Aims This study compares the PFC total knee arthroplasty (TKA) system in a prospective randomized control trial (RCT) of the mobile-bearing rotating-platform (RP) TKA against the fixed-bearing (FB) TKA. This is the largest RCT with the longest follow-up where cruciate-retaining PFC total knee arthroplasties are compared in a non-bilateral TKA study. Patients and Methods A total of 167 patients (190 knees with 23 bilateral cases), were recruited prospectively and randomly assigned, with 91 knees receiving the RP and 99 knees receiving FB. The mean age was 65.5 years (48 to 82), the mean body mass index (BMI) was 29.7 kg/m2 (20 to 52) and 73 patients were female. The Knee Society Score (KSS), Knee Society Functional Score (KSFS), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 12-Item Short-Form Health Survey Physical and Mental Component Scores (SF-12 PCS, SF-12 MCS) were gathered and recorded preoperatively, at five-years’ follow-up, and at ten years’ follow-up. Additionally, Knee Injury and Osteoarthritis Outcome Scores (KOOS) were collected at five- and ten-year follow-ups. The prevalence of radiolucent lines (RL) on radiographs and implant survival were recorded at five- and ten-year follow-ups. Results At the ten-year follow-up, the RP group (n = 39) had a statistically significant superior score in the OKS (p = 0.001), WOMAC (p = 0.023), SF-12 PCS (p = 0.019), KOOS Activities of Daily Living (ADL) (p = 0.010), and KOOS Sport and Recreation (Sport/Rec) (p = 0.006) compared with the FB group (n = 46). The OKS, SF-12 PCS, and KOOS Sport/Rec at ten years had mean scores above the minimal clinically important difference (MCID) threshold. There was no significant difference in prevalence of radiolucency between groups at five-years’ follow-up (p = 0.449), nor at ten-years’ follow-up (p = 0.08). Implant survival rate at 14 years postoperative was 95.2 (95% CI 90.7 to 99.8) and 94.7 (95% CI 86.8 to 100.0) for the RP and FB TKAs, respectively. Conclusion At ten-year follow-up, the mobile-bearing knee joint arthroplasty had statistically and clinically relevant superior OKS, SF-12 PCS, and KOOS (Sport/Rec) than the fixed-bearing platform. No difference was seen in prevalence of radiolucent lines. There was a greater than 94% implant survival rate for both cohorts at 14 years. Cite this article: Bone Joint J 2018;100-B:1336–44.

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Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training.

Existing industry standards have established the compressive strain capacity of pipelines within an empirical basis. The compressive strain capacity is generally associated with the peak moment. This approach has evolved from elastic stability concepts used in structural engineering for unrestrained pipe segments subject to primary loading (i.e. force or load control) conditions. This limiting condition does not take advantage of the observed performance for buried pipelines, when subjected to displacement control events such as differential ground movement, where the pipe curvature can exceed the peak moment response without loss of pressure containment integrity. This inherent conservatism may have a negative impact on project economics or sanction where the compressive strain capacity, rather than tensile rupture limits, governs the strain based design methodology. For these conditions, alternative performance limits defining the pipe compressive strain capacity are required. A numerical study was conducted, using finite element methods, to examine possible alternative compressive strain criteria for use in strain-based design applications. The results from this study and the requirements to bring these concepts forward through integration with industry recommended practice are presented.

— The elastic—plastic fracture mechanics test method EGF P1–87 D: EGF Recommendations for Determining the Fracture Resistance of Ductile Materials has been validated by an extensive round robin, covering fracture tests and their evaluation as well as scanning electron fractography. The results confirmed the suitability of the procedure, but suggested some modifications. The resulting procedure ESIS P1–90 was then further modified and its actual designation is ESIS P1–92. The present report provides comprehensive information on the determination of crack growth resistance curves and initiation values. Particular emphasis is on single specimen techniques and on determining the stretch zone width. Beyond the validation of the ESIS procedure the information given is pertinent to elastic‐plastic fracture testing in general.