Treatment of symptomatic calcaneal lipoma with osseoscopy using a synthetic allograft

Objective: This study evaluated the results of symptomatic calcaneal lipoma patients treated with a recently introduced minimally invasive arthroscopic method. Materials and methods: Seven patients treated with osseoscopy in our clinic for calcaneal lipoma between 2013 and 2018 were evaluated. The median age of the patients was 37.7 years and five were male. The common compliant of the patients was pain that partially disrupted daily life. Surgery was utilized for patients who did not respond to conservative methods (sports restriction, partial weight bearing, and heel support) had persistent pain longer than 3 months and had a risk of impending fracture (>30% loss in trabecular bones). Results: The mean follow-up period after surgery was 21 (12–33) months. In all patients, the location of the ICL was in Ward’s triangle and the mean size was 28.8 (20-43) mm. According to Milgram’s classification, three ICLs were stage I, two were stage II, and two were stage III. The radiological result was evaluated using the classification system of Glutting and Chang. There was no persistent cyst and no recurrence. The radiological success rate was 100%. The mean ankle-hindfoot scale score (max. 100 pts) increased from a preoperative 74.7 ± 5.3 points (range: 69–83) to a postoperative 96.7 ± 2.62 points (range: 93-100). Conclusions: In the treatment of calcaneal lipoma, treatment with osseoscopy is easy and fast, has low complication rates, and is a cosmetically desirable alternative. The use of synthetic allografts to fill the cavity is a safe, inexpensive, and easy alternative

Comparative analysis of percutaneous excision and radiofrequency ablation for osteoid osteoma

BACKGROUND This retrospective study aims to compare the efficacy of computed tomography-guided percutaneous excision and radiofrequency ablation in the treatment of osteoid osteoma. MATERIAL AND METHODS We evaluated 40 patients with osteoid osteoma who underwent either percutaneous excision or radiofrequency ablation between 2012 and 2015. The cohort consisted of 10 female and 30 male patients, with a mean age of 15.1 years (range: 4-27 years) and a mean follow-up time of 19.02 months (range: 11-39 months). Percutaneous excision was performed in 20 patients, while radiofrequency ablation was performed in the remaining 20 patients. RESULTS The success rates of percutaneous excision and radiofrequency ablation were comparable, with unsuccessful outcomes observed in 10% and 5% of patients, respectively. The reasons for failure in the percutaneous excision group were attributed to a marking error and incomplete excision of the wide-based nidus. Complications were limited to pathological fracture (n=1) and deep infection (n=1) in the percutaneous excision group, while no complications were encountered in the radiofrequency ablation group. CONCLUSIONS Both percutaneous excision and radiofrequency ablation demonstrate high success rates in treating osteoid osteoma. However, radiofrequency ablation offers the advantage of a quicker return to daily activities without the need for activity restrictions or splints. While being a more cost-effective option, percutaneous excision should be considered cautiously to minimize potential complications

Big and deep seated lipomatous tumours in children : Results of surgical treatment

The objective of the study is to evaluate results of our pediatric patients with big and deep-seated lipomatous tumors Results of 32 children who underwent resection for 5 cm or larger and deep-seated lipomas were evaluated. The mean age of the patients was 9.1 years (range, 0-16 ; 11 female/21 male), and median follow-up period was 3.21 years (range, 1-10 years). The median size of the excised tumour was 11 cm (range, 6-28 cm) in maximal dimension. Big lipomas in children can be treated with marginal resection procedures without biopsy with lower complication and local recurrence ratio compared to adult patients with similar tumours in similar size and location

Türkiye’de total eklem artroplastisi sonrası venöz tromboembolizm profilaksisi tercihlerindeki değişimler: Bir anket

