The Clinical Results of Percutaneous Drilling in the Treatment of Chronic Lateral Epicondylitis.

AIM: Lateral epicondylitis is one of the leading orthopedic problems encountered in daily practice. Treatments are more symptomatic than curative. Percutaneous drilling is a minimally invasive method that provides satisfactory results. The aim of this study was to evaluate patients who had undergone percutaneous drilling for chronic lateral epicondylitis. MATERIAL AND METHOD: The study included 31 patients who underwent surgical percutaneous drilling because of chronic lateral epicondylitis between 2018 and 2021. The patients were evaluated with respect to demographic characteristics, including age, gender, body mass index (BMI), occupation, education level, hobbies, dominant side, and smoking status. The VAS (Visual Analog Scale) pain scores, PRTEE score (Patient-Rated Tennis Elbow Evaluation - a lateral epicondylitis function scale), and Roles-Maudsly score were examined preoperatively and at one and 12 months postoperatively together with grip strength measured with a Jamar hand dynamometer. RESULTS: Statistically significant improvements were determined in the VAS score during activity from 8.9 preoperatively to 2.06 at 12 months postoperatively (p<0.01), and in the PRTEE score, from 64.12 preoperatively to 20.61 at 12 months postoperatively (p<0.01). The Roles-Maudsly score at 12 months postoperatively was determined to be excellent in 13 (41.9%) patients, and good in 14 (45.2%). Mean grip strength increased from 69.55 before treatment to 90.97 at the end of 12 months postoperatively. CONCLUSION: Autobiological treatments are at the forefront of current treatments for tendinopathies. Percutaneous drilling is a closed method and can be considered an ideal method in the treatment of tendinosis caused by inflammation and mesenchymal stem cells (MSCs) contained in hematoma. It is also an advantageous treatment method for patients with aesthetic concerns as it does not leave any scar tissue and has a low risk of complications.

Early results of a novel modular knee arthrodesis implant after uncontrolled periprosthetic knee joint infection.

AIM: The aim of this study is to evaluate the functional outcomes and complications after non-fusion knee arthrodesis with a modular segmental intramedullary implant used for infected total knee arthroplasty revisions. METHODS: A retrospective review of the patients who had been surgically treated with a modular intramedullary arthrodesis implant for recurrent infection after revision TKA between January 2016 and February 2020 were included. The indications for arthrodesis were failed infected TKA with massive bone loss, deficient extensor mechanism and poor soft tissue coverage that precluded joint reconstruction with revision TKA implants. Clinical outcomes were assesed with visual analogue scale for pain (pVAS), Oxford knee score (OKS) and 12-item short form survey (SF-12). Full-length radiographs were used to verify limb length discrepancies (LLD). RESULTS: Fourteen patients (4 male and 10 female) patients with a mean age of 69.3 (range, 59 to 81) years at time of surgery were available for final follow-up at a mean of 28.8 months (range, 24-35 months). All clinical outcome scores improved at the final follow-up (pVAS, 8.5 to 2.6, p = .01; OKS, 12.6 to 33.8, p = .02; SF-12 physical, 22.9 to 32.1, p = .01 and SF-12 mental, 27.7 to 40.2, p = .01). The mean LLD was 1.0 cm (range, + 15 - 2.3 cm). Re-infection was detected in three patients (21.4%). Two patients were managed with suppressive antibiotic treatment and a third patient required repeat 2-stage revision procedure. In one patient, a periprosthetic femur fracture was observed and treated with plate osteosynthesis. CONCLUSION: Uncontrolled infection after total knee arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail and satisfactory functional results can be obtained. LEVEL OF EVIDENCE: Level 4, Retrospective cohort study.

Risk factors for mortality and survival rates in elderly patients undergoing hemiarthroplasty for hip fracture.

