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1.
Knee Surg Sports Traumatol Arthrosc ; 25(1): 314-318, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25763850

RESUMO

PURPOSE: In this study, postoperative changes in the posterior tibial slope angle and clinical outcomes following open-wedge high tibial osteotomy were evaluated. METHODS: This study included 39 knees (18 left, 21 right) of 35 patients (three male, 32 female; median age, 53 years; age range 37-64 years) with symptomatic isolated medial joint osteoarthritis who underwent open-wedge high tibial osteotomy and fixation with a Puddu plate. The patients were clinically assessed according to the Lysholm knee score, a visual analogue pain scale, and a patient satisfaction questionnaire. Radiological assessment was made according to the changes in the posterior tibial slope angle and the correlation between these changes and clinical signs. The median follow-up period was 11 years (range 7-14 years). RESULTS: Significant improvements were observed in the preoperative and postoperative clinical scores of the Lysholm knee scale, visual analogue pain scale, and patient satisfaction questionnaire (p < 0.05). Radiological assessment showed that the posterior tibial slope angle was significantly higher during the postoperative and follow-up periods (p  0.05). There was no correlation between the postoperative Lysholm scores and the increase in the posterior tibial slope angle (p = n.s.). CONCLUSIONS: We conclude that both the conventional Puddu plate design and its anteromedial plate placement are what increase the tibial slope after an opening-wedge proximal tibial osteotomy. Therefore, current new plate design may help preserve the posterior tibial slope angle. LEVEL OF EVIDENCE: IV.


Assuntos
Genu Varum/cirurgia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Osteotomia/métodos , Tíbia/cirurgia , Adulto , Placas Ósseas , Feminino , Genu Varum/complicações , Genu Varum/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/diagnóstico por imagem , Medição da Dor , Satisfação do Paciente , Período Pós-Operatório , Radiografia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Resultado do Tratamento
2.
Knee Surg Sports Traumatol Arthrosc ; 25(2): 485-492, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27056686

RESUMO

PURPOSE: This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis (OA) given an intra-articular injection of platelet-rich plasma (PRP), hyaluronic acid (HA) or ozone gas. METHODS: A total of 102 patients with mild-moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were randomly separated into three groups. Group 1 (PRP group) received intra-articular injection of PRP × 2 doses, Group 2 (HA group) received a single dose of HA, and Group 3 (Ozone group) received ozone × four doses. Weight-bearing anteroposterior-lateral and Merchant's radiographs of both knees were evaluated. WOMAC and VAS scores were applied to all patients on first presentation and at 1, 3, 6 and 12 months. RESULTS: At the end of the 1st month after injection, significant improvements were seen in all groups. In the 3rd month, the improvements in WOMAC and VAS scores were similar in Groups 1 and 2, while those in Group 3 were lower (p < 0.001). At the 6th month, while the clinical efficacies of PRP and HA were similar and continued, the clinical effect of ozone had disappeared (p < 0.001). At the end of the 12th month, PRP was determined to be both statistically and clinically superior to HA (p < 0.001). CONCLUSION: In the treatment of mild-moderate knee OA, PRP was more successful than HA and ozone injections, as the application alone was sufficient to provide at least 12 months of pain-free daily living activities. LEVEL OF EVIDENCE: Therapeutic study, Level I.


Assuntos
Comportamento de Escolha , Ácido Hialurônico/administração & dosagem , Injeções Intra-Articulares , Osteoartrite do Joelho/tratamento farmacológico , Ozônio/administração & dosagem , Dor/tratamento farmacológico , Plasma Rico em Plaquetas , Idoso , Feminino , Humanos , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Radiografia , Resultado do Tratamento , Suporte de Carga
3.
J Foot Ankle Surg ; 56(3): 497-504, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28258948

RESUMO

We compared the outcomes of the distal oblique metatarsal (DOM) osteotomy, which is parallel to the articulation surface of the proximal phalanx, with those of the chevron osteotomy and evaluated whether displacement and shortening of the first metatarsal have any effect on the incidence of metatarsalgia and patient satisfaction. Patients treated with the DOM osteotomy (n = 30) or distal chevron osteotomy (n = 31) were evaluated retrospectively. The chevron and DOM osteotomies both provided significant improvement in the first intermetatarsal angle (p < .001), hallux valgus angle (p < .001), distal metatarsal articular angle (p < .001), range of first metatarsophalangeal joint motion (p < .001), American Orthopaedic Foot and Ankle Society score (p < .001), and sesamoid position (p < .001), without any significant differences between the 2 groups. Patient satisfaction and metatarsalgia also were not different between the study groups. The DOM osteotomy group had higher plantar displacement (0.1 ± 0.1 mm versus 1.0 ± 0.1 mm; p < .001) and absolute shortening of the first metatarsal (1.0 ± 0.4 mm versus 6.8 ± 1.0 mm; p < .001). In conclusion, the DOM osteotomy is an alternative treatment method for mild and moderate hallux valgus.


