Placement Technique Research Articles

Intraocular Lens (IOL) Exchange Procedure in Refractive Surprise After Ten Years of Cataract Surgery

Introduction: Postoperative refractive surprises may manifest following cataract surgery. A residual refraction difference of > 2.0 D after cataract surgery was considered a refractive surprise. Treating refractive error after cataract surgery includes non-surgical and surgical options. The objective is to report clinical outcomes of intraocular lens (IOL) exchange with ciliary sulcus placement technique to manage refractive surprise. Case Presentation: A female patient aged 70 years reported experiencing blurred vision in her right eye (RE) for the past two years. History of RE cataract surgery ten years ago, however, she only had control 1-2 times after surgery. After that, the patient underwent cataract surgery on the left eye (LE), and then she complained that her RE was getting blurry. Her RE's visual acuity (VA) was 1/60 with best corrected visual acuity (BCVA) S-8.00 C-1.00 X100° to 6/10, and her LE was 7/10 with BCVA C-0.75 X60° to 10/10. The anterior segment examination of the RE was a 3-piece sulcus intraocular lens with complete continuous curvilinear capsulorhexis (CCC) intact anterior capsule, posterior capsule rupture, and the LE was in the bag IOL. Ultrasound examination of the RE revealed posterior staphyloma. She was diagnosed with OD refractive surprise, pseudophakia, posterior staphyloma, and OS pseudophakia. She underwent IOL exchange surgery on her RE. Post-operatively, the visual acuity of the RE was 7/45 using the Snellen chart. Three months post-op, the BCVA of RE was 10/10. Conclusions: In well-prepared cataract surgery, unexpected refractive outcomes such as a refractive surprise can be prevented. IOL exchange with ciliary sulcus placement technique is a treatment option for refractive surprise associated with posterior capsule rupture, and it has a good outcome.

EC-IC bypass for occlusion of the internal carotid artery

There are barely any alternative treatment options to the drug treatment of hemodynamically caused cerebral ischemia, as in occlusion of the internal carotid artery. For secondary prevention of an ischemic stroke due to carotid occlusion and hemodynamic instability, extracranial-intracranial (EC-IC) bypass surgery can be an important option in selected patients. The development, study situation, indications and surgical technique for placement of an EC-IC bypass in cases of occlusion of the internal carotid artery are presented. With appropriate expertise and strict selection of patients, the placement of an EC-IC bypass enables stabilization of cerebral perfusion with a low rate of complications. The study situation is controversially discussed; nevertheless, surgical treatment in a specialized neurovascular center should at least be considered.

Optimizing capacitor size and placement in radial distribution networks for maximum efficiency

As distribution systems continue to expand, they face challenges such as increased system losses and inadequate voltage regulation. To address these issues, shunt capacitors are being deployed in distribution networks. These capacitors offer reactive power compensation, enhance power factor, improve voltage profiles, promote system stability, and significantly reduce losses. However, determining the appropriate capacitor sizes and their optimal placements requires careful consideration of both technical and economic factors. The nonlinear nature of optimal capacitor placement and sizing, leveraging optimization techniques becomes crucial in identifying the best locations and values for capacitors. This paper demonstrates the effective utilization of Particle Swarm Optimization (PSO) and Real Coded Genetic Algorithm (RCGA) optimization techniques for capacitor placement and selection. The optimization techniques are applied to a 33-bus IEEE standard radial distribution system, to reduce the real power loss and to improve the voltage profile considering both constant and variable loads. Both PSO and RCGA algorithms identify suitable locations for the placement of capacitors for reactive power compensation within the distribution system. By optimizing the objective function associated with capacitor placement costs and maximizing annual cost savings, the PSO and RCGA techniques yield promising results. After implementing the optimal capacitor placements at the identified candidate nodes, a significant reduction in losses within the radial distribution system is observed. Moreover, the cost savings achieved through optimal placement and sizing are substantial.

Analysis of the therapeutic efficacy of robot-assisted percutaneous screw fixation in the minimally invasive treatment of pelvic fractures.