OBJECTIVE: The aim of this study was to analyze the relationship between mortality and possible risk factors in elderly patients surgically treated with hemiarthroplasty for hip fracture and to determine mortality rates and yearly survival outcome in a selected cohort. METHODS: A total of 92 patients (51 men (55.4%) and 41 women (44.6%); mean age: 76.47 years) who underwent hemiarthroplasty for hip fracture were included into the study. The following data associated with risk factors were recorded for 92 patients: age, gender, pre-fracture activities of daily living (ADL), type of fracture, American Society of Anesthesiologists (ASA) score, therapeutic procedure, type of anesthesia, length of time after fracture until operation, postoperative mobility, and duration of hospitalization. A multivariate logistic regression test was used to evaluate the correlation between the risk factors and first- and second-year mortality rates. Third-year mortality rate after surgery was analyzed and compared with the general mortality rate in a similar population of the same age group living in the same city. RESULTS: The mortality rate was 18.5% (17 patients) after the first-year follow-up and 25% (23 patients) after the second year. The mortality risk after hip fracture was found to be 11.7 times greater than the similar age group population in the third year. In addition, there was a significant relationship between a low (dependent) preoperative ADL score, advanced age (>80 years), male gender, high ASA score and poor ability to walk (unable to walk), and first- and second-year mortalities (p<0.05). However, no significant relationship was found between fracture type, fracture side, anesthesia type, time from fracture to surgery, or duration of hospitalization and mortality (p>0.05). CONCLUSION: Advanced age, male gender, a high ASA score, a dependent preoperative ADL score, and a postoperative inability to walk were determined to be the most important risk factors affecting mortality in elderly patients with hip fracture. The mortality risk was 11.7 times greater than that of a population with similar characteristics. LEVEL OF EVIDENCE: Level IV, Therapeutic study.

Epidermal growth factor (EGF) promotes bone healing in surgically induced osteonecrosis of the femoral head (ONFH).

Angiogenic effects of epidermal growth factor (EGF), a potent mitogen, have been demonstrated previously. Moreover, different in vitro studies showed that EGF affects processes associated with bone healing, such as osteoblast differentiation and bone resorption. The aim of this study was to investigate the effect of combined core decompression (CD) and recombinant human EGF (rhEGF) treatment on early-stage osteonecrosis of the femoral head (ONFH) surgically induced in rats. ONFH was induced by dissecting the cervical periosteum and placing a ligature tightly around the femoral neck. Thirty rats were assigned to one of the following groups (n = 10 each group): sham-operated control, CD, and CD+rhEGF group. rhEGF was injected intraosseously into infarcted areas 2 weeks after the surgery. Preservation of femoral head architecture was assessed at 8 weeks post treatment by radiographic and histomorphological analyses. Osteopontin (OPN) and cluster of differentiation 31 (CD31) were detected by immunochemistry, as indicators of bone remodeling and vascular density, respectively. Inter- and intra-group (non-operated left and operated right femur) differences in radiographic and histomorphological results were analyzed. The femoral head area and sphericity were more preserved in CD+rhEGF compared to CD and sham-control group. CD31 levels were significantly different between the three groups, and were higher in CD+rhEGF compared to CD group. OPN levels were increased in CD and CD+rhEGF groups compared to sham control, but with no significant difference between CD and CD+rhEGF groups. Overall, our results indicate that EGF promotes bone formation and microvascularization in ONFH and thus positively affects the preservation of femoral head during healing.

Is ACL reconstruction a prerequisite for the patients having recreational sporting activities?

OBJECTIVE: Whether surgical or conservative treatment is more effective in allowing patients to return to physical activity after anterior cruciate ligament (ACL) injury is controversial. We sought to compare mid-term outcome measures between isolated ACL tear patients who underwent reconstruction followed by closed kinetic chain exercises and those who underwent neuromuscular training only. METHODS: We retrospectively evaluated patients with ACL tears who underwent post-surgery CKC strength training after ACL reconstruction (Group A), and patients who only underwent neuromuscular training (Group B) with a minimum follow-up time of 5 years. Surgical techniques, rehabilitation, assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile of the patient were evaluated. RESULTS: Overall, 43 patients were included in Group A (mean age, 32.56 ± 4.89; Tegner activity scale, 5) and 39 patients in Group B (31.67 ± 7.27; 5). Patients in both groups returned to their regular physical activity level after a similar time frame (Group A: average, 12 months; Group B, average, 13.4 months). The mean Lysholm knee score was 88.52 ± 7.65 in Group A and 86.21 ± 13.72 in Group B. Mean distances for the one-leg hop test for Group A were 135.21 ± 31.66 and 145.36 ± 42.10 mm in the reconstructed and uninjured knees, respectively. In Group B, the mean hop distances were 132.47 ± 28.13 and 147.89 ± 21.45 mm in the rehabilitated and uninjured knees, respectively. No statistical difference was observed between the groups for any of the parameters evaluated, including assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile. CONCLUSION: Our data suggest that early surgical reconstruction may not be a prerequisite to returning to recreational physical activities after injury in patients with ACL tears. LEVEL OF EVIDENCE: Level IV, therapeutic study.

