Lanthanum(III)hydroxide Nanoparticles and Polyethyleneimine-Functionalized Graphene Quantum Dot Nanocomposites in Photosensitive Silicon Heterojunctions.

Lanthanides are largely used in optoelectronics as dopants to enhance the physical and optical properties of semiconducting devices. In this study, lanthanum(III)hydroxide nanoparticles (La(OH)3NPs) are used as a dopant of polyethylenimine (PEI)-functionalized nitrogen (N)-doped graphene quantum dots (PEI-NGQDs). The La(OH)3NPs-dopedPEI-NGQDs nanocomposites are prepared from La(NO)3 in a single step by a green novel method and are characterized by Fourier-transform infrared spectroscopy (FT-IR), ultraviolet-visible spectroscopy (UV-vis), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). Deposited over an n-type Si wafer, the La(OH)3NPs-dopedPEI-NGQDs nanocomposites form Schottky diodes. The I-V characteristics and the photoresponse of the diodes are investigated as a function of the illumination intensity in the range 0-110 mW cm-2 and at room temperature. It is found that the rectification ratio and ideality factor of the diode decrease, while the Schottky barrier and series resistance increase with the enhancing illuminations. As a photodetector, the La(OH)3NPs-dopedPEI-NGQDs/n-Si heterojunction exhibits an appreciable responsivity of 3.9 × 10-3 AW-1 under 22 mW cm-2 at -0.3 V bias and a maximum detectivity of 8.7 × 108 Jones under 22 mW cm-2 at -0.5 V. This study introduces the green synthesis and presents the structural, electrical, and optoelectronic properties of La(OH)3NPs-dopedPEI-NGQDs, demonstrating that these nanocomposites can be promising for optoelectronic applications.

Phenotyping of the Turkish population according to Coronal Plane Alignment of the Knee classification: A retrospective cross-sectional study.

OBJECTIVES: This study aimed to phenotype healthy individuals and patients with arthritic knees in the Turkish population according to the Coronal Plane Alignment of the Knee (CPAK) classification. PATIENTS AND METHODS: The retrospective cross-sectional study included 207 healthy individuals (109 males, 98 females; mean age: 32.9±8.4 years; range, 20 to 45 years) with a total of 414 knees (Group 1) and 296 patients (155 females, 141 males; mean age: 54.5±7.9 years; range, 43 to 80 years) with a total of 408 arthritic knees (Group 2) who met the inclusion criteria and underwent evaluation using digital long-leg radiographs between January 2019 and July 2023. Mechanical lateral distal femoral angle and medial proximal tibial angle were measured. Subsequently, the arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO) were calculated. Based on the results obtained, participants in both groups were categorized according to the CPAK classification. RESULTS: In Group 1, the mean aHKA was 0.3°±2.5°, and the mean JLO was 175.2°±3.5°. In Group 2, the mean aHKA was -1.4°±3.9°, and the mean JLO was 174.6°±3.7°. The most common CPAK type in healthy individuals (Group 1) was type 2 (41.5%), followed by type 3 (14.7%) and type 1 (14.5%). In arthritis patients (Group 2), the most common CPAK type was type 2 (31.6%), followed by type 1 (28.2%) and type 3 (13.5%). CONCLUSION: The CPAK classification serves as an important guide for categorizing lower extremity alignment. In the Turkish population, healthy individuals most commonly exhibited CPAK type 2, 3, and 1 alignments, respectively, while osteoarthritic patients predominantly displayed CPAK type 2, 1, and 3 alignments.

The Effects of the Use of Single-Screw Plates (Univertebral Screw Plates) versus Double-Screw Plates (Bivertebral Screw Plates) on Fusion After One-Level or Two-Level Anterior Cervical Discectomy and Fusion.

