Can fracture healing be accelerated by serum transfer in head trauma cases? An experimental head trauma model in rats

Objectives: In this study, we aimed to investigate whether the positive union effect caused by head trauma could be transferred between individuals.& nbsp; Materials and methods: Seventy-two male rats with an average weight of 375 g were used in this study and divided into four groups including 18 in each group. Group 1 consisted of serum donor rats that were exposed to head trauma, while Group 2 consisted of study rats with long bone fractures that were given the serum obtained from the rats in Group 1, Group 3 included control rats with isolated long bone fractures, and Group 4 included control rats with both head trauma and long bone fractures. For radiological evaluation, the ratio of the width of the callus to the width of the neighboring diaphysis was considered as the callus-todiaphyseal ratio in the study and control groups. Histopathological and radiological evaluations was made on Days 10, 20, and 30.& nbsp; Results: In evaluation of the radiological data regarding the callusto-diaphyseal ratio, Group 3 was found to have significantly lower radiological values than Group 4 on Day 10 (p=0.006). Group 2 had significantly higher values than Group 3 (p=0.02). On Day 20, Group 2 exhibited significantly higher radiological values than Group 3 (p=0.004), but lower than Group 4 (p=0.032). As for Day 30, Group 2 exhibited significantly higher radiological values than Group 3, but lower than Group 4 (p=0.001). In the evaluation of the Huo scores obtained for histopathological evaluation, there was no significant difference among the groups on Days 10, 20, and 30 (p=0.295, p=0.569, and p=0.729, respectively).& nbsp; Conclusion: Our study results suggest that the osteoinductive effect after head trauma can be transmitted between individuals by means of serum transfer

Correction of more hallux valgus pathologic disorders with a single distal osteotomy a new surgical technique

Background: Hallux valgus, one of the most common deformities of the great toe, may cause pain, dysfunction, and impaired gait pattern. In this retrospective study we report the results of a new type of distal metatarsal osteotomy combined with distal soft-tissue release in patients with mild-to-moderate hallux valgus deformity. Methods: This new technique was used in the management of 32 feet of 31 patients (eight men and 23 women) with mild-to-moderate hallux valgus. Hallux valgus angle, i ntermetatarsal angl e, and distal metatarsal articular angl e were measured on preoperative, earl y postoperative (6–8 weeks), and l ate (1 year) postoperative radiographs. American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal score was calculated. Sesamoid position, by considering medial sesamoid position, and metatarsal shortness were also measured. Results: Statistically significant differences were detected between the preoperative and late postoperative measurements of the hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position parameters in patients operated on with this technique. Improvement was 14° for the hallux valgus angle, 4° for the distal metatarsal articular angle, and 4° for the intermetatarsal angle. Sesamoid position was also improved, and the mean American Orthopaedic Foot and Ankle Society score was significantly improved. Metatarsal shortness greater than 2 mm was observed in two patients without resulting in any clinical discomfort. Conclusions: This new technique was easy, safe, and promising in patients diagnosed as having mild-to-moderate hallux valgus deformity. © 2021, American Podiatric Medical Association. All rights reserved

COMPARISON OF CHANGES IN THE ANKLE AFTER UNICONDYLAR KNEE ARTHROPLASTY AND HIGH TIBIAL OSTEOTOMY

Objectives: We aimed to compare the changes in the coronal alignment of the ankle joints and their clinical effects after high tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA). Methods: 50 HTO and 54 UKA patients who were operated on for medial knee osteoarthritis between 2013 and 2018 were retrospectively evaluated. The hip-knee-ankle angle (HKA), the medial proximal tibial angle (MPTA), the tibial plafond inclination (TPI) and the talar inclination (TI) angles were measured before and after operation. Visual analog scale (VAS), short form 36 (SF-36), and ankle-hindfoot scale (AHS) scores of both groups were evaluated and recorded. Results: Angular changes in the HKA, MPTA, TPI and TI values showed significantly greater values in the HTO group (p<0.001). When asymptomatic and symptomatic cases were compared, it was found that changes in the HKA, TPI and TI values were significantly greater in symptomatic cases in the HTO group (p<0.05). A significant decline was observed in the VAS, SF-36 and AHS scores in the HTO group in the postoperative period (p<0.05). In intergroup evaluations, a significant decline was detected in pain and functional scores of the HTO group when compared to the UKA group (p<0.05). Conclusion: Unicondylar knee arthroplasty can be a good alternative to HTO in selected cases for postoperative ankle complaints.Level of Evidence III; Therapeutic Studies Investigating the Results of Treatment

