Background/Objectives: Cancer-associated cachexia in head and neck squamous cell carcinoma (HNSCC) is challenging to diagnose due to its complex pathophysiology. This study aimed to identify metabolic biomarkers linked to cachexia and survival in HNSCC patients using [¹⁸F]FDG-PET/CT imaging and machine learning (ML) techniques. Methods: We retrospectively analyzed 253 HNSCC patients from Vienna General Hospital and the MD Anderson Cancer Center. Automated organ segmentation was employed to quantify metabolic and volumetric data from [¹⁸F]FDG-PET/CT scans across 29 tissues and organs. Patients were categorized into low weight loss (LoWL; grades 0–2) and high weight loss (HiWL; grades 3–4) groups, according to the weight loss grading system (WLGS). Machine learning models, combined with Cox regression, were used to identify survival predictors. Shapley additive explanation (SHAP) analysis was conducted to determine the significance of individual features. Results: The HiWL group exhibited increased glucose metabolism in skeletal muscle and adipose tissue (p = 0.01), while the LoWL group showed higher lung metabolism. The one-year survival rate was 84.1% in the LoWL group compared to 69.2% in the HiWL group (p < 0.01). Pancreatic volume emerged as a key biomarker associated with cachexia, with the ML model achieving an AUC of 0.79 (95% CI: 0.77–0.80) and an accuracy of 0.82 (95% CI: 0.81–0.83). Multivariate Cox regression confirmed pancreatic volume as an independent prognostic factor (HR: 0.66, 95% CI: 0.46–0.95; p < 0.05). Conclusions: The integration of metabolic and volumetric data provided a strong predictive model, highlighting pancreatic volume as a key imaging biomarker in the metabolic assessment of cachexia in HNSCC. This finding enhances our understanding and may improve prognostic evaluations and therapeutic strategies.

Background: Young patients with tongue squamous cell carcinoma (TSCC) mostly lack typical prognostic markers and face a dire prognosis. The aim of this study was to analyze the prognostic relevance of lymphocyte-to-monocyte ratio (LMR) in TSCC patients, with a special emphasis on patients under 45 years. Methods: This retrospective study included all patients primarily treated for TSCC. The prognostic relevance of LMR was investigated in terms of predicting the overallsurvival (OS) and disease-free survival (DFS). Results: A total of 74 patients were included and the young cohort (<45 years) comprised 27 individuals. The mortality and recurrence rates were 39.2% (n = 29) and 37.8% (n = 28), respectively. OS and DFS were significantly shorter in the low LMR group within the whole cohort. Furthermore, low LMR was associated with worse prognosis, particularly inferior OS (median OS 1.7 vs. 14.6 years, p = 0.0156) and worse DFS (median DFS 0.8 years vs. not reached, p = 0.0405) in the young patient cohort. Conclusions: Our results reveal that pretreatment LMR might become a prognostic tool for young TSCC patients, especially due to its availability. However, further studies on larger cohorts are necessary to validate our results.

Purpose: The purpose of this study was to compare the biomechanical properties of a latest generation all‐suture anchor repair device (ASARD) for meniscal repair with that of a latest generation PEEK‐cage anchor repair device (PCARD) in an experimental setting using cadaveric menisci.Methods: Twenty‐six menisci were obtained from the knees of fresh body donors. Artificially created meniscal lesions were treated randomly, using a single stitch with either an ASARD or a PCARD. Cyclic biomechanical testing, utilising a universal material testing machine and following an established protocol, was carried out and load‐to‐failure (LTF), displacement, stiffness, and mode‐of‐failure (MOF) reported.Results: Mean LTF was found to be 61% higher in the ASARD group at 107.10 N (standard deviation [SD], 42.34), compared to 65.86 N (SD, 27.42) in the PCARD group with statistical significance (p = 0.022). The ASARD exhibited a trend towards higher stiffness (10.35 N; SD, 3.92 versus 7.78 N; SD; 3.59) and higher displacement at cycles one, 100, and 499 (1.64, 3.27, and 4.17 mm versus 0.93, 2.19, and 2.83 mm) compared to the PCARD. Cheese wiring was the most common mode‐of‐failure in both groups (76.9%).Conclusions: This study demonstrates that an ASARD shows a higher mean LTF than a PCARD when compared in an experimental biomechanical setting.Level of evidence: Level III

Background: Osseointegration is essential for the long-term survival of cementless femoral stems and is dependent on periprosthetic bone quality and correct implantation technique. The aim of this study was to evaluate the 3-dimensional long-term fixation patterns of, and bone microarchitecture around, cementless hip stems. Methods: Four specimens with varying degrees of bone quality and fixation characteristics from body donors who had received Alloclassic Zweymüller hip stems during their lifetime (mean time in situ at the time of death: 12.73 years) were evaluated with use of radiographs, high-resolution computed tomography (CT) scans, and hard-tissue histology. The CT voxel size was 85 µm, and the following parameters were calculated: total bone volume, total bone volume fraction, trabecular bone volume, trabecular bone volume fraction, cortical bone volume, cortical bone volume fraction, and cortical thickness. Bone-implant contact and canal fill index values for each Gruen zone of the specimens were calculated with use of histological samples. Results: Femoral stems with apparently good cortical contact on clinical radiographs showed higher values for cortical bone volume, trabecular bone volume, and cortical thickness in the high-resolution CT analysis than femoral stems with apparently weak cortical contact on clinical radiographs. Based on the histological evaluation, the mean bone-implant contact ranged from 22.94% to 57.24% and the mean canal fill index ranged from 52.33% to 69.67% among the specimens. Conclusions: This study demonstrated different osseointegration patterns of cementless femoral stems on the basis of radiographs, high-resolution CT scans, and histological evaluation. Femora with high cortical bone volume and cortical thickness were associated with higher canal fill indices, whereas femora with low cortical bone volume and cortical thickness had lower canal fill indices and showed a characteristic corner-anchorage pattern. Clinical Relevance: Osseointegration patterns and thus the long-term survival of cementless femoral stems are dependent on cortical bone volume and cortical thickness.

During knee arthroscopy, easy orientation is important, and possible landmarks include the lateral intercondylar ridge (LIR) and the lateral bifurcate ridge (LBR). The objective was to show the feasibility of the LIR and the LBR as landmarks of the femoral attachment of the anterior cruciate ligament (ACL) among subjects with different levels of training. Thirty-six formalin-phenol-fixed lower extremities were acquired for this prospective macroscopic anatomical study. All soft tissue apart from the ligaments was removed. The two bundles of the ACL and their origins were identified, marked and photographed. Photographs were taken in an arthroscopic setting. An orthopedic surgeon, an anatomist and a medical student identified the ridges. The LIR existed in 80.6% of samples, while the LBR existed in 13.8% of samples. A significant difference existed between the raters in correctly identifying the LIR (p < 0.01). Due to its high frequency, the LIR seems more reliable than the LBR, especially as the LBR has the potential for false positive identification. Nevertheless, as these ridges are not easily discernible, the surgeon has to know the anatomy of the intercondylar notch perfectly to stand even a small chance of correctly placing drill holes in ACL reconstruction. New guidelines for more easily recognizing LIR and LBR arthroscopically are proposed.