Assuntos
Hallux Valgus/cirurgia , Ossos do Metatarso/cirurgia , Osteotomia/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/fisiopatologia , Articulação Metatarsofalângica/cirurgia , Pessoa de Meia-Idade , Satisfação do Paciente , Radiografia , Amplitude de Movimento Articular , Estudos Retrospectivos , Adulto Jovem
4.
J Foot Ankle Surg ; 56(1): 54-58, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27839662

RESUMO

Controversy is ongoing regarding the use of bone grafts to fill cavities that occur with collapse of the posterior facet in the joint and for repair of the calcaneal height with plating. The present study included 40 patients with 43 displaced intra-articular calcaneal fractures treated with open reduction and internal fixation from March 2009 to November 2013. In the present case-control study, the patients were separated into 2 groups: group A received an allograft (20 patients, 22 calcaneal fractures) and group B did not (20 patients, 21 calcaneal fractures). The calcaneal height and Böhler's angle were compared between the 2 groups. The final outcomes for all patients were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot scale score and compared between the 2 groups. No significant differences were observed between the groups with regard to the basic demographic variables (p > .05). Using Sanders classification, 8 (18%) were type 2, 19 (44%) were type 3, and 16 (37%) were type 4 fractures. The comparisons between the 2 groups showed a loss of Böhler's angle and loss of calcaneal height that was significantly greater in group B (p < .001). No significant differences were observed between the 2 groups in the AOFAS ankle hindfoot scale scores (p > .05). In conclusion, although no differences were found in the clinical results between the 2 groups, more satisfactory radiologic results were obtained in group A, in which bone grafts were used.


Assuntos
Transplante Ósseo/métodos , Calcâneo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Intra-Articulares/cirurgia , Luxações Articulares/cirurgia , Adolescente , Adulto , Idoso , Fraturas do Tornozelo/diagnóstico por imagem , Fraturas do Tornozelo/cirurgia , Calcâneo/diagnóstico por imagem , Calcâneo/lesões , Estudos de Casos e Controles , Feminino , Seguimentos , Consolidação da Fratura/fisiologia , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Luxações Articulares/diagnóstico por imagem , Instabilidade Articular/prevenção & controle , Masculino , Pessoa de Meia-Idade , Radiografia/métodos , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto Jovem
5.
Knee Surg Sports Traumatol Arthrosc ; 24(8): 2595-605, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26590567

RESUMO

PURPOSE: Determination of the effect of tourniquet use in total knee arthroplasty (TKA) on thigh and quadriceps muscle volume using magnetic resonance imaging (MRI). METHODS: A total of 148 knees of 74 patients (mean age 66.5 ± 4.8 years; female/male, 62/12) with bilateral primary varus gonarthrosis underwent unilateral TKA with a tourniquet (Group A, n = 35) or without a tourniquet (Group B, n = 39). The total thigh volume and connective, bone, and muscle tissue volumes were stereologically measured on preoperative and postoperative MRI. The Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were calculated to evaluate functional outcomes. RESULTS: After TKA, the knees of patients in Group A exhibited a significant decrease in all tissue measurements, except bone tissue volume; however, the knees of patients in Group B exhibited no significant difference in tissue measurements. Although no difference was found between the operated and contralateral non-operated thighs (4076.9 and 4073.4 cm(3), respectively) in Group B postoperatively at 1 month (p > 0.05), the operated thighs had lost 20 % of its volume in Group A postoperatively at 1 month (p < 0.001). A significant difference was found in all tissue measurements, except the connective and bone tissue volumes of the thigh between the operated and contralateral non-operated knees in Group A. No significant difference was identified between the operated and contralateral non-operated knees in Group B. The total WOMAC score was significantly higher, and the total KSS was significantly lower in Group A than in Group B during the postoperative follow-up period of 1-6 months (p < 0.001 for all) but not 12 months (n.s.). CONCLUSION: Tourniquet use in TKA decreases the thigh and quadriceps muscle volumes and postoperatively delays the recovery of knee function. Therefore, caution should be exercised for tourniquet use during TKA in daily clinical practice and using alternative methods for tourniquet application in preventing intraoperative blood loss. LEVEL OF EVIDENCE: III.


