Erdem Sahin

Chronic plantar fasciitis is a common cause of persistent heel pain, often resistant to conservative treatments. This prospective, randomized controlled tr

Surgical intervention is the treatment of choice for recurrent lateral patellar instability. Surgery should be considered for first time lateral patella dislocations with osteochondral fractures or underlying anatomical risk factors. Primary repair and nonanatomical imbrications/reconstructions have fallen out of favor due to abnormal biomechanics and high rates of recurrence. Anatomical reconstruction of the MPFL using a variety of auto and allograft tissues have yielded good outcomes and low redislocation rates. Physeal sparing MPFL reconstruction techniques under radiological control are safe and do not cause growth disturbance. Allografts may be indicated for hyperlax patients. Although no clear cutoff points exist, correction of valgus and excessive femoral anteversion should be considered when indicated. Osteochondral and chondral injuries are common and should be addressed during surgery for instability.

Background/Aim: Most scoring systems in healthcare take into account the physical condition and pain status of a patient, but the impact of society on the individual is ignored. The aim of our study was to evaluate the social media posts made by patients regarding lumbar discectomy surgery. The objective was to identify and explore concerns and issues that may not be immediately evident during clinical evaluations but are significant to the patients themselves. Methods: Public posts with the hashtags #discectomy, #lumbardisectomy, and #discectomyrecovery were examined on the Instagram application. The tone of the post, return to sports (RTS), rehabilitation or physical therapy (PT), return to work (RTW), incision site (e.g., scarring, sutures, and dressing), pain, activities of daily living (ADL), and X-ray/magnetic resonance imaging (MRI) data were evaluated. The "Instagram likes ratio" was determined by dividing the total number of likes received for each post by the number of followers. Results: 272 posts were assessed, and 77.9% of them exhibited a positive tone. The topic that was most frequently discussed was ADL, which was discussed in 24.6% of the posts. Statistical analysis demonstrated a significant association between positive tone and ADL, as well as positive tone and RTS (P<0.001). A statistically significant correlation was observed between negative tone and neurological deficits, pain, and X-ray/MRI findings (P<0.001). Conclusion: Our study offers a unique perspective on the experience and satisfaction of patients who have undergone lumbar discectomy. Neurologic deficits and pain were notably significant in the negative posts. However, in general, the majority of the posts maintained a positive tone. The results could provide insights into patients' experiences and perspectives that can potentially inform healthcare professionals in providing more comprehensive and patient-centered care.

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.

Category: Other Introduction/Purpose: The significance of trial registration has grown rapidly as an increasing number of journals require NCT IDs prior to publication. Although various reports have been published in different medical fields, including several orthopaedic subspecialties, no study has examined the discrepancies between trial registries and publications in the area of foot and ankle surgery. Therefore, this study aimed to investigate (1) the characteristics of foot and ankle surgery-related clinical trials registered in the widely used Clinicaltrials.gov (CTG) clinical trials database, (2) the publication rates, (3) inconsistencies between the original trial plans and final publications, and (4) possible risk factors that could contribute to discrepancies. The hypothesis was that foot and ankle surgery-related trials would have a low publication rate, and discrepancies would exist between trial registries and final published results. Methods: The study used the CTG database to identify eligible trials based on the following inclusion criteria: (1) related to foot and ankle surgery, (2) interventional study, (3) randomized controlled, and (4) anticipated completion date before the end of 2018. Exclusion criteria consisted of (1) ongoing trials, (2) trials assessing vascular surgeries or anesthetic procedures, and (3) trials examining conservative treatment methods without any surgical intervention. The search was performed on January 1, 2021, allowing the authors at least 24 months from trial completion to publication. The corresponding publications of the included trials were searched using various databases, including Medline, Web of Science, Scopus, and Google Scholar. NCT ID, title, keywords, and the name of the principal investigator provided in CTG were used for literature search, and the title and abstract of the publications were reviewed to confirm the match with the trial. Results: Out of all the trials analyzed, 67.5% were registered either during the trial period or after completion. Industry funded 46.5% of trials. A reported 54.8% of trials were completed, and only 42% (66 trials) were published in a journal. Among the analyzed trials, 57.6% had a sample size discrepancy, 28.8% had a follow-up time discrepancy, 45.5% had a primary outcome discrepancy, and 89.4% had an inclusion/exclusion criteria discrepancy. Trials funded by industry exhibited significantly more sample size and inclusion/exclusion criteria discrepancies (p=0.024, 0.001, 0.037, respectively). Furthermore, industry-funded studies had a higher frequency of positive results (p=0.011). Conclusion: The findings of this study draw attention to the existing issues in clinical trials related to foot and ankle surgery. The results not only serve as a warning to researchers regarding potential inconsistencies but also support the need for stricter trial registry regulations. Registering a trial does not guarantee its publication or ensure that there will be no modifications to the methodology during the trial period. Therefore, it is crucial to register trials before enrolling the first patient to minimize the risk of bias.