Management of unstable pertrochanteric fractures with proximal femoral locking compression plates and affect of neck-shaft angle on functional outcomes.

BACKGROUND: Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting. In the present study we aimed to evaluate the functional and radiological outcomes of proksimal femoral locking compression plates in open reduction and internal fixation of AO/OTA 31A2-2 and 3 fractures. METHODS: Patients older than 18 years of age with a minimum follow-up time of 1 year matching the inclusion criteria retrospectively evaluated. Patients' demographics, Singh index, intra and post-operative data, mobilization and union time gathered from the patients' files. Baumgaertner modified criteria of fracture reduction was used to assess the post-operative reduction quality. Early and last follow-up radiographs were used to evaluate malunion and change in neck- shaft angle. Final clinical outcome was assessed using the Harris Hip scoring system. RESULTS: 18 male and 13 female patients with the mean age of 74 (46-88) met the inclusion criteria. Reduction quality according to Baumgaertner modified criteria was good in 25 patients and acceptable in 6. Mean union time was 21.53 ± 4.18 weeks. There was neither non-union nor malunion. The mean neck-shaft angle change was -3.1° ± 2.16°. The mean HHS was 77.90 ± 4.84 and there was no significance in HHS according to reduction quality and change in neck-shaft angle (p = 0.385, p = 0.0059). HHS was negatively correlated with age, mobilization time and, longer union time (p < 0.05). There was no correlation between Singh index and reduction quality (p = 0.865). Singh index was only correlated with the patient's age (p = 0.000, rho = -0.595). There were 2 infections and, 2 backing of the proximal screws. CONCLUSION: Even though PFLCP is not the first choice in management of unstable pertrochanteric fractures, it must be kept in mind as an alternative to the other conventional plates and intramedullary implants with the properties of an increased stability by multiaxial screw locking and the results are satisfactory when appropriate settlement achieved.

Is depression associated with functional recovery after hip fracture in the elderly?

AIM: The aim of this study was to examine the effects of depression on functional healing and the return to pre-fracture daily activities in elderly patients with a hip fracture. METHODS: The study comprised 104 elderly patients, who had a unilateral hip fracture between 2009 and 2012. To evaluate daily activities and functional healing of the cases, the study was designed as a prospective comparative study. RESULTS: The analysis results revealed that the change in the mean ADL scores was related to depression at a statistically significant level (p = 0.000). DISCUSSION: This study results showed that depression had a negative effect on the daily activity level of these cases.

The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

The purpose of this study is that to evaluate superiority and results of open technique in the treatment of femoral shaft fracture with interlocking intramedullary nailing. The retrospective study is designed to evaluate results of our technique. In this study, the patients that were admitted to the Orthopedics and Traumatology Department of University Hospital that is third level of trauma center. We claim that open technique is not a disadvantage during union process over closed technique in treatment of femoral shaft fracture with interlocking nailing. In this study, 44 patients that were consulted for adult femoral shaft fracture between January 2008 to July 2010 were included. Patients with open fractures, gunshot wounds, neurovascular injuries, and patients that did not have isolated femoral diaphysis fractures were excluded from the study. Clinical and radiological results of the patients were checked periodically. The open interlocking intramedullary nailing was used in treatment. Complete union rate was 90.9 % in 40 patients who were treated with open interlocking intramedullary nailing for adult femoral shaft fracture, and nonunion rate was 9.1 % in four patients. Mean union time was 18.3 weeks (12-36 weeks). Evaluation of 44 patients according to Thoresen criteria was excellent in 22 patients, good in 6 patients, and bad in 4 patients. We think that open technique is an acceptable technique because all results of our study were similar to results of closed intramedullary nailing technique in literature and some advantages of open technique over closed technique.

Is scintigraphy a guideline method in determining amputation levels in diabetic foot?

