nd patients with OSD have an increased PTSA when compared with the control group. This information adds to the body of evidence that increased tibial slope places the proximal tibial physis under abnormal stress which may contribute to the development of pathologic conditions of proximal tibia such as OSD and tibial tubercle fractures.

Level III; retrospective comparative study.

Level III; retrospective comparative study.

Hydroxyapatite (HA) coated flexible intramedullary nailing (FIN) stimulates osteogenic activity. The role of HA-coated intramedullary nails remains unclear in normal bone lengthening. The goal of this study was to quantify the influence of FIN on the External Fixation Index (EFI) in patients with congenital lower limb discrepancy.

Patients with femoral deficiency and fibular hemimelia underwent lengthening by the combined technique of external fixation with titanium (Ti) FIN or HA coated FIN and returned for follow-up at least 12 months after frame removal.

Seventy patients (mean age of 12.6 y) were included 19 monofocal femoral lengthenings, 35 tibial monofocal lengthenings, 16 tibial bifocal lengthenings. The mean EFI’s for those treated with and without HA-coated nails were not significantly different. The Conover posthoc analysis did not reveal a significant influence of the type of FIN on EFI in any subgroup. However, 2-way analysis of variance revealed simultaneous effects of nail types and age one ratio of “elastic Ti-nail diameter/medullary canal diameter at narrowest site” <0.15 seems to be associated with higher risk of fracture at the lengthening site after frame removal.

Both Ti-nail and HA-coated nail lengthening provide good and excellent outcomes for femoral and tibial monosegmental lengthening procedures and ensure reduced EFI. In congenital disorders which were not associated with abnormal bone, there are no differences with regard to EFI using HA-coated or non-HA-coated FIN. The ratio of “elastic Ti-nail diameter/medullary canal diameter at narrowest site” less then 0.15 seems to be associated with higher risk of fracture at the lengthening site after frame removal.

The aim of this study was to investigate whether C7 slope can be used as a substitute for T1 slope in idiopathic scoliosis.

From January 2014 to October 2019, 101 patients who received posterior spinal internal fixation and fusion in our hospital were retrospectively analyzed. After analyzing the visibility of vertebral endplates, 46 cases of C7/T1 vertebral endplates were visible, including 14 males and 32 females, aged 9 to 18 years (mean 14.6±2.0 y). The upper C7 slope, lower C7 slope, T1 slope, cervical lordosis and C2 to 7 sagittal vertebral axis were measured before and after operation and at the last follow-up. Pearson correlation coefficient was used to evaluate the correlation strength between upper C7 slope and T1 slope, and lower C7 slope and T1 slope. Through simple linear regression analysis, linear regression equations were generated from the upper and lower C7 slopes to predict T1 slope.

According to the 2 researchers’ judgment, the visibility rate of the upper C7 endplate was 93.1% beforndplate of T1 is not visible on standard radiographs, the upper or lower C7 slope can be used as a reliable alternative measurement parameter for sagittal balance assessment.

Recent focus on surgical site infections (SSIs) after posterior spine fusion (PSF) has lowered infection rates by standardizing perioperative antibiotic prophylaxis. CQ211 in vitro However, efforts have neglected to detail antibiotic treatment of SSIs. Our aim was to document variability in antibiotic regimens prescribed for acute and latent SSIs following PSF in children with idiopathic, neuromuscular, and syndromic scoliosis.

This study included patients who developed a SSI after PSF for scoliosis at a pediatric tertiary care hospital between 2004 and 2019. Patients had to be 21 years or younger at surgery. Exclusion criteria included growing rods, staged surgery, and revision or removal before SSI diagnosis. Infection was classified as acute (within 90 d) or latent. Clinical resolution of SSI was measured by return to normal lab values. Each antibiotic was categorized as empiric or tailored.

Eighty subjects were identified. The average age at fusion was 14.7 years and 40% of the cohort was male. Most diagnoses werel III.

Level III.

Current advanced imaging classification systems for osteochondritis dissecans (OCD) of the knee grade severity of disease by identifying certain lesion characteristics. The most widely used are the Hefti and Nelson systems. A novel classification presents a simpler 3-group approach to diagnose knee OCD by magnetic resonance imaging (MRI), compared with the Hefti (5-group) and Nelson (4-group) classifications. The purpose of this study was to compare the reliability of this novel classification with that of the more complex, established systems-an initial step in establishing validity and clinical utility.

In total, 120 standardized knee MRIs of patients with established knee OCD were preselected to capture the spectrum of lesion types, with regard to both progression and location of the lesion. Each of the MRIs were independently classified by 2 readers into the novel, Hefti, and Nelson classification systems. A random sample was rereviewed by 1 rater 6 weeks after initial review. The inter-rater and intrninvasive diagnostic method to guide clinical treatment.

Level IV.

Level IV.

Treating neovascular age-related macular degeneration (nAMD) with intravitreal aflibercept (IVT-AFL) treat-and-extend (T&E) can reduce treatment burden. ARIES assessed whether IVT-AFL early-start T&E was noninferior (NI) to late-start T&E.

A randomized, open-label, Phase 3b/4 study that included treatment-naïve patients aged ≥50 years with best-corrected visual acuity (BCVA) 73-25 Early Treatment Diabetic Retinopathy Study letters and active choroidal neovascularization secondary to AMD. Patients received 2mg IVT-AFL at Week (W)0, W4, W8, and W16. At W16 patients were randomized 11 to early-start (2W interval adjustments) or late-start T&E (8W intervals until W48 then 2W interval adjustments). Primary endpoint BCVA change from randomization to W104.

271 patients were randomized. Mean (standard deviation [SD]) BCVA at baseline was 60.2 (12.1; early-T&E) and 61.3 (10.8; late-T&E) letters. Mean (SD) BCVA change (W16-104) was -2.1 (11.4) vs -0.4 (8.4) letters (early- vs late-T&E; least-squares mean difference -2.