OBJECTIVE: To evaluate the effect of patient sex on 10-year patient-reported outcomes (PROs) and survivorship after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS).
METHODS: Patients who underwent primary HA for FAIS with minimum 10-year follow-up from 1/2012-12/2013 were retrospectively reviewed. Female patients were propensity-matched to male patients in a 1:1 ratio by age and body mass index. PROs and rates of minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) achievement were compared between cohorts. Rate of reoperation-free survivorship was compared between sexes.
RESULTS: One-hundred and twenty-one- females (age: 36.2 ± 12.3 years) were matched to 121 males (age: 35.7 ± 11.3 years, p = 0.594) at average follow-up of 10.4 ± 0.4 years. There were no differences in any preoperative demographic characteristics between the groups (p ≥ 0.187). Both groups demonstrated significant improvement in every PRO measure between the preoperative and 10-year postoperative time points (p < 0.001). The magnitude of improvement was similar between the groups for all PRO measures (p ≥ 0.139). At 10-years, female patients trended towards higher MCID achievement for the Hip Outcome Score-Activities of Daily Living subscale (HOS-ADL) than male patients (72.7% vs. 57.3%, p = 0.061), with otherwise similar MCID achievement rates. Females trended towards significantly lower HOS-Sports Subscale PASS achievement (65.4% vs. 77.1%, p = 0.121) with otherwise similar PASS achievement rates between the groups (p ≥ 0.170).
CONCLUSIONS: Female and male patients experienced similar improvement in PROs at ten-year follow-up. MCID and PASS achievement rates were predominantly similar between sexes. Survivorship did not differ between groups. Long-term success can be expected for appropriately indicated patients undergoing HA for FAIS, regardless of sex.
METHODS: III, Retrospective Cohort Study.

UNASSIGNED: Robotic-arm-assisted unicompartmental knee arthroplasty (UKA) is an excellent solution for patients suffering from single-compartment knee arthritis. While outcomes tend to be favorable for UKAs, revision operations, commonly due to component malpositioning and malalignment resulting in accelerated wear, are a major concern. Intraoperative technologies, such as robotic assistance, can help better ensure that implants are positioned based on a patient\'s specific anatomy and mechanical physiology. However, long-term survivorship and patient-reported satisfaction with robotic-assisted UKAs are limited. Therefore, the purpose of this study was to assess the 10-year outcomes of patients who underwent robotic-arm-assisted unicompartmental knee arthroplasty. Specifically, we evaluated: 1) 10-year survivorships; 2) patient satisfaction scores; and 3) re-operations.
UNASSIGNED: From a single surgeon and single institution, 185 patients who had a mean age of 65 years (range, 39 to 92) and a mean body mass index of 31.6 (range, 22.4 to 39) at a mean of 10 years follow-up were evaluated (range, 9 to 11). For all patients, the same robotic-assistive device was utilized intraoperatively, and all patients underwent standardized physical therapy and received standardized pain control management. Then 10-year survivorships with Kaplan-Meir curves, patient satisfaction evaluations with a 5-point Likert scale, and re-operations were assessed as primary outcomes.
UNASSIGNED: Overall implant survivorship was 99%, with only two patients requiring revision surgery. There was one patient who was converted to a total knee arthroplasty, while the other patient underwent polyethylene exchange at 5 weeks for an acute infection with successful implant retention. Overall, 97% of the patients were satisfied with their postoperative outcomes, with 81% of patients reporting being very satisfied. There were two other patients who required arthroscopic intervention: one to remove a cement loose body, the other to remove adhered scar from the fat pad and the anterior cruciate ligament.
UNASSIGNED: This study is one of the first to provide longer-term (mean 10-year) survivorship and patient-reported satisfaction outcomes for robotic-assisted UKA patients. These data show strong support for utilizing this surgical technique, as nearly all patients maintained their original prostheses and reported being satisfied after a mean of 10 years. Therefore, based on these results, we recommend the use of robotic assistance when performing UKAs.

