Graft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique

Introduction: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. Materials and methods: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7 months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel. Results: Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78° and 46.80° (p  0.05). Conclusions: Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane

PD-L1 expression in immune cells is a favorable prognostic factor for nasopharyngeal carcinoma

Background: Programmed death-ligand 1 (PD-L1) has been determined as a reliable prognostic factor for various malignancies. In this study, we aimed to determine the prognostic effect of PD-L1 expression in tumor-infiltrating immune cells (TIICs) of nasopharyngeal carcinoma (NPC) patients.Methods: Seventy patients diagnosed with non-metastatic NPC were included in the study. PD-L1 expression on immune cells was analyzed by immunohistochemical method. Patients were categorized into two groups according to the PD-L1 expression level in TIICs (level of PD-L1 staining ≥5% positive vs <5% negative).Results: Median follow-up period was 34 months (range = 1 - 188). 1 and 2 years survival rate were found as 75% and 63% in PD-L1 negative TIICs group (47%), and 85% and 83% in PD-L1 positive TIICs group (53%), respectively. PD-L1 positivity in immune cells (ICs) was detected in 53% of the patients. The survival rate was found better in the PD- L1 positive group compared to the negative group (P = 0.049).Discussion: In conclusion, the survival rate was found significantly better in the PD-L1 positive TIICs group, compared to the negative group

Radiological and clinical effect of prosthesis design in varus knees?

WOS: 000385436400009PubMed ID: 26566321Purpose: The aim of the study is to investigate the efficacy of the prosthesis design used in total knee arthroplasty in patients with varus malalignment. Methods: After exclusion criteria we classified 90 patients underwent total knee arthroplasty according to prosthesis used into two groups: posterior cruciate ligament substituting and retaining. Mean follow up period was 25-98 months. We evaluated pre-operative and postoperative radiological and as well as clinical parameters such as pain, knee function, flexion deformity. Results: We found statistically significant difference in both groups in terms of deformity correction (p = 0.000). Conclusion: Prosthesis design affects radiological outcomes in varus knees

Comparison of extracorporeal shock wave therapy in acute and chronic lateral epicondylitis

Objective: The aim of this study is to evaluate and compare the results of extracorporeal shock wave therapy (ESWT) in the treatment of acute (6 months) LE groups. Methods: Fifty-four patients who were diagnosed with LE and treated with BTL-5000 SWT Power (BTL Türkiye Medikal Cihazlar, Ankara, Turkey) ESWT were included in the study. Twenty-four patients who had symptoms for 6 months were defined as the chronic LE group (Group B). All cases were evaluated pretherapy and at Weeks 2, 12, and 24 posttherapy according to pain while resting, pain while stretching, pain when pressed, pain while lifting chair, pain while working, nighttime pain on LE zone. Results: Almost all values in both Group A and Group B were significantly improved at Weeks 2, 12, and 24 compared to the baseline values. Conclusion: ESWT is equally effective in the treatment of acute LE and chronic LE. In addition, the current data suggest the progression of LE cases from acute phase to chronic phase may be prevented by treatment with ESWT

Evaluation of results of conservative therapy in patients with transient osteoporosis of hip

The present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of followup of TOH cases using physical examination and laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3 ± 4.3 years) and 12 males (mean age, 40.7 ± 10.5 years) was 6.1 ± 2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intra-articular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6 ± 7.8 before the treatment, it increased to 88.8 ± 5.8 in the 3rd month and to 96.0 ± 1.8 in the 6th month after the treatment. This change in score over time was found to be significant

Comparison of MRI results of grafts obtained by unilateral anterior cruciate ligament reconstruction either using anteromedial portal only or transtibial method with contralateral healthy knee: Tibial tunnel or graft insertion?

