Murat Yilmaz

Purpose: This study aimed to compare the radiological, macroscopic, biomechanical and histological outcomes of osteochondral autograft transplantation (OAT) and a combination of intralesional scaffold with intra‐articular losartan injection in a rabbit model of osteochondral injury. Methods: Twelve rabbits received bilateral osteochondral defects (4 × 4 mm) in the trochlear region of both knees and were divided into two groups. Group A received scaffold implantation with intra‐articular losartan (1 mg per knee, injected in 0.1 mL of solution), while Group B underwent OAT with re‐implantation of the original plug. After 6 months, bilateral knee magnetic resonance imaging (MRI), macroscopic, histological and biomechanical assessments were performed. Results: Macroscopic examination demonstrated that the defect areas were filled and integrated with the surrounding cartilage. MRI evaluations revealed complete closure of the osteochondral defects. Histological evaluation using Wakitani scores showed no statistically significant difference between the groups (Group A: 3.63 ± 2.13, Group B: 2.63 ± 2.01, p = 0.423). Finally, no significant difference was observed in biomechanical load testing between the groups (Group A: 219.2 ± 72.9 N, Group B: 270.8 ± 67.6 N, p = 0.149). Conclusions: The scaffold‐losartan combination may offer a promising, less invasive alternative to traditional OAT for osteochondral defect repair. Level of Evidence: N/A.

Amaç: Sigaranın insan sağlığına olan birçok olumsuz etkisi bilinmektedir. Bunlardan biri de kemik iyileşme sürecine olan negatif etkisidir. Sigara içen bireylerde kırık kaynama süresinin daha uzun olduğu ve daha çok komplikasyon geliştiği yönünde kanıtlar artmaktadır. Bu konudaki çalışmaların çoğunluğu geniş bir yaş aralığı ve birden fazla tedavi şekli içermektedir. Amacımız sigaranın kaynama gecikmesine veya kaynamamaya etkisini daha homojen bir hasta grubunda incelemektir. Yöntem: 18-40 yaş arası femur şaft veya tibia şaft kırığı geçirmiş ve sadece intramedüller çivileme yöntemiyle 2015 ile 2020 yılları arasında ameliyat edilmiş 73 hasta; sigara içen grup ve sigara içmeyen grup olarak ikiye ayrıldı. Bu hastaların tüm bilgisayar kayıtları, x-ray grafileri ve arşiv dosyaları geriye dönük olarak incelendi. Bulgular: Sigara içen grupta 37, içmeyen grupta 36 hasta mevcuttu. Sigara içen hastaların kırık kaynama süresi ortalama 26,1 hafta; içmeyen hastaların ise ortalama 16,3 hafta olarak bulundu. İstatistiksel olarak sigara içen grubun ortalama kırık kaynama süresi anlamlı uzundu (p=0,001). Kaynamama ve enfeksiyon oranları açısından ise anlamlı fark bulunamadı. Sonuç: Sigara; düşük kemik yoğunluğuna, artmış kırık ve kaynamama riskine, geç kaynamaya ve ameliyatla ilgili komplikasyonlarda artışa neden olmaktadır. Kemik kırığı gelişen veya elektif kemik ameliyatı olacak kişiler sigara kullanıyorsa, en kısa sürede bırakması için uyarılmalıdır.

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 identify the most common mistakes made during pelvic radiography in pediatric patients and to give advice to physicians and technicians on how to avoid these mistakes. Material and Method:Between 2016 and 2020, 1150 pelvic radiographs (in pediatric patients for any reason) were analyzed by two independent orthopaedic surgeons. Radiographs taken in trauma patients were not included in the study due to the patient's discomfort and agitation. Interobserver and intraobserver reliability for radiographic measurements were determined using intra-class correlation coefficients (ICC) obtained from three replicate sets of measurements on a sample of 1150 radiographs recorded by each observer at least one week apart. Results: The mean age of the patients included in this study was 4.28±3.86 (range: 0-14) years. Of the 1150 patients, 935 (81.30%) were female and 215 (18.69%) were male. When pediatric pelvic radiographs were evaluated, the most common mistake was made during gonad protection. It was found that 71.22% of the patients' gonads could not be protected. While this rate was 82.24% in female patients, this rate was 23.34% in male patients. There was a statistically significant difference when compared by gender (p= 0.015). Giving the malposition was the second most common mistake. Conclusion: The most common errors in pediatric pelvic radiographs are failure to provide gonad protection and malposition of the patient. To minimize these errors, it is necessary to inform both the doctor and the technician.

Aim: Acetabular fractures were evaluated by Judet and Letournel in two main groups as elementary and associated fractures. There are publications in the literature that the results are worse as the complexity of the fracture increases. The aim of this study was to evaluate whether clinical outcomes are worse in associated fractured patients. Material and Methods: The study included 48 acetabular fractures admitted to the emergency room and treated surgically between December 2011 and October 2020. Patient’s trauma, additional injuries, surgical method, early or late complications, and range of motion at the last follow-up were documented. Clinical and radiological results of the patients were evaluated by modified Merle d'Aubigné, functional capacities by Harris hip scoring systems. Results: There were 25 elementary fractures and 23 associated fractures in patients. When the complication rates were examined, the rate of those without complications was 52.0% (n=13) among elementary fractures, while the rate was 34.8% (n=8) in associated fractures. When the fracture types were evaluated according to the Harris hip score, elementary fractures have better score than associated fractures, but no statistically significant difference was observed between them (p=0.056). When evaluated according to Merle d'Aubigne score, it was observed that elementary fractures had significantly better scores (p=0.004). Conclusion: As the complexity of the fracture increases, it can be predicted that the clinical outcomes of the patient will be worse. It is also concluded that the elementary fracture type had better clinical outcomes than the associated fracture type in our own surgically treated acetabular fractures.