranges were 0-2 in the experimental group and 0 in the control group. No discomfort was reported after wearing the prosthetic eyepiece, and the difference was not statistically significant (Z=-1.100, P>0.05). There was no statistically significant difference between pre- and post-treatment satisfaction. A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries, alleviate patients' economic burdens, satisfy patients' psychological eyeball retention requirements, and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.

Due to rising antibiotic resistance rates, treating infections becomes more complex. To tackle this, old and new antibiotics will need to be used more frequently for additional indications outside the scope of their original registrations. We aimed to introduce a mixed methods approach to identify off-label indications for antimicrobials in specific settings, and applied this to an antimicrobial not commonly used in the Netherlands, ceftaroline. We developed the Exploratory Positioning of Antimicrobials in New Settings (EXPANS) approach, which includes a systematic literature review, an observational study and an expert meeting. We applied our approach to ceftaroline to explore off-label indications and its potential use in outpatient parenteral antimicrobial therapy (OPAT). In both the literature and Dutch hospitals, ceftaroline was mainly prescribed as second-line treatment following treatment failure or side effects, often for endocarditis and bone and joint infections. Combination therapy with daptomycin was common, and ceftaroline was used in OPAT. In Dutch hospitals, only 48 patients were prescribed ceftaroline in the last five years. Experts experienced a lack of evidence, reimbursement issues, and the risk of leukopenia as key barriers to its use. Dutch experts noted potential for off-label use of ceftaroline in endocarditis and as prophylaxis for prosthetic joint revision surgery. The components used in our EXPANS approach were complementary, gathering original data on clinical experiences with specific antimicrobials and identifying barriers to their use in practice. We recommend this systematic approach to explore untapped potential of existing antimicrobial agents and optimize their use.

Background and Aims: Hemophilic arthropathy is a chronic, progressive joint disease caused by repeated hemarthroses, leading to joint degeneration, pain, stiffness, and disability. It is a major source of morbidity in patients with severe hemophilia A, significantly impairing their functional independence and quality of life. The knee, hip, and ankle are the most frequently affected joints, often requiring surgical intervention when conservative measures are no longer effective. Joint prosthetic surgery represents a crucial therapeutic option for restoring mobility and reducing pain, but it requires careful multidisciplinary planning, particularly regarding perioperative bleeding management through factor VIII (FVIII) replacement therapy. The aim of this study was to evaluate the efficacy of perioperative FVIII treatment in ensuring adequate hemostasis and to assess the clinical-functional outcomes and impact on quality of life following joint replacement in patients with hemophilia A. Methods: This prospective observational study included 22 patients with severe hemophilia A (mean age: 49 years) who underwent a total of 30 prosthetic joint surgeries at our center. The procedures included 18 total knee replacements (TKR), 7 total hip replacements (THR), 3 total ankle replacements, and 2 revision surgeries (1 for knee and 1 for hip periprosthetic infections). The average follow-up duration was 49 months. Perioperative FVIII replacement was administered according to individualized pharmacokinetic protocols. Clinical-functional evaluations included the Visual Analog Scale (VAS) for pain, Range of Motion (ROM), Gilbert Score for joint status, and the Knee Society Score (KSS). Quality of life was assessed pre- and post-operatively using the SF-36 questionnaire and the Haemophilia Activities List (HAL), focusing on lower limb functions. Results: Surgical hemostasis was judged good or excellent in all patients. The mean in-hospital FVIII consumption was 58,000 IU (range: 25,000–83,000 IU). Pain relief was substantial: VAS scores improved from 8.2 to 1.4 for hips and from 8.2 to 1.8 for knees. The Gilbert Score improved from 10/18 to 1.8/18 for hips and from 13.6/18 to 3.05/18 for knees, indicating a marked reduction in joint damage-related symptoms. The HAL score increased from 55/100 to 90/100 in simple activities and from 42/100 to 65/100 in complex activities, reflecting greater autonomy in daily life. SF-36 scores improved from 20.28 to 47.35 (hip) and from 17.36 to 43.00 (knee), highlighting a considerable enhancement in overall well-being. Functional recovery was confirmed by KSS improvement (from 33.7/100 to 82.8/100) and by gains in ROM: +60° in hips and +30° in knees. Conclusions: Joint prosthetic surgery, supported by personalized FVIII prophylaxis, is a safe and effective strategy for patients with hemophilia A and advanced arthropathy. It leads to significant reductions in pain, improvements in joint function and mobility, and marked gains in quality of life. These outcomes support the integration of orthopedic intervention within comprehensive hemophilia management programs.

Fungal infections after inflatable penile prosthesis (IPP) surgery are uncommon but clinically significant due to their association with prosthesis loss and reoperation. While antifungal prophylaxis has been proposed as a preventive strategy, supporting evidence remains limited and inconsistent. At our institution, perioperative antifungal agents have never been part of the IPP protocol. Among 1772 cases performed without antifungal use, we encountered a single fungal infection caused by Meyerozyma guilliermondii, which matched the operating surgeon's otitis externa isolate. Following this event, we implemented routine use of surgical hoods that fully cover the ears and scalp for all scrubbed personnel. Since then, over 1535 IPP procedures have been performed without a single fungal infection. Based on this experience and a review of relevant literature, we propose that surgical hoods that fully cover the ears and scalp may offer a simple, cost-effective, and underutilized means of reducing fungal contamination during urologic prosthetic surgery.