BACKGROUND: In this study, we aimed to evaluate the potential use of a 3-phase bone scintigraphy method to determine the level of amputation on treatment cost, morbidity and mortality, reamputation rates, and the duration of hospitalization in diabetic foot. METHODS: Thirty patients who were admitted to our clinic between September 2008 and July 2009, with diabetic foot were included. All patients were evaluated according to age, gender, diabetes duration, 3-phase bone scintigraphy, Doppler ultrasound, amputation/reamputation levels, and hospitalization periods. Patients underwent 3-phase bone scintigraphy using technetium-99m methylene diphosphonate, and the most distal site of the region displaying perfusion during the perfusion and early blood flow phase was marked as the amputation level. Amputation level was determined by 3-phase bone scintigraphy, Doppler ultrasound, and inspection of the infection-free clear region during surgery. RESULTS: The amputation levels of the patients were as follows: finger in six (20%), ray amputation in five (16.6%), transmetatarsal in one (3.3%), Lisfranc in two (6.6%), Chopart in seven (23.3%), Syme in one (3.3%), below-the-knee in six (20%), above the knee in one (3.3%), knee disarticulation in one (3.3%), and two patients underwent amputation at other centers. After primary amputation, reamputation was performed on seven patients, and one patient was treated with debridement for wound site problems. No mortality was encountered during study. CONCLUSIONS: We conclude that 3-phase bone scintigraphy prior to surgery could be a useful method to determine the amputation level in a diabetic foot. We conclude that further, comparative, more comprehensive, long-term, and controlled studies are required.

Surgical treatment of osteopetrosis-related femoral fractures: two case reports and literature review.

Osteopetrosis is a rare hereditary disease which is characterized by increased bone density. Bone resorption is insufficient or fails due to the osteoclast defect in osteopetrosis. Half of the patients are asymptomatic and diagnosed incidentally or based on the presence of fracture. Adult onset osteopetrosis usually presents with hip and proximal femoral fractures. Internal fixation can be performed; however, technical challenges may be experienced due to increased bone density. As in other fractures, nonunion or varus malunion of these fractures may occur. Although rare, osteopetrosis may complicate treatment of fractures in such patients. In this study, we aimed to present two new cases of ADO type II with an osteopetrotic femoral fracture along with the clinical and radiological findings in the light of a comprehensive literature review. Orthopaedics surgeons should be aware of intraoperative technical difficulties and possible postoperative complications during the follow-up period. Investigation would be beneficial for the diagnosis of osteopetrosis such the patient with fractures who has minor trauma history and increased bone density in radiography.

Influence of 1800 MHz GSM-like electromagnetic radiation exposure on fracture healing.

BACKGROUND AND AIMS: In this study, we aimed to investigate whether 1800 MHz frequency electromagnetic radiation (EMR) has an effect on bone healing. METHODS: A total of 30 Wistar albino rats were divided into two equal groups. Fractures were created in the right tibias of all rats; next, intramedullary fixations with K-wire were performed. A control group (Group I) was kept under the same experimental conditions except without EMR exposure. Rats in Group II were exposed to an 1800 MHz frequency EMR for 30 min a day for 5 days a week. Next, radiological, mechanical, and histological examinations were performed to evaluate tibial fracture healing. RESULTS: Radiological, histological and mechanical scores were not significantly different between groups (respectively, p = 0.114, p = 0.184 and p = 0.083), and all of these scores were lower than those of the controls. CONCLUSIONS: EMR at 1800 MHz frequency emitted from cellular phones has no effect on bone fracture healing.

Effect of 900MHz electromagnetic fields emitted from cellular phones on fracture healing: an experimental study on rats.

OBJECTIVE: The aim of this study was to investigate the effect of electromagnetic fields (EMFs) at 900 MHz frequencies on bone fracture healing. METHODS: The study included 30 adult male Wistar albino rats (average weight: 256 g) divided into two equal groups. Transverse fracture was created manually by pressing a finger on the right tibias of all rats and fractures were fixed intramedullary using a K-wire. Rats in Group 1 were exposed to EMF at 900 MHz frequency 30 minutes a day, 5 days a week for 8 weeks. Group 2, the control group, was kept under the same experimental conditions without EMF exposure. Radiological, mechanical and histological examination of tibial fracture healing was performed. RESULTS: There was a significant difference between radiological, histological and manual biomechanical scores of the study and control groups (p=0.020, p=0.006 and p=0.032, respectively). All scores were lower in the study group than the control group. CONCLUSION: Results of this study demonstrate that EMF at 900 MHz of frequency emitted from cellular phones has a significantly negative effect on bone fracture healing in a rat tibia model.

Results of vacuum assisted wound closure application.

In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11-61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm(2) (13.7-216.3 cm(2)) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7-15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions.