Assuntos
Artroplastia do Joelho/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Artropatias/cirurgia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Músculo Quadríceps/diagnóstico por imagem , Torniquetes/estatística & dados numéricos , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/diagnóstico por imagem , Tamanho do Órgão , Período Pós-Operatório , Músculo Quadríceps/anatomia & histologia , Coxa da Perna , Resultado do Tratamento
6.
Arch Orthop Trauma Surg ; 136(11): 1571-1580, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27484876

RESUMO

INTRODUCTION: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. MATERIALS AND METHODS: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7 months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel. RESULTS: Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78° and 46.80° (p < 0.01). With respect to TT patients, ACL graft angle was 58.87° and 70.04° on sagittal and frontal planes in operated knees versus 47.38° and 61.82° in healthy knees (p < 0.001). ACL graft angle was significantly different between the groups on both sagittal and frontal planes (p < 0.001). Sagittal graft insertion tibia midpoint distance ratio was 0.51 and 0.48 % in the operated and healthy knees of AM group (p < 0.001) and 0.51 and 0.48 % in TT group (p < 0.001). Sagittal tibial tunnel midpoint distance ratio did not differ from sagittal graft insertion tibia midpoint distance of healthy knees in either group. Femoral tunnel clock position was better in AM [right knee 10:19 o'clock-face position (310° ± 4°); left knee 1:40 (50° ± 3°)] compared with TT group [right knee 10:48 (324° ± 5°); left knee 1:04 (32° ± 4°)]. With respect to the sagittal plane, the anterior-posterior position of femoral tunnel was better in AM patients. Lysholm scores and range of motion of operated knees in the AM and TT groups showed no significant difference (p > 0.05). CONCLUSIONS: Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Tendões dos Músculos Isquiotibiais/transplante , Articulação do Joelho/cirurgia , Adulto , Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/diagnóstico , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Masculino , Curva ROC , Amplitude de Movimento Articular , Transplante Autólogo
7.
J Foot Ankle Surg ; 55(1): 99-105, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26364236

RESUMO

The purpose of the present study was to evaluate the benefits and importance of pedobarography in the diagnosis and treatment of plantar pressure changes in the postoperative follow-up of calcaneus fractures treated with open reduction and internal fixation. The 28 patients included 23 males (82%) and 5 females (18%). The clinical evaluation was performed using the American Orthopaedic Foot and Ankle Society hindfoot scoring system. The Böhler and Gissane angles were measured on the preoperative and postoperative radiographs. In the postoperative follow-up period (mean ± standard deviation 22.25 ± 10.8 months), all the patients underwent analysis with a dynamic pedobarogram. Because the arch index of the operated feet was 29.73% and that of the nonoperated feet was 28.94%, a similar slightly low arch was seen in both feet (p = .078). When the plantar surface maximum pressures were evaluated, a significant reduction was seen in the operated feet in the second, third, fourth, and fifth metatarsals and the medial hindfoot (p < .05). Displaced intra-articular calcaneus fractures resulted in a significant reduction in maximum pressure of the second, third, fourth, and fifth metatarsals and the medial hindfoot. Also, the hindfoot pressure was lateralized. Pedobarography is a simple and useful method for the diagnosis of plantar pressure changes occurring postoperatively.


Assuntos
Calcâneo/cirurgia , Traumatismos do Pé/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Marcha/fisiologia , Fraturas Intra-Articulares/cirurgia , Adulto , Calcâneo/diagnóstico por imagem , Feminino , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/fisiopatologia , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/fisiopatologia , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Fraturas Intra-Articulares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Pressão , Radiografia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
J Pak Med Assoc ; 66(9): 1142-1148, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27654736