HOW USEFUL IS ELASTOGRAPHY IN THE FOLLOW-UP OF ACHILLES TENDON REPAIR?

Introduction: In addition to conservative modalities in the treatment of Achilles tendon injuries, open, percutaneous and minimally invasive semi-open techniques, as well as biological open surgical repair methods are used as surgical options. Compression elastography is one of the methods used for the follow-up of treatment in Achilles tendon injuries. Methods: 23 patients were included in our study between July 2013 and June 2014, as long as they had at least 4 years of follow-up. In the final control, the intact side and the operated side were both examined and compared. The variables were the American Orthopedic Foot and Ankle Score (AOFAS) which is measured as a functional score considering plantar flexion and dorsiflexion; calf circumference; Achilles tendon anteroposterior (AP) diameter; and elastographic examination. Results: The strain ratio value and AP diameter of the patients was significantly higher on the operated side than on the non-operated side (p 0.05). No correlation was observed between strain ratio and AOFAS (p: 0,995). Conclusion: Elastography is not a useful technique to evaluate functional results on long-term tendon healing. Level of Evidence III; Retrospective comparative study. © 2022. Acta Ortopedica Brasileira. All Rights Reserved.Thanks to Prof. Dr. Ebru Yeşildağ for consultation of study plannin

Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure

Purpose: In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures. Methods: Computed tomography images of 120 patients (mean age: 41.18 +/- 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques. Results: There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results (p > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size (p > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness (p < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders (p < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders. Conclusion: Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques

The Effect of Tranexamic Acid and Tourniquet Use on Tibial Cement Penetration in Primary Total Knee Arthroplasties

Background: In this study, our aim was to compare the effects of tourniquet and tranexamic acid (TXA) use on tibial cement penetration in primary total knee arthroplasty (TKA) using radiograph images. In addition, we also aimed at investigating the effects of age, gender, body mass index (BMI), and bone mineral density on cement penetration. Methods: One hundred seventy patients who underwent TKA for primary osteoarthritis were retrospectively evaluated. TXA was administered to patients in group 1 (n = 96), and tourniquet application was used in patients in group 2 (n = 74). Tibial cement penetration was evaluated radiologically on a total of 4 zones: 2 anteroposterior and 2 lateral zones. In addition, age, gender, BMI, and bone mineral density were recorded in each group. Results: The mean cement penetration in the total study population was 2.34 ± 0.24 mm, with a mean of 2.33 ± 0.25 mm in the TXA group and a mean of 2.35 ± 0.24 mm in the tourniquet group (P = .453). A negative correlation was detected between BMI and anteroposterior 1 values in the total and TXA groups (P = .022 and P = .029). In the evaluation of the differences between genders, significantly higher penetration values were observed only in the females in the tourniquet group (P = .024). Conclusions: The use of TXA instead of a tourniquet does not reduce the depth of cement penetration in TKA. The clinical implications of individual-induced penetration differences may be significant for future implant survival. © 2020 The Author

Is Cyclic Exercise Performed before Tibial Fixation Effective on Grafts during Anterior Cruciate Ligament Reconstruction?

