Artroskopik yardımlı mini-açık yöntem ile rotator manşet tamiri yapılan hastalarda gözetimli fizyoterapi programı ile ev egzersiz programının sonuçlarının karşılaştırılması

Objectives: This study aims to compare the results of supervised exercise program versus standardized home-based exercise program after rotator cuff repair with respect to severity of pain, functional status, quality of life, and depression. Patients and methods: Twenty-eight patients (5 males, 23 females; mean age 59.8 +/- 9.1 years; range 40 to 83 years) who had rotator cuff repair were evaluated. Patients were divided into two groups and the first group was treated with supervised physiotherapy (n=15) and the second group was treated with home-based exercise program (n=13). Pendulum exercises and passive exercises within pain limits were performed by all patients in the six-week immobilization period with shoulder sling with abduction pillow after rotator cuff repair. After this period, the patients in home-based exercise program were taught to perform active exercises and the patients in supervised physiotherapy group were treated with active shoulder range of motion exercises under the supervision of the physiotherapist. When patients reached to active full range of motion, strengthening exercises were added to exercise program. Patients were assessed preoperatively and at the end of the postoperative third month. Pain was evaluated with visual analog scale (VAS), functional status with Constant shoulder score, quality of life with short form-36 (SF-36), and depressive symptoms with Beck depression inventory (BDI). Results: There were significant improvements in all evaluation parameters in both groups after rotator cuff repair. Conclusion: There were no statistical differences between the patients who received exercise program under the supervision of the physiotherapist and the patients who were treated with standardized home-based exercise program for the efficacy of treatment in the evaluation of pain, functional status, quality of life, and depression status. When the rehabilitation programs were analyzed for cost effectiveness, the supervised physiotherapy group was found to have higher costs.Amaç: Bu çalışmada rotator manşet tamiri sonrası uygulanan gözetimli fizyoterapi programı ile standardize edilmiş ev egzersiz programının ağrı şiddeti, fonksiyonel durum, yaşam kalitesi ve depresyon durumu açısından sağladığı sonuçlar karşılaştırıldı. Hastalar ve yöntemler: Rotator manşet tamiri yapılan toplam 28 hasta (5 erkek, 23 kadın; ort. yaş 59.8±9.1 yıl; dağılım 40-83 yıl) değerlendirildi. Hastalar iki gruba ayrıldı, birinci gruba gözetimli fizik tedavi (n=15), ikinci gruba ev egzersiz programı (n=13) ile tedavi uygulandı. Tüm hastalara rotator manşet tamiri sonrası altı haftalık omuz abdüksiyon yastıklı kol askısı ile immobilizasyon döneminde ağrı sınırı içinde sarkaç egzersizleri ve pasif egzersizler uygulandı. Bu dönemi takiben ev egzersiz programı grubundaki hastalara aktif egzersizler öğretildi ve gözetimli fizyoterapi grubundaki hastalara fizyoterapist gözetiminde aktif omuz eklem hareket açıklığı egzersizleri yaptırıldı. Hastalar tam aktif eklem hareket açıklığına ulaşınca, egzersiz programına kuvvetlendirme egzersizleri eklendi. Çalışmada hastalar cerrahi öncesi ve sonrası 3. ay sonunda değerlendirildi. Ağrı şiddeti görsel analog skala (GAS) ile fonksiyonel durum Constant omuz skoru ile yaşam kalitesi kısa form-36 (KF-36) ile depresif semptomlar ise Beck depresyon envanteri (BDE) ile değerlendirildi. Bulgular: Her iki grupta da rotator manşet tamiri sonrası tüm değerlendirme verilerinde anlamlı düzeyde gelişme gözlendi. Sonuç: Fizyoterapist gözetiminde egzersiz programı alan hastalar ile standardize edilmiş ev egzersiz programı ile tedavi edilen hastalar arasında, ağrı, fonksiyonel durum, yaşam kalitesi ve depresif durum değerlendirmelerinde tedavi etkinliği için istatistiksel farklılık yoktu. Rehabilitasyon programları maliyet-etkinlik açısından incelendiğinde gözetimli fizyoterapi grubunun daha yüksek maliyete sahip olduğu bulundu

Functional results of local corticosteroid injections in the management of shoulder pain