OBJECTIVE: In this study, we aimed to retrospectively analyze the effects of the use of univertebral screw plates (USPs) and bivertebral screw plates (BSPs) on fusion in patients who underwent anterior cervical discectomy and fusion (ACDF). METHODS: Forty-two patients who were treated with USPs or BSPs after 1-level or 2-level ACDF and had a minimum follow-up period of 2 years were included in the study. Fusion and the global cervical lordosis angle were evaluated using direct radiographs and computed tomography images of the patients. The clinical outcomes were assessed using the Neck Disability Index and visual analog scale. RESULTS: Seventeen patients were treated using USPs and 25 patients using BSPs. Fusion was achieved in all patients who underwent BSP fixation (1-level ACDF, 15 patients; 2-level ACDF, 10 patients) and 16 of the 17 patients who underwent USP fixation (1-level ACDF, 11 patients; 2-level ACDF, 6 patients). The plate of the patient with fixation failure had to be removed because it was symptomatic. A statistically significant improvement was observed in the immediate postoperative period and at the last follow-up in terms of global cervical lordosis angle, visual analog scale score, and Neck Disability Index of all patients who underwent 1-level or 2-level ACDF surgery (P < 0.05) CONCLUSIONS: Although USPs are less costly and easier to implant, the effect of USPs and BSPs on fusion and clinical outcomes is similar. Thus, surgeons may prefer to use USPs after 1-level or 2-level ACDF.

Investigation of diode laser effect on the inactivation of selected Gram-negative bacteria, Gram-positive bacteria and yeast and its disinfection on wastewater and natural milk.

Disinfection can be accomplished by adding external chemical agents to kill harmful microorganisms or by removing them using membranes. However, most chemicals are toxic for humans and animals if it is consumed above a certain concentration. Likewise, membranes have fouling problems. The aim of this study is to investigate the effect of diode laser, which is an environmentally friendly application, on pathogenic microorganisms such as Escherichia coli (ATCC 10536), Staphylococcus aureus (ATCC 6538) and Candida albicans. To reveal the effect of diode laser on aforementioned, various parameters have been studied on how diode laser type, laser irradiation time, laser power density, laser penetration efficiency and biofilm inhibition affect microorganisms. As a result of the study, it was observed that the blue laser was more effective than red and green lasers, and the inhibition rates for 15 min at 0.36 W/cm2 laser power density were 65.9% > 34.52% > 43.63% for S. aureus, E. coli and C. albicans, respectively. After 30 min of blue laser irradiation, the microbial growth inhibitions were found as 85.39%, 41.18% and 54.55% for S. aureus, E. coli and C. albicans, respectively. The highest biofilm inhibition was 94.61% when S. aureus cells were exposed to blue laser irradiation for 60 min. The microbial growth kinetics on three microorganisms were tested by using at 0.54 W/cm2 laser power density for 28 h, and there were not observed any microbial development in microbial cultures. Moreover, blue laser irradiation was successfully disinfected wastewater and natural milk at 0.54 W/cm2 laser power density.

Delayed osteochondral fracture fixation of the knee in a pediatric patient.

The frequency of osteochondral fractures in the knee joint in the pediatric population is not clearly known. Although fragment fixation is generally considered to be the ideal treatment method in acute injuries, the data of the results of late fixation in neglected and/or late-diagnosed cases are very limited. In this paper, we report our findings regarding the fixation of a delayed large osteochondral fracture in lateral femoral condyle in a pediatric patient.

The Effect of the Coronavirus 2019 (COVID-19) Pandemic on the Number and Characteristics of Orthopedic Trauma Patients in a Tertiary Care Hospital in Istanbul.

Objective The aim of this study was to investigate the distribution of the causes of traumatic fractures, types of fractures, and fractures requiring surgery occurred during the one month period following the measures taken by the government due to the COVID-19 pandemic and to compare these data with that of the previous year. Patients and methods The number of patients with fractures, the distribution of these fractures and the number of patients who had surgical indications and underwent a surgery were identified. Patients' age, gender and the type of trauma they were exposed to were determined. Results While there were 117 patients who were diagnosed with a fracture during the one month period in 2020, 619 patients had presented to our department during the same period in 2019. When compared to 2019, the prevalence of the trauma mechanisms for falling from height, traffic accident, low-energy trauma, firearm injury and sports injuries decreased by 91.7%, 85.7%, 80.3%, 80.0% and 72.7%, respectively, in 2020. A statistically significant increase was proportionally observed in pediatric supracondylar humerus, boxer's and hip fractures (p<0.001). Conclusion Compared to the same period last year, although the number of patients with fractures decreased significantly following the implementation of most of the public quarantine measures, a statistically significant increase was observed in pediatric supracondylar humerus, boxer and hip fractures on a proportional basis.

