The Effect of COVID-19 Pandemic on the Hip Fractures in Advanced Age

Objective: Hip fractures due to domestic low-energy traumas are common problems that can cause significant morbidity and mortality in the elderly population. Since the Covid-19 outbreak, although the lock-down of older people could decrease contagion,the incidence of domestic traumas did not decrease, and led to development of various comorbidities. In this study, we aimed to compare the epidemiology of hip fractures in 6 months of the pandemic in 2020, with the equivalent 6-month period in the previous year to determine the relationship between lock-down and hip fractures due to domestic falls. Method: In this retrospective study, patients over 65 years old who were hospitalized due to hip fractures between May 1st, 2020 - November 30th, 2020 were compared with the similar cohort hospitalized between May 1st, 2019 - November 30th, 2019. The patients were compared in terms of demographic characteristics, American Society of Anesthesiologists (ASA) scores, type of anesthesia, time until surgery, comorbidities, surgical treatment modality, need for postoperative primary care unit, postoperative complications, and mortality. Results: Overall, 210 patients were included in our study. There was no significant difference between the groups regarding demographic characteristics and ASA scores. In the 2020 group, there were eight patients (8.6%) who were Covid-19 PCR- positive. There was no death proven by PCR that was related to COVID-19 disease. Time to surgery, fracture type, anesthesia type did not differ between the two groups. The need for a postoperative primary care unit was higher in the 2020 group. Ninety-day mortality rates were not significantly different between the two groups. Conclusions: In conclusion, despite higher mortality rates described in the literature, there was no Covid -19 associated mortality in our study. Hip fractures in the elderly did not alter with social mobilization; hence they usually occur due to domestic low- energy traumas. Reporting of the information in this patient group by all centers will provide important data in the management of hip fractures in this special process

More extensile osteotomy in the treatment of posterior calcaneal osteophyte (Haglunds disease)

The aim of this study is to present a more extensile osteotomy performed for the treatment of Haglunds disease and the results of 2-year follow-up of these patients.Fifteen feet of 15 patients who underwent open surgery by the same surgeon between 2011 and 2015 were included in the study. In this technique, the Achilles tendon is split into two in the middle and tenotomized at its insertion. Retrocalcaneal bursa and exocytosis is completely excised and tenodesis of the Achilles tendon to its old insertion is performed with the help of two 5 mm suture anchors. All patients were discharged on the postoperative first day. Postoperatively, a short leg plaster cast was applied for six weeks with the ankle in slightly plantar flexed position. For the next six weeks, patients were followed up with an ankle foot orthosis with the ankle in neutral position. At the end of the third month, orthosis treatment was discontinued in all patients. The patients were evaluated with the visual analog scale (VAS) and American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores (FAOS) preoperatively and at 3 months postoperatively. The mean follow-up period was 27.4 months. A statistically significant difference was found between preoperative and postoperative for both VAS and FAOS scores (p [Med-Science 2019; 8(4.000): 923-6

Difference between spinecor brace and rigid brace in deformity correction and quality of life in adolescent idiopathic scoliosis

Although there are several conservative treatment options only bracing found effective in preventing curve progression and subsequent need for surgery. The objective of this study is to compare the results of SpineCor brace and rigid brace in adolescent idiopathic scoliosis radiologically and clinically.Sixty-four adolescent idiopathic scoliosis patients treated with brace included in this study. Height, T1-Coccygx distance, gibbosity was measured. Rib hump deformity was evaluated with scoliometer. SRS-22 questionnaire used to determine the quality of life of patients after the first year of brace treatment.Differences in Cobb angles and gibbosity were insignificant in both groups. SRS-22 questionnairre results showed significant difference in pain, self image and function/activity subgroups. Mental health and satisfaction scores of patients were insignificant.These braces has similar effect on deformity correction. Surgery rates and success rates braces are approximately equal. Major difference between SpineCor and rigid brace is health related quality of life

The effect of tranexamic acid on hidden blood loss in total hip arthroplasty

Objectives: In this study, we aimed to examine the effect of tranexamic acid (TXA) on hidden blood loss in total hip arthroplasty (THA) patients. Patients and methods: Between June 2015 and June 2021, a total of 120 patients (45 males, 75 females; mean age 57.2±4.9 years; range, 45 to 67 years) with primary osteoarthritis who underwent THA without the use of TXA and 53 patients who received TXA were retrospectively analyzed. Demographic data, amount of transfusion, early complications, preoperative and postoperative hemoglobin and hematocrit values, total blood loss, visible blood loss, and hidden blood loss values were compared. Results: There was a significant difference between the groups with and without the use of TXA in terms of intraoperative bleeding, amount of blood in the drain, total blood loss, hidden blood loss, and blood transfusion (p<0.05). A significant positive correlation was found between intraoperative blood loss and hidden blood loss (r=0.325 p<0.01), while no significant correlation was found between postoperative drainage volume and hidden blood loss (r=-0.006 p=0.946). Conclusion: The use of TXA in patients undergoing THA reduces blood loss, including hidden blood loss, thereby reducing the need for blood transfusion after hip arthroplasty. However, there seems to be no linear relationship between postoperative blood loss and hidden blood loss. Considering these results, the routine use of TXA can be recommended in THA, unless there is a contraindication