Objective: To investigate the intensity of pain, range of motion (ROM) of shoulder and functional status in patients with shoulder pain after subacromial injection. Methodology: Mixed injection which was composed of 1cc/40 mg metilprednizolon asetat and 1 cc/9 mg bupivacaine was applied into subacromial zone for patients with shoulder pain. Patients were evaluated before injection and three months, one year after injection. ROM was measured with goniometer. Pain was evaluated with Visual Analog Scale (VAS). General condition of extremities was evaluated with Constant Shoulder Score and functional status of shoulder was evaluated with Turkish version of Disabilities of Arm, Shoulder and Hand (DASH-T). Short Form-36 was used to assess general health status of the patients. Beck Depression Scale was used for evaluation of depressive symptoms. Results: Sixty two patients were evaluated. Mean age was 51.16 +/- 10.58 years. It was observed that there was significant decrease for pain intensity and BDI scores, and significant increase for ROM of shoulder. Significant improvement in the functional status of upper extremities was also observed in these patients. Conclusion: Improvements for functional status of upper extremities and pain relief in patients with shoulder pain at short term after injection was observed

A new surgical technique to facilitate osteochondral autograft transfer in osteochondral defects of the capitellum: A case report

A 17-year-old boy who was engaged in amateur weightlifting and body building presented with complaints of right elbow pain and limitation in elbow range of motion. Plain x-rays and magnetic resonance imaging showed an osteochondral defect in the medial third of the capitellum. At surgery, as a new technique, the lateral collateral ligament was detached from the humeral attachment to provide access to the capitellum with a clear and perpendicular exposure. Following removal of loose fragments within the joint, an osteochondral graft harvested from the lateral femoral condyle was implanted to the defect area of the capitellum. Postoperative radiologic controls showed that the defect was entirely filled by the graft with appropriate graft height. On follow-up examination at 12 months, the patient did not have any complaint about his elbow, and had no limitation of movement compared to the left elbow. Magnetic resonance imaging showed that the graft was successfully adapted to the recipient site without any sign of loosening. At final follow-up 40 months after surgery, the surface of the articular cartilage appeared normal. The range of elbow motion was preserved and the patient had no restriction in daily and sports activities. Considering technical difficulties posed by the narrow and complex structure of the elbow joint, this new technique involving detachment of the lateral collateral ligament facilitates perpendicular implantation of the graft. In our opinion, utilization of this new technique will improve functional and radiological results of osteochondral autograft transfer. © 2010 Turkish Association of Orthopaedics and Traumatology

Halı sahada oluşan futbol yaralanmaları

Objectives: Football injuries that occur during football matches played on synthetic fields and the features of these injuries were investigated and the data was pursued for the prevention and reduction of these injuries. Patients and methods: All adolescent and adult trauma cases who admitted to the Emergency Department with football injuries on synthetic fields were retrospectively investigated. Nine hundred and eighty-five male cases were detected with a mean age of 30.1±4.2 years (range 15-57 years). Age, gender, times of admittance to the Emergency Department, site of injury, type of injury, and clinical result data of the cases were examined. Results: 19:00 to 24:00 hours (n=852, 86.5%) and weekdays were the most frequent admittance times. It was detected that lower-extremities (n=583, 59.2%) were the most commonly affected body parts and the upper-extremity injuries (n=281, 28.6%) and the head and neck injuries (n=75, 7.6%) were the second and third most commonly seen injuries, respectively. The most frequently observed injury types were contusions, abrasions and hematomas in all cases (n=364, 37.0%). Sprains/ strains were the second most common types of injuries (n=343, 34.8%). When the final diagnoses of all cases were examined, it was determined that the anterior talofibular ligament injuries were the second most frequent after softtissue injuries (n=217, 22%). Conclusion: Football matches on synthetic fields can lead to serious orthopedic injuries. Investigation of the mechanisms of these injuries, which cause workday and economic losses, will be a guide for the future studies on the prevention of these injuries

A concise review on the use of mesenchymal stem cells in cell sheet-based tissue engineering with special emphasis on bone tissue regeneration

The integration of stem cell technology and cell sheet engineering improved the potential use of cell sheet products in regenerative medicine. This review will discuss the use of mesenchymal stem cells (MSCs) in cell sheet-based tissue engineering. Besides their adhesiveness to plastic surfaces and their extensive differentiation potential in vitro, MSCs are easily accessible, expandable in vitro with acceptable genomic stability, and few ethical issues. With all these advantages, they are extremely well suited for cell sheet-based tissue engineering. This review will focus on the use of MSC sheets in osteogenic tissue engineering. Potential application techniques with or without scaffolds and/or grafts will be discussed. Finally, the importance of osteogenic induction of these MSC sheets in orthopaedic applications will be demonstrated. © 2017 A. Cagdas Yorukoglu et al

Cefazolin-sodium has no adverse effect on fracture healing in an experimental rabbit model