The effect of soft tissue interposition of the Endobutton on clinical results and on its postoperative migration after single-bundle anterior cruciate ligament reconstruction.

BACKGROUND: This study aimed to investigate the possible consequences of soft tissue interposition of Endobutton on clinical outcomes and reoperation rates after anterior cruciate ligament reconstruction. METHODS: We measured the distance between the centre of the Endobutton and the lateral femoral cortex on the postoperative first day anteroposterior X-rays of the 156 knees that underwent anterior cruciate ligament reconstruction. Those with a distance less than 1 mm were regarded as Group 1 (118 patients), the ones between 1 mm and 2 mm were regarded as Group 2 (30 patients) and the ones more than 2 mm were regarded as Group 3 (8 patients). The movement of the Endobutton of more than 1 mm along the femoral tunnel axis on anteroposterior X-rays or its rotation by more than 5° on lateral X-rays during follow-up were considered migration. Clinical assessment scores (Lysholm, Tegner Activity Scale), clinical examination tests, and rates of Endobutton migration in the groups were analysed. RESULTS: Eleven Endobuttons (9.3%) in Group 1, 26 Endobuttons (86.7%) in Group 2 and all of the 8 Endobuttons (100%) in Group 3 were observed to have migrated. Clinical results and examination tests showed no significant difference between Groups 1 and 2, whereas a significant difference was detected in Group 3 compared to Groups 1 and 2 (p < 0.05). CONCLUSION: Soft tissue interposition is a major cause of Endobutton migration, and an interposition over 2 mm between the Endobutton and the lateral femoral cortex can negatively affect the outcomes after an anterior cruciate ligament surgery.

Tibial tubercle-trochlear groove (TT-TG) distance is a reliable measurement of increased rotational laxity in the knee with an anterior cruciate ligament injury.

BACKGROUND: The aims of this study were: 1. To evaluate the use of the tibial tubercle-trochlear groove (TT-TG) distance as a measurement showing rotational instability after anterior cruciate ligament (ACL) injury. 2. To determine the effect of concomitant anterolateral ligament (ALL) injury on TT-TG distance. METHODS: Knee magnetic resonance (MR) images of 251 patients were retrospectively evaluated to compare the study group (131 patients) who underwent ACL reconstruction due to acute complete ACL injury and the control group (120 patients) without any trauma and/or patellofemoral instability. The rate of secondary signs of ACL injury (Anterolateral ligament injury, Kissing lesion, Anterior tibial translocation, Buckling of the posterior cruciate ligament (PCL)) in the study group was noted. The relationship between the TT-TG distance and other secondary signs was examined. RESULTS: TT-TG distance was measured as 10.83 ± 1.2 mm, 12.88 ± 1.1 mm, 14.17 ± 1.5 mm in control, isolated ACL and ACL + ALL groups, respectively (p < 0.05). TT-TG distance was significantly higher in the patients with ALL injury and kissing lesions than the patients without these lesions (p Ë‚ 0.05). TT-TG distance did not differ significantly between the patients with and without anterior tibial translocation or buckling of the PCL (p Ëƒ 0.05). TT-TG distance measurements showed significant interobserver 0.994 (0.992-0.996) and intraobserver 0.997 (0.996-0.998) correlation. CONCLUSIONS: TT-TG distance measurement can be used as a reliable quantitative measure of the increased rotational instability after ACL injury. TT-TG distance increases significantly if there is an ALL injury accompanying the ACL injury.

FACTORS AFFECTING THE FUNCTIONAL OUTCOME OF OXFORD PHASE 3 UNICOMPARTMENTAL KNEE ARTHROPLASTY.

