Emre Gültaç

There are studies indicating that both statins and Platelet-Rich Plasma (PRP) have effects on inflammation and the arthritis process. The aim of our study was to investigate the effect of statin use on the clinical and functional outcomes of PRP treatment in patients with early-stage knee osteoarthritis. Between January 2018 and August 2020, the medical records of all patients who underwent PRP treatment for stage I–II knee osteoarthritis were retrospectively reviewed. Patients who did not use statins and received PRP treatment for knee osteoarthritis were designated as Group 1, while patients who used statins for hypercholesterolemia and received PRP treatment for knee osteoarthritis were designated as Group 2. Patient demographics, radiological images, and clinical records were retrospectively analyzed. The clinical and functional effects of PRP treatment were compared between the two groups. A total of 70 patients aged 40–70 years with stage I–II knee osteoarthritis were included in the study. In the EQ5D5L quality of life scale, a statistically significant difference was observed between the two groups before PRP treatment (p = 0.036). No statistically significant difference was observed in any other parameters examined. Our study investigated whether statin use had a positive or negative effect on PRP treatment; no significant difference was found in terms of functional and clinical results. Regardless of statin use, PRP treatment was found to improve patients’ clinical and functional scores.

The aim of this study was to compare the clinical, functional, and stability outcomes of arthroscopic Bankart repair performed using either a single or double soft anchor in patients with limited anterior Bankart lesions between the 1 and 5 o’clock positions. Our retrospective cohort included patients underwent arthroscopic Bankart repair for anterior shoulder instability between January 2018 and December 2023. Glenoid defects or other associated shoulder pathologies were excluded, and all patients had a minimum two years follow-up. The patients were divided into two groups: single soft anchor (n=36) and double soft anchor (n=26). Demographic data, recurrent subluxation/ dislocation, necessity of revision surgery, pain scala, functional outcomes, patient satisfaction rates, and return to sports rates were assessed at the second postoperative year. The mean age was 29.5 ± 7.7 years in the single soft anchor group and 28.0 ± 5.9 years in the double soft anchor group. Recurrent dislocation was observed in three patients in the single soft anchor group, whereas no recurrent dislocation occurred in the double soft anchor group, showing no statistically significant difference between the groups. Pain and functional outcomes were similar between groups at year two, and no statistically significant differences were observed regarding patient satisfaction or return to sports. In patients with limited anterior Bankart lesions, arthroscopic repair using a single soft anchor provides clinical, functional, and stability outcomes comparable to those achieved with double soft anchor fixation.

This study endeavors to compare the clinical and radiological outcomes of 2 different types of plate fixation for posterior acetabular wall and/or column fractures, transverse and posterior wall fractures. We designed an anatomical plate that is easy to apply for acetabular posterior wall and column fractures and can simultaneously fix the column and wall as support with the buttressing effect. Weight-bearing and bending biomechanical tests were performed for the development of the plate. The 39 acetabular fractures operated between January 2013 and June 2017 were divided into 2 groups. Group 1 (n = 17) received treatment using the Paseos anatomical plate, while Group 2 (n = 22) with conventional reconstruction plates. Merle d’Aubigné and Postel score and Matta reduction criteria were utilized for the functional and radiological evaluations. According to Matta reduction criteria, in Group 1, anatomical reduction was achieved in 14 patients (82.3%), good reduction in 2 patients (11.7%), and poor reduction in 1 patient (5.9%). In Group 2, anatomical reduction was observed in 19 patients (86.4%), good reduction in 2 patients (9.1%), and poor reduction in 1 patient (4.5%). At the 12-month follow-up, functional outcomes were evaluated using Merle d’Aubigné and Postel scoring system. In Group 1, excellent scores were recorded in 13 patients (76.4%), good scores in 3 patients (17.6%), and fair scores in 1 patient (5.9%). In Group 2, excellent scores were observed in 19 patients (86.4%), good scores in 2 patients (9.1%), and fair scores in 1 patient (4.5%). The median operation duration in Group 1 was significantly lower than Group 2 ( P < .001). Paseos plate demonstrated clinical and radiological outcomes comparable to conventional reconstruction plates. Due to its special anatomical structure, it can support a wide bony area with its buttress effect and also it can be applied directly without the need for reshaping during surgery, thus shortening the surgical duration.