RESUMO

OBJECTIVE: To evaluate the results of the minimally invasive internal fixation method using reverse Less Invasive Stabilisation System locking plate in unstable proximal femur extracapsular fractures. METHODS: The retrospective study was conducted at Department of Orthopaedics in Taksim Training and Research Hospital (Istanbul, Turkey) and comprised data of patients in whom osteosynthesis was applied with reverse Less Invasive Stabilisation System locking plate for an unstable extracapsular femur fracture between September 2006 and June 2011. Evaluation was made of the fracture reduction quality and degrees of varus-valgus and anteversion-retroversion on the postoperative radiographs which were compared to the healthy hip. At the final follow-up examination, evaluation was made using the Harris Hip Score and Visual Analogue Scale score. The follow-up period ranged from 12 to 35 months. RESULTS: Of the 42 patients, 16 (38%) were females and 26 (62%) were males, with an overall mean age of 64.2±22.25 years (range: 23-97 years). The trauma was low-energy in 24 (57%) patients and high-energy in 18 (43%). Union was achieved in 38 (90%) patients with secondary bone healing in mean 14 weeks (range: 12-20 weeks). Complications were seen in 4 (9%) patients and additional surgical interventions were made. Radiographically, reduction was anatomic in 33 (79%) patients, acceptable in 8 (19%) and poor in 1 (2%). At the 12-month follow-up, the mean Harris Hip Score was 88,6 (range: 59-100) and mean Visual Analogue Scale score was 2.19 (range: 0-9). CONCLUSIONS: In the surgical treatment of unstable extracapsular proximal femur fractures, reverse Less Invasive Stabilisation System plate could be easily applied with a minimally invasive fixation method as an alternative to other treatment methods with successful results.


Assuntos
Placas Ósseas , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia , Estudos Retrospectivos , Resultado do Tratamento , Turquia , Adulto Jovem
9.
J Pak Med Assoc ; 66(4): 393-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27122263

RESUMO

OBJECTIVE: To investigate the middle- and long-term radiological and functional results of children with type III supracondylar humerus fractures treated with a limited medial approach and internal fixation. METHODS: The retrospective study was conducted at Department of Orthopaedics in Goztepe Training and Research Hospital, Istanbul, Turkey, and comprised data of children who underwent surgery between April 1991 and June 2009. Patients in group I underwent surgery within the first 8 hours after admission, and those in group II did so 8-24 hours after admission. Patients were evaluated according to the Flynn scoring system. RESULTS: Of the 79 patients, 52(65.8%) were male and 27(34.2%) were female. Fractures involved the left side in 49(62%) patients. Group I had 39(49.4%) patients and group II 40(50.6%). The overall mean age was 6.2±2.95 years (range: 2-13 years), and the mean follow-up was 53.2±14.9 months (range: 26-193 months). Functional scores were satisfactory (excellent, good and fair results) in all cases in both groups (100%), and the cosmetic results were satisfactory in 37(95%) in group I, and 39(97.5%) in group II (p>0.05). CONCLUSIONS: Limited medial approach to the treatment of supracondylar humerus fractures yielded successful functional and cosmetic results.


Assuntos
Fios Ortopédicos , Fixação Interna de Fraturas/métodos , Fraturas do Úmero/cirurgia , Amplitude de Movimento Articular , Criança , Pré-Escolar , Intervenção Médica Precoce , Articulação do Cotovelo/fisiopatologia , Feminino , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/fisiopatologia , Masculino , Radiografia , Estudos Retrospectivos , Resultado do Tratamento
10.
J Phys Ther Sci ; 28(11): 3036-3040, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27942115

RESUMO

[Purpose] There are many types of hyaluronic acid preparations, but no clear data are available about which preparations is more effective. The aim of this trial was to investigate the effectiveness of different types of hyaluronic acid preparations on pain and function of inpatients with knee osteoarthritis. [Subjects and Methods] All patients were diagnosed by clinical examination and x-ray. Ostenil PLUS® was injected into 28 patients (group 1, 1.6 million daltons), and MONOVISC® (group 2, 2.5 million daltons) was injected into 46 patients. Demographic data and Western Ontario and McMaster Universities Osteoarthritis Index and Visual Analog Scale scores were used for clinical evaluation at 1, 3, and 6 months post injection. [Results] In both groups, baseline Ontario and McMaster Universities Osteoarthritis Index and Visual Analog Scale scores were higher compared with those in subsequent evaluations. Based on the pre- and post-injection data, a significant reduction in all scores was observed after the injections for in both groups. According to intergroup comparisons, there was no significant difference in any of the scores between the two groups. [Conclusion] There were no difference in Ontario and McMaster Universities Osteoarthritis Index and Visual Analog Scale scores in patients with knee osteoarthritis injected with two different hyaluronic acid structures in short-term preparations.

