[Osteoblastoma in the os hamatum: a rare case report]. / Hamatum kemiginde osteoblastom: Nadir bir olgu sunumu.

Osteoblastoma in the os hamatum is rarely seen. Although curettage and grafting seems to be disadvantageous, it offers advantages in the functional protection in the treatment of carpal bone-located osteoblastoma. In a 39-year-old housewife who was admitted with painful left wrist through all day for the past one year, physical examination revealed painful hypothenar region with the wrist adduction to the ulna. Radiography showed radial inclination of the wrist, ring appearance in the scaphoid bone, and slight radiolucency in the hamatum and adjacent bones. Computed tomography demonstrated an expanded lesion which separated the surrounding tissue with a thin edge layer and perforated the cortex mildly. Intralesional curettage was performed. The pathological examination of the specimen obtained was consistent with osteoid osteoma or osteoblastoma. Curettage and grafting were performed in case of recurrence. In this article, we present a rare case of carpal bone and hamatum-located osteoblastoma. The patient was free of pain with normal wrist functions at 16 months postoperatively.

Anterior cruciate ligament reconstruction improves the metabolic energy cost of level walking at customary speeds.

PURPOSE: The metabolic energy cost of walking is altered by pathological changes in gait. It is thought that anterior cruciate ligament (ACL) deficiency alters the energy requirement for level walking through its effect on gait pattern. In this study, it is hypothesised that the metabolic energy cost of walking would improve after ACL reconstruction. METHODS: Eight patients who were undergoing ACL reconstruction for an isolated rupture were included in this prospective study. Clinical examinations, Lysholm scores and metabolic tests were performed preoperatively and at 3, 6 and 12 months after ACL reconstruction using autologous quadruple hamstring tendons. For the metabolic evaluation, net oxygen cost was calculated while walking on a treadmill at 50-, 70- and 90-m/min velocities. A two-way factorial ANOVA was performed in order to evaluate the primary effects and interactions of the time point and velocity variables on net oxygen cost. RESULTS: All patients had positive Lachman and anterior drawer tests preoperatively that became negative postoperatively and remained negative until the last follow-up point. The mean preoperative Lysholm score was 66, whereas the mean postoperative follow-up scores were 85, 91 and 94, respectively. The interaction between follow-up time point and velocity was not significant. Regardless of the selected velocity, the net oxygen cost was lower than that at preoperative levels at each postoperative time point (p < 0.05). CONCLUSION: The results of the present study indicate that the energy cost of level walking in chronic ACL-deficient patients improves after ACL reconstruction. Cause-effect-based studies with correlation evaluations that compare kinetic, kinematic and electromyographic data and metabolic cost calculations should facilitate more accurate analyses. LEVEL OF EVIDENCE: Therapeutic study, Level 4.

Intrapelvic mass causing femoral compression neuropathy in a patient with Gaucher disease: a case report.

Gaucher disease is a lysosomal storage disorder in which glucocerebroside accumulates within the macrophages in any part of the body. Varying degrees of skeletal involvement may occur besides anemia, coagulation abnormalities and hepatosplenomegaly. Most of the factors influencing the quality of life in a patient with Gaucher disease are related to bone involvement. Gaucher cell deposits may extrude through cortical erosions and cause soft tissue masses around bones which are involved by the disease. We present a 38-year-old female patient with Gaucher disease who had a large intrapelvic mass originating from left iliac bone causing femoral compression neuropathy. The classification of disease is based on neurological involvement and if symptoms exist whether the symptoms are acute or subacute. The neurological impairment caused by compression by a tumor should be distinguished from the ones reported in neurogenic forms of the disease.

[The effect of low-intensity pulsed sound waves delivered by the Exogen device on Staphylococcus aureus morphology and genetics]. / Exogen cihazi kaynakli düsük yogunluklu ses dalgalarinin Staphylococcus aureus morfolojisi ve genetigi üzerine etkileri.