[Effect of bone cement application on the incidence of deep vein thrombosis in major joint arthroplasties]. / Büyük eklem artroplastilerinde kemik çimentosu uygulamasinin derin ven trombozu sikligina etkisi.

OBJECTIVES: In this study, we have investigated whether the application of bone cement has an effect on the frequency of deep vein thrombosis (DVT) in major joint arthroplasties (MJA). PATIENTS AND METHODS: A total of 95 MJA cases meeting the inclusion criteria of this study between January 2004 and January 2005 were divided into cemented and cementless groups. For prophylaxis, all patients were given low molecular weight heparin (LMWH). The patients were scanned for DVT preoperatively and on the postoperative 12(th) day by color Doppler ultrasonography. RESULTS: In hip arthroplasties, in knee arthroplasties and in general, DVT was seen more frequently in cemented group, however, there was no statistically significant difference between groups in the frequency of DVT (p=0.549, p=0.749 and p=0.462, respectively). Also, there was no significant difference between the results of the different LMWH groups (p=0.616). CONCLUSION: The results of this study shows that bone cement application in MJAs such as hip or knee arthroplasties has no significant effect on the frequency of DVT.

Effect of electromagnetic field induced by radio frequency waves at 900 to 1800 MHz on bone mineral density of iliac bone wings.

OBJECTIVE: Telecommunication has gained a different meaning in daily life with the introduction of the mobile phone system. However, electromagnetic pollution has increased in parallel to this improvement. In this study, we aimed to investigate the effects of electromagnetic waves emitted from cellular phones operating at a frequency of 900 to 1800 MHz on the bone mineral density of the human iliac bone wings, which are the most common carriage sites for mobile phones. MATERIALS AND METHODS: A total of 150 male volunteer participants were included in this study. The mean age was 31.85 years, and the age range was between 21 and 57 years. The participants were separated into 2 groups based on as follows: iliac side exposed to electromagnetic wave (group 1) and unexposed side (group 2). Of the total number of participants, 122 were carrying their phones on their right iliac wings, whereas 28 were carrying their phones on their left iliac wings. The mean daily carriage duration was 14.7 hours (between 12 and 20 h), and the mean duration for cellular phone use was 6.2 years (between 4 and 9 yr). Mineral bone density was measured using dual-energy x-ray absorptiometry in the right and the left iliac wings of all the participants. The SPSS 15 software (SPSS Inc, Chicago, IL) was used for statistical analysis. In the comparison of the 2 sides, Student t test was performed and P < 0.05 was considered significant. RESULTS: The mean dual-energy x-ray absorptiometry values measured from group 1 were slightly lower than those from group 2, but there was no statistically significant difference between the groups (P > 0.05). In addition, the mean values of group 1 were not as low as those measured in osteopeny or osteoporosis cases. CONCLUSIONS: Current data may suggest that taking into consideration cellular phone use when iliac bone graft is necessary in clinical practice would constitute an important factor for more favorable outcomes.

Optical detection of brain cell activity using plasmonic gold nanoparticles.

Metal nanoparticles are being actively explored for applications that use localized surface plasmon (LSP) resonance for optical sensing. Here we report an electrostatic field sensing technique which has been applied to detection of mammalian brain cell activity, by optically measuring the cellular potential induced shift in the SP resonance mode of an adjacent planar gold nanoparticle array. An experimental scheme was first devised which enables a quantitative calibration of the field-induced plasmon resonance modulation in air. Hippocampal (brain) neural cells were then grown onto the nanoparticle template and cellular level individual transient signals were detected optically when the chemically triggered neurons switched their potential. Experimental data are compared with calculations using the Drude model for the dielectric response of gold and the Stern model for the metal-electrolyte junction, with good agreement.

[The efficacy of low- and high-molecular-weight hyaluronic acid applications after arthroscopic debridement in patients with osteoarthritis of the knee]. / Gonartrozlu hastalarda artroskopik debridman sonrasi düsük ve yüksek molekül agirlikli hiyalüronik asit uygulamalarinin etkinligi.

