The mobile biconcave insert design in the lateral unicompartmental knee replacement seems appropriate as a innovative, anatomy imitating solution, resulting in a good clinical outcome. Still, bearing dislocation remains a concern, especially in extended indication.

Objective: This prospective study examined risk and resilience predictors of pain and functional recovery in the first six months after major surgery in adolescents. Methods: Adolescents with Adolescent Idiopathic Scoliosis undergoing spinal fusion surgery (n = 100, aged 12 to 18 years, 77% girls) completed assessments prior to surgery, and at three weeks, six weeks, and six months after surgery. Recovery trajectories in pain, health-related quality of life, and objectively registered physical activity were identified. Pre-surgical pain catastrophizing and pain intensity (risk), and psychological flexibility and postsurgical pain acceptance (resilience) were examined as predictors of recovery.Results: Latent growth class analyses revealed four distinct pain recovery trajectories (i.e., Severe-Moderate (11 %, n = 9), Mild-No (58%, n = 49), Moderate-Mild (24%, n = 20), and Moderate-Severe (7%, n = 6) pain trajectory), two Health-Related Quality of Life (HRQOL) recovery trajectories, two trajectories characterizing recovery in average daily physical activity at moderate-to-vigorous intensity (MVPA), and three trajectories characterizing recovery in total physical activity volume characterized by the average daily number of steps. Subsequent MANOVA analyses revealed that pre-surgical pain intensity (partial η 2 = .21, p < .001)and pain catastrophizing (partial η 2 = .13, p < .01) were both predictive of poorer recovery in HRQOL, and pain catastrophizing additionally predicted poorer pain recovery (partial η 2 = .15, p < .05). Psychological flexibility (partial η 2 = .25, p < .001) and postsurgical pain acceptance (partial η 2 = .07, p < .05) were predictive of more favorable recovery trajectories in HRQOL, and psychological flexibility additionally predicted more favorable recovery trajectories in postsurgical pain (partial η 2 = .15, p < .05). Daily MVPA trajectories were not significantly predicted by any of the hypothesized factors, while pre-surgical pain catastrophizing levels were predictive of a delayed recovery trajectory in daily amount of steps (partial η 2 = .17 p < .01). Conclusions: Pre-surgical screening could include assessment of pain intensity, pain catastrophizing, psychological flexibility, and pain acceptance to identify adolescents who are at-risk for poorer recovery. These are potentially modifiable factors that can be targeted in pre-surgical interventions to prevent poor and foster adaptive outcomes after major surgery in adolescents.

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Staged insertion of dual GR systems permits strong distraction, with acceptable correction of severe deformities and minimal complications. These slides can be retrieved under Electronic Supplementary Material.

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