To compare the therapeutic efficacy of robot-assisted and manual screw placement techniques for the treatment of pelvic fractures. This study included patients with pelvic fractures admitted to our orthopedic department between January 2020 and January 2022. They were randomly assigned to either the robot-assisted group or the control group. Various parameters, including surgical duration, intraoperative bleeding, fluoroscopy frequency, postoperative pain, length of hospitalization, postoperative hematological indices, postoperative functional scores, and postoperative complications, were compared between the two groups. There were no significant differences in age, sex, body mass index, and preoperative hematological parameters between the two groups. The robot-assisted group exhibited significantly shorter surgical duration, lower fluoroscopy frequencies, lower postoperative pain scores, and shorter length of hospitalization compared to the control group. At 3 and 6 months postoperatively, patients in the robot-assisted group demonstrated significantly higher Majeed functional scores in comparison to the control group. However, there were no significant differences in Majeed scores at 12 months postoperatively. Moreover, there were no significant differences in postoperative complications between the two groups. Robot-assisted minimally invasive treatment of pelvic fractures using hollow screws effectively reduced surgical duration, mitigated intraoperative bleeding and postoperative pain, shortened hospital stays, and promoted faster functional recovery.

Novel method of iliac accessory rods for rod fracture prevention in adult deformity surgery: a case series of 82 patients with outcomes and complications.

Primary rod fracture after surgery for adult spinal deformity (ASD) is a leading cause of revision, with recent prospective multicenter fracture rates reported at 11%-14% by 2 years. Consequently, the addition of supplemental rods has been explored to reduce fractures. Here the authors describe their experience with a novel iliac accessory rod technique in which each accessory rod anchors to an independent iliac bolt caudally via lateral connector, and attaches to the primary rod rostrally via side-to-side connector. This retrospective, single-center case series included patients who underwent thoracolumbar/lumbar fusion for ASD between March 2019 and August 2023. Data on baseline demographics, radiographic parameters, surgical characteristics, complications, rod fracture, and revision rates were collected. Paired, 2-tailed t-tests were used to compare pre- and postoperative radiographic outcomes. Rod fracture rates were compared to prior investigations via chi-square goodness of fit testing. The technique for iliac accessory rod placement is described. The study consisted of 82 patients (mean age 66 years, 51% female, 26% with prior fusion) with a median follow-up of 2 years (IQR 28-104 weeks). A total of 50 patients (61%) had ≥ 2-year follow-up. Each surgery involved an average of 4 posterior column osteotomies and 8 segments. Iliac accessory rods were cobalt chromium and were placed bilaterally in 87% of constructs. Postoperative alignment improved significantly in the following parameters: maximum coronal Cobb angle, fractional curve, sagittal vertical axis, lumbar lordosis, thoracic kyphosis, and pelvic incidence to lumbar lordosis mismatch (p < 0.001 for all comparisons). Of 50 patients with ≥ 2-year follow-up, rod fracture occurred in 1 (2.0%), which was incidentally found and required no intervention. The present rod fracture rate was significantly lower than the authors' historically reported institutional rate of 21% for traditional dual-rod constructs, and the 11%-14% reported in recent prospective multicenter studies that used traditional and supplemental rod constructs (p < 0.05 for all comparisons). Reoperation occurred in 12 patients (14.6%); 7 (8.5%) for proximal junctional kyphosis and 5 (6.1%) for wound complication. Here the authors describe their experience with a novel iliac accessory rod technique to prevent rod fracture in patients undergoing surgery for ASD. The 2-year rod fracture rate (2.0%) in this study is significantly lower than the authors' historical dual-rod fracture rate, and other prospective multicenter investigations. Future studies with longer follow-up are needed to determine the durability of this technique.

Rives-Stoppa Repair Versus Bilateral Inguinal Hernioplasty: A Comprehensive Review of Surgical Techniques and Patient Outcomes.

