Purpose: This study focused on analyzing the contact pressure and area on different patellar component designs in total knee arthroplasty (TKA) to evaluate biomechanics related to the patellofemoral (PF) joint. Materials and Methods: The patellar components studied included the dome design, modified dome design, and anatomical design implants. Using finite element analysis and mechanical testing, the pressure and area were evaluated. The first loading condition was simulated at flexion angles of 0°, 15°, 45°, 90°, 120°, and 150°. The second loading condition was simulated for a clinically relevant scenario, involving a 2-mm medial shift at a flexion angle of 45°. Results: For both the modified dome and anatomical designs, the contact area and pressure increased with the flexion angle. The dome design reached its maximum contact area at a flexion angle of 120°. Among the designs, the anatomical design had the largest contact area and a lower contact pressure compared to the dome and modified dome designs. However, when a medial shift of 2 mm was simulated at a 45° flexion angle, which can occur clinically, the anatomical design showed edge contact, leading to higher contact pressure and reduced contact area. In contrast, the modified dome design demonstrated the lowest contact pressure and the greatest contact area under the same shifted conditions. Conclusion These findings suggest that the design of the patellar component significantly affects patellar biomechanics and stability. Specifically, the modified dome design showed improved biomechanical effects in clinically relevant scenarios. Therefore, patellar components with a modified dome design are expected to better manage PF joint pain and reduce complications in TKA.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Purpose: This study focused on analyzing the contact pressure and area on different patellar component designs in total knee arthroplasty (TKA) to evaluate biomechanics related to the patellofemoral (PF) joint. Materials and Methods: The patellar components studied included the dome design, modified dome design, and anatomical design implants. Using finite element analysis and mechanical testing, the pressure and area were evaluated. The first loading condition was simulated at flexion angles of 0°, 15°, 45°, 90°, 120°, and 150°. The second loading condition was simulated for a clinically relevant scenario, involving a 2-mm medial shift at a flexion angle of 45°. Results: For both the modified dome and anatomical designs, the contact area and pressure increased with the flexion angle. The dome design reached its maximum contact area at a flexion angle of 120°. Among the designs, the anatomical design had the largest contact area and a lower contact pressure compared to the dome and modified dome designs. However, when a medial shift of 2 mm was simulated at a 45° flexion angle, which can occur clinically, the anatomical design showed edge contact, leading to higher contact pressure and reduced contact area. In contrast, the modified dome design demonstrated the lowest contact pressure and the greatest contact area under the same shifted conditions. Conclusion These findings suggest that the design of the patellar component significantly affects patellar biomechanics and stability. Specifically, the modified dome design showed improved biomechanical effects in clinically relevant scenarios. Therefore, patellar components with a modified dome design are expected to better manage PF joint pain and reduce complications in TKA.

Purpose: This study focused on analyzing the contact pressure and area on different patellar component designs in total knee arthroplasty (TKA) to evaluate biomechanics related to the patellofemoral (PF) joint. Materials and Methods: The patellar components studied included the dome design, modified dome design, and anatomical design implants. Using finite element analysis and mechanical testing, the pressure and area were evaluated. The first loading condition was simulated at flexion angles of 0°, 15°, 45°, 90°, 120°, and 150°. The second loading condition was simulated for a clinically relevant scenario, involving a 2-mm medial shift at a flexion angle of 45°. Results: For both the modified dome and anatomical designs, the contact area and pressure increased with the flexion angle. The dome design reached its maximum contact area at a flexion angle of 120°. Among the designs, the anatomical design had the largest contact area and a lower contact pressure compared to the dome and modified dome designs. However, when a medial shift of 2 mm was simulated at a 45° flexion angle, which can occur clinically, the anatomical design showed edge contact, leading to higher contact pressure and reduced contact area. In contrast, the modified dome design demonstrated the lowest contact pressure and the greatest contact area under the same shifted conditions. Conclusion These findings suggest that the design of the patellar component significantly affects patellar biomechanics and stability. Specifically, the modified dome design showed improved biomechanical effects in clinically relevant scenarios. Therefore, patellar components with a modified dome design are expected to better manage PF joint pain and reduce complications in TKA.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Purpose: This study focused on analyzing the contact pressure and area on different patellar component designs in total knee arthroplasty (TKA) to evaluate biomechanics related to the patellofemoral (PF) joint. Materials and Methods: The patellar components studied included the dome design, modified dome design, and anatomical design implants. Using finite element analysis and mechanical testing, the pressure and area were evaluated. The first loading condition was simulated at flexion angles of 0°, 15°, 45°, 90°, 120°, and 150°. The second loading condition was simulated for a clinically relevant scenario, involving a 2-mm medial shift at a flexion angle of 45°. Results: For both the modified dome and anatomical designs, the contact area and pressure increased with the flexion angle. The dome design reached its maximum contact area at a flexion angle of 120°. Among the designs, the anatomical design had the largest contact area and a lower contact pressure compared to the dome and modified dome designs. However, when a medial shift of 2 mm was simulated at a 45° flexion angle, which can occur clinically, the anatomical design showed edge contact, leading to higher contact pressure and reduced contact area. In contrast, the modified dome design demonstrated the lowest contact pressure and the greatest contact area under the same shifted conditions. Conclusion These findings suggest that the design of the patellar component significantly affects patellar biomechanics and stability. Specifically, the modified dome design showed improved biomechanical effects in clinically relevant scenarios. Therefore, patellar components with a modified dome design are expected to better manage PF joint pain and reduce complications in TKA.