11.
J Foot Ankle Surg ; 54(4): 620-4, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25937564

RESUMO

Ingrown toenails are one of the most frequent nail disorders and can be treated with conservative or surgical approaches. Although discovered a long time ago, the available data are still very limited on the potential effectiveness of nail braces for ingrown toenail treatment. In the present retrospective study, we compared nail braces with surgical wedge excision using the Winograd technique with respect to the time to return to work, recurrence, interval to recurrence, and patient satisfaction. A total of 159 patients were divided into the nail brace (n = 74; mean age 29.51 ± 8.48 years) and Winograd technique (n = 85; mean age 26.95 ± 8.06 years) groups. In the nail brace group, the mean time to return to work (4.15 ± 1.07 days) was significantly shorter than that in the Winograd technique group (13.8 ± 2.26 days; p < .001). Patient satisfaction was significantly greater in the nail brace group (94.6%) compared with the Winograd technique group (82.4%; p = .018). Of the 159 patients, 6 (8.1%) in the nail brace group and 8 (9.4%) in the Winograd technique group developed recurrence; however, this difference was not statistically significant (p > .05). A statistically significant difference was observed in the mean interval to recurrence (12.46 ± 1.60 versus 13.24 ± 2.48 months, respectively; p = .031). The progression-free follow-up periods for the nail brace and Winograd technique groups were 15.45 ± 0.22 months (95% confidence interval 15.02 to 15.88) and 17.18 ± 0.29 months (95% confidence interval 16.61 to 17.84), respectively. We have concluded that the use of nail braces is an appropriate alternative treatment of ingrown toenails with high patient satisfaction, fast recovery times, and a low recurrence rate.


Assuntos
Braquetes , Unhas Encravadas/terapia , Procedimentos Ortopédicos , Adulto , Feminino , Humanos , Masculino , Satisfação do Paciente , Recidiva , Estudos Retrospectivos , Retorno ao Trabalho , Fatores de Tempo
12.
Acta Orthop Belg ; 81(3): 420-6, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26435236

RESUMO

The present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of follow-up of TOH cases using physical examination and laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3±4.3 years) and 12 males (mean age, 40.7±10.5 years) was 6.1±2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intra-articular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6±7.8 before the treatment, it increased to 88.8±5.8 in the 3rd month and to 96.0±1.8 in the 6th month after the treatment. This change in score over time was found to be significant.


Assuntos
Terapia por Exercício/métodos , Articulação do Quadril/patologia , Oxigenoterapia Hiperbárica/métodos , Aparelhos Ortopédicos , Osteoporose/terapia , Amplitude de Movimento Articular/fisiologia , Suporte de Carga/fisiologia , Adulto , Feminino , Seguimentos , Articulação do Quadril/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteoporose/diagnóstico , Osteoporose/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
13.
J Back Musculoskelet Rehabil ; 35(1): 169-175, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34151830

RESUMO

BACKGROUND: Total knee arthroplasty (TKA) is one of the most common orthopaedic surgical procedures in the advanced stages of knee arthritis. OBJECTIVE: The purpose of this study was to define the sex differences in the Turkish population's morphological measurements of the distal femoral and proximal tibial surfaces that form the knee joint and to compare their compatibility with conventional prosthetic implants commonly used in TKA for advanced-stage knee arthritis. METHODS: Anthropometric data for a total of 240 knees from 240 patients were measured using 3-dimensional computed tomography (3D CT). All morphological data were compared with the dimensions of four conventional knee prostheses commonly used in Turkey. RESULTS: A comparison of the four tibial components revealed that the majority of female proximal tibias matched with smaller-sized tibial components, whereas those of males matched the larger sizes. Comparing the morphological data with similar values for the four femoral components currently used in Turkey, we found that all the prostheses had similar values. CONCLUSION: The four conventional prosthetic brands included in this study matched the distal femoral dimensions of both sexes. On the other hand, we need smaller size tibial components for our female population.