BACKGROUND: Total hip replacement (THR) is one of the most common surgical procedures performed worldwide. The controversy surrounding the relative merits of a cemented composite beam or cemented taper-slip stem in total hip replacement continues. Our aims primarily were to assess the 10-year outcomes of cemented stems using Charnley and Exeter prostheses with regional registry data and secondarily to assess the main predictors of revision.
METHODS: We prospectively collected registry data for procedures performed between January 2005 and June 2008. Only cemented Charnley and Exeter stems were included. Patients were prospectively reviewed at 6 months, 2, 5 and 10 years. The primary outcome measure was a 10-year all-cause revision. Secondary outcomes included \'re-revision\', \'mortality\' and functional \'Western Ontario and McMaster Universities Osteoarthritis Index\' (WOMAC) scores.
RESULTS: We recorded a total of 1351 cases in the cohort, 395 Exeter and 956 Charnley stems. The overall all-cause revision rate at 10 years was 1.6%. The revision rate for Charnley stem was 1.4% and 2.3% revision rate for all Exeter stems with no significant difference noted between the two cohorts (p = 0.24). The overall time to revision was 38.3 months. WOMAC scores at 10 years were found to be insignificantly higher for Charnley stems (mean 23.8, σ = 20.11) compared to Exeter stems (mean 19.78, σ = 20.72) (p = 0.1).
CONCLUSIONS: There is no significant difference between cemented Charnley and Exeter stems; they both perform well above the international average. The decline in the use of cemented THA is not fully supported by this regional registry data.

UNASSIGNED: We aimed to compare the 10-year survival outcomes of induction docetaxel plus cisplatin and 5-fluorouracil (TPF), docetaxel plus cisplatin (TP), and cisplatin plus 5-fluorouracil (PF) regimens additional to concurrent chemoradiotherapy (CRT) in locoregionally advanced nasopharyngeal carcinoma (NPC).
UNASSIGNED: Eligible patients with newly diagnosed stage III-IVA NPC were included. Propensity score matching (PSM) was used to balance prognostic covariates. Survival outcomes and toxicities between different groups were compared.
UNASSIGNED: A total of 855 patients between 2009 and 2012 were included, with 395 (46.2%), 258 (30.2%), and 202 (23.6%) receiving TPF plus CRT, TP plus CRT, and PF plus CRT regimens, respectively. After a median follow-up of 111.8 months, multivariate analysis both in the whole cohort and PSM selected 202 pairs showed that TPF plus CRT and TP plus CRT achieved significantly better 10-year overall survival (OS) than PF plus CRT. Sensitivity analysis after excluding patients with T3-4N0 disease demonstrated that TPF plus CRT still achieved significantly better OS than PF plus CRT (HR, 0.580; 95% CI, 0.395-0.852; P = 0.005), while the difference between TP plus CRT and PF plus CRT was marginally significant (HR, 0.712; 95% CI, 0.503-1.008; P = 0.056). With regard to toxicity profile, PF regimen achieved the lowest grade 3-5 toxicities (27.3%).
UNASSIGNED: TPF plus CRT and TP plus CRT were better than PF plus CRT in improving the 10-year OS of patients with stage III-IVA NPC.

Few long-term outcome studies exist evaluating glenohumeral osteoarthritis (GHOA) treatment with arthroscopic management.
To determine outcomes, risk factors for failure, and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at minimum 10-year follow-up.
Case series; Level of evidence, 3.
The CAM procedure was performed on a consecutive series of patients with advanced GHOA who opted for joint preservation surgery and otherwise met criteria for total shoulder arthroplasty. At minimum 10-year follow-up, postoperative outcome measures included change in the American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, 12-Item Short Form Health Survey (SF-12) Physical Component Summary, and visual analog scale for pain, along with the QuickDASH (shortened version of Disabilities of the Arm, Shoulder and Hand) and satisfaction score. Kaplan-Meier survivorship analysis was performed, with failure defined as progression to arthroplasty.
In total, 38 CAM procedures were performed with 10-year minimum follow-up (range, 10-14 years) with a mean patient age of 53 years (range, 27-68 years) at the time of surgery. Survivorship was 75.3% at 5 years and 63.2% at minimum 10 years. Those who progressed to arthroplasty did so at a mean 4.7 years (range, 0.8-9.6 years). For those who did not undergo arthroplasty, American Shoulder and Elbow Surgeons scores significantly improved postoperatively at 5 years (63.3 to 89.6; P < .001) and 10 years (63.3 to 80.6; P = .007). CAM failure was associated with severe preoperative humeral head incongruity in 93.8% of failures as compared with 50.0% of patients who did not go on to arthroplasty (P = .008). Median satisfaction was 7.5 out of 10.
Significant improvements in patient-reported outcomes were sustained at minimum 10-year follow-up in young patients with GHOA who underwent a CAM procedure. The survivorship rate at minimum 10-year follow-up was 63.2%. Humeral head flattening and severe joint incongruity were risk factors for CAM failure. The CAM procedure is an effective joint-preserving treatment for GHOA in appropriately selected patients, with sustained positive outcomes at 10 years.