OBJECTIVES: We investigated the effect of low-intensity pulsed sound waves delivered by the Exogen device, which is recommended for the treatment of delayed union and nonunion in orthopedic surgery, on the colony number, antimicrobial susceptibility, bacterial morphology, and genetics of Staphylococcus aureus, which is a frequent pathogen in orthopedic infections. METHODS: Thirty tubes containing 0.5 McFarland suspensions of S. aureus (ATCC 25923) were used. Fifteen tubes forming the test group were subjected to low-intensity sound waves by the Exogen device for 20 minutes. The remaining 15 tubes were untreated as controls. The two groups were then compared with respect to colony number, antibiotic susceptibility, and genotypic properties. The tubes were examined histologically by electron microscopy. RESULTS: The test tubes treated with sound waves showed a significantly lower number of bacteria colonies compared to the control tubes (p<0.001). The two groups were similar with respect to antibiotic susceptibility and genotypic properties. Bacterial cell wall structure in the control group was of normal appearance, whereas partial destruction and break-up were observed in test samples. Bacterial cell wall thickness was significantly higher in the test group compared to the control group (41.54 nm and 24.27 nm, respectively; p<0.001). CONCLUSION: Low-intensity sound waves may be beneficial as a prophylactic measure to prevent infections in primary orthopedic operations and as an adjuvant therapy for infected nonunions.

Comparison of bony healing and cartilage degeneration following strut grafting and trapdoor procedures in an ovine model.

This experimental study compared bony healing and cartilage degeneration following strut grafting and trapdoor procedures for osteonecrosis of the femoral head in an ovine model. Osteonecrosis and a bony defect were created surgically in 16 hips of 8 Merino sheep, and the index grafting procedures were performed in a second session. Three months after surgery, the hips treated by strut grafting yielded better articular cartilage protection and bony healing compared to the osteonecrosis groups. The trapdoor group yielded better bony healing compared to the rest of the groups, but the grafts and the osteochondral flaps failed to unite with the host bone. These findings indicate elevating the osteochondral flap during the trapdoor procedure injures the cartilage and may cause degeneration.

An alternative patellar resurfacing technique in knee replacement: patellofemoral fascial interposition arthroplasty.

The present study reports the early clinical results of 38 osteoarthritic patients (38 knees) who were treated by total knee replacement in conjunction with patellofemoral fascial interposition arthroplasty (PFIA). After the femoral and tibial components were inserted, a fasciotendinous graft was harvested from the anterior surface of the quadriceps tendon and sutured around the articular surface of the patella. The patients were followed-up for a minimum of 24 months. The durability of the fascial graft was assessed radiographically by addition of a wire suture marker placed into the fascia in the first five patients. Patients were evaluated using the Hospital for Special Surgery (HSS) knee-rating system, and anterior knee pain was assessed using specific patellofemoral-related questions. The average HSS knee score improved from 61 points preoperatively to 92 points at 24 months' follow-up (P<0.001). Twenty-five patients (65.7%) had anterior knee pain preoperatively, and seven patients (18.4%) revealed anterior knee pain at their last visits (P<0.001). The position of the markers in the fascial grafts did not show any change during radiological follow-ups. Our data suggest that, PFIA provides good pain relief and it may be an alternative resurfacing technique avoiding the complications of patellar components.

[The effect of human placental suspension on rat sciatic nerve healing]. / Siçan siyatik sinir iyilesmesinde insan plasenta süspansiyonunun etkisi.