WOS: 000449003900003PubMed ID: 30376797Objectives: This study aims to investigate the changes in preferences of orthopedic surgeons for venous thromboembolism (VTE) prophylaxis after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and the factors that affect such changes in Turkey. Materials and methods: Turkish Orthopedics and Traumatology Association members (n=2.180) were invited to fill in the questionnaire. A total of 366 orthopedic surgeons responded and completed questionnaire. The questionnaire was comprised of 12 questions investigating the demographics of surgeons. their preferences for VTE prophylaxis. the changes in their preferences over the course of the past three years. and the causes of such changes. Results: In the past three years, 31.1% of surgeons changed their VTE prophylaxis method and 32.7% used risk classifications. The use of low molecular weight heparin (LMWH) decreased from 89.4% to 42.5% and from 85.8% to 44.2% after TKA and THA. respectively. The use of aspirin increased from 10.6% to 43.4% and from 9.7% to 37.2% after TKA and TIIA, respectively. The use of oral anticoagulants increased from 11.5% to 41.6% and from 10.6% to 39.8% after TKA and THA, respectively. Still, orthopedic surgeons in Turkey preferred LN1W11 at rates of 75.7% and 74% after TKA and Tim. respectively. Congressional presentations were the first (47.7%) among the causes of the changes in preferences for VTE prophylaxis. Preferences of up to 60% of surgeons working at universities were influenced by the American Academy of Orthopedic Surgeons guidelines. Conclusion: In the past three years, approximately one third of orthopedic surgeons changed their preferences for VTE prophylaxis after total joint arthroplasty in Turkey. Changes in preferences were largely in favor of aspirin and oral anticoagulants in parallel to changes in guidelines for VTE prevention.Amaç: Bu çalışmada Türkiye’de total diz artroplastisi (TDA) ve total kalça artroplastisi (TKA) sonrası ortopedik cerrahların venöz tromboembolizm (VTE) profilaksisi tercihlerindeki değişimler ve bu değişimlerde etkili olan faktörler araştırıldı. Gereç ve yöntemler: Türk Ortopedi ve Travmatoloji Derneği üyeleri (n=2180) soru formunu doldurmaya davet edildi. Toplam 366 ortopedik cerrah yanıt verdi ve anketi tamamladı. Anket; cerrahların demografik özelliklerini, VTE profilaksisi tercihlerini, son üç yıl içerisinde tercihlerindeki değişimleri ve bu değişimlerin nedenlerini araştıran 12 sorudan oluşuyordu. Bulgular: Son üç yıl içerisinde cerrahların %31.1’i VTE profilaksisi yöntemini değiştirdi ve %32.7’si risk sınıflaması kullandı. Düşük moleküler ağırlıklı heparin (DMAH) kullanımı TDA ve TKA sonrası sırasıyla %89.4’ten %42.5’e ve %85.8’den %44.2’ye düştü. Aspirin kullanımı TDA ve TKA sonrası sırasıyla %10.6’dan %43.4’e ve %9.7’den %37.2’ye yükseldi. Oral antikoagülan kullanımı TDA ve TKA sonrası sırasıyla %11.5’ten %41.6’ya ve %10.6’dan %39.8’e yükseldi. Bununla birlikte, Türkiye’de ortopedik cerrahlar TDA ve TKA sonrası sırasıyla %75.7 ve %74 oranlarında DMAH tercih etti. Venöz tromboembolizm profilaksisi için tercihlerdeki değişimlerin nedenleri arasında kongre sunumları ilk sırada (%47.7) idi. Üniversitelerde çalışan cerrahların %60’a kadarının tercihleri Amerikan Ortopedik Cerrahlar Akademisi kılavuzlarından etkilendi. Sonuç: Son üç yılda Türkiye’de ortopedik cerrahların yaklaşık üçte biri total eklem artroplastisi sonrası VTE profilaksisindeki tercihlerini değiştirdi. Venöz tromboembolizmin önlenmesi için kılavuzlardaki değişikliklere paralel olarak tercihlerdeki değişiklikler büyük oranda aspirinin ve oral antikoagülanların lehine idi