OBJECTIVE: To determine the factors that affect the functional outcome of Oxford Phase 3 unicompartmental knee arthroplasty (UKA). METHODS: We assessed a total of 52 UKA knees of 49 patients with a minimum follow-up of 2 years (24-72 months). We recorded the results for Range of motion (ROM) and body mass index (BMI) and the presence o patello-femoral arthrosis (PFA). In the radiological evaluation, we measured the posterior tibial slope (PTS), the tibial plateau angle (TPA) and the femorotibial angle, in addition to an assement using the Oxford radiological criteria. Patients were grouped by age, follow-up time, BMI, radiological criteria, PFA presence, occurance of complications and revision surgery. The clinical and functional results of these groups were compared statistically. RESULTS: A total of 40 women and 9 men participated in the study, with an average age of 60 years, and a mean BMI of 34.6. No significant differences were found among the age and PFA groups. Postop VAS scores were high and knee evaluation scores were significantly lower in the morbidly obese group and in the groups with postop TPA <85º and >90º. The revision ratio was 11.5%. CONCLUSION: Postop TPA, PTS and morbid obesity are the most significant factors that can lead to revision surgery. Level of Evidence IV, Case series.

OBJETIVO: Determinar os fatores que afetam o resultado funcional da artroplastia unicompartimental do joelho Oxford Phase 3 (AUJ). MÉTODOS: Foram incluídos 52 joelhos AUJ de 49 pacientes com um período mínimo de 2 anos (24-72 meses) de acompanhamento. Foram registrados: amplitude de movimento (ADM), índice de massa corporal (IMC) e presença de artrose femoropatelar (AFP). Na avaliação radiológica, medimos o declive tibial posterior (DTP), o ângulo do planalto tibial (APT) e o ângulo femorotibial, além de usarmos os critérios radiológicos de Oxford. Os pacientes foram agrupados de por idade, tempo de acompanhamento, IMC, critérios radiológicos, presença de AFP e ocorrência de complicações e cirurgias de revisão. Os resultados clínicos e funcionais desses grupos foram comparados estatisticamente. RESULTADOS: Participaram do estudo 40 pacientes do gênero feminino e 9 do gênero masculino, com idade média de 60 anos, IMC de 34,6. Não foram encontradas diferenças significativas entre os grupos formados por idade e presença de AFP. As marcações da EVA pós-operatória foram altas e as marcações do joelho foram significativamente baixas no grupo com obesidade mórbida e nos grupos com APT pós-operatória <85º e >90º. A taxa de revisão foi de 11,5%. CONCLUSÃO: APT e DTP pós-operatório e obesidade mórbida são os fatores mais significativos que podem levar à cirurgia de revisão. Nível de Evidência IV, Série de casos.

Orthopedic treatment, complications, and cost analysis of 67 soldiers injured in a three-month period.

OBJECTIVES: This study aims to analyze the musculoskeletal injury types, injury mechanisms, treatment modalities, complications, and costs of 67 consecutive soldiers wounded in the battlefield in Syria civil war over a period of three months. PATIENTS AND METHODS: This retrospective study was conducted between January 2018 and March 2018 at Kilis State Hospital. The study included 67 male patients (median age 28.5 years; range, 15 to 46 years). Patients' ages, injury mechanisms, fracture types, fracture locations, injury severity scores, mangled extremity severity scores, complications, and treatment costs were evaluated. RESULTS: Twenty-three patients were injured due to handmade explosives, 21 patients due to gunshots, 16 patients due to landmines, five patients due to rockets, and two patients due to grenades. A total of 35.8% of the patients (n=24) had concomitant trauma. The mean hospitalization period was 10.2 days (range, 1-45 days). A total of 88 treatments were performed on these patients. Thirty-six of these treatments were external fixators, 21 were amputations, 12 were open reduction internal fixations, seven were closed reduction internal fixations, five were intramedullary nailings, three were cannulated screws, three were fasciotomies, and one was an arthrodesis. The treatment costs ranged from 1,577 to 296,286 Turkish Liras. Complications were observed in 17 patients and 11 of them developed infections, three of them had compartment syndrome, and three died during the hospitalization period. CONCLUSION: The increase in warfare technology is correlated with the severity of military injuries in the battlefields. These injuries still lead to high traumatic amputation rates, high-risk complications, and high costs.

Radiologic Outcomes and Complication Analysis of the Posterior Vertebral Column Resection in the Treatment of Previously Operated Severe Kyphoscoliosis: A Retrospective Case Series.

