PRP on Prevention of Tunnel Enlargement in ACL Reconstruction.

BACKGROUND: The purpose of this study is to describe the role of Platelet Rich Plasma in preventing tunnel enlargement in anterior cruciate ligament reconstruction with a hamstring autograft Material and methods. Forty-four patients who underwent transtibial reconstructive surgery with a hamstring tendon autograft between March 2014 and July 2015 were included in this study. This study involved two groups. Group A consisted of 18 patients who underwent PRPadministration into the femoral and tibial tunnel. Group B was a control group that included 26 patients who underwent ACL reconstruction surgery with a hamstring autograft without PRP. The patients were evaluated preoperatively and postoperatively with the IKDC score, Lysholm score, Tegner activity scale and a KT-1000 arthrometer device. The diameter of the tibial and femoral tunnels of the operated knees was measured on the first day and at three months postoperatively using CT. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial images from 64-slice MSCT scans. RESULTS: On comparison of radiological data between both groups, there was less tunnel enlargement in PRP-administered group for the femoral tunnel, but the result was not statistically significant. No difference was seen between clinical examination results and the grading scales used. CONCLUSIONS: 1. The radiological findings of our study indicated that while there was less tunnel enlargement in the PRP group, there was no statistically significant difference between the groups. 2. Similarly, clinical exa-mination results and scoring scales used did not de-monstrate any intergroup difference. 3. As a result, we donot recommend routine use of PRP for the prevention of tunnel enlargement after ACL reconstruction.

Comparison of Simple Decompression and Anterior Subcutaneous Transposition of the Ulnar Nerve for the Treatment of Cubital Tunnel Syndrome.

BACKGROUND: In this study, we aim to evaluate clinical and functional results in patients with cubital tunnel syndrome who were treated with subcutaneous anterior transposition vs simple decompression of the ulnar nerve. MATERIAL AND METHODS: Fifty-five patients were separated into two groups according to surgical technique. Group 1 comprised 35 patients (23 males, 12 females; mean age, 42.1 years; range, 28-56 years) who underwent anterior subcutaneous transposition of the ulnar nerve, whereas Group 2 included 20 patients (11 males, 9 females; mean age, 47.4 years; range, 25-59 years) who underwent simple decompression of the ulnar nerve. RESULTS: The mean modified Bishop scores were 7.26 and 7.85 in Group 1 and Group 2, respectively (P< .05). The mean Q-DASH scores were 16.94 in Group 1 and 15.80 in Group 2 (P> .05). Postoperatively, paraesthesia regressed in 17 (85.7%) and 30 (85%) patients in Group 1 and Group 2, respectively (P> .05). Both groups demonstrated improvement in ulnar nerve function in comparison with the preoperative period, and ulnar nerve paralysis was not seen in any of our patients. A postsurgical incision scar developed in six (17.1%) and three patients (15%) in Group 1 and Group 2, respectively. CONCLUSION: Both simple decompression and anterior subcutaneous transposition of the ulnar nerve are effective and safe for the treatment of cubital tunnel syndrome, so we would favour simple decompression as it is a less extensive procedure.

Atypical femoral shaft fractures secondary to long-term bisphosphonate therapy.

BACKGROUND: Bisphosphonates (BPs) are one of the most commonly used agents in the treatment of post-menopausal osteoporosis and other metabolic bone diseases. METHODS: Between 2010 and 2015, data of 22 osteoporotic women with femoral fractures due to low-energy trauma who received BPs previously were analysed. RESULTS: The mean duration of BP therapy was 7.6 years. The mean duration of union was 7.4 months. Five patients had non-union. Stress reaction was observed in the contralateral femur in 11 patients. CONCLUSION: Radiographic studies should be performed on a regular basis to prevent atypical femoral fractures in patients on long-term BP therapy.