Hernia repair surgery is a common procedure to address the protrusion of organs or tissues through weakened muscles or connective tissue. This review compares two prominent surgical techniques for hernia repair: the Rives-Stoppa repair and bilateral inguinal hernioplasty. The Rives-Stoppa repair involves a posterior approach with extensive mesh placement suitable for complex and recurrent hernias. In contrast, bilateral inguinal hernioplasty focuses on simultaneously repairing bilateral hernias, potentially reducing operative time and enhancing recovery. This review examines each approach's technical aspects, including incision methods, mesh placement, and closure techniques. Patient outcomes, such as postoperative pain, recovery time, recurrence rates, and quality of life, are critically analyzed based on current research and clinical data. Economic considerations are also evaluated, encompassing each technique's cost-effectiveness and economic impact. By synthesizing these findings, this review aims to provide valuable insights for surgeons, healthcare providers, and policymakers in optimizing hernia repair strategies. The evolving landscape of surgical techniques and materials underscores the importance of ongoing research to refine practices and improve outcomes for patients undergoing hernia repair surgery.

Comparative Effects of Isometric Quadriceps Training, Glucosamine and Chondroitin Sulphate Iontophoresis on Pain Intensity and Physical Functions of Patients with Knee Osteoarthritis

This study was with a view to comparing the effective means of alleviating pain and improving physical functions in patients with knee osteoarthritis using quadriceps strengthening exercises, glucosamine and chondroitin sulphate iontophoresis. Seventy-eight participants with grade II knee OA were purposively selected and randomly assigned to three groups using fish bowl technique. Group one participants received 1g of glucosamine sulphate (GS) through iontophoresis while group two received 1g of chondroitin sulphate (CS) iontophoresis (40mA- min as dosage) using trans-arthral electrode placement technique twice a week, for 12 weeks. Group three participants had intervention in the form of quadriceps muscle strengthening exercise (1RM, 10 reps and 3 sets), which was a baseline treatment for all the groups. Pain intensity, active knee range of motion and physical function were assessed. Descriptive statistics, ANOVA and Kruskal-wallis test were used to analyze the data. Alpha level was set at p ≤ 0.05. The three modes of interventions significantly alleviated pain (p = 0.001), improved the Functional Activity Level and active ranges of motion (p = 0.001) in the groups after 12 weeks. Although, the administration of Quadriceps strengthening exercise alone, significantly improved the Functional Activity Level than Chondroitin sulphate iontophoresis and Glucosamine sulphate (H = 19.89, p = 0.001). However; there was no significant difference in the active range of motion across the 3 groups. In conclusion, Quadriceps strengthening exercise, Glucosamine and Chondroitin sulphate iontophoresis were effective in alleviating pain, enhancing range of motions and improving physical functions. However, Quadriceps strengthening exercise showed higher efficacy compared to others.

Stability of orthodontic anchoring devices: a narrative review

Background and objectives. Temporary anchoring devices (TADs) are essential for controlling unwanted reactive movements in teeth because orthodontic treatments require effective anchorage to control tooth movement. The goal of this systematic review is to collect information on the advantages, disadvantages, and applications of TADs in orthodontic treatment by addressing the variables affecting their stability and efficacy. Materials and methods. Our review is a non-Cochrane review, following the PICO format for selection criteria, analyzed studies published between 2011 and 2021. The review focused on systematic reviews, meta-analyses, RCTs, case control, and cohort studies in English, extracted from PubMed and Google Scholar databases. A total of 123 papers were assessed, with 39 included for review. Results. The review found that TAD stability is highly influenced by micro-implant design, operator experience, placement technique, bone morphology and histology, and patient variables (such as age and sex). Notably, the quality and amount of bone, the length and diameter of the implant, and the surgical method all played a significant role in achieving primary stability. Although loosening and discomfort are possible side effects, TADs have been demonstrated to provide reliable and effective anchoring during orthodontic treatment. Conclusions. Greater treatment efficacy and patient comfort are made possible by the significant advancement in orthodontic anchoring that TADs represent. The performance of TADs is largely dependent on variables like operator experience, micro-screw size, and bone quality. The mandibular site presented a higher risk of loosening, although patient factors such as age and sex did not significantly affect the loosening rate. This review emphasizes how important it is to take these factors into account in order to maximize TAD stability and, consequently, therapeutic results.