OBJECTIVES: We investigated the effect of human placental suspension (HPS) on rat sciatic nerve regeneration. METHODS: Eight adult female Sprague-Dawley rats weighing between 250 and 300 g were randomly divided into control and study groups equal in number. Both sciatic nerves were explored under anesthesia, transsected and then immediately repaired. At the end of the operation, and on the second and fifth days, HPS and saline were administered to the operation zone in the test and control groups, respectively. For functional examination, electromyographic activity was measured in posterior extremities of all rats preoperatively and at the end of eight weeks. The rats were then sacrificed to obtain transections from the repaired area and its distal region for histologic examination and the number of myelin-sheathed axons was estimated in both regions. RESULTS: Electromyographic study showed delayed latency and decreased amplitude following operation in both groups, being less severe in the study group without reaching a significant difference from the control group (p>0.05). The most notable histopathologic finding was increased endoneural collagen in the control group and regenerative axonal growth in the HPS group. The number of axons was greater in the distal region in both groups. In both regions, the number of myelin-sheathed axons was greater in the HPS group, but this difference was significant only for the number of axons in the repair zone (p=0.001). CONCLUSION: Our data suggest that HPS may exert a favorable effect on peripheral nerve regeneration.

Treatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing.

INTRODUCTION: The aim of this study was to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of type IIIA open fractures of the tibia. MATERIALS AND METHODS: Sixty-one patients with open type IIIA tibial shaft fractures were treated with an IEF (n = 32) or UTN (n = 29). Both groups were compared for union time, secondary outcomes of nonunion, infections, mechanical failure of the implant, and malunion. RESULTS: The average time-to-bone healing was 19 weeks (range 14-23 weeks) for IEF and 21 weeks (range 16-36 weeks) for UTN; it was significantly shorter in the IEF group (P = 0.039). One patient had refracture in the IEF group. Malunion occurred in four patients for each group. Posttraumatic osteomyelitis occurred in two patients in the IEF group and in three patients in the UTN group. In the IEF group, additional surgical procedures were indicated in three cases including sequestrectomy (n = 1), and pin replacement (n = 2). In the UTN group, seven patients needed additional surgery including bone grafting (n = 3), nail exchanged (n = 1), and posttraumatic osteomyelitis (n = 3). CONCLUSION: The results of the current study showed that IEF technique had a notable incidence of pin-tract infection, joint contracture, and shorthening related to treatment of the delayed union. The UTN technique had the disadvantage of a posttraumatic osteomyelitis and delayed union requiring additional surgery. We believe that the decision to use IEF or UTN should be made on a case-by-case basis.

Histoacryl glue in meniscal repairs (a biomechanical study).

The purpose of this study was to investigate the biomechanical efficacy of Histoacryl (cyanoacrylate, N-asetil 2 butyl sistein) in meniscal tear repair. In our study, the primary stability of three different repair techniques in delaying the formation of a gap of 2 mm was investigated. A meniscal tear was repaired with two vertical sutures and Histoacryl in the first group; it was repaired only with Histoacryl in the second group, and with only two vertical sutures in the third group. Menisci were then placed in a tensile loading machine, and the primary stability of the repair zones was measured until a displacement of 2 mm occurred. Biomechanical force was significantly (P<0.05) high (112.0+/-17.20 N) in all groups when vertical suture and Histoacryl glue were used together during displacements of 0.5, 1.0, 1.5 and 2.0 mm. We believe that Histoacryl is superior to vertical sutures regarding gap delaying. It potentiates the effect of vertical suture strength, permits early motion and thus merits an in vivo study.

Effect of end-to-side repair of proximal nerve stumps of transected peripheral nerves on the development of neuroma (experimental study).

