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Introduction: Mean Platelet Volume (MPV) is encountered in the literature as a diagnostic marker used to monitor infectious and inflammatory events. We aimed to investigate whether or not there was a change in platelet and MPV parameters in patients diagnosed with periprosthetic join infection (PJI). Material and Methods: A total of 110 patients were included in the study, consisting of 37 (33.6%) patients with periprosthetic join infection, 38 (34.6%) patients with total knee arthroplasty (TKA), and 35 (31.8%) control group subjects. During the preoperative period and follow-up, MPV, platelet, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values were assessed from routine laboratory tests. Statistical analyses of values between and within groups were conducted using Shapiro-Wilk test, One-way ANOVA, Bonferroni’s test, Pearson’s test, and Chi-square test. P0.05). Postoperative MPV levels were significantly lower and platelet, ESR and CRP levels were significantly high in the PJI group compared to both the control group and the TKA group (p

Background: To evaluate whether there are any differences in the efficacies of microfracture (MF) surgeries used in the treatment of focal cartilage lesions alone or in combination with adjuvant therapies.Methods: 42 rats were included in the study. Group 1 received MF alone, Group 2 received platelet rich plasma (PRP) after MF, Group 3 received hyaluronic acid (HÁ) after MF, Group 4 received a synthetic peptide (SP) after MF, Group 5 received a SP plus PRP therapy after MF, and Group 6 received a SP plus HA therapy. Group 7 was designated as the control group. The rats knees were evaluated with the International Cartilage Repair Society Cartilage Repair Assessment 1 and 2 (ICRS-1 and ICRS-2).Results: The ICRS-1 scores were lower in Group 1 than in Group 2, Group 3, Group 4, and Group 7 (p < 0.05). The ICRS-1 scores were higher in Group 7 than in Group 5 and Group 6 (p < 0.05). The ICRS-2 scores in Group 7 were similar to those in Group 2, Group 3, and Group 4 (p < 0.05), the scores were found to below in Group 1, Group 5, and Group 6 (p < 0.05). The inflammation scores were lower in Group 3 than in Group 2 and Group 4 (p < 0.05).Conclusion: In the MF treatment of focal chondral lesions, SP, PRP, and HA injections have a beneficial adjuvant effect based on macroscopic and histopathological findings. However, the combination of these adjuvants is less beneficial than their individual usage

Amaç: Kronik peroneal tendon yırtıklarının rekonstrüksiyonunda tendon transferleri ve otogreftler kullanılabilir. Bu kadavra çalışmasında peroneal tendonların rekonstrüksiyonu için otogreft hamstring tendonlarının kullanımının çap uygunluğu açısından değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmada 13 (4 kadın, 9 erkek) taze donmuş kadavra alt ekstremitesinden otogreft olarak 13 adet makroskopik yaralanması ve dejenerasyonu olmayan, hamstring tendonları (gracilis, semitendinosus) standart yöntemler ile elde edildi ve ölçüme alındı. Ardından aynı kadavraların peroneal tendonları (peroneus longus, peroneus brevis) standart yöntemler ile elde edilerek ölçüme alındı. Tendon çap ölçümleri tendonların en kalın olduğu orta bölgesinden dijital mikro kumpas yardımıyla yapıldı. Ölçümler sonucunda hamstring tendonları ile her iki peroneal tendon kalınlıkları istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen kadavraların yaş ortalaması 74,07±12,25 (minimum: 51, maksimum: 94) yıl iken vücut kitle indeksi ortalaması 25,38±6,07 olarak bulundu. Çapları değerlendirilen tendonlar ile cinsiyet arasında istatistiksel olarak anlamlı bir fark bulunmadı (her biri için p>0,05). Hamstring tendonları (grasilis ve semitendinosus) boyutları ile, peroneus longus ve brevis tendonları arasında pozitif bir korelasyon mevcuttu (her biri için p