Objectives: The necessity of cyclic exercise to pre-stretch the autograft before tibial fixation during ACL reconstruction is unknown. In this study, we evaluated whether there was a statistically significant difference between the results of patients whounderwent cyclic exercise by way of physical examinations, knee joint stability tests, and functional evaluation tests, comparedwith the patients who underwent ACL reconstructions with or without cyclic exercise.Methods: Between March 2016 and May 2018, 59 patients with at least eight months’ follow-up of an ACL reconstruction wereidentified. Thirty patients (Group 1) who underwent cyclic exercise before tibial fixation and 29 patients (Group 2) who did notundergo cyclic exercise were evaluated and compared.Results: The mean age of the patients in Group 1 and Group 2 was 25.9 (range, 18-36) years and 25.2 (range, 18-35) years, respectively. The mean follow-up period in Group 1 was 14.6 (range, 8-22) months and 13.5 months in Group 2 (range, 8-21 months).The mean Lysholm scores of Group 1 and 2 were 95.1 (range, 83-100) and 87.1 (range, 78-100), respectively. The modified Cincinnati scores of Groups 1 and 2 were 28.7 (range, 24-30) and 26.2 (range, 21-30). The mean IKDC subjective knee evaluation scoresin Groups 1 and 2 were 91.9 (range, 83-100) and 86.7 (range, 75-100). The mean thigh atrophy was 1.5 cm in Group 1 and 2.5 cm inGroup 2. In Group 1, 23 patients jumped 85% of the distance compared with the intact side in the single-legged hop test, and 12patients in Group 2 were able to hop this distance successfully.Group 1 had statistically significantly better results in Lysholm activity scores, modified Cincinnati scores, IKDC subjective kneeassessment scores, two-time IKDC activity scale results, comparison of thigh diameters, and single-legged hop tests (p<0.05). Nosignificant difference was found in other examinations and tests.Conclusion: Cyclic exercise during the operation had a positive effect on functional scores. We believe that cyclic exercise shouldbe added to the operative procedur

Minimally invasive treatment options of benign prostatic hyperplasia

Benign prostat hiperplazisi cerrahi tedavisinde transüretral rezeksiyon [TUR(P)], altmış yıldan beri en çok tercih edilen yöntem olmuştur. Buna karşın TUR(P) ile görülen %18 morbidite ve %0.2 mortalite nedeni ile TUR(P)’a alternatif cerrahi tedavi seçeneklerinde son yıllarda önemli gelişmeler olmuştur. Bu derlemede, BPH’nde minimal invazif tedavi seçenekleri son literatür eşliğinde gözden geçirilmiştir.Transurethral resection of the prostate is being the most preferred treatment options of benign prostatic hyperplasia for the last sixty years. TUR(P) has 18% morbidity and 2% mortality rates and it caused an important developments in alternative surgical therapies to TUR(P) in BPH. In this article, minimally invasive treatment options of BPH were reviewed with current literature. [Key words: benign prostatic hyperplasia, minimally invasive treatment

