Adult lumbar scoliosis

Scoliosis in the adult is a disorder that involves a convergence of deformity and degenerative disease in the spine. It can be defined as a coronal deformity with Cobb angle of more than 10 degrees in mature patients. The treatment of adult lumbar scoliosis deformity requires a multidisciplinary approach and preoperative planning, and to be extended to the development of new treatment methods in the future along with the expected life expectancy. It often manifests with low back pain. Etiology of the disease is related with primary degeneration or continuation of a deformity from adolescence. The main objective of surgical management is to decide which patient is to be treated with surgical treatment, to evaluate the general condition and to analyze the comorbidities of the patient and to draw a treatment scheme considering the patient’s expectations.Publisher's Versio

Ganglion cysts in the lateral portal region of the knee after arthroscopy: report of two cases

A ganglion cyst (GC) is a mucinous or gelatinous-filled benign tumor overlying a joint or tendon sheath, which commonly arises in the dorsal and volar wrist side but may occur anywhere in the body. Although cystic lesions around the knee are common, the occurrence of GCs are rare. Ganglia may arise from intra or extra-articular, soft tissue, intraosseous, or periosteal location. Symptoms may vary according to the size and location. After the more frequent performance of magnetic resonance imaging for the assessment of a knee joint, the number of incidental, asymptomatic lesions have been increasingly diagnosed. The etiology of GC remains unclear; however, trauma and a flaw in the joint tissues may explain its appearance. The authors report two cases of women aged 47 years and 37 years who presented pain and swelling in their left knees following arthroscopic partial medial meniscectomy. The former was surgically treated and had a favorable outcome, while the latter had conservative treatment and a gloomy outcom

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

Ganglion cysts in the lateral portal region of the knee after arthroscopy: report of two cases

A ganglion cyst (GC) is a mucinous or gelatinous-filled benign tumor overlying a joint or tendon sheath, which commonly arises in the dorsal and volar wrist side but may occur anywhere in the body. Although cystic lesions around the knee are common, the occurrence of GCs are rare. Ganglia may arise from intra or extra-articular, soft tissue, intraosseous, or periosteal location. Symptoms may vary according to the size and location. After the more frequent performance of magnetic resonance imaging for the assessment of a knee joint, the number of incidental, asymptomatic lesions have been increasingly diagnosed. The etiology of GC remains unclear; however, trauma and a flaw in the joint tissues may explain its appearance. The authors report two cases of women aged 47 years and 37 years who presented pain and swelling in their left knees following arthroscopic partial medial meniscectomy. The former was surgically treated and had a favorable outcome, while the latter had conservative treatment and a gloomy outcom

Comparison of magnetic resonance imaging and pysical examination of knee with arthroscopic findings

Fizik muayene bulguları ile birlikte manyetik rezonans (MR) görüntüleme sonuçlarının artroskopik cerrahi yapılması kararı üzerine olan etkilerini belirlemek. Yöntem: Kliniğimizde diz artroskopisi yapılan hastaların ameliyat öncesi fizik muayene bulguları ile MR tetkiki sonuçları referans artroskopi alınarak retrospektif olarak istatistiksel değerlendirilmesi yapıldı. Bulgular: Çalışmaya katılan hastalrın yaş ortalaması 47,2 (22,73) olarak belirlendi. Çalışmadaki hastaların 25’i kadın, 20’si erkek, 27sol dize, 18 sağ dize artroskopik cerrahi yapıldı. Medial menisküs yırtığı olan hastalarda Mc murray testinin duyarlılığı %69,8 medial eklem çizgisi hassasiyetinin duyarlılığı %97,7 MR görüntüleme yönteminin duyarlılığı %93 olarak belirlenmiştir. Lateral menisküs yırtığı olan hastalarda Mc murray testinin duyarlılığı %71,4 lateral eklem çizgisi hassasiyetinin duyarlılığı %100 MR görüntüleme yönteminin duyarlılığı %85,7 olarak belirlenmiştir. Medial ve lateral menisküs yırtıklarında ayrım yapılmaksızın Mc murray testinin duyarlılığı %68,9 eklem çızgısı hassasiyetinin duyarlılığı %97,8 Mr görüntüleme yönteminin duyarlılığı %93,3 olarak belirlenmiştir. Sonuç: Dikkatli yapılan bir fizik muayenenin menisküs patolojilerini belirlemede en etkin tanı yöntemi olduğunu düşündürmektedir ve gereksiz yere MR tetkiki istemi oranlarını azaltabileceğini düşünmekteyiz.Objective: To determine the effects of physical examination findings with the results of manyetik rezonans imaging (MRI) on the decision for arthroscopic surgery. Methods: Preoperative physical examination findings and MRI results of the patients undergoing knee arthroscopy in our clinic were evaluated statistically by reference of arthroscopy retrospectively. Results: The mean age of patients in the study is 47.2 (22.73), respectively. 25 of the patients were female, 20 of them were male. Arthroscopic surgery was performed for 27 left knee and 18 right knee. Mc Murray test sensitivity in patients with medial meniscus tear is 69.8%. The medial joint line tenderness sensitivity is 97.7% in the patients with medial meniscus tear. Sensitivity of MRI is determined as 93% in the group with medial meniscus tear. Mc Murray test sensitivity in patients with lateral meniscal tear is 71.4%. The lateral joint line tenderness sensitivity is 100% in the patients with lateral meniscus tear. Sensitivity of MRI is determined as 85.7% in the group with lateral meniscus tear. Mc Murray test sensitivity is 68.9%, joint line tenderness sensitivity is 97.8% and sensitivity of MRI is determined as 93.3% without discrimination on the medial and lateral meniscal tear. Conclusion: A careful physical examination is the most effective diagnostic method to determine meniscal pathologies. We think that careful physical examination could reduce the rates of unnecessary MRI exams

An undescribed monteggia type 3 equivalent lesion: Lateral dislocation of radial head with both-bone forearm fracture

Monteggia fractures are accepted as hard-to-recognize and easy-to-handle fractures. Adequate radiographic investigations and clinical examinations are necessities. This case holds unique features involving diagnosis and treatment. In this case, the radial head was dislocated laterally while both bones were fractured in the proximal diaphysis, being the first to be mentioned in the literature. Closed reduction of the ulna is the preferred method of handling and almost always results in reduction of the radial head. Literature obligates ulnar reduction as a preliminary to reduce and stabilize the radial head. Closed reduction reduced the ulna but the radial head was not reduced. Hence an intramedullary K-wire was used to reduce the radial head and a long arm cast was used to stabilize the reduction. The operation was successful and follow-up showed no complications