Objectives: Our aim is to compare graft angles and tibial tunnel insertion in patients undergone single bundle ligament reconstruction using anatomical anteromedial (AM) and transtibial (TT) method with the contralateral healthy knee by using MR imaging. And to investigate correlation of this evaluation with functional results. Methods: We investigated 96 knees of 48 patients undergone anterior cruciate ligament (ACL) reconstruction with AM or TT method. 23 of 48 patients were operated with AM method. These patients were named as Group A. 25 patients were operated with TT method and named as group B. MRI was taken for both knees in each group postoperatively at the mean 10.47 (9-15) and 11.72 (9-17) months, respectively. Angle between ACL graft and anatomical axis of tibia in coronal and sagittal plane, [Sagittal ACL graft angle (SAGA), Frontal ACL graft angle (FAGA)], middle insertion point on tibial articular surface, [Sagittal ACL middle point (SGMP), Frontal ACL tibial tunnel middle point (FTMP), and Sagittal ACL tibial tunnel middle point(STMP)] was assessed by three orthopaedic surgeons. Values in both groups, inter observer, values between operated and healthy knees and differences between two groups were statistically evaluated. Functional scores between operated and healthy knees were evaluated with the Lysholm scoring system. Results: Inter observer results were statistically significant in group A between operated and healthy knees for 1st and 2nd observers in SAGA values and for 1st and 3rd, and 2nd and 3rd observers in FAGA values (p0.05). Statistically significant difference was detected between SAGA and FAGA values of operated knees in both groups (p0.05). Conclusion: ACL reconstruction surgery with TT and AM methods do not provide anatomical reconstruction in Sagittal plane. Moreover, functional results were not as good as contralateral healthy knees. Although tibial tunnel was in anatomical position in both TT and AM methods, the posterior insertion of graft is thought to be the result of anterior placement of interference screw

Esen I HES Projesi Alanın Jeoteknik Özellikleri

Bu çalısma, Esen Çayı üzerinde yapılması planlanan Esen-1 Hidroelektrik Santralı için göl alanı sınırı, bent yeri ve kuvvet tüneli güzergah yerinin belirlenmesi ve jeoteknik özelliklerini kapsar. Inceleme alanında yüzeyleyen jeolojik birimler: Otokton konumlu “Güneydag Grubu” ile allokton konumlu “Kürdük Grubu”ndan ve bu iki grubu diskordan olarak örten Tersiyer yaslı kırıntılı çökellerden olusur. Göl alanında yaygınca yüzeylemeleri bulunan birimler, Tersiyer yaslı Çameli formasyonu ve Seki Formasyonuna ait kırıntılı tortullar ile alüvyonlardır. Çameli formasyonu ile Seki formasyonu geçirimsiz-az geçirimli, alüvyonlar ise geçirimlidir. Baraj yerinde sag sahilde yeralan Karabögürtlen formasyonundan türemis bloklardan olusan yamaç döküntülerinin baraj insaasından önce kaldırılması gerekmektedir. Göl alanında uygulanan sismik ve elektrik yöntemler ile taban kaya derinligi, üstteki katmanların kalınlıgı ve su sızdırma olasılıgı bulunan kritik yerler belirlenmistir. Bu yerlerde mekanik sondajlar yapılmıs, sondaj logları ve basınçlı su deneyleri degerlendirilerek, bu alanda yeralan birimlerin su sızdırma durumları, yamaç duraylılıgı jeoteknik yönden ayrıntılı olarak arastırılmıstır. Esen-I Hidroelektrik santralı bent yerinde ve göl alanında duraylılık ve su sızdırması yönünden önemli bir sorunla karsılasılmayacagı ortaya konmustur. Tünel güzergahında ise genel olarak Mesozoyik yaslı kireçtasları (Dokluca fm ve Ardıçdere fm) ile bloklu filis karakterinde (Gacak fm.) formasyonlar yeralır

A microgravity model for the city of A degrees zmir (Western Anatolia) and its tectonic implementations

Western Anatolia has an extensional tectonic regime and the characteristics of the deformation in the continental crust observed in Aegean Region have a very complex structure. In our study area, the A degrees zmir city, Turkey, which is located within this active region, the general geological setting is also rather complex. This first microgravity study in A degrees zmir and its surroundings is related to the determination of active fault zones. It was conducted in the south of A degrees zmir, with the aim to investigate this complex structure in detail through microgravity data collected from six profiles throughout the survey area. The variation in Bouguer values was profoundly investigated along Profile P1 in N-S direction that was delineated to intersect all the tectonic elements. For this reason, Profile P1 was modeled in this study as 2D. As a result, the created gravity model was investigated together with geology, earthquake focal depths, and isostasy