OBJECTIVE: Neuroma is a psychologically and physically disabling problematic condition without any current standard therapy. For that reason, we investigated whether end-to-side anastomosis of the proximal end of the transected nerve into the adjacent nerve will prevent the development of neuroma in different types of nerve injuries. STUDY DESIGN: In this study, hind legs of 18 Sprague-Dawley female rats were used. Six groups were formed. In group I, peroneal nerves were transected and its proximal end was attached end-to-side through the epineural window to the adjacent tibial nerve. In group II, contrary to group I, an epineural window was created in the tibial nerve and the same number of sutures were employed. In group III, tibial nerve was transected proximal to the end-to-side repair site, whereas in group IV, distal segment of the nerve was cut, and an end-to-end repair procedure was repeated. In group V, unlike group I, an approximately 1-cm segment was resected and removed distal (from tibial nerve) to the end-to-side repair site. In group VI, an epineural window was created in the tibial nerve and the same number of sutures were used, and also a 1-cm distal nerve segment was resected. The rats were followed for 2 months, and then all of the groups were evaluated histopathologically, and weights of the posterior muscle groups of hind legs were evaluated. FINDINGS AND CONCLUSIONS: No neuroma formation was observed in the proximal stumps of peroneal nerve segments in end-to-side repair sites in groups I, III, IV, and V, and proximal stumps of the tibial nerve in group V. In group VI, neuroma formation was observed in the proximal end of the tibial nerve. When weights of the posterior muscle groups of hind legs in groups I and II were comparatively assessed, statistically significant difference was not detected. In conclusion, based on histological data obtained for proximal nerve ends and segments distal to the end-to-side repair sites, we think that end to side neurorrhaphy of the proximal end of the damaged nerve to adjacent nerve will prevent the development of neuroma without injuring the intact nerve segment.

Somatotrophic reorganization in the brain after extremity replantation, revascularization and amputations: investigated by SPECT analysis.

BACKGROUND: We wanted to investigate the somatotropic reorganization occurring in the motor and somatosensory cortex by using 99mTc-HMPAO SPECT analyses, after the extremity revascularization, replantation or amputation. METHODS: Twelve patients (11 men, 1 female; mean age 38.9+/-14.7 years) and controls (5 men, mean age 32.2+/-7.9 years) were enrolled in this study. After reconstruction, lower, middle and upper orbitomeatal slices with precentral and postcentral slices were obtained. All images were visually and semi-quantitatively evaluated. Mann-Whitney U-test was used for statistical analysis. RESULTS: In the revascularization and replantation patients, postcentral and precentral hypoperfusions were seen at dominant hemisphere. In the amputated patients, postcentral (in 3 of 4 cases) and precentral hypoperfusions were seen at non-dominant hemisphere and postcentral hypoperfusion (in 1 of 4 cases) was seen at dominant hemisphere. In our patients, most significant difference in regional cerebral blood flow was found in posterior parietal cortex (somatic associated area). CONCLUSION: Changes that take place in precentral and postcentral cortical areas subsequent to the extremity replantation-revascularization of the organ is a good indicator of somatotrophic reorganization.

Early internal fracture fixation prevents bacterial translocation.

The aim of our study was to determine whether early internal fixation of major bone fractures helps prevent bacterial translocation in patients with multitrauma. Thirty-seven Sprague-Dawley rats were divided into three groups: (1) anesthesia only (n = 12); (2) the trauma group: tibia and femur fractures and moderate head trauma under anesthesia (n = 14); and (3) the fixation group: fixation of tibia and femur fractures and moderate head trauma under anesthesia (n = 11). After 24 hours, mesenteric lymph nodes, liver, spleen, and systemic blood samples were quantitatively cultured. The terminal ileum was assessed histopathologically. The incidence of bacterial translocation was less in the anesthesia group (two of 12 rats) and the fixation group (two of 11 rats) than in the trauma group (10 of 14 rats). The number of organs containing viable bacteria was significantly lower in the fixation group than in the trauma group. Histopathologically, villous architecture was preserved mostly in the fixation group; however, marked mucosal damage was detected in the trauma group. Our data suggest early internal fixation of long bone fractures in polytraumatized experimental animals with head injury results in preservation of the intestinal mucosal barrier and decreased bacterial translocation from the gut.

Evaluation of cyanoacrylate augmentation of transpedicular screw pullout strength.