Full arch rehabilitation of patients with severe atrophy of the upper jaw using the transnasal technique of implants placement

Full arch rehabilitation of patients with severe atrophy of the upper jaw using the transnasal technique of implants placement

Fluoroscopy guided teardrop technique for open trans-muscular iliac screw placement and open reduction maneuvers during modified triangular spinopelvic fixation for unstable U-shaped sacral and tile C pelvic traumas: technical note.

Unstable traumas of the spinopelvic junction, which include displaced U-shaped sacral fractures (Roy-Camille type 2 and type 3) and Tile C vertical shear pelvic ring disruptions, occur in severe traumas patients following high speed traffic accident or fall from a height. These unstable traumas of the spinopelvic junction jeopardize one's ability to stand and to walk by disrupting the biomechanical arches of the pelvis, and may also cause cauda equina syndrome. Historically, such patients were treated with bed rest and could suffer a life-long burden of orthopedic and neurological disability. Since Schildhauer pioneer work back in 2003, triangular spinopelvic fixation, whether it is performed in a percutaneous fashion or by open reduction and internal fixation, allows to realign bone fragments of the spinopelvic junction and to resume walking within three weeks. Nevertheless, such procedure remains highly technical and it not encountered very often, even for spine surgeons working in high-volume level 1 trauma centers. Hence, this visual technical note aims to provide a few tips to guide less experience surgeons to complete this procedure safely.

Vertical Mouth Opening Requirements for CAD/CAM Fully Guided Implant Surgery: An Analysis of Different Implant Systems.

To determine the vertical space required for implant osteotomy preparation when utilizing a CAD/CAM fully guided surgical template. A total of 14 surgical osteotomy drills (individual and sequential drills) were collected and measured individually using a digital caliper, as well as the total length when the drills were positioned in a surgical handpiece. The height of the surgical guide sleeves and the offset of 14 implant systems in the market were also collected. The vertical dimension of the drills included in this study ranged from 28.2 to 46.3 mm. When these drills were inserted into the handpiece, the total length ranged from 30.0 to 49.5 mm. The height of the surgical guide sleeve and the offset required for the guide had a range of 3.2 to 7.0 mm and 5.0 to 13.5 mm, respectively. This dimension resulted in the total vertical space required for CAD/CAM fully guided surgical templates for each implant system, which ranged from 30.0 to 58.5 mm. Limited mouth opening can pose challenges and limitations in both guided and nonguided dental implant surgery. It can affect the accessibility of surgical implant placement and may result in increased patient discomfort, surgical implant positioning errors, and postoperative complications. Clinicians should determine the patient's mouth opening capabilities during the treatment planning phase prior to deciding on the appropriate implant system to be used and the implant placement technique.

Enhancing orthodontic precision: A comprehensive review of temporary anchorage devices

Temporary anchorage devices (TADs) have revolutionized orthodontic treatment by providing additional support for tooth movement, enabling precise control over tooth positioning, and expanding the scope of treatment options available to orthodontists. Temporary anchoring devices (TADs) provide a dependable means of accomplishing efficient and consistent tooth movement, and have emerged as a key breakthrough in modern orthodontic practice.: The present review aims to provide a comprehensive overview of TADs, including their types, applications, advantages, and limitations. : The review begins by elucidating the various types of TADs, such as mini-implants, miniplates, and microscrews, highlighting their differences in design, placement techniques, and biomechanical characteristics. Subsequently, it explores the diverse clinical applications of TADs, ranging from orthodontic tooth movement, space closure, intrusion, and extrusion to the management of skeletal discrepancies and complex cases requiring multidisciplinary approaches.: Moreover, the review examines the advantages offered by TADs, including enhanced treatment precision, reduced reliance on patient compliance, and the ability to achieve challenging tooth movements with minimal side effects. It also addresses the limitations and potential complications associated with TADs, such as risk of infection, mucosal irritation, and mechanical failure, emphasizing the importance of careful patient selection, proper placement techniques, and vigilant monitoring throughout treatment, highlighting their potential to further enhance orthodontic outcomes and patient satisfaction.: The significant role of temporary anchorage devices in modern orthodontic practice, emphasizing their versatility, efficacy, and potential to optimize treatment outcomes while minimizing the reliance on traditional anchorage methods and enhancing patient comfort and experience.