Objectives: This study aims to investigate whether cefazolinsodium has any adverse effect on fracture healing in an experimental rabbit model. Materials and methods: The study was performed on 50 male New-Zealand white rabbits. Under general anesthesia, closed double fracture of middle one-third of the tibia-fibula of the left lower extremity of the subjects was produced by manual compression followed by closed reduction of fracture and long leg circular cast was applied. Subjects were divided randomly into five groups including 10 rabbits in each group. The first and second group were administered ciprofloxacin 50 mg/kg SC bid and cefazolin-sodium 50 mg/kg IM on the seventh day of fracture. The third group was applied a single high-dose of vitamin D (50.000 IU/kg) IM following fracture. The fourth group was applied daily vitamin E (alphatocopherol) 20 mg/kg IM for five days from one hour before the production of fracture. Control group did not receive any treatment before and after fracture. Initial and control X-ray examinations were performed immediately and four weeks after production of fracture, respectively. At the end of the fourth week, animals were sacrificed and a histological examination of the fracture site was performed. Results: Histological evaluation showed that the histological grade of the fracture healing was significantly lower in the ciprofloxacin group, while it was significantly higher in the cefazolin-sodium, vitamin D and vitamin E groups, compared to control group (p<0.005). Conclusion: Significantly improved histological grade of the fracture healing in subjects treated with cefazolin-sodium than controls suggest that it may be reasonable to choose cefazolin-sodium as an antibiotic therapy for the treatment of infection in patients with bone fractures

Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength

Aims: We ascertained effects of hand dominance in both right and left-handed volunteers on the thickness and cross sectional area (CSA) of pronator quadratus (PQ) muscle as measured by the axial and sagittal views of ultrasound imaging. Secondly, we also aimed to document the extent of the relationship between the PQ measurements and handgrip. Materials and methods: Healthy adults from the volunteer medical staff were included in the study. Handedness was assessed via The Flinders Handedness survey. The sonographic appearance of the PQ was evaluated on sagittal and axial images for both hands. CSA of PQ muscle was digitally drawn and calculated on the axial plane. Handgrip was measured by using adjustable-handle dynamometer. Results: Eighty-nine healthy volunteers were included (54 right and 35 left-handed). Significant difference was detected between dominant and non-dominant hands in CSA and muscle thickness in both right and left-handed volunteers (p<0.05). These measurements were correlated with the handgrip strength (p<0.05, r=0.55, and r=0.43 for right-handed volunteers, r=0.67 and r=0.48 for left-handed volunteers, respectively). There were also significantly high correlations between the measurements of CSA and PQ thickness of the corresponding extremity in both right-handed and left-handed volunteers (p<0.05). Conclusions: A statistically significant difference exists between dominant and non-dominant hands in CSA and muscle thickness measured by US in both right and left handed volunteers, and this is correlated with handgrip strength. Hand dominance should be considered to compare healthy and affected sites during US of PQ while investigating for occult fractures of distal forearm or PQ atrophy due to anterior interosseous nerve injury

Energy efficiency improvement of the heat pump by employing synthesized CuO/ZnO hybrid nanofluid

WOS:000729464600001In this experimental study, CuO/ZnO hybrid nanoparticles were synthesized by the co-precipitation method. While solid nanoparticles were synthesized, 5%, 10%, and 15% mass fractions of CuO were doped into ZnO nanoparticles. While preparing the nanofluids, sodium dodecyl benzene sulphonate (SUBS) surfactant material was used to prepare a homogeneous and hydrophobic suspension. The results of physical and chemical analyses of the synthesized nanoparticles were examined. In the experiments made with the heat pump, the coefficient of performance (COP) of the heat pump was calculated as 4.23 when deionized water was used as the working fluid. In the experiments with nanofluids using ZnO and 15% (wt./wt.) CuO/ZnO instead of deionized water, COP values of 4.31 and 4.44 were obtained, respectively

The impacts of synthesized Ag doped ZnO nano-materials on the energy efficiency of the refrigeration system

WOS:000787868000001Nanofluids are used to increase thermal performance in various applications of heat transfer. In the present study, to increase the performance of the cooling system, nanolubricant prepared with zinc oxide (ZnO) and silver (Ag) doped ZnO nanoparticles were used. ZnO and Ag/ZnO nanoparticles were synthesized via precipitation and co-precipitation methods, respectively. The effects of Ag particles added to ZnO nanoparticles at the rate of 5% on thermal performance were investigated. XRD and SEM examinations of the synthesized nanoparticles were made in detail and their suitability was determined. Nanolubricants were prepared by mixing 0.5% and 1.0% (wt./wt.) ZnO or Ag/ZnO and 0.5% (wt./wt.) Tween 80 (T80). The coefficient of performance (COP) values maximum increased by 18.20% and 23.68%, respectively, in the use of mineral oil with added 1.0% ZnO and 1.0% Ag/ZnO nanoparticles in the nanolubricants. In the cooling system, the compressor work decreased by 18.71% using the nanolubricant prepared with Ag-doped ZnO hybrid nanoparticles at a 1.0% mass fraction