OBJECTIVES: We evaluated the efficacy of viscosupplementation with low- or high-molecular-weight hyaluronic acid (HA) preparations following arthroscopic debridement (AD) in patients with osteoarthritis of the knee. METHODS: The study included 45 patients (19 men, 26 women; mean age 53 years; range 41 to 66 years) with Kellgren-Lawrence grade 2-3 osteoarthritis of the knee. Following AD, the patients were randomized to three groups to receive three intra-articular injections of 2 ml hylan G-F 20 (Synvisc, n=16), five intra-articular injections of 2 ml sodium hyaluronate (Hyalgan, n=14), and no injections (controls, n=15). Injections were administered at one-week intervals. All the patients were evaluated with pain, stiffness, and functional capacity scores of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index before and 6 and 12 months after AD. RESULTS: Two patients and three patients complained of transient pain in Synvisc and Hyalgan groups, respectively. WOMAC scores showed significant decreases in all the groups at 6 and 12 months. There were no significant differences between the three groups with respect to improvement in WOMAC scores at 6 months. However, compared to the control group, differences between pre- and posttreatment scores at 12 months were significantly greater in the Synvisc (p=0.004) and Hyalgan (p=0.003) groups, with no significant difference between the two HA groups (p>0.05). CONCLUSION: Our findings show that AD is beneficial in osteoarthritis of the knee in patients with appropriate indications, viscosupplementation increases the efficacy of treatment, and that low- and high-molecular-weight HA preparations have similar efficacy.

The effect of arthroscopic surgery and intraarticular drug injection to the antioxidation system and lipid peroxidation at osteoarthritis of knee.

OBJECTIVE: To elucidate the effects of arthroscopy and intraarticular hyaluronan therapies on antioxidant enzyme activity and lipid peroxidation. METHODS: This study was conducted between January and May 2005, at the Department of Orthopedics and Traumatology, Suleyman Demirel University, Isparta, Turkey. A total of 60 patients with knee pain who were diagnosed as knee osteoarthritis according to the American College of Rheumatology (ACR) criteria were included in this study and randomly and equally divided into 4 groups. Intraarticular Hylan G-F 20 treatment was given to group 1 for 3 weeks. Intraarticular Hylan G-F 20 treatment plus oral vitamin E were administered to group 2 for 3 weeks. Only arthroscopy treatment was applied to the control group (group 3). Intraarticular Na-hyaluronate treatment was given to group 4 for 5 weeks. Blood and synovial fluid samples were taken from all the patients for biochemical analysis, and the following parameters were measured: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA). RESULTS: There was no significant difference in blood SOD, CAT, GPx levels, and synovial SOD and GPx levels in groups treated with hyaluronan, when compared with the controls. However, there was a significant change in MDA levels in synovial fluid samples of group 1, group 2, and group 4, when compared with the controls. CONCLUSION: In knee osteoarthritis, intraarticular hyaluronan therapy following arthroscopy may diminish lipid peroxidation in synovial fluid.

Highly efficient resonant coupling of optical excitations in hybrid organic/inorganic semiconductor nanostructures.

The integration of organic and inorganic semiconductors on the nanoscale offers the possibility of developing new photonic devices that combine the best features of these two distinct classes of material. Such devices could, for example, benefit from the large oscillator strengths found in organic materials and the nonlinear optical properties of inorganic species. Here we describe a novel hybrid organic/inorganic nanocomposite in which alternating monolayers of J-aggregates of cyanine dye and crystalline semiconductor quantum dots are grown by a layer-by-layer self-assembly technique. We demonstrate near-field photon-mediated coupling of vastly dissimilar optical excitations in the two materials that can reach efficiencies of up to 98% at room temperature. By varying the size of the quantum dots and thus tuning their optical resonance for absorption and emission, we also show how the ability of J-aggregates to harvest light can be harnessed to increase the effective absorption cross section of the quantum dots by up to a factor of ten. Combining organic and inorganic semiconductors in this way could lead to novel nanoscale designs for light-emitting, photovoltaic and sensor applications.

Large enhancement of fluorescence efficiency from CdSe/ZnS quantum dots induced by resonant coupling to spatially controlled surface plasmons.

Nanoengineered fluorescent response is reported from semiconductor core-shell (CdSe/ZnS) quantum dots in proximity to the surface plasmon polariton field of periodic Ag nanoparticle arrays. Tuning the surface plasmon polariton resonance to the quantum dot exciton emission band results in an enhancement of up to approximately 50-fold in the overall fluorescence efficiency, in a design where each Ag nanoparticle is interconnected by a continuous Ag thin film. Propagating modes of surface plasmon resonances have a direct impact on the fluorescence enhancement.