Lateral and Medial Epicondylitis: Definition, Diagnosis, Screening and Treatment Algorithms

Medial/lateral epicondylitis is related to repetitive work activities which causes loss of labor. It sometimes becomes a chronic painful pathology. The main effect to protect the patients from such pathology should focus on avoiding repetitive patterns of work actually; however, it is not possible generally. Traditional treatment modalities such as physical therapies with the use of epicondylitis bands and intralesional steroid injections should be combined with newer modalities such as prolotherapy and prp injections in the treatment algorithm. In this chapter stages of the disease will be explained and those newer techniques and the mechanism of the healing would be detailed

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

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'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>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