BPH tedavisinde terazosin ve doksazosin anahtarlama sonuçları

Objective: Medical treatment of the BPH is one of the alternatives among a variety of therapeutic options. Doxazosin and terazosin are the most widely used molecules in the treatment of BPH. We compared the effectivity of these molecules by switching the drug in those who did not benefit from the first drug. Methods: This was a prospective randomized study. Patients in the study were similar in age, prostatic weight, International Prostatic Symptom Score (I-PSS), uroflow parameters and PSA levels. Fifty men (mean age 59.4 years, SD 7.6, range 48-78) received either doxazosin (25 men), or terazosin (25 men), once daily at night. Patients were evaluated at one, 2 and 3 months. Improvement in I-PSS and the maximal flow rate (Qmax) by minimum 20% was accepted as improvement. Patients who showed improvement in none of the parameters have switched the drug and these patients were followed in the next 3 months. Results: Of the 25 men using doxazosin, 11 (44%) showed improvement both in I-PSS and Qmax at 3 months. Of the 25 men using terazosin, 10 (40%) showed improvement both in I-PSS and Qmax at 3 months (p>0.05). After 3 months of treatment, the peak urinary flow rate increased significantly (p< 0.001) for both doxazosin (+4.5 mL/s) and terazosin (+3.1 mL/s) groups. The International Prostatic Symptom Score improved significantly (p< 0.01) with both alpha-blockers after 3 months of treatment in these groups. Nineteen patients, who did not show improvement in any of the parameters, switched the drug. Of the patients who switched the drug, 2 (4%) showed improvement both in I-PSS and in the peak urinary flow rate, 2 (4%) showed improvement only in I-PSS but not in the peak urinary flow rate and 15 (30%) did not show improvement in any of the parameters. Conclusion: These results suggest that alpha blockade with either doxazosin or terazosin is effective in men with symptomatic BPH. Two of the alpha-blocking molecules showed equal effectivity in the treatment of BPH. If one of the molecules is ineffective in the treatment of BPH, then the other molecule will probably be ineffective.Amaç: BPH'nin tıbbi tedavisi, çeşitli tedavi seçenekleri arasındaki alternatiflerden biridir. Doksazosin ve terazosin, BPH tedavisinde en yaygın kullanılan moleküllerdir. İlk molekülten faydalanmayanlarda ilacı değiştirerek bu moleküllerin etkinliğini karşılaştırdık. Yöntemler: Bu prospektif bir randomize çalışmaydı. Çalışmadaki hastalar yaş, prostat ağırlığı, Uluslararası Prostat Semptom Skoru (I-PSS), üroflow parametreleri ve PSA düzeylerinde benzerdi. Elli erkek (ortalama yaş 59.4 yıl, SD 7.6, aralık 48-78), günde bir kez, günde bir kez, doksazosin (25 erkek) veya terazosin (25 erkek) almıştır. Hastalar bir, 2 ve 3 ayda değerlendirildi. I-PSS'de ve maksimum debinin (Qmax) en az% 20 oranında iyileştirilmesi iyileştirme olarak kabul edildi. Parametrelerin hiçbirinde düzelme göstermeyen hastalar ilacı değiştirdi ve bu hastalar sonraki 3 ayda takip edildi. Bulgular: Doksazosin kullanan 25 erkekten 11'i (% 44) 3 ayda hem I-PSS hem de Qmax'ta düzelme gösterdi. Terazosin kullanan 25 erkekten 10'u (% 40) 3 ayda hem I-PSS hem de Qmax'ta düzelme gösterdi (p> 0.05). 3 aylık tedaviden sonra, her iki doksazosin (+4.5 mL / s) ve terazosin (+3.1 mL / s) grupları için pik üriner akış hızı anlamlı şekilde (p <0.001) arttı. Uluslararası Prostatik Semptom Skoru, bu gruplarda 3 aylık tedaviden sonra her iki alfa bloker ile önemli ölçüde düzeldi (p <0.01). Herhangi bir parametrede düzelme göstermeyen 19 hasta ilacı değiştirdi. İlacı değiştiren hastaların, 2 (% 4) hem I-PSS'de hem de en yüksek idrar akış hızında iyileşme gösterdi, 2 (% 4) sadece I-PSS'de düzelme gösterdi, ancak en yüksek idrar debisinde değil ve 15 (% 30) iyileşme göstermedi parametrelerin herhangi birinde. Sonuç: Bu sonuçlar, semptomatik BPH'li erkeklerde, doksazosin veya terazosinli alfa blokajının etkili olduğunu göstermektedir. Alfa bloke edici moleküllerden ikisi, BPH tedavisinde eşit etkinlik göstermiştir. Eğer moleküllerden biri BPH tedavisinde etkili değilse, diğer molekül muhtemelen etkisiz olacaktır. Alfa bloke edici moleküllerden ikisi, BPH tedavisinde eşit etkinlik göstermiştir. Eğer moleküllerden biri BPH tedavisinde etkili değilse, diğer molekül muhtemelen etkisiz olacaktır. Alfa bloke edici moleküllerden ikisi, BPH tedavisinde eşit etkinlik göstermiştir. Eğer moleküllerden biri BPH tedavisinde etkili değilse, diğer molekül muhtemelen etkisiz olacaktır

Notes bibliographiques

Notes bibliographiques. In: Revue d'histoire de la pharmacie, 66ᵉ année, n°237, 1978. p. 138