Cervical disc arthroplasty (CDA) has been advocated as an alternative to anterior cervical discectomy and fusion (ACDF) with the added potential to reduce the risk of adjacent level disc degeneration and segmental instability. However, the long-term adverse events of arthroplasty have yet to be fully reported.
To investigate the 10-year follow-up adverse events rates between CDA and ACDF.
The study was a randomized, prospective, multicenter Investigational Device Exemption (IDE) trial and its continued follow-up as a postapproval study (PAS). Single level surgeries were performed for cervical disc pathologies between May 2002 and October 2004.
n=463 patients.
Adverse events comparison of CDA and ACDF from self-reported and physiologic measures.
At each evaluation time point, subjects were queried for adverse events since their last visit; and all adverse events were documented, regardless of whether or not they appeared related to the surgery or device. Adverse events were recorded, categorized, and assessed for severity and relationship to the study device and/or surgical procedure. The 10-year cumulative rates for each type of adverse events were summarized using a life-table method for the time-to-event analysis. A log-rank test was used to compare the two treatment groups.
A total of 242 patients received CDA and 221 patients received ACDF. At 10-year follow-up, 54% (130/242) of CDA patients and 47% (104/221) of the ACDF subjects were evaluated. At up to 10-year follow-up, 231 patients in the CDA group (cumulative rate 98.4%) and 199 patients in the ACDF group (cumulative rate 98.7%) had at least one adverse event. Overall, the difference in the cumulative rate of all adverse events over 10 years was not statistically different (p=0.166). The cumulative rates of the following adverse events were not different between the two groups for cancer, cardiovascular, death, dysphonia/dysphagia, gastrointestinal, infection, urogenital, respiratory, implant displacement/loosening, implant malposition, neck and arm pain, neurological, other pain, spinal events, and intraoperative vascular injury. However, there were more adverse events in the CDA group resulting from trauma (p=.012) and more spinal events at the index level (p=.006). The ACDF group had significantly more nonunion events (p=.019), and nonunion outcome pending (p=.034), adjacent level spinal events (p=.033), and events that fell into the \"other\" category (p=.015).
The cumulative rates of patients who had any adverse events were not different between the artificial cervical disc and the anterior cervical arthrodesis groups. In addition, the cumulative rates were not different between the two groups for the majority of categories as well.

BACKGROUND: Despite evidence on the short-term benefits of early intervention (EI) service for psychosis, long-term outcome studies are limited by inconsistent results. This study examined the 10-year outcomes of patients with first-episode psychosis who received 2-year territory-wide EI service compared to those who received standard care (SC) in Hong Kong using an historical control design.
METHODS: Consecutive patients who received the EI service between 1 July 2001 and 30 June 2002, and with diagnosis of schizophrenia-spectrum disorders, were identified and matched with patients who received SC first presented to the public psychiatric service from 1 July 2000 to 30 June 2001. In total, 148 matched pairs of patients were identified. Cross-sectional information on symptomatology and functioning was obtained through semi-structured interview; longitudinal information on hospitalization, functioning, suicide attempts, mortality and relapse over 10 years was obtained from clinical database. There were 70.3% (N = 104) of SC and 74.3% (N = 110) of EI patients interviewed.
RESULTS: Results suggested that EI patients had reduced suicide rate (χ2 (1) = 4.35, p = 0.037), fewer number [odds ratio (OR) 1.56, χ2 = 15.64, p < 0.0001] and shorter duration of hospitalization (OR 1.29, χ2 = 4.06, p = 0.04), longer employment periods (OR -0.28, χ2 = 14.64, p < 0.0001) and fewer suicide attempts (χ2 = 11.47, df = 1, p = 0.001) over 10 years. At 10 years, no difference was found in psychotic symptoms, symptomatic remission and functional recovery.
CONCLUSIONS: The short-term benefits of the EI service on number of hospitalizations and employment was sustained after service termination, but the differences narrowed down. This suggests the need to evaluate the optimal duration of the EI service.