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Hallux valgus is a triplanar deformity with rotation being a significant contributing factor. Several methods exist for evaluating rotational deformity of the first ray, one of which involves assessing the shape of the lateral edge of the first metatarsal head. This study aimed to investigate the interobserver and intraobserver reliabilities of circle measurements on weight-bearing anteroposterior radiographs to categorize the shape of the lateral edge of the first metatarsal head. A power analysis determined that a minimum of 128 radiographs was required to assess observer agreement for categorical data (alpha = 0.05, beta = 0.2, power = 80%). Patients diagnosed with hallux valgus at our institution between January 2015 and December 2019 were retrospectively reviewed and 128 radiographs were randomly selected. Two foot and ankle surgeons and 2 radiologists evaluated the radiographs on 2 separate occasions, classifying the first metatarsal head shape into 3 categories (angular, intermediate, and round) using circular measurements. Interobserver reliability was assessed using Fleiss’ kappa, whereas intraobserver reliability was evaluated using Cohen kappa. Interobserver reliability for classifying the shape of the lateral edge of the first metatarsal head was found to be very good in both assessments (Fleiss’ kappa = 0.83 and 0.84, respectively). The subcategory analysis revealed the highest agreement for the angular type, followed by the round type, with the lowest agreement observed for the intermediate type. The intraobserver Cohen kappa values ranged from 0.78 to 0.91. The level of interobserver agreement was found to be very good for the classification of the shape of the first metatarsal, and the intraobserver agreements were substantial to very good. In our opinion, this method is reliable and may be useful in determining the necessity for rotation-correcting surgery and advanced imaging with weight-bearing computed tomography.

To evaluate the clinical and radiological outcomes of core decompression combined with bone marrow aspirate injection (BMAI) in patients with femoral head avascular necrosis (AVN) before articular surface collapse. Twenty-two patients with AVN underwent core decompression and BMAI. The patients were followed for at least 12 months. Radiological assessments were performed using plain radiography and magnetic resonance imaging, and staging was conducted based on the Association Research Circulation Osseous system. Clinical outcomes were evaluated using the Harris Hip Score and Merle d’Aubigne-Postel scoring systems. At the 12-month follow-up, hip function scores showed significant improvement. The mean Harris Hip Score increased by 23 points (P < .001), and the mean Merle d’Aubigne-Postel score increased by 1 point (P < .001). Radiologically, all stage I lesions regressed to stage 0 (P < .001). Among stage II lesions, 83% remained stable, while progression was observed in 17%. 75% of the stage IIIA lesions showed radiological progression. Core decompression combined with BMAI effectively halts the progression of early-stage AVN, preserving joint integrity and delaying the need for total hip arthroplasty. Further studies are warranted to explore the efficacy of biological therapy in treating femoral head AVN.

Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Aim: This study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures. Materials and Methods: 75 closed subtrochanteric fractures treated with cephalomedullary nails by two different surgeons with at least 10 months of follow-up were included in the study. Patients operated by Surgeon 1 were grouped as Group 1 (closed cephalomedullary nailing without cables, n=43), patients operated by Surgeon 2 with 1-2 cables as Group 2 (n=20), and those operated with 3-4 cables were grouped as Group 3 (open cephalomedullary nailing + cable fixation, n=12). Postoperative radiographs were evaluated for the presence of cables, the number of cables used, deformity, the residual gap between the fracture ends, and the union time. Results: The cable fixation rate was calculated as 42.6%. There was a statistically significant relationship between cable use and the amount of gap (p=0.033). The average gap was 3.97 mm in patients without cables, 0.65 mm in patients with 1-2 cables, and 0.66 mm in patients with 3-4 cables. A positive correlation was found between the amount of gap and the time to union (Spearman's rho= 0.468, p=0.001). A statistically significant difference was found between Group 1 and Group 2 and also between Group 1 and Group 3 regarding the union time (p=0.007, p=0.001, respectively). The mean time to union was determined as 7.3 months in Group 1, 5.4 months in Group 2, and 5.7 months in Group 3. Conclusion: Reducing the gap in the fracture line by using cables provides a better reduction, stability, and a shorter union time than fixation without a cable in subtrochanteric fractures treated with cephalomedullary nailing.

