Effects of preoperative anxiety level on pain level and joint functions after total knee arthroplasty.

This study examined the effect of preoperative anxiety level on postoperative pain, opioid and nonopioid analgesic use requirements and joint function in patients undergoing primary knee arthroplasty for knee osteoarthritis. 106 patients were included in the study. Situational anxiety score (STAI-S) and trait anxiety score (STAI-T) were divided into two groups as below and above 40. Visual analog scale (VAS), Lysholm scores, and anxiety levels were assessed preoperatively, at the third and sixth month postoperatively to investigate their effects on the use of opioid and non-opioid drugs during the postoperative period. For those with low situational and trait anxiety scores, the median duration of hospital stays was significantly shorter compared to those with high anxiety scores. In groups where anxiety levels were initially low, the median anxiety levels at the postoperative 3rd month were also observed to be lower compared to the other group. In the same groups, the median VAS values and the median Lysholm knee scores were significantly better both preoperatively and at the postoperative 3rd month compared to the other group. There was no significant difference in Lysholm score between the two groups at the 6th postoperative month. Similarly, in the preoperative period, groups with low anxiety levels had a significantly lower median usage of both opioids and non-opioids compared to the other group. These findings suggest that high preoperative anxiety may have a negative effect on functional outcomes in the early postoperative period, but this effect disappeared at 6 months. It can be concluded that reducing preoperative anxiety may have a positive effect on early outcomes. We believe that preoperative psychological evaluation and treatment can increase the satisfaction level in patients undergoing total knee arthroplasty (TKA).

Viscosupplementation of the knee: Three cases of acute Pseudoseptic Arthritis with painful and irritating complications and a literature review.

Acute pseudoseptic arthritis is a very rare complication that is associated with intra-articular hyaluronic acid injections, which normally involve minimal risk. The most common adverse events that are caused by hyaluronic acid injections are inflammatory reactions or flares at the injection site. In this study, we described three cases of acute pseudoseptic arthritis that was caused by hyaluronic acid; the symptoms in these cases were reminiscent of acute septic arthritis. Moreover, we performed a literature review on pseudoseptic arthritis following hyaluronic acid injections to determine the manner in which this condition can be described, diagnosed, and treated.

An alternative method in fixation of tibial transverse fractures by intramedullar nailing: biomechanical and histopathologic investigation.

A new method was used in fixation of tibial bone fractures. Intramadular nailing (IMN) has been used into mid-diaphysis on left tibias of New Zeland rabbits (n = 5) via an in vivo work. To enable fixation of fracture, without causing too much screw damage on bone and avoiding malunion, nano- and micro-scale hydroxyapatite (HA) was coated at two ends (25 mm in length) of intramadular nails before implantation. After six weeks of survival period and sacrifizing, biomechanical tests and histopathologic examinations were executed. Such experiments have revealed that good stabilization and hence better fracture union for both treated IMN groups (NHA and MHA) over the standard IMN'. Pull-out tests showed the tensile strengths obtained to be significantly higher for the nano (NHA) and micro scale-MHA coated IMN compared to the uncoated standard IM nailing.