Acta orthopaedica et traumatologica turcica最新文献

{"title":"Correspondence on \"exploring the role of artificial intelligence in turkish orthopedic progression exams\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.5152/j.aott.2025.25418","DOIUrl":"10.5152/j.aott.2025.25418","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 4","pages":"230-231"},"PeriodicalIF":1.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of bursa repair and steroid injection on lateral trochanteric pain following total hip arthroplasty: a retrospective cohort study.","authors":"Mehmet Süleyman Abul, Duygu Şahiner, Ömer Faruk Sevim, Ömer Hekim, Selim Ergün, Engin Eceviz","doi":"10.5152/j.aott.2025.25271","DOIUrl":"10.5152/j.aott.2025.25271","url":null,"abstract":"<p><p>Objective: This study aimed to evaluate the clinical outcomes of preserving and repairing the bursal tissue-rather than excising it-during total hip arthroplasty (THA), and to assess the additional e!ect of administering a steroid injection into the repaired bursa. Methods: Patients who underwent total hip arthroplasty (THA) via a posterior approach were retrospectively reviewed and divided into three groups based on the intraoperative bursal tissue management technique. The first group (PB) included patients who received an intraoperative injection of corticosteroid (40 mg methylprednisolone) and local anesthetic (bupivacaine 5 mg/mL) into the pre- served bursa. The second group (BR) consisted of patients who underwent bursal repair without injection. The third group (BE) comprised patients who underwent total excision of the bursa. Clinical outcomes were assessed using the Harris Hip Score (HHS), the Visual Analogue Scale (VAS) for pain during daily activities, and VAS for pain while lying on the ipsilateral hip at 6 and 24 months postoperatively. Results: A total of 41 patients (27 females, 14 males) who underwent THA were included in the study. No statistically significant di!erences were observed between the groups in lateral trochanteric VAS scores during daily activities at both 6 and 24 months postoperatively (P > .05). However, a significant di!erence was found in VAS scores assessed while lying on the operated side at 6 months, favoring the PB group (P < .001). Additionally, Harris Hip Score (HHS) values were significantly higher in the PB group compared to the other groups at both 6 months (P < .001) and 24 months (P = .006). Conclusion: Intraoperative corticosteroid and local anesthetic injection, in addition to bursa repair, may improve early postoperative outcomes and pain relief in patients undergoing THA using the posterior approach, without increasing infection risk.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 4","pages":"195-200"},"PeriodicalIF":1.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Think before you speak, read before you think\".","authors":"Javad Parvizi","doi":"10.5152/j.aott.2025.250817","DOIUrl":"10.5152/j.aott.2025.250817","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 4","pages":"189-190"},"PeriodicalIF":1.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the role of disulfidoptosis in spinal cord injury and development of a novel diagnostic model.","authors":"Chao Wang, Lu Yu, Hongyan Ma","doi":"10.5152/j.aott.2025.24248","DOIUrl":"10.5152/j.aott.2025.24248","url":null,"abstract":"<p><p>Objective: The objective of this study is to explore the role and regulatory mechanisms of disulfidoptosis in spinal cord injury (SCI) and to develop a diagnostic model based on this cell death mechanism. Methods: The peripheral blood RNA-seq data from SCI patients sourced from dataset GSE151371 was utilized in the study. Various analytical techniques, including differential gene expression analysis, immune infiltration profiling, consistency clustering, and pathway enrichment analysis, were employed to investigate the impact of disulfidoptosis. Machine learning models were also developed to aid in the diagnosis of SCI based on gene expression profiles related to disulfidoptosis. Results: Gene expression analysis revealed significant upregulation of genes such as GYS1, PDLIM1, NDUFA11, and MYL6, and down-regulation of NUBPL, LRPPRC, and CD2AP in SCI patients, with statistical significance (P < .05). Immune infiltration profiling showed a decrease in CD4+ and CD8+ T cells, contrasted by an increase in gamma delta T cells (P < .05), indicating an altered immune landscape. Furthermore, 2 distinct subgroups were identified through consistency clustering, highlighting significant differences in disulfidoptosis- related gene expression. Pathway enrichment analysis revealed different pathways between clusters, suggesting diverse regulatory mechanisms within SCI subtypes. The diagnostic model evaluation using random forest achieved the highest accuracy with an area under the curve (AUC) of 0.955, demonstrating its potential utility in clinical settings for SCI diagnosis. Conclusion: Disulfidoptosis plays a significant role in the pathophysiology of SCI. This study offers novel insights into its molecular mechanisms and presents a potential foundation for diagnostic modeling.