OBJECTIVE The aim of this study was to investigate whether collagenase clostridium histolyticum (CCH) reduces intra-articular fibrotic adhesion formation in a rat model of arthrofibrosis. METHODS A total of 24 male Wistar rats (7 months old, weighing 220 -275 g) were randomly and equally assigned to one of two groups: the collagenase group and the control group (n = 12 each). In each group, a partial capsulotomy, and synovectomy were performed in knee. After a partial capsulotomy and synovectomy were performed in each group, the collagenase group received intra-articular CCH of 0.008 mg in 0.1 mL saline solution while the control group received the equal volume of intra-articular saline solution alone. After 6 weeks of surgery, the rats were sacrificed by decapitation, and the following outcome measures were collected. Knee range of motion (ROM) was measured using with a goniometer under 20 g force. Adhesion formation was rated using the macroscopic visual scoring system after the knee joint was exposed through a lateral parapatellar approach. Histological evaluation was performed on samples including connective tissue and fibrotic adhesions, and fibroblast cell numbers were measured performed per square. Levels of interleukin 1 (IL-1) and fibroblast growth factor (FGF) were assayed by ELISA from the intra-articular fluid. RESULTS The macroscopic visual scoring system was significantly lower in the collagenasegroup (median = 1, range = 0-2) than in the control group (median = 2, range = 1-3)( < 0.001).ROMwas significantly higher in the collagenase group (102° ± 12.1°) than in the control group (77° ±8.94°) (P

Background The Internet has developed into a fast and easy to access source of information. The second most popular social media network is YouTube. We aimed to evaluate the accuracy and quality of videos uploaded to YouTube about Bankart lesion without diagnostic or treatment-related criteria. Methods Various keywords were searched for on YouTube. Videos were evaluated with the DISCERN and JAMA Benchmark scoring systems by two independent reviewers. Results A total of 48 videos were taken into evaluation as a result of the search. The mean view count was 28909.68 ± 30264.3. Mean length of the videos was 313,06 ± 344.65. The average DISCERN score of both reviewers was 2.35 ± 0.91. The average JAMA Benchmark score of both reviewers was 2.11 ± 0.77. Conclusion We concluded that the accuracy and reliability of the videos obtained from YouTube by searching for the words Bankart and labrum lesion/injury/treatment are low.

Purpose: The aim of the study was to evaluate whether or not there was any incompatibility between two-strand hamstring tendons taken from the same knee and the ATFL and it was the determination of suitable footprint points in the fibula and talus for anatomical ATFL reconstruction. Methods: 16 fresh frozen cadaver specimens were dissected to gracilis and semitendinosus tendons and the anterior talofibular ligament. The origins, insertions, distances from osseous landmarks of fibular talus of ATFL were determined. The diameters of gracilis, semitendinosus and ATFL were calculated. There was a moderate correlation between body height and the distance between the distal of inferior lateral malleolus and the fibular adhesion site of ATFL (r: 36.5 p: 0.036). There was a weak correlation between body height and the distance between the apex of the lateral talar process and the talus adhesion site of ATFL in a single bundle (r: 28.4 p: 0.002). There was no correlation between the distance from proximal and distal adhesion side of ATFL and body height in the double bundle (p: 0.241). Results: There was no significant relationship between ATFL diameter and gracilis, semitendinosus and both hamstring in women. A significant relationship at 80.5% was determined between the ATFL and the gracilis diameter in man. A significant relationship at 92.6% was determined between the ATFL and the semitendinosus diameter in man. Conclusion: It was determined that there is not compatibility between the gracilis tendons, the semitendinosus tendon and ATFL in women. It should be supported by biomechanical and clinical studies whether this incompatibility has a clinical effect or not.

WOS: 000361650300007 PubMed: 26133944 Background Hyaluronic acid and glycosaminoglycans have shown positive effects in improving lateral epicondylitis and other tendinosis conditions. Therefore, we designed a prospective, randomized study to compare the effects of a combined sodium hyaluronate and chondroitin sulfate (HA + CS) injection versus a triamcinolone injection in the treatment of lateral epicondylitis. Methods In total, 57 consecutive patients with clinically diagnosed lateral epicondylitis were divided randomly into two groups. In the HA + CS group, 25 patients received a single injection of a solution containing an HA + CS combination and prilocaine HCl, while the 32 patients in the triamcinolone group received a single injection of a solution of triamcinolone and prilocaine HCl. We evaluated the pain and function outcome measures using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire at the beginning of the study, and 3 and 6 months after the injection. Additionally, the Minimum Clinically Important Difference values and percentage changes in the PRTEE subscale scores between the assessments were calculated. Results No serious adverse events were reported throughout the study. The mean pain and function scores for the HA + CS and triamcinolone groups had significantly improved at 3 months, but the mean function scores in the HA + CS group were statistically significantly better when compared to the triamcinolone group. At 6 months, both groups had significantly improved mean pain and function scores, compared to the baseline scores; however, the mean pain and function scores in the 6-month HA + CS treatment group were better than in the 6-month triamcinolone group. The relative change for the mean total score in the HA + CS group was much better when compared with the triamcinolone group, and the HA + CS treatment group showed clinically significant improvement when compared with triamcinolone group at 3 and 6 months. Conclusions This study supports the idea that for a single injection treatment of patients with lateral epicondylitis, a combination injection of HA + CS may offer better pain benefits for 6 months after injection, when compared to triamcinolone. Type of study/level of evidence Level II, Randomized Clinical Trial, Prospective Comparative Study.