Background and Objectives: Among various emerging catheter-based treatments for severe tricuspid regurgitation (TR), the spacer device can reduce the regurgitation orifice without manipulating the valve leaflet. However, its clinical application has been hampered by traumatic anchoring to the myocardium and the coaxial alignment of the balloon resulting in insufficient TR reduction. This study aimed to evaluate the early-stage safety, technical feasibility, and preliminary efficacy of the novel atraumatic vertical spacer in patients with isolated severe TR. Methods: All procedures were guided by fluoroscopy and transthoracic echocardiography.The maximum device placement time with an inflated balloon was 24 hours. Changes in the amount of TR, right ventricular function, and patient hemodynamics were measured during balloon deployment. Results: A total of 7 patients (median age 74), underwent successful device implantation without procedure-related complications. During balloon inflation (median 25 minutes), there were no symptoms or signs indicative of TR intolerance. TR was reduced by 1 grade or greater in all patients, with 2 patients exhibiting a reduction of 3 grades, from torrential TR to a moderate degree. Mild TR after balloon inflation was achieved in 3 patients with baseline severe TR. The TR reduction observed during initial balloon deployment was sustained during the subsequent balloon maintenance period. Conclusions The Pivot-balloon procedure was safe, technically feasible, and effective in reducing TR in patients with severe TR. No periprocedural complications or adverse cardiovascular events were reported during device placement with TR reduction observed in all patients. However, longer-term follow-up is needed to confirm safety and treatment effect.

Purpose: This study focused on analyzing the contact pressure and area on different patellar component designs in total knee arthroplasty (TKA) to evaluate biomechanics related to the patellofemoral (PF) joint. Materials and Methods: The patellar components studied included the dome design, modified dome design, and anatomical design implants. Using finite element analysis and mechanical testing, the pressure and area were evaluated. The first loading condition was simulated at flexion angles of 0°, 15°, 45°, 90°, 120°, and 150°. The second loading condition was simulated for a clinically relevant scenario, involving a 2-mm medial shift at a flexion angle of 45°. Results: For both the modified dome and anatomical designs, the contact area and pressure increased with the flexion angle. The dome design reached its maximum contact area at a flexion angle of 120°. Among the designs, the anatomical design had the largest contact area and a lower contact pressure compared to the dome and modified dome designs. However, when a medial shift of 2 mm was simulated at a 45° flexion angle, which can occur clinically, the anatomical design showed edge contact, leading to higher contact pressure and reduced contact area. In contrast, the modified dome design demonstrated the lowest contact pressure and the greatest contact area under the same shifted conditions. Conclusion These findings suggest that the design of the patellar component significantly affects patellar biomechanics and stability. Specifically, the modified dome design showed improved biomechanical effects in clinically relevant scenarios. Therefore, patellar components with a modified dome design are expected to better manage PF joint pain and reduce complications in TKA.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.