Aim: This study aimed to examine the effect of cable cerclage on reduction quality and union time in patients treated with cephalomedullary nails for subtrochanteric fractures. Materials and Methods: 75 closed subtrochanteric fractures treated with cephalomedullary nails by two different surgeons with at least 10 months of follow-up were included in the study. Patients operated by Surgeon 1 were grouped as Group 1 (closed cephalomedullary nailing without cables, n=43), patients operated by Surgeon 2 with 1-2 cables as Group 2 (n=20), and those operated with 3-4 cables were grouped as Group 3 (open cephalomedullary nailing + cable fixation, n=12). Postoperative radiographs were evaluated for the presence of cables, the number of cables used, deformity, the residual gap between the fracture ends, and the union time. Results: The cable fixation rate was calculated as 42.6%. There was a statistically significant relationship between cable use and the amount of gap (p=0.033). The average gap was 3.97 mm in patients without cables, 0.65 mm in patients with 1-2 cables, and 0.66 mm in patients with 3-4 cables. A positive correlation was found between the amount of gap and the time to union (Spearman's rho= 0.468, p=0.001). A statistically significant difference was found between Group 1 and Group 2 and also between Group 1 and Group 3 regarding the union time (p=0.007, p=0.001, respectively). The mean time to union was determined as 7.3 months in Group 1, 5.4 months in Group 2, and 5.7 months in Group 3. Conclusion: Reducing the gap in the fracture line by using cables provides a better reduction, stability, and a shorter union time than fixation without a cable in subtrochanteric fractures treated with cephalomedullary nailing.

Purpose: Shoulder joint range of motion (ROM) limitation and pain are the most common clinical conditions and complaints of patients who undergo shoulder arthroscopy. Identifying the possible causes of pain and limitation of the joint motion in the early postoperative period, positively affect both the success of the surgery and patient satisfaction. This study aims to evaluate the effect of soft tissue debridement around the subscapularis muscle tendon on postoperative shoulder ROM. Material and methods: 155 patients who underwent arthroscopic subacromial decompression for subacromial impingement were investigated and after excluded cases, 97 patients were eligible for this study. The patients were divided into two groups. Group 1 included 54 patients who underwent subscapular soft tissue debridement with RF device and Group 2 included 43 patients who were only operated for subacromial impingement. Postoperative shoulder early ROM and pain scores at the third-month follow-up were used. The data were compared to evaluate the effect of debridement of the surrounding soft tissue adhesions around the subscapularis tendon. Results: The patients who underwent arthroscopic subscapular debridement had a better active internal and external rotation range at third-month follow-up as well as the pain score. There was a statistically significant difference between the two groups in terms of early ROM and pain (p=0.001). When the type of adhesion is investigated, it is found that this statistically significant difference is mostly between debridement and non-debridement patients who had synovial hypertrophy (p=0.001). Patients who had a combination of synovial hypertrophy and pulley formation also benefited greatly from debridement like synovial hypertrophy alone. Conclusion: Arthroscopic debridement of soft tissue around the subscapularis tendon showed better early ROM and less pain at postoperative third-month follow-up. We believe that debridement of the contiguous soft tissue with an RF device around the subscapularis tendon during arthroscopic shoulder surgery will most likely improve postoperative results and, therefore, should be added.