A novel dual-band elliptical ring slot MIMO antenna with orthogonal circular polarization for 5G applications

This paper presents a dual-band 4-element multiple-input-multiple-output (MIMO) antenna featuring orthogonal circular polarization (CP) for Sub-6 GHz 5G applications. The single antenna combines a non-uniform width elliptical ring slot and a feed network, utilizing two L-shaped secondary feed lines to generate CP within the targeted frequency bands (3.55−3.80 GHz and 4.60−4.80 GHz). Using the single antenna as a unit antenna, a 4-element MIMO configuration is devised, employing a mirror technique for element placement to achieve orthogonal CP. This placement method effectively enhances coverage area and enlarges the 3-dB axial ratio bandwidth in the lower band (3.40–3.80 GHz). The common ground connections among elements are established via four strip lines. The antenna shows a good diversity performance considering the envelope correlation coefficient (ECC) result of less than 0.04 and isolation greater than 15 dB. The simulated gains of the MIMO antenna are 4 and 5 dBic in the respective bands. The single and MIMO antennas are fabricated, and the antennas’ performances are evaluated. A good agreement is observed between the measured and simulated results. The dual CP and diversity performances of the MIMO antenna make it more efficient for 5G wireless applications.

Nonlinear Model Predictive Control with Evolutionary Data-Driven Prediction Model and Particle Swarm Optimization Optimizer for an Overhead Crane

This paper presents a new approach to the nonlinear model predictive control (NMPC) of an underactuated overhead crane system developed using a data-driven prediction model obtained utilizing the regularized genetic programming-based symbolic regression method. Grammar-guided genetic programming combined with regularized least squares was applied to identify a nonlinear autoregressive model with an exogenous input (NARX) prediction model of the crane dynamics from input–output data. The resulting prediction model was implemented in the NMPC scheme, using a particle swarm optimization (PSO) algorithm as a solver to find an optimal sequence of the control actions satisfying multi-objective performance requirements and input constraints. The feasibility and performance of the controller were experimentally verified using a laboratory crane actuated by AC motors and compared with a discrete-time feedback controller developed using the pole placement technique. A series of experiments proved the effectiveness of the controller in terms of robustness against operating condition variation and external disturbances.

Open Retromuscular Sugarbaker vs Keyhole Mesh Placement for Parastomal Hernia Repair

Durable parastomal hernia repair remains elusive. There is limited evidence comparing the durability of the open retromuscular Sugarbaker and keyhole mesh configurations. To determine if the open retromuscular Sugarbaker mesh placement technique would lower parastomal hernia recurrence rates. In this single-center, randomized clinical trial, 150 patients with a permanent stoma and associated parastomal hernia who were candidates for open retromuscular parastomal hernia repair were enrolled and randomized from April 2019 to April 2022 and followed up for 2 years. Following intraoperative assessment to determine the feasibility of either technique, enrolled patients were randomized to receive either retromuscular Sugarbaker or keyhole synthetic mesh placement. The primary outcome was parastomal hernia recurrence at 2 years. Secondary outcomes included mesh-related complications, wound complications, reoperations, as well as patient-reported pain, abdominal wall-specific quality of life, stoma-specific quality of life, and decision regret at 1 year and 2 years. A total of 150 patients were randomized, and with 91% follow-up at 2 years, there were 13 (17%) parastomal hernia recurrences in the retromuscular Sugarbaker arm and 18 (24%) in the keyhole arm (adjusted risk difference, -0.029; 95% CI, -0.17 to 0.153, and adjusted risk ratio, 0.87; 95% CI, 0.42 to 1.69). There were no statistically significant differences between the Sugarbaker and keyhole groups regarding reoperations for recurrence (2 vs 7, respectively), nonhernia intra-abdominal pathology (4 vs 10, respectively), stoma necrosis (1 vs 0, respectively), mesh-related complications (4 vs 1, respectively), patient-reported pain, abdominal wall-specific quality of life, stoma-specific quality of life, and decision regret at any time point. In the setting of open parastomal hernia repair, a retromuscular Sugarbaker mesh placement technique was not superior to a keyhole configuration 2 years after repair. Further innovation is necessary to improve parastomal hernia repair outcomes. ClinicalTrials.gov Identifier: NCT03972553.