OBJECTIVE: The aim of this study was to evaluate the radiologic outcomes and complication analysis of posterior vertebral column resection (PVCR) performed on previously operated patients with severe kyphoscoliosis (SK). METHODS: Twelve patients (6 men and 6 women) with SK underwent PVCR. The mean age of the patients preoperatively was 16 years (range, 10-26 years). The mean follow-up period was 5.3 years (range, 2-7 years). Previous surgeries included posterior growth arrest in 3 patients, hemivertebrectomy in 4 patients, and posterior fusion in 5 patients. The sagittal plane parameters and coronal parameters were measured in the preoperative, in the early postoperative, and during the last follow-up stages. Complications were also noted. RESULTS: The mean thoracic scoliosis Cobb angle was 76.8° (range, 35°-142°) preoperatively, 37.8° (range, 5°-80°) early postoperatively, and 41.5° (range, 11°-80°) during the last follow-up (P < 0.0001). The mean thoracic kyphosis angle was 84.7° (range, 23°-132°) preoperatively, 50.3° (range, 25°-78°) early postoperatively, and 48.5° (range, 25°-80°) during the last follow-up (P = 0.0032). Complications occurred in 5 patients (41.7%); a hemothorax in 1 patient, rod fracture in 3 patients, and permanent neurologic deficit in 1 patient. Temporary loss of neuromonitoring motor evoked potentials developed in 2 patients during deformity correction. CONCLUSIONS: PVCR provides effective correction in patients with SK. However, expected surgical correction of a deformity may not always be achieved because of intraoperative neuromonitoring changes. Furthermore, PVCR can lead to a large number of major complications in patients with SK who have undergone previous spinal surgery.

Can Breast Asymmetry Following the Treatment of Juvenile Idiopathic Scoliosis with Growing Rod Be Prevented? : A Preliminary Analysis.

OBJECTIVE: It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. METHODS: Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. RESULTS: In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). CONCLUSION: In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

Evaluation of the Knees of Asymptomatic Kangoo Jumpers with MR Imaging.

PURPOSE: The aim of this study is to determine the prevalence of pathologic findings in asymptomatic knees of Kangoo Jumpers by using a 3T MRI and to compare them with age and sex-matched controls who do not regularly participate in any impact sports. METHODS: Both knees of 18 Kangoo Jumpers were examined by 3T MRIs in a total of 36 MRI scans. The control group was comprised of 20 volunteers from the same age group and with similar weights who did not participate in any competitive sports, in a total of 40 MRI scans. Two orthopedists and one radiologist independently assessed all images for the presence or absence of any abnormalities. RESULTS: In 32 (88.9%) of the 36 Kangoo Jumpers' knees, one or more abnormalities were observed. The most prevalent abnormality was bone marrow edema, which was detected in 32 knees (88.9%). The other significant findings were quadriceps tendinopathy (80.6%), patellar tendinopathy (63.9%), gastrocnemius tendinopathy (63.9%), infrapatellar fat pad edema (75%), suprapatellar fat pad edema (63.9%), meniscal signal change (72.2%) and cartilage damage in the patellofemoral joint (72.2%). There were no statistically significant differences in terms of joint effusion (8.3%), ganglion cysts (8.3%) or tibiofemoral joint cartilage injury (0%). CONCLUSION: This study reveals many types of knee MRI findings of asymptomatic Kangoo Jumpers compared to the control group. These MRI findings may be associated with acute knee injuries or chronic joint problems such as osteoarthritis, which may develop in long-term follow-up studies.

Objective Measurement of Medial Joint Space Widening with Percutaneous "Pie Crust" Release of Medial Collateral Ligament during Knee Arthroscopy.