PURPOSE: Pedicle screw fixation of osteoporotic bone in the elderly is a challenge. Various augmentation methods have been studied by many authors. Although polymethylmethacrylate (PMMA) augmentation is believed to be a standard method, its usage is fraught with complications. Butyl-2-cyanoacrylate is an alternative to PMMA as it is bioresorbable, biocompatible, inexpensive, and noninfective. The objective of the current study was to determine the pullout strength of the pedicle screws when butyl-2-cyanoacrylate is used for augmentation. METHODS: Fresh calf lumbar vertebrae were obtained from male calves weighing 100-120 kg and implanted with pedicle screws. The screws were placed in native, unaugmented bone (group 1), butyl-2-cyanoacrylate-augmented bone (group 2), and PMMA-augmented bone (group 3). Axial pullout tests were done by an Instron 4411 universal testing machine. Statistical analysis was performed using the SPSS 9.0 for Windows program. Paired samples t test was used, and P < 0.05 was considered significant. RESULTS: The mean bone mineral density of the vertebrae was 1.6 +/- 0.1 g/cm2. The mean pullout strengths were 1.55 +/- 0.23 kN for group 1, 1.62 +/- 0.42 kN for group 2, and 2.55 +/- 0.22 kN for group 3. There was no statistically significant difference between groups 1 and 2. PMMA augmentation increased the pullout strength significantly when compared with butyl-2-cyanoacrylate augmentation and native bone (P = 0.002 and P = 0.001, respectively). CONCLUSIONS: The results of this study show that butyl-2-cyanoacrylate has no contribution to the augmentation of pedicle screw fixation in a calf model when compared with native bone or PMMA augmentation. Further studies are required to evaluate the effectiveness of butyl-2-cyanoacrylate in osteoporotic specimens and under cyclic loading in calf vertebra and animal and cadaver models before dispensing with its utility as an augmentation method in the clinical setting.

[The use of N-butyl-2-cyanoacrylate (Histoacryl) in primary tendon repair: a biomechanical study with sheep flexor tendons]. / Tendon onariminda N-butil-2-siyanoakrilat (Histoakril) kullanimi: Koyun fleksör tendonuyla biyomekanik çalisma.

OBJECTIVES: In this study, the biomechanical properties of peripheral tendon repair with the use of epitendinous suture technique and N-butyl-2-cyanoacrylate (Histoacryl) (NBSA), a biodegradable glue, were compared. METHODS: Twenty-four flexor tendons were harvested from sheep hind limbs. Following transection of the tendons, 12 tendons (group 1) were repaired with modified Kessler core sutures using no 2 prolene and epitendinous running sutures with 3/0 prolene. In the other 12 tendons (group 2), NBSA was applied between the cut surfaces before placing modified Kessler core sutures. Placed on an hydrolic test machine, half of the tendons from each group were subjected to load to failure with a tensile force of 20 mm/min and the other half to cyclic loading with a tensile loading between 1-15 N at a rate of 20 cycles/min. Observation of a gap of 1 mm between the tendon ends in each test was regarded as repair failure. RESULTS: The mean load to failure was 27.3 N (range 25 to 32 N) for group 1 and 50.4 N (range 32 to 63 N) for group 2 (p=0.022). The mean number of cycles at failure was 140 (range 45 to 250) in group 1 and 350 (range 150 to 600) in group 2 (p=0.032). CONCLUSION: Our results showed that peripheral tendon repair with the use of NBSA has biomechanical advantages over repair with the epitendinous running suture technique.

[The factors affecting thermal necrosis secondary to the application of the Ilizarov transosseous wire]. / Ilizarov transosseöz telin kemikten geçirilmesine bagli olusan termal nekrozu etkileyen faktörler.