Assuntos
Artroplastia do Joelho , Prótese do Joelho , Antropometria , Feminino , Fêmur/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Masculino , Turquia
14.
Acta Ortop Bras ; 30(1): e248473, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35431623

RESUMO

Introduction: We compared the mechanical properties of two fixation techniques for the treatment of extra-articular distal third humeral fractures. Materials and Methods: Two groups were created from twenty-four humeri. Group 1 was instrumented using a new, precontoured, 8-hole (3.5-mm-diameter) locking compression plate (LCP) placed anterolaterally. Group 2 was instrumented using an 8-hole (3.5-mm-diameter) precontoured posterolateral LCP plate placed on the distal humerus. Four-point bending tests and torsion tests were performed until the specimens broke. Results: The four-point bending stiffness test showed that the stiffness of anterolaterally fixed humeri was significantly higher than that of posterolaterally fixed humeri (p<0.05). Torsion testing revealed that posterolateral fixation was associated with better yield strength (p<0.05), but the torsional stiffness did not differ significantly between the two plates (p> 0.05). Conclusions: The anterolateral plate exhibited higher bending stiffness and torsional yield strength than the posterolateral plate. Anterolateral plate fixation can thus be used to manage extra-articular distal humeral fractures. Multiaxial locking screws ensure rigid fixation, allow early elbow motion without olecranon fossa impingement, and prevent iatrogenic injury of the triceps muscle. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment.


Introdução: Comparamos as propriedades mecânicas de duas técnicas de fixação para o tratamento de fraturas extra-articulares do terço distal do úmero. Materiais e Métodos: Dois grupos foram criados a partir de vinte e quatro úmeros. O Grupo 1 foi instrumentado com uma nova placa de compressão com travamento (LCP) pré-contornada e com oito orifícios (3,5 mm de diâmetro) posicionados anterolateralmente. O Grupo 2 foi instrumentado com uma placa LCP pré-contornada posterolateral com oito orifícios (3,5 mm de diâmetro) colocada na parte distal do úmero. Testes de flexão e testes de torção a quatro pontos foram realizados até que os corpos de prova quebrassem. Resultados: O teste de rigidez à flexão de quatro pontos mostrou que a rigidez dos úmeros fixados anterolateralmente foi significativamente maior do que os úmeros fixados posterolateralmente (p <0,05). O teste de torção revelou que a fixação posterolateral foi associada a melhor força de rendimento (p <0,05), mas a rigidez à torção não diferiu significativamente entre as duas placas (p > 0,05). Conclusões: A placa anterolateral apresentou maior rigidez à flexão e resistência à tração do que a placa posterolateral. A fixação anterolateral da placa pode, portanto, ser usada para tratar fraturas extra-articulares da parte distal do úmero. Os parafusos de travamento multiaxiais garantem uma fixação rígida, permitem o movimento precoce do cotovelo sem causar impacto à fossa do olécrano e previnem lesão iatrogênica do músculo tríceps. Nível de evidência I, Estudos terapêuticos - Investigação dos resultados do tratamento.

15.
Anticancer Agents Med Chem ; 21(13): 1732-1737, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33267766

RESUMO

BACKGROUND: Autophagy is a cellular process that plays a role in the destruction of proteins and organelles. It has been shown that impaired autophagic flux triggers canceration, infectious disease, and neurodegenerative diseases. It has been suggested that tumor formation is inhibited by autophagy that reduces oxidative stress and recycles damaged organelles. microRNAs are 17-25 bp in length, single-stranded, and noncoding small RNAs that play roles in the regulation of metabolic gene expression at the post-transcriptional level. Osteosarcoma is an aggressive bone cancer that affects mainly children and adolescents. OBJECTIVE: The current article aims to profile autophagy-associated miRNAs in osteosarcoma cell lines and to examine the therapeutical potentials of these miRNAs by suppressing their expressions with Adriamycin and Rapamycin. METHODS: We used fluidigm dynamic array nanofluidic chip 96.96 for mRNA expression assay in osteosarcoma cell line U2OS. RESULTS: It was probed that after the suppression of autophagy-associated miRNAs by adriamycin and rapamycin, while most of the miRNAs were down-regulated in osteosarcoma cell lines, some miRNAs' expressions, such as miR-3141, miR-4296, miR-133b, and miR-720, were strikingly increased. Rapamycin and adriamycin, mTOR inhibitors, stir autophagic machinery, which results in decreased cell survival. CONCLUSION: Together, we propose that the expressions of miR-3141, miR-4296, miR-133b, and miR-720 might exacerbate the pathogenesis of osteosarcoma; therefore, the suppression of these miRNAs with the loss-offunction approaches could be an appropriate strategy that is worth testing in osteosarcoma.