Knee arthroscopy may be called the most commonly and increasingly performed orthopaedic procedure. Posterior medial compartment visualization may be quite challenging. The aim of the present study is to detect objective measurement of medial joint space widening with percutaneous "pie crust" release of medial collateral ligament (MCL) during knee arthroscopy. We used this technique for all knees that require any intervention in the posteromedial compartment and for tight knees in which adequate visualization of the posteromedial compartment cannot be obtained. Eighteen patients (18 knees) were included in this study. Patients were evaluated clinically with the Lysholm and Tegner scores at the final office visit. Joint balance, valgus instability, pain or tenderness on MCL region, and numbness over the medial side of the joint were also noted. Measurements of medial joint space (mm) were obtained at three different times with perioperative C-arm images: normal, controlled valgus force, and after pie crusting. The median follow-up time was 9 (6-12) months. Final follow-up Lysholm (p < 0.05) and Tegner scores (p < 0.05) increased significantly compared with preoperative scores. At the final follow-up, there was no pain or tenderness over MCL and there were no signs of saphenous nerve or vein injury. Medial joint space values in after pie crusting increased significantly (p < 0.05) compared with neutral position measurements and controlled valgus force application (p < 0.05). Controlled release of the MCL in knees provided ∼2.45 times wider visualization place. Furthermore, pie crusting of MCL is a safe and effective technique that provides enough space for visualization and instrumentation in knees. This is a Level IV study.

Comparison of open and endoscopic carpal tunnel surgery regarding clinical outcomes, complication and return to daily life: A prospective comparative study.

OBJECTIVE: This study aimed to compare the clinical results and complications as well as patient satisfaction in patients with carpal tunnel syndrome operated with open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR) techniques. METHODS: This study conducted in Istanbul Training and Research Hospital between August 2016 and January 2018. A total of 54 patients were operated with the ECTR technique and 50 patients were operated with the OCTR technique after failing nonsurgical treatment. Patients functional scores are assessed with the carpal tunnel syndrome-functional status score (CTS-FSS) and carpal tunnel syndrome-symptom severity score (CTS-SSS). Operation time, incision length and complications of the two techniques were noted and compared. RESULTS: The age, sex distribution, distribution of sides, and complaint period were not significant (p > 0.05) between the groups. The preoperative or postoperative CTS-SSS and CTS-FSS values did not differ significantly (p > 0.05). Incision length, time to return to work and return to daily life in the OCTR group was significantly higher than the ECTR group (p < 0.05). CONCLUSION: ECTR has similar results in terms of symptom relief, severity, functional status, pillar pain and complication rates compared to OCTR. However, it has the advantages of early return to daily life, early return to work and less incision length.

Medial Swivel Dislocation of the Talonavicular Joint with Associated Cuboid Fracture.

Medial talonavicular dislocation associated with cuboid fracture is rare. We report an 18-year-old man with this injury who exhibited excellent results after open reduction and stabilization of the joint with temporary Kirshner wires.

Comparison of early clinical results and re-tear rates of transosseous-equivalent rotator cuff repairs with or without medial knots.

OBJECTIVES: This study aims to compare the clinical results and repair integrity of two of the commonly used transosseous-equivalent arthroscopic rotator cuff repair techniques, which are the knotless and the medial knotted suture bridge, for patients with full-thickness medium to large-sized rotator cuff tears. PATIENTS AND METHODS: The study included 121 patients (55 males, 66 females; mean age 56.7±7.3 years; range, 39 to 72 years) with cuff tears. In total, 64 shoulders were operated on using the conventional medial knotted suture bridge technique (group A) and 57 shoulders were operated on using the knotless suture bridge technique (group B). The Constant score, visual analog scale (VAS) and active forward flexion angle were assessed preoperatively and after a minimum of 12 months postoperatively. Postoperative rotator cuff integrity was evaluated by magnetic resonance imaging (MRI) after a mean of 19±4.7 months. RESULTS: There were no significant differences between the groups in terms of age, gender, body mass index, and anteroposterior extension of the tear on the sagittal MRIs. Postoperatively, the mean Constant score increased from 32.3±8.5 points to 84±11.6 points in group A and from 31.3±9.3 points to 86.4±8.7 points in group B (p<0.001), while the mean VAS score decreased from 6.0±1.0 to 1.3±1.2 in group A and from 6.4±1.0 to 1.0±0.8 in group B (p<0.001). According to the control MRIs, the re-tear rate was 10.9% (n=7) in group A and 8.8% (n=5) in group B. No statistically significant difference was found in either the clinical scores or re-tear rates between the groups (p>0.05). CONCLUSION: In comparison to the medial knotted technique, less time-consuming and simpler knotless technique provides similar satisfactory outcomes after a minimum of one year postoperatively.

The effects of cryopreserved human amniotic membrane on fracture healing: Animal study.