“Mail-slot” Technique for Minimally Invasive Placement of Subdural Grid Electrodes: A Single-institution Experience

BackgroundIn the management of multi-drug-resistant focal epilepsies, intracranial electrode implantation is employed for precise localization of the ictal onset zone. In select patients, subdural grid electrode implantation is utilized. Subdural grid placement traditionally requires large craniotomies to visualize the cortex prior to mapping. However, smaller craniotomies may enable shorter operations and reduced risks. We aimed to compare surgical outcomes between patients undergoing traditional large craniotomies with those undergoing tailored 'mini' craniotomies (the “Mail-Slot” technique) for subdural grid placement. MethodsThis retrospective cohort study included 23 patients who underwent subdural electrode implantation for epilepsy monitoring between 2014 and 2020. Patients were categorized into mini craniotomies (N=9) and traditional large craniotomies (N=14) groups. Demographics, operative details, and outcomes were reviewed. Craniotomy size and number of electrodes were determined via post-hoc radiographs. ResultsOf the 23 patients studied, the mini group had smaller craniotomy sizes (mean=22.71 cm2 vs. 65.17 cm2, p<0.001) and higher electrode-to-size ratios (mean=4.25 vs. 1.71, p<0.0001). The mini group had slightly fewer total electrodes (mean=88.67 vs. 107.43, p=0.047). No significant differences were found in operative duration, blood loss, invasive EEG duration, complications, or Engel scores between the groups. One patient per group required further invasive epilepsy monitoring for localization; all patients underwent therapeutic surgery. ConclusionOur findings suggest that mini craniotomies for subdural grid placement in epilepsy monitoring offer significant advantages, including smaller craniotomy sizes and shorter operation durations, without compromising safety or efficacy. These results support the trend towards minimally invasive, patient-tailored surgical approaches in epilepsy treatment.

Accurate Surge Arrester Modeling for Optimal Risk-Aware Lightning Protection Utilizing a Hybrid Monte Carlo–Particle Swarm Optimization Algorithm

The application of arresters is critical for the safe operation of electric grids against lightning. Arresters limit the consequences of lightning-induced over-voltages. However, surge arrester protection in electric grids is challenging due to the intrinsic complexities of distribution grids, including overhead lines and power components such as transformers. In this paper, an optimal arrester placement technique is developed by proposing a multi-objective function that includes technical, safety and risk, and economic indices. However, an effective placement model demands a comprehensive and accurate modeling of an electric grid’s components. In this light, appropriate models of a grid’s components including an arrester, the earth, an oil-immersed transformer, overhead lines, and lightning-induced voltage are developed. To achieve accurate models, high-frequency transient mathematical models are developed for the grid’s components. Notably, to have an accurate model of the arrester, which critically impacts the performance of the arrester placement technique, a new arrester model is developed and evaluated based on real technical data from manufacturers such as Pars, Tridelta, and Siemens. Then, the proposed model is compared with the IEEE, Fernandez, and Pinceti models. The arrester model is incorporated in an optimization problem considering the performance of the over-voltage protection and the risk, technical, and economic indices, and it is solved using the particle swarm optimization (PSO) and Monte Carlo (MC) techniques. To validate the proposed arrester model and the placement technique, real data from the Chopoghloo feeder in Bahar, Hamedan, Iran, are simulated. The feeder is expanded over three different geographical areas, including rural, agricultural plain, and mountainous areas.

A biomechanical investigation of miniscrews placed on a mandible for temporary anchorage; a patient-specific finite element analysis

