The importance of background correction during calculation of the major salivary gland function in salivary gland scintigraphy

Objective: The aim of this study was to compare the parotid (P) and submandibular (SM) glands uptake and excretion ratios of 99mTc-pertechnetate, which were calculated by using the backgrounds drawn on five different areas. Methods: Ninety-eight P and 98 SM glands of totally 48 patients were included in the study. 99mTc-pertechnetate salivary gland scintigraphy was performed in all patients. Oral stimulation with lemon juice was made at 15th minute of the imaging. The 99mTc-pertechnetate uptake and excretion ratios of the P and SM glands were calculated separately without using any background, and by using the backgrounds drawn on wide frontal, narrow frontal, temporal, cervical and shoulder regions. These values were statistically compared with each other in pairwise manner. Results: The radioactivity uptake and excretion ratios of the P and SM glands calculated without using any background correction were statistically different from that calculated by using any background correction. In addition, the radioactivity uptake and excretion ratios of the P and SM glands calculated by using the backgrounds drawn on five different areas were mostly found statistically different from each other (p<0.05). Conclusion: Background correction is important during the calculation of the uptake and excretion ratios of P and SM glands. This study demonstrates that calculated uptake and excretion ratios of P and SM glands may differ according to the used background area

Posterior cruciate ligament reconstruction via tibial inlay technique in multiligament knee injuries

Objective: The aim of this study is to report our institution's experience regarding the use of open tibial inlay technique in patients undergoing single-stage combined posterior cruciate ligament (PCL) reconstruction.Methods: Records of 17 patients who underwent PCL reconstruction with tibial inlay technique were retrospectively reviewed. Patients with ipsilateral femoral or tibial osteochondral avulsion fractures or ipsilateral concomitant tibia and femur shaft fractures were excluded. Out of these 17 patients, six cases underwent anterior cruciate ligament (ACL) + PCL reconstruction, nine cases underwent ACL+ PCL + posterolateral corner reconstruction, one case underwent ACL + PCL + MCL reconstruction and one case underwent ACL+ PCL + posterolateral corner + MCL reconstruction. Mean follow-up was 14.27±6.77 (range: 6-30) months.Results: In preoperative assessments, all patients had 3+ posterior laxity in posterior drawer test; at final follow-up, 6 patients had 0 laxity, 7 patients had 1+ laxity, and 4 patients had 2+ laxity (p<0.001). International Knee Documentation Committee (IKDC) objective evaluation showed severe disability in all patients preoperatively, whereas 5 knees were grade A, 8 knees were grade B, 3 knees were grade C, and 1 knee was grade D at final follow-up. Mean IKDC subjective score was 75.22±7.53 at final follow-up. Postoperatively, mean side-to-side difference in KT-1000 arthrometer measurement was 2.45±1.80 mm. At final follow-up, mean range of motion (ROM) was 0&ordm; on extension and 123.56±6.31&ordm; on flexion.Conclusion: Open tibial inlay approach is beneficial during PCL reconstruction. Further study is warranted to establish its effectiveness on functional outcomes and prevention of complications.Objective: The aim of this study is to report our institution's experience regarding the use of open tibial inlay technique in patients undergoing single-stage combined posterior cruciate ligament (PCL) reconstruction.Methods: Records of 17 patients who underwent PCL reconstruction with tibial inlay technique were retrospectively reviewed. Patients with ipsilateral femoral or tibial osteochondral avulsion fractures or ipsilateral concomitant tibia and femur shaft fractures were excluded. Out of these 17 patients, six cases underwent anterior cruciate ligament (ACL) + PCL reconstruction, nine cases underwent ACL+ PCL + posterolateral corner reconstruction, one case underwent ACL + PCL + MCL reconstruction and one case underwent ACL+ PCL + posterolateral corner + MCL reconstruction. Mean follow-up was 14.27±6.77 (range: 6-30) months.Results: In preoperative assessments, all patients had 3+ posterior laxity in posterior drawer test; at final follow-up, 6 patients had 0 laxity, 7 patients had 1+ laxity, and 4 patients had 2+ laxity (p<0.001). International Knee Documentation Committee (IKDC) objective evaluation showed severe disability in all patients preoperatively, whereas 5 knees were grade A, 8 knees were grade B, 3 knees were grade C, and 1 knee was grade D at final follow-up. Mean IKDC subjective score was 75.22±7.53 at final follow-up. Postoperatively, mean side-to-side difference in KT-1000 arthrometer measurement was 2.45±1.80 mm. At final follow-up, mean range of motion (ROM) was 0&ordm; on extension and 123.56±6.31&ordm; on flexion.Conclusion: Open tibial inlay approach is beneficial during PCL reconstruction. Further study is warranted to establish its effectiveness on functional outcomes and prevention of complications