Objectives: Greater trochanteric pain syndrome (GTPS) is one of the causes of lateral hip pain. We aimed to determine the significance of certain anatomical parameters related to GTPS in imaging tests. Methods: Data of patients who were treated with glucocorticoid injection for trochanteric bursitis in our clinic between July 2019 and July 2022 for GTPS were analyzed. The control group was constituted of patients without GTPS but with hip and spinal problems who had pelvic computerized tomography (CT) images and undergone robotic-assisted knee arthroplasty. Standard anteroposterior pelvic radiograms, pelvic CTs, or magnetic resonance images were evaluated for anatomical parameters. Results: Among anatomical parameters, acetabular anteversion, length of trochanter major, and abductor index were significantly different between the patients with and without GTPS. Although mean age was different between the GTPS and control patient groups, age was not found to be correlated with any anatomical parameter. Abductor lever arm length (p = 0.001) and abductor index (p = 0.009) were found to be correlated. Conclusions: The length of trochanter major and abductor index were shown to be predisposing anatomical parameters for GTPS.

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.

Objective: This study aimed to determine whether a standard anesthetic protocol consisting of combined spinal epidural anesthesia (CSEA) in conjunction with controlled hypotensive anesthesia (CHA), which was used for conventional total knee arthroplasty (cTKA), could provide equally effective anesthetic conditions for robotic total knee arthroplasty (rTKA). Methods: Data were collected from the medical records of 113 patients (median age=67 years; age range=55-84) who underwent elective unilateral cTKA (n=52) or rTKA (n=61) without a tourniquet from 2021 to 2023. The primary outcome measure was the rate of patients whose anesthetic method did not provide adequate motor and sensory block during the surgery and had to be converted to general anesthesia. The secondary outcome measure was to compare perioperative variables, including pain scores, analgesic consumption, blood loss, transfusions, and complications. Results: In 6 patients (11.5%) in group rTKA, it was required to convert CSEA to general anesthesia at 160-180 minutes due to the pain at the operative knee and/or to the movement of the operative leg during surgery compared to none / zero in group cTKA (P=.008). Motor and sensory blocks terminated earlier than the total surgery time in those patients. Mean total surgery time was significantly higher in group rTKA than in group cTKA (151.25 ± 24.51 (120-240) minutes vs. 116.72 ± 4.99 (105-125) minutes, P < .001). Total surgery times tended to decrease gradually in group rTKA after the 11th case, indicating a learning curve for surgical performance. Conversion to general anesthesia was required only in 1 patient after the 11th case compared to the previous 5 patients. Mean pain scores and rescue analgesic consumption were higher in group rTKA at postoperative 0 hour and between 0 and 4 hours (P < .05) but similar at the following time points (P > .05). Blood loss, transfusion, and complication rates were similar (P > .05). Hospital discharge times were higher in group rTKA (P < .05). Conclusion: Although our standard CSEA protocol failed due to the regression of motor and sensory block during surgery in 11.5% of patients in rTKA, the CSEA technique combined with controlled hypotensive anesthesia provided similar anesthetic conditions in the remaining patients in group rTKA as in group cTKA. The CSEA may be considered an effective and safe anesthetic method for rTKA if interventions are applied to extend the duration of the CSEA for this novel surgical technique. Level of Evidence: Level III, Therapeutic Study Cite this article as: Süzer AM, Şahin E, Özhan MÖ, Kara U. Comparison of conventional and robotic knee arthroplasty results: A retrospective observational study. Acta Orthop Traumatol Turc., 2023;57(5):277-282.