OBJECTIVES: We investigated thermal changes associated with the application of the Ilizarov transosseous wires, the extent of necrosis, and the factors affecting necrosis. METHODS: We used a pair of tibiae from a 1-year-old cow. After removal of metaphyseal areas, each of four equal diaphyseal zones marked on both tibiae was drilled at 600, 900, 1,200 and 1,800 rpm, each time with a new wire. Heat changes were recorded with heat electrodes during the application and the speed of the wire was calculated. For histopathological examination, specimens were obtained at the access and exit sites to assess the extent of necrosis. Thermal changes between the zones and immediate and remote cortices were compared. The most significant factor affecting the heat changes was analyzed by linear regression. RESULTS: Heat changes varied between 48.4 degrees C (at 1,200 rpm) and 151.9 degrees C (at 600 rpm). The thickness of the immediate cortex, the time and speed for the wire to pass the cortex were found as significant parameters in heat changes (p=0.003, p=0.01, and p=0.01, respectively). A negative correlation was found between the speed of the wire and the thickness of the necrotic area (r=-0.901, p=0.001). Regression analysis showed that the time for the wire to pass through the cortex was the most significant factor in inducing heat changes in both cortices (p=0.001, p=0.003, respectively). Histopathologically, the extent of necrosis and bone erosion was associated with lower drill speeds. Necrosis was significantly notable in the immediate cortex than that of the remote one (p=0.006). CONCLUSION: Transosseous wires should be passed at high drill speeds and with earliest time elapses to reduce thermal necrosis.

[Radial artery pellet embolism: a case report]. / Radial arterde saçma tanelerinin yol açtigi emboli: Olgu sunumu.

A fifty-four-year-old male patient presented to our emergency department with a gunshot injury in his arm, caused by pellets. Surgical exploration showed injury to the brachial artery, which was then repaired with a saphenous vein graft. Conservative treatment was planned for associated nerve injuries. After arterial flow began, two pellet-like solid bodies were palpated in the radial artery trace at the wrist level and the pellets were removed from the lumen of the artery. Ten days after surgery, the patient had profuse bleeding in the arm. On exploration, partial necrosis was detected in the saphenous vein graft and primary repair was performed. However, on the 19th day, the bleeding recurred and increased necrosis and rupture of the artery, 2-3 cm in size, were detected. Arterial repair was repeated with another saphenous vein graft from the other limb. The patient returned to normal daily activities nine months after the injury, with slight cold intolerance. Clinical examination and Doppler studies did not show any signs of vascular deficiency. Arterial or venous pellet embolism should be included in the evaluation of patients with gunshot injuries.

Head injury-associated bone fractures induce bacterial translocation: an experimental study.

OBJECTIVES: To determine whether long bone fractures cause bacterial translocation and to investigate the effect of concomitant head trauma on this process. DESIGN: An in vivo animal model. SETTING: Animal Laboratory, University of Mersin School of Medicine, Mersin, Turkey. SUBJECTS: Male Sprague-Dawley rats (n = 60). INTERVENTION: Sixty male Sprague-Dawley rats were divided into five groups: (1). anesthesia only (control group, n = 12); (2). anesthesia and tibia fracture (n = 12); (3). anesthesia, tibia fracture, and femur fracture (n = 12); (4). anesthesia, tibia fracture, femur fracture, and moderate head trauma (n = 12); and (5). moderate head trauma only (n = 12). After 24 hours, mesenteric lymph nodes, liver, spleen, ileum, and systemic blood samples were quantitatively cultured for aerobic organisms. MAIN OUTCOME MEASUREMENTS: Colony-forming unit per gram for bacteria count. RESULTS: The incidence of bacterial translocation was higher in groups that had fractures (4/12 in group 2; 5/12 in group 3) than in the control group (2/12); however, this did not reach statistical significance. There was a significant increase in the number of subjects with bacterial translocation in group 4 (9/12) compared with the control group and group 5 (3/12) (P = 0.0123, P = 0.0391). CONCLUSIONS: Multiple fractures of long bones associated with head injury promote bacterial translocation.

[Clinical and radiologic results of surgically-treated acetabular fractures]. / Asetabulum kiriklarinin cerrahi tedavisinde klinik ve radyolojik sonuçlar.