OBJECTIVE: The aim of this study was to investigate the effects of human amniotic membrane (HAM) on fracture healing in an animal model. METHODS: Standard tibial diaphysial fractures were created in twenty-eight Wistar-Albino rats and treated with intramedullary Kirschner wire (K-wire) and HAM (HAM (+) group) or K-wire only (HAM (-) group). Fracture healing was evaluated by histological analysis, radiologic X-ray views and callus diameter measurements at 3rd and 6th weeks postoperatively. RESULTS: Fracture healing was histologically better in the HAM (+) group and the difference was statistically significant at both 3rd and 6th weeks postoperatively (p < 0.05). The highest histologic scores and entire woven bone formation (Huo Stage 8-9) were obtained at 6th weeks postoperatively in the HAM (+) group. Histological examination also revealed predominant fibrous tissue and partial cartilage formation (Huo Stage 2) at the postoperative 3rd week in the HAM (-) group. Equal amounts of woven bone and cartilage formation (Huo Stage 6-7) were observed at 3rd weeks postoperatively in the HAM (+) group and at 6th weeks postoperatively in the HAM (-) group. The callus diameters were greater in the HAM (+) group and the difference was statistically significant (p < 0.05) at 3rd and 6th weeks postoperatively. Although there was only a statistically significant difference (p < 0.05) at the postoperative 3rd week, radiological scores tended to be higher in the HAM (+) group at both the 3rd and 6th weeks postoperatively. CONCLUSION: HAM is a cheap and easily accessible alternative biological material. HAM may be used to support surgical treatment of fractures, particularly where bone healing is expected to last longer.

Comparison of the Effects of Magnetically Controlled Growing Rod and Tradiotinal Growing Rod Techniques on the Sagittal Plane in the Treatment of Early-Onset Scoliosis.

OBJECTIVE: Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). METHODS: Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. RESULTS: Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. CONCLUSION: There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

The Effect of Critical Shoulder Angle on Clinical Scores and Retear Risk After Rotator Cuff Tendon Repair at Short-term Follow Up.

The authors aimed to investigate whether standard acromioplasty can reduce critical shoulder angle (CSA) effectively and to investigate the effects of postoperative CSA on the clinical outcomes and retear rates. Patients are divided in to three groups: group 1 (24 patients): CSA under 35° before surgery, group 2 (25 patients): CSA over 35° before surgery and under 35° after surgery and group 3 (17 patients): CSA over 35° before and after surgery. Standard acromioplasty was performed if CSA is over 35 and no acromioplasty was performed if the CSA is already under 35. Preoperative and postoperative CSAs, UCLA, Constant-Murley clinical score and visual analog scale (VAS) pain score were measured. The size of the rotator cuff tear was classified by the Patte classification in preoperative MRI and the quality of the repair was evaluated as retear if discontinuity detected in the postoperative first year MRI. There were 31 female and 35 male patients with a mean age of 59.3 ± 4.5 years (range, 48-68) at the time of surgery. The mean CSA is reduced from 37.8° ± 1.4 to 34.9° ± 1.2 (p < 0.001) significantly for patients who underwent acromioplasty. In 25 (59.5%) of the 42 patients, the CSA was reduced to under 35°, whereas in the other 17 (40.5%) patients, it remained over 35°. The mean Constant and UCLA score was 46.4 ± 6.6; 18.5 ± 1.6 preoperatively and 82.4 ± 6.2; 31.1 ± 1.9 postoperatively respectively (p < 0,001). The mean VAS decreased from 4.94 ± 1.09 to 0.79 ± 0.71 (p < 0.001). No Clinical difference was seen between patients in which CSA could be reduced under 35° or not in terms of Constant-Murley score, UCLA and VAS score. Retear was observed in 2 (8.3%) patients in group 1, in 4 (16%) patients in group 2 and in 3 patients (17.6%) in group 3. There was not any significant difference between the patients who had retear or not in terms of neither the CSA values nor the change of CSA after the surgery. Standard acromioplasty, which consists of an anterolateral acromial resection, can reduce CSA by approximately 3°. This is not always sufficient to decrease the CSAs to the favorable range of 30°-35°. In addition, its effect on clinical outcomes does not seem to be noteworthy.