Assuntos
Autofagia/genética , MicroRNAs/genética , Osteossarcoma/genética , Sobrevivência Celular , Regulação Neoplásica da Expressão Gênica/genética , Humanos , MicroRNAs/isolamento & purificação , MicroRNAs/metabolismo , Osteossarcoma/patologia , Células Tumorais Cultivadas
16.
J Orthop Surg Res ; 14(1): 460, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870392

RESUMO

This article [2] was published twice [1] due to a production error. The original article [1] should be considered the version of record and used for citation purposes. The publisher apologizes to the authors and readers for the error and any inconvenience caused.

17.
J Clin Orthop Trauma ; 10(2): 290-295, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30828196

RESUMO

INTRODUCTION: Comparison was made of the clinical and radiological results of the surgical treatments of proximal femoral nail (PFN), dynamic hip screw (DHS) or proximal femoral locking compression plate (PF-LCP) in patients with AO 31A2.2/2.3 unstable intertrochanteric femoral fracture(ITF). METHODS: Evaluation was made of a total of 91 patients in respect of age, gender, time from fracture to surgery, operating time, amount of blood replacement, total hospitalisation, follow-up period, time to full weight-bearing, time to union, complications and Harris hip scores(HHS). RESULTS: A statistically significant difference was determined between the groups in respect of perioperative operating time, blood replacement and hospitalisation period with the values of the PFN group seen to be superior to those of the other two groups (p < 0.001). No significant difference was determined beween the DHS and PFN groups in respect of time to union and in the long-term HHS, both groups were seen to be superior to the PF-LCP group (p < 0.001). Full weight-bearing was statistically significantly earlier in the PFN group (p < 0.001). The numbers of implant failures was statistically significantly higher in the PF-LCP group (p < 0.001). CONCLUSION: The new generation intra-medullar nails are easy to apply and have more successful clinical results compared to extra-medullar implants in the treatment of A2 unstable ITF. Due to the high rates of implant failure, PF-LCP should not be preferred in these fractures.

18.
Ann Med Surg (Lond) ; 26: 38-42, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29348913

RESUMO

OBJECTIVES: Intramedullary nailing is the treatment of choice for fractures of the tibial shaft, which might necessitate the nail removal due to complications in the long-term. Although considered as a low-risk procedure, intramedullary nail removal is also associated with certain complications. Here, we compared the most commonly used stainless steel and titanium nails with respect to the complications during removal and clinical outcome for intramedullary nailing of diaphyseal fractures of the tibia. PATIENTS AND METHODS: Sixty-two patients (26 females, 36 males) were included in this retrospective study. Of the removed nails, 24 were of stainless steel and 38 of titanium. Preoperative and intraoperative parameters, such as implant discomfort, anterior knee pain, operating time and amount of bleeding, and postoperative outcomes were evaluated for each patient. RESULTS: Titanium nail group had more, but not statistically significant, intraoperative complications than stainless steel group during the removal of nails (p = .4498). Operating time and amount of intraoperative bleeding were significantly higher in titanium group than stainless steel group (p = .0306 and p < .001, respectively). Preoperative SF-36 physical component and KSS scores were significantly lower in patients who had removal of titanium nails than those of stainless steel nails, whereas there was no difference in terms of postoperative SF-36 and KSS scores. CONCLUSION: In conclusion, although greater bone contact with titanium increases implant stability, nail removal is more difficult, resulting in more longer surgical operation and more intraoperative bleeding. Therefore, we do not recommend titanium nail removal in asymptomatic patients.

19.
J Orthop Surg Res ; 12(1): 68, 2017 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-28449701

RESUMO

BACKGROUND: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. METHODS: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. RESULTS: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70. Both VPS and AOFAS-Hallux scores changed significantly. DISCUSSION: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. CONCLUSIONS: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.


Assuntos
Artroscopia/métodos , Hallux Rigidus/diagnóstico por imagem , Hallux Rigidus/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
20.
J Orthop Surg Res ; 12(1): 95, 2017 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-28637481

RESUMO

BACKGROUND: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early-grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. METHODS: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. RESULTS: The patients had mean preoperative VPS (visual pain scale) and AOFAS (American Orthopedic Foot and Ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70, respectively. Both VPS and AOFAS-Hallux scores changed significantly. DISCUSSION: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. CONCLUSIONS: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.


Assuntos
Artroscopia/métodos , Hallux Rigidus/cirurgia , Articulação Metatarsofalângica/cirurgia , Adulto , Artroscopia/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
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