The Royal Berkshire NHS Foundation Trust is an NHS foundation trust in England, which is responsible for the management of the Royal Berkshire Hospital in Reading, Berkshire, as well as the Prince Charles Eye Unit and the Dialysis Unit, both in Windsor; Bracknell Healthspace, Townlands Hospital in Henley-on-Thames, and West Berkshire Community Hospital, which is between Newbury and Thatcham.
INTRODUCTION:Artificial intelligence (AI) chatbots, powered by large language models, are used increasingly for disseminating surgical information, but concerns about accuracy, hallucinations and source reliability persist. This study evaluates the sources of information upon which these systems rely when producing medical information. As these models generate language without true comprehension or reasoning, assessing the credibility and nature of their referenced sources is essential to promote transparency and support evidence-based integration of AI in healthcare. METHODS:Nine AI chatbots (ChatGPT-5, ChatGPT-5 Think, DeepSeek R1, DeepSeek DeepThink, Google Gemini 2.5 Flash, Grok 3, Grok 4, Perplexity Research and Perplexity Search) were queried with six standardised general surgery prompts, both with and without explicit requests for references (n=108 outputs); 1,249 references were extracted and assessed for quantity, authenticity, quality, source category, accessibility, geographic origin and attribution. RESULTS:Reference provision varied: four chatbots required explicit prompting, whereas others cited consistently. Hallucination rates ranged from 0% (five models) to 34% (Grok 3). Mean quality scores differed significantly, with Perplexity Research achieving the highest score (4.08) and ChatGPT-5 the lowest (2.39), reflecting differences observed in source type. Most references originated from the US or UK. Accessibility was best in Google Gemini (100% open access, clickable citations). Explicit prompting increased reference quantity significantly in six models and quality in one. CONCLUSIONS:AI chatbots exhibit heterogeneous reference integrity, with risks of hallucinations and biases underscoring the need for prompt engineering, model refinements and ongoing evaluation. Our findings suggest ongoing caution is required in surgical contexts to ensure safe, equitable information dissemination.
Knee osteoarthritis (KOA) is a prevalent musculoskeletal condition characterized by a significant therapeutic gap between the failure of conservative medical therapies and surgical arthroplasty. Contemporary evidence supports a model in which chronic synovitis and pathologic neoangiogenesis, closely coupled to perivascular nociceptive nerve growth, serve as significant contributors of pain and peripheral sensitization in KOA. Genicular artery embolization has emerged as a targeted, joint-preserving vascular intervention performed by interventional radiologists that directly addresses the inflammatory and neurovascular components of KOA. The purpose of this societal-endorsed position statement is to synthesize the current knowledge base for genicular artery embolization and review its biologic rationale, clinical evidence, technical considerations, safety profile, and evolving regulatory landscape.
To investigate reperfusion after genicular artery embolization (GAE) in patients with severe osteoarthritis (OA) or persistent pain after total knee replacement (post-TKR), who did not achieve clinical improvement after initial GAE, and to evaluate the clinical efficacy of repeat GAE (reGAE). This prospective observational study included patients with radiographically severe OA or post-TKR pain. GAE was performed using permanent microspheres. Clinical outcome was assessed at 6 weeks, 3, 6, 9, and 12 months using the numeric rating scale (NRS). Minimal clinically important difference (MCID) was defined as an improvement of at least 2 points compared with baseline. Patients failing to achieve MCID at 6 months underwent reGAE. Angiographic blush size before and after embolization during GAE and reGAE was measured and compared. In 55 patients (87 GAEs), a median of 4 (range, 2–6) vessels was treated, with a median total embolic volume of 4.5 mL (1.5–10.1 mL). After initial GAE, 23 patients (42
BACKGROUND AND AIMS:The gut microbiota in active ulcerative colitis (UC) differs from that of healthy individuals. Human milk oligosaccharides (HMOs) are prebiotics found in human breastmilk which promote infant health, but are lesser studied in adults. The objective of this study was to assess the impact of the HMO 2'-fucosyllactose (2'-FL) on symptoms, inflammation, gut microbiota, and systemic metabolism in mild-to-moderate UC. METHODS:In this randomized, double-blind, placebo-controlled crossover clinical trial, 38 patients with mild-to-moderate UC were randomized to receive 28 days of 2'-FL or 28 days of maltodextrin placebo, followed by washout and crossover. Patient-reported outcome measures, feces, urine, and serum samples were collected before and after each intervention, and after a final washout period. RESULTS:Although no clear treatment effect was observed on conventional clinical indices, 2'-FL exposure was associated with improved patient-reported disease control. 2'-FL significantly modulated the gut microbiota, markedly increasing Bifidobacterium abundance (effect size 4.4%, 95% CI 2.33%-6.47%, P = 6.5 × 10-5). Fecal metabolite profiles showed changes consistent with altered microbial carbohydrate metabolism. Exploratory analyses suggested that age and baseline microbiota may influence clinical and biological responsiveness to 2'-FL. CONCLUSIONS:2'-FL exposure was associated with improvement in patient-reported disease control, gut microbiota modulation, and cross-compartmental host-microbial metabolic profile modifications; Clinicaltrials.gov number, NCT06050811.
Despite 14 systematic reviews and meta-analyses published between 2018 and 2026, the role of capsular closure after hip arthroscopy for femoroacetabular impingement syndrome remains controversial. While several studies report superior outcomes following capsular repair, others demonstrate little or no clinically meaningful benefit. This persistent inconsistency raises the possibility that current meta-analyses may be addressing the wrong question. Most published studies compare different capsular management strategies, including non-closure, partial (T-capsule) repair and complete capsular closure, across highly heterogeneous patient populations while largely ignoring baseline hip stability characteristics. Patients with BDDH, generalized ligamentous laxity, increased femoral version, and other manifestations of microinstability are frequently analysed together with mechanically stable hips. Consequently, pooled estimates may represent averages across fundamentally different biomechanical phenotypes. The common hidden thread running through all the studies might simply be that capsular closure is likely dependent on the underlying stability profile of the hip rather than being universally beneficial or universally unnecessary. Future studies and meta-analyses should move beyond simple comparisons of closure versus non-closure and instead focus on stability phenotype-based analyses. The key question may no longer be whether capsular closure works, but rather in which hips capsular closure matters.