Background: Polycarbonate–urethane (PCU) is a recently developed bearing surface used in prosthetic hip surgery. It offers several theoretical advantages, including an elasticity modulus similar to that of natural cartilage, good lubrication properties, low wear, and the possibility of using large heads. However, comparative clinical experience is limited. The purpose of this study was to analyze the results of the PCU bearing surface and compare them with those of ceramic-on-ceramic (CoC) bearings using the same femoral stem model. (2) Methods: Following a propensity score matching analysis of a prospectively collected database, patients with a primary total hip arthroplasty aged between 18 and 60 years were included. Subjects were divided into two groups (PCU and CoC). Demographic, patient satisfaction, and implant survival data were recorded. Clinical results were evaluated using the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). (3) Results: A total of 105 patients were included in each group. All patients exhibited a positive evolution on both the HHS and the WOMAC subscales between pre-op and one year post-op, no statistically significant differences being found between the groups with respect to improvement on the HHS (p = 0.172) or the pain (p = 0.523), stiffness (p = 0.448), and physical function (p = 0.255) subscales of the WOMAC. Head sizes in the PCU group were found to be larger, but this was not seen to have any effect on the patients’ clinical status or the prostheses’ dislocation rate. Although the complication rate was similar across the groups (p = 0.828), the incidence of squeaking was higher in the PCU group (p = 0.010). No differences were observed when comparing the implant survival rate (p = 0.427). nor in mean patient satisfaction (p = 0.138). (4) Conclusions: No differences were found in terms of clinical results, complications, implant survival, or patient satisfaction between the bearing surfaces under analysis, indicating that all of them are valid alternatives in total hip replacement, although the higher proportion of squeaking observed makes it advisable to exercise some caution.

Interobserver concordance analysis for the evaluation of internal rotation with elbow at the side during shoulder clinical examination.

BackgroundThe advent of navigation, followed by robotics in knee prosthetic surgery aims, among other things, to enhance the alignment of components and to improve the control of stress forces (i.e., weight, gravity, and static and dynamic stabilizers) on the bearing surface throughout the range of motion; however, the benefits of robotic-assisted total knee arthroplasty (TKA) are debated.ObjectiveThis quasi-randomized controlled trial (RCT) compares robotic-assisted and conventional TKA, focusing on surgical duration, hospital stay and serum markers. It aims to address current gaps in the literature and clarify potential advantages.Material and methodsAll patients who received a TKA at the Department of Orthopedic Surgery of the Eifelklinik St. Brigida in Simmerath, Germany, between 2021 and 2025 were prospectively invited to participate in the present clinical trial. All patients followed the same clinical, imaging, and anesthesiological presurgical and postsurgical pathways irrespective of their allocation. All surgeries were performed using a standard medial parapatellar approach and a functional alignment philosophy. Both groups received the same implants, and patients followed the same postoperative physiotherapy program. Deviation from the planned surgical procedure and rehabilitation protocol warranted exclusion from the study. For patients allocated to robotic-assisted TKA, the CORI system (Smith & Nephew plc, Watford, United Kingdom) was used.ResultsA total of 1099 patients completed the study, 59% (649 of 1099) of the patients were women and 50% (547 of 1099) of TKAs were performed on the left side. The mean body mass index (BMI) was 30.2 ± 4.9 kg/m2, and the mean age was 66.9 ± 8.2 years. Comparability was found between the two cohorts regarding the number of women, side of surgery, mean BMI, age, hemoglobin, hematocrit and leucocyte count at admission. Robotic-assisted TKA was associated with a longer surgical time of 1.6 min (p = 0.04) and a lower C‑reactive protein level at both the first (p = 0.0003) and fifth (p = 0.003) postoperative days. No other difference between groups was found.ConclusionRobotic-assisted TKA was associated with lower serum C‑reactive protein levels. No difference was found in the length of hospitalization and erythropoietic function in serum. Although the surgical execution of conventional TKA was statistically significantly faster, the clinical relevance of the endpoint surgical duration is negligible.

Modifiable risk factors for culture positivity after primary Latarjet procedure. Should we change any practice?