OBJECTIVES: We evaluated the functional and radiologic results of surgical treatment in patients with displaced acetabular fractures. METHODS: The study included 21 patients (13 males, 8 females; mean age 35 years; range 21 to 63 years). Before surgery, all the patients were evaluated with anteroposterior, iliac, and obturator oblique views and computed tomography scans. According to the Letournel-Judet classification, the fractures were simple in 10 patients and complex in 11 patients. Twelve patients had posterior wall and/or the posterior column fractures. Four patients underwent closed reduction under emergency settings for accompanying posterior dislocations. The mean time to surgery was 4.8 days (range 1 to 13 days). Surgery was performed by the Kocher-Langenbeck approach (n=12), a triradiate approach (n=5), and a modified extended iliofemoral approach (n=4). Functional results were assessed by the D'Aubigne-Postel's knee scoring system and radiologic results using anteroposterior, iliac, and obturator oblique views. The mean follow-up was 31 months (range 19 to 64 months). RESULTS: Functional results were excellent in eight patients (38.1%), good in seven (33.3%), satisfactory in four (19.1%), and poor in two patients (9.5%). Radiologic examination showed posttraumatic arthrosis in four patients (19.1%), heterotopic ossification in three patients (14.3%), and avascular necrosis in two patients (9.5%). Radiologic results were excellent and good in 16 patients (76.2%), satisfactory in three patients (14.3%), and poor in two patients (9.5%). CONCLUSION: Clinical and radiologic results showed concordance. The presence of dislocations and inadequate reduction were associated with poor functional results.

Effect of caffeic acid phenethyl ester on cartilage in experimental osteoarthritis.

Activation of nuclear factor kappa B (NF-kappaBeta) in synovial cells is seen in RA and OA patients. Caffeic acid phenethyl ester (CAPE) is a specific and potent inhibitor of NF-kappaBeta. We aimed to determine the in vivo effects of intra-articular injections of CAPE on cartilage in an experimental rabbit osteoarthritis (OA) model. Two groups of six New Zealand white rabbits underwent unilateral anterior cruciate ligament transection (ACLT). Four weeks after ACLT, the test group was injected with 150 micro g/kg CAPE in 0.5% ethanol once daily for 2 weeks and the control group was injected the same amount of 0.5% ethanol intra-articularly. All rabbits were killed 2 weeks after the last injection, and cartilage tissue was evaluated morphologically. A histological score totaling 7 points was determined for each knee. The CAPE group showed significantly decreased cartilage destruction and reduced loss of matrix proteoglycans. The histological score for cartilage tissue was significantly better in the CAPE group than in the control group (3.0+/-0.25 vs 5.3+/-0.55, P=0.005). This study suggests that intra-articular injection of CAPE may protect cartilage against the development of experimentally induced OA.

[The effect of continuous passive motion after repair of Achilles tendon ruptures: an experimental study in rabbits]. / Asil tendon rüptürlerinin onarimi sonrasi devamli pasif hareketin etkisi: Tavsanlarda deneysel çalisma.

OBJECTIVES: The effect of continuous early passive motion on morphologic and histologic healing following repair of Achilles tendon rupture was evaluated in comparison with cast immobilization. METHODS: Achilles tendons of 20 adult rabbits were repaired with the use of modified Kessler technique after surgical transection. Throughout the postoperative six weeks, the rabbits were randomly assigned to cast immobilization (n=10) and to continuous early passive motion four hours a day (n=10). All the rabbits were sacrificed at the end of six weeks and their tendon tissues were removed for macroscopic and histologic examinations. RESULTS: On macroscopic evaluation, findings on adhesions at the operation site, periarticular atrophy, and the ROM of the ankle joint were found significantly more favorable with continuous early passive motion than those of the control group (p<0.001, p<0.05, and p<0.001, respectively). On histologic evaluation, regular collagen bundle alignment was 70% and 20% in the study and control groups, respectively (p<0.05), whereas findings on hyalinization and inflammatory infiltration were not significantly different. CONCLUSION: The utilization of continuous controlled passive motion following repair of Achilles tendon rupture was shown to have beneficial effects on tendon healing and ankle range of movement, without leading to eventual ruptures.