The influence of the approach for blood loss and transfusion in total knee arthroplasty: Medial parapatellar vs. subvastus

The medial parapatellar (MP) and subvastus (SV) approaches are the most common approaches used in total knee arthroplasty (TKA). Blood loss and transfusion requirements during these approaches varies in different studies. This study compared the MP and SV techniques in terms of blood loss and transfusion needs. Sixty-four patients were enrolled for this retrospective, single-centre and single-surgeon study. Patients were allocated into two groups of 32 patients each: TKA utilizing a MP approach (MP group) and TKA utilizing a SV approach (SV group). The calculated blood loss, determined using the Gross method, was the study&apos;s primary outcome. Additionally, the amounts of haemoglobin and haematocrit decrease from preoperative to postoperative 3rd day as well as the need for blood transfusions were compared. The mean calculated blood loss was lower in the SV group compared to the MP group (953±362 mL vs. 1245±404 mL, p=0.003). The haematocrit decrease from preoperative to postoperative 3rd day was in favour of the SV group (7.0±2.9 % vs. 9.5±3.0 %, p=0.005). The mean units of packed red cells transfused in the MP and SV groups were 0.28±0.45 and 0.19±0.4, respectively (p&gt;0.05). Although lower blood loss was observed in the SV approach, the postoperative transfusion rates were not affected. When selecting the approach to use in TKA, surgeons should consider that SV approach is efficient in reducing blood loss without any change in transfusion requirement. [Med-Science 2023; 12(1.000): 259-63

Treatment Of Implant-Related Methicillin-Resistant Staphylococcus Aureus Osteomyelitis With Vancomycin-Loaded Vk100 Silicone Cement: An Experimental Study In Rats

Introduction: The purpose of this present study is to investigate the efficacy of vancomycin-loaded VK100 silicone cement drug delivery system in the treatment of implant-related methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis in rats. Materials and Methods: Thirty-six adult (18-20 weeks old) female Sprague-Dawley rats were included in the study. All rats underwent experimental osteomyelitis surgery via injecting 100 mu L bacterial suspension of MRSA into the medullary canal. After a 2-week duration for the formation of osteomyelitis model, rats were assigned Introduction: randomly into four groups: control (C), systemic vancomycin (V), local vancomycin-loaded VK100 silicone cement (vVK100), and systemic vancomycin and local vancomycin-loaded VK100 silicone cement (V+vVK100). The following treatment protocols were administered to each group for 4 weeks. For group C, 0.9% saline solution equivalent to the volume of vancomycin dose (approximately 1 ml/kg) was administered intraperitoneally twice daily (12-h intervals). For group V, 15 mg/kg of vancomycin was administered intraperitoneally twice daily (12-h intervals). For group vVK100, vVK100 polymer was included so that the intramedullary canal of the rats are affected. For group V+vVK100, vVK100 polymer was included so that the intramedullary canal of the rats are affected and 15 mg/kg of vancomycin was administered intraperitoneally twice daily (12-h intervals). After 4 weeks of treatment, clinical, radiologic, microbiologic, and histopathologic evaluations were performed for all groups. Results: Results of this study revealed that all scores of the evaluation criteria for the treatment groups (groups V, vVK100, and V+vVK100) decreased due to the treatment protocols when compared to group C. These results show the effectiveness of all treatment protocols for the implant-related chronic MRSA osteomyelitis. However, there were no statistical difference between these three protocols. Conclusions: vVK100 polymer, as a local antibiotic delivery system, seems to be an effective method for the treatment of implant-related chronic MRSA osteomyelitis.WoSScopu

Does ABO blood type is a novel risk factor for osteoporosis or low bone density among postmenopausal women or not?

ABO blood types may cause a vulnerability to individuals for conditions such as malignancies or chronic diseases. However, the interaction of ABO blood types and osteoporosis is inexplicit. In this study, we focused on the role of ABO blood types on bone health by comparing bone mineral density (BMD), and the prevalence of low bone mass (LBM) and osteoporosis among postmenopausal women. Non-institutionalized postmenopausal women aged over 50 years were prospectively enrolled in the study following the measurement of BMD by dual-energy X-ray absorptiometry (DEXA). The prevalence of osteoporosis and LBM were interpreted according to T scores of either site. Self-reported blood types of participants were noted. The study included 220 postmenopausal women, and the median age of participants were 59 (11) years (min:50 years, and max:82 years). The mean BMD values at the lumbar spine, femoral total, and femoral neck of participants were 0.821±0.118 g/cm2, 0.810±0.121 g/cm2, and 0.716±0.112 g/cm2, respectively. Both mean BMD and T scores of enrollees for either site were similar across blood types (p-value &gt;0.05 for all). The prevalence of osteoporosis and LBM showed no significant association between blood groups (p=0.45, and p=0.226, respectively).The present study showed evidence of a similar BMD, the prevalence of LBM, and osteoporosis among postmenopausal women over 50 years regardless of ABO blood type. [Med-Science 2022; 11(2.000): 672-6