Fungal endocarditis (FE) is still an uncommon but devastating infection, especially when immunosuppression, prosthetic valve surgery, or prolonged health care is involved. Although being only responsible for 1–6% of infective endocarditis cases, the mortality rate is higher than 40–60% due to the time lag from diagnosis and therapeutic complexity. Etiology is led by Candida species, especially Candida albicans, followed by Aspergillus, and new pathogens like multidrug-resistant Candida auris are also seen. Non-C. albicans and the biofilm-forming species also add more complexity to the manageability. Diagnosis is challenging due to the high percentage of culture-negative cases, particularly for molds, requiring sophisticated investigations such as fungal biomarkers (β-D-glucan, galactomannan), molecular tests, and imaging studies such as 18F-FDG PET/CT (fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography). Early transesophageal echocardiography is crucial in the diagnosis of vegetations, whereas histopathology of resected non-cardiac tissue offers a definitive diagnosis. Treatment requires aggressive antifungal therapy, echinocandins, amphotericin B, or azoles, in conjunction with urgent valve surgery to reduce embolic risk and enhance survival. However, drug resistance, biofilm resistance, and patient comorbidities counteract the efficacy. Novel treatments such as rezafungin and ibrexafungerp are promising but have limited clinical hands-on evidence. Risk factors of immunosuppression, indwelling devices, and IV drug use imply a need for increased clinical suspicion in high-risk groups. Although there have been minor improvements in FE survival, the grim situation of FE persists, highlighting the importance of a multidisciplinary approach, early diagnosis, and tailored antifungal therapy to control this deadly infection.

Role of synovial biopsy in diagnosis of chronic periprosthetic infection in total hip and knee arthroplasties.

The purpose of this research is to determine the effectiveness and safety of a vaginal mesh intended to resolve multicompartmental prolapse in individuals with substantial vaginal vault prolapse. From 2015 to 2020, 67 patients with recurrent apical prolapse ≥ III stage (POP-Q grading) underwent transvaginal vault repair using the isoelastic mesh InGYNious. Operative time, blood transfusions, spontaneous voiding, perioperative issues, postoperative hospital stay, and postoperative complications (early within 30 days and late after 30 days) were also investigated. Following the first preoperative examination, clinical and QoL questionnaires were examined both before and after surgery at the long-term follow-up (> 60 months). The average surgery duration was 41 ± 21 min, with an estimated blood loss of 50 ± 21 mL. The total number of surgical complications was eight (11.9%). The study discovered significant reductions in the apical (from 1.88 ± 2.59 to -6.73 ± 1.77) and anterior (from 1.34 ± 1.67 to -2.25 ± 0.95) deficiencies, as well as improvements in PQOL (from 67.72 ± 19.25 to 33.74 ± 7.48), PISQ-12 (from 29 to 36), FSFI (from 20 to 29), and FSDS (from 21 to 8). Finally, we identified three cases of full recurrence and only two occurrences needed reoperation. Transvaginal mesh repair is a safe and effective surgical technique that can treat multi-compartment prolapse, improve anatomical success, and reduce the risk of recurrence in certain patient populations, such as those with significant comorbidities, elderly patients, patients with recurrent POP, or patients with very challenging cases of POP.

Utilizing myoelectric control systems in robotic lower-limb prosthetics is becoming increasingly prevalent, capturing user intent. However, AI-based myoelectric systems often experience high latency and require extensive training data and calibration. Our study introduces a minimalist ridge regression approach for interpreting surface electromyography signals, enabling real-time control of ankle prosthetics. The proof-of-concept system features three open-loop control modes: Position, Velocity, and Torque, which require minimal calibration. Five able-bodied participants participated in a Target Achievement Control test with varying levels of difficulty. Velocity control yielded the highest Completion Rate (CR = 83.3%, p = 0.031 vs Torque) but differences in Overshoot and Movement Time were not statistically significant. Position control achieved solid performance (CR = 71.4 %), whereas direct Torque control suffered from large variability (CR = 40.0 %). The results emphasize the promise of ridge regression for real-time myoelectric control, which could lead to affordable, low-latency prosthetic operation.

Objectives: Preoperative malnutrition has been associated with higher rates of morbidity and death, longer hospital admissions, and a worse quality of life after surgery. This study aimed to examine the association between the Prognostic Nutritional Index (PNI) and the duration of hospitalization, in-hospital, and 1-year all-cause mortality among patients having surgery on metallic prosthetic mitral valves. Methods: The study retrospectively included 90 consecutive patients with metallic prosthetic mitral valve surgery at Dicle University Hospital between January 2021 and December 2023. Patients were split into two groups based on the median length of stay in the hospital (14 days). Those who stayed ≥14 days were included in the longer in-hospital stay group (53 patients), and those who stayed &amp;lt;14 days were included in the shorter in-hospital stay group (37 patients). Results: The study included patients aged 52.3±15.2 years, 48.9% (n=44) female. Patients with longer hospital stays had wider left atrial diameters, lower albumin levels, and lower PNI values (34.7±6.1 vs. 38±4, P=0.002). Inotropic support was more frequent in this group (18.9% vs. 2.7%, P=0.021). ROC analysis identified PNI &amp;lt;37.2 as predictive of prolonged stays (AUC=0.653, P=0.014). Logistic regression analysis revealed significant associations between prolonged stays and inotropic support, left atrial diameter, albumin, CRP, and PNI values. PNI also predicted in-hospital and 1-year all-cause mortality. Conclusions: PNI was associated with hospital stay duration, in-hospital, and 1-year all-cause mortality in patients undergoing metallic prosthetic mitral valve surgery. Incorporating PNI into routine preoperative evaluation may enhance perioperative management and outcomes.