OBJECTIVES This study aims to evaluate clinical and radiological findings of a series of patients with avascular necrosis of the femur head (ANFH) treated by core decompression and vascular pedicled iliac crest grafting. PATIENTS AND METHODS This retrospective study included 26 hips of 22 patients (14 males, 8 females; mean age 36 years; range 16 to 48 years) with ANFH using the vascularized iliac bone grafting between March 2003 and July 2010 in our clinic. The main predisposing factor was steroid use in 13 patients. All patients were assessed clinically according to the Harris hip score and by radiographs by the Association Internationale de Recherche sur la Circulation Osseuse (ARCO) staging system. RESULTS The mean follow-up was 36 (range 14 to 62) months. Eleven hips (42%) had stage II and 15 hips (58%) had stage III ANFH. The mean Harris scores increased from 52 (range 31 to 63) to 82.8 (range 62 to 90) after surgery. Based on clinical outcomes, 18 hips (69%) were presented as excellent and good, while eight hips presented fair and poor. According to the ARCO staging system, satisfactory results were provided in 17 (65%) of the 26 hips. Two of four hips at preoperatively stage II progressed to stage III, two other hips to stage IV. Five hips at stage III preoperatively progressed to stage IV and these hips had to undergo hip replacement. CONCLUSION Our results suggest that core decompression and the vascular pedicled iliac bone grafting are effective in early stages of ANFH.

Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months). Patients%u2019 scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85%) A (excellent) and B (good) group and 3 patients took place as C (adequate) group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large numbers in order to determine improving clinical outcome, preventing degeneration and restoring the knee biomechanics better.

The use of arthroscopy in the management of tibial plateau fractures is not a particularly new concept. It has been used successfully for Schatzker types I–III fractures. In addition to evaluating the fracture itself, it is easier to evaluate the other intraarticular structures. Coventionally, reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window, which is not without limitations, including difficulty with reduction of the fracture, as well as bone grafting though the resultant short subchondral tunnel. Also, there is a risk of lateral vascular supply distrubtion because of same side fracture. A medially based metaphyseal window to approach lateral tibial plateau fractures allows for minimal insult to the soft tissues, with advantageous ease of reduction and grafting through a longer tunnel for subchondral support. We aimed to present our initial experiences in twelwe cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Material-Methods: Our series involves 12 patients with 7 Schatzker type II, 3 Schatzker type I, and 2 Schatzker type III fractures. There were 8 males and 4 females. The average age at the time of surgery was 37 (25-57) years. All of the patients underwent plain radiography and BT in each knee Time from injury to surgery was 6.2 days. Follow up was 18 months (9-22 months).Firstly diagnostic arthroscopy was performed. Concomittant pathology was adreessed as needed. There was 3 lateral meniscus tear that treated with partial meniscectomy. An ACL guide pin was placed percutaneously anteromedial tibia approximately 9 cm distal to the joint line. Once stisfactory positioning a cortical window 1x2 cm. made around the guide pin. Reduction was accomplished with a bone tamp that fits easily into the tunnel. Screws were used as rafters to support the articular surface and subchondral bone. We used in 7 patients lateral plate and screws and in 5 patients only screws. Care was taken to keep pump pressure at approximately 40 millimeters of mercury for alleviate the risk of compartment syndrome. Results: No complications related to the procedure were observed. No secondary loss of reduction was observed in radiological controls. Functional assessment according to HSS of the patients were excellent in 5 cases, good in 5 cases and fair 2 cases. Discussion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. This case series showed satisfactory early clinical results. [Figure: see text][Figure: see text]