Miniscrews are temporary skeletal anchorage devices that are widely used in orthodontic treatment, and their success depends on the placement area, angle, technique, and screw dimensions. This study aimed to investigate the effects of miniscrew lengths, insertion angles, and force directions on a mandible model consisting of teeth, cortical and cancellous bones. One Dental Volumetric Tomography (DVT) scan from a patient who had miniscrews were used for mandibular bone modeling to perform finite element analysis. The model variables included miniscrew lengths (6, 8, and 10 mm), insertion angles (−15°, 45°, 60°, and 90°), and force directions (30°, 45°, and 60°). The minimum and maximum stresses were calculated as 18.61 and 37.11 MPa at 6 mm and 10 mm, respectively. According to the insertion angles, the lowest stress was observed at 60°, while the highest stress was found at 15° in the ventral direction. At force directions, the lowest stress was at 60°, and the highest stress was at 45°. However, there were no significant differences in insertion angles and force directions. A statistically significant difference was determined in miniscrew length. As a result, the best result was calculated to be 6 mm inserted at a 60° angle, which could induce the lowest stress. Increasing the miniscrew length will increase the stress on the mandible. In addition, because of the higher force direction, stress decreases with shorter power arms.

Leveraging Descriptor Learning and Functional Map-based Shape Matching for Automatic Landmark Acquisition.

Geometric morphometrics is widely employed across the biological sciences for the quantification of morphological traits. However, the scalability of these methods to large datasets is hampered by the requisite placement of landmarks, which can be laborious and time consuming if done manually. Additionally, the selected landmarks embody a particular hypothesis regarding the critical geometry pertinent to the biological inquiry at hand. Modifying this hypothesis lacks flexibility, necessitating the acquisition of an entirely new set of landmarks on the entire dataset to reflect any theoretical adjustments. In our research, we investigate the precision and accuracy of landmarks derived from the comprehensive set of functional correspondences acquired through the functional map framework of geometry processing. We use a deep functional map network to learn shape descriptors that effectively yield functional map-based and point-to-point correspondences between the specimens in our dataset. We then interrogate these maps to identify corresponding landmarks given manually placed landmarks from the entire dataset. We assess our method by automating the landmarking process on a dataset comprising mandibles from various rodent species, comparing its efficacy against MALPACA, a cutting-edge technique for automatic landmark placement. Compared to MALPACA, our model is notably faster and maintains competitive accuracy. The Root Mean Square Error (RMSE) analysis reveals that while MALPACA generally exhibits the lowest RMSE, our models perform comparably, especially with smaller training datasets, suggesting strong generalizability. Visual evaluations confirm the precision of our landmark placements, with deviations remaining within an acceptable range. These findings underscore the potential of unsupervised learning models in anatomical landmark placement, providing a viable and efficient alternative to traditional methods.

Arthroscopic Management of Anterior Shoulder Instability: A Study of Functional Outcome and Analysis.

Background The remarkable range of motion of the shoulder comes at the cost of increased instability, especially anterior instability. Arthroscopic Bankart repairwith or without remplissage, which is a minimally invasive surgery, is the preferred treatment for recurrent anterior instability. This study investigated the effectiveness of Bankart repair, with or without remplissage, in restoring function, preventing redislocation, and improving patient satisfaction. Methods A prospective observational study examined 40 patients (19-50years old) with recurrent anterior instability and MRI-confirmed Bankart or Bankartwith Hill-Sachs lesions. Patients underwent arthroscopic Bankart repair with or without remplissage based on the inclusioncriteria of this study. Preoperative assessments included demographics, history, physical examination, American Shoulder and Elbow Surgeons (ASES) score, Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score, ROWE score,and plain MRIof the shoulder joint. Post-operative radiographs and rehabilitation were advised. Functional recovery was evaluated at three months and six months after surgery. Results All patients underwent Bankart repair. Among them, 22 with engaging Hill-Sachs lesions received an additional remplissage procedure. Both groups showed significant improvements in their functional scores (p<0.05) and returned to their prior activities. However, the additional remplissage group had a slightly reduced meanexternal rotation (86.59°) compared with the Bankart repair-onlygroup (90°). Notably, the recurrence rate was very low, with only one patient (2.5%) experiencing instability. Conclusion Our study emphasizes the importance of propercapsulolabraltissue elevationto achieve a sufficient labral bump during Bankart repair. This technique allowed us to efficiently use only two suture anchors in 35 cases (87.5%). Additionally, remplissage was performed on all identified engaging Hill-Sachs lesions. We found that proper anchor placement and suturing techniques were crucial for successful Bankart repair.The emphasis on the potential cost benefits of a two-anchor approach is a valuable contribution to the field.