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 4","pages":"201-209"},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Gritti-Stokes amputation for periprosthetic fracture with irremovable femoral nail: case report and review of an overlooked procedure.","authors":"Han-Po Tseng, Chi-Sheng Chien, Tsung-Mu Wu","doi":"10.5152/j.aott.2025.24213","DOIUrl":"10.5152/j.aott.2025.24213","url":null,"abstract":"<p><p>The management of retained orthopedic hardware during amputation procedures presents significant challenges. A case utilizing a modified Gritti-Stokes through-knee amputation to address a periprosthetic fracture with an exposed intramedullary nail (IMN) in a patient with multiple comorbidities is reported. A 47-year-old male with a history of human immunodeficiency virus, hepatitis C virus, and type 2 diabetes mellitus presented with a left femoral periprosthetic supracondylar fracture. The patient had an existing IMN from a previous femoral shaft fracture 20 years prior, along with a left below-knee amputation. Due to the newly occurred periprosthetic fracture and the patient's immunocompromised status, further amputation was deemed necessary. However, removal of the well-integrated IMN posed significant risks. A modified Gritti-Stokes through-knee amputation was performed, adapting the procedure to use the patella as a biological cap to cover the exposed IMN tip. At 4-month follow-up, the patient demonstrated satisfactory wound healing and stable positioning of the patellar cap. The patient achieved ambulation with an above-knee prosthesis and crutch assistance, reporting high satisfaction and no pain or discomfort. This case highlights the versatility of the Gritti-Stokes procedure in addressing complex scenarios involving retained hardware. By utilizing the patella as a biological cover for the exposed IMN, the risks associated with hardware removal was avoided while achieving a stable, well-healed amputation stump. This modification of the Gritti-Stokes technique offers a viable solution for patients with retained IMNs requiring through-knee amputation, particularly in cases where hardware removal is contraindicated or highly risky.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 4","pages":"232-236"},"PeriodicalIF":1.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catastrophic wound dehiscence in early onset scoliosis secondary to hyperinflammatory response: a case report.","authors":"Wasim Shihab, Aaradhana Jha, Ozgur Dede","doi":"10.5152/j.aott.2025.24107","DOIUrl":"10.5152/j.aott.2025.24107","url":null,"abstract":"<p><p>Early onset scoliosis (EOS) poses significant treatment challenges, often exacerbated by postoperative wound complications. A novel case of hyperinflammatory wound complications in a child with a confirmed NFKB1 mutation is presented, successfully managed with immunomodulation. A 6-year-old boy experienced wound dehiscence and persistent inflammation following rod placement, unresponsive to conventional treatments including surgical debridement and antibiotics. Further evaluation identified an NFKB1 mutation associated with hyperinflammatory states. Targeted treatment with Anakinra, an interleukin (IL)-1 receptor antagonist, resulted in rapid wound healing and normalization of inflammatory markers. Subsequent serial rod expansions, pretreated with Anakinra, were complication-free, and the patient remained stable for 4 years post treatment. This case emphasizes the critical role of genetic predispositions, such as NFKB1 mutations, in postoperative complications. Dysregulated IL-1β activity was effectively managed with targeted immunomodulation, highlighting the importance of recognizing and addressing non-infectious hyperinflammatory processes. Patients presenting with very early wound dehiscence, disproportionate inflammatory responses, and unresponsiveness to infection management may benefit from detailed immunologic evaluation. Rare hyperinflammatory conditions should be considered in the differential diagnosis of challenging postoperative wound healing scenarios.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 3","pages":"185-188"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new perspective on forefoot biomechanics: the dual arch structure of the metatarsal transverse arch and the trimaran effect.","authors":"Dilek Bayraktar, Ali Ozyalcin, Mehmet Halit Ozyalcin","doi":"10.5152/j.aott.2025.24033","DOIUrl":"10.5152/j.aott.2025.24033","url":null,"abstract":"<p><p>Objective: The structure and function of the Metatarsal Transverse Arch (MTA) remain underexplored. It was hypothesized that, during the push-off phase of gait, the MTA does not form a single arch between the first and fifth metatarsals; rather, it consists of 2 separate arches-one spanning the first to the third metatarsals and the other spanning the third to the fifth metatarsals-that function like the hulls of a trimaran boat. This study aims to investigate the biomechanical role of the MTA during this critical phase. Methods: Dynamic pedobarographic measurements were utilized from 1250 adults (847 females, 403 males). Maximum pressures on all metatarsal heads during the push-off phase were recorded, and MTA arches were calculated using the SAP2000 program. Statistical significance was set at P < .05. Results: The mean pressure on the third metatarsal was 160.0 (minimum: 9.0, maximum: 1799.0) for the left foot and 142.0 (minimum: 0.0, maximum: 1753.0) for the right foot. The maximum pressure in both feet occurred at the third metatarsal head (left: 67.0%, right: 54.6%). There was no statistically significant difference between genders regarding the maximum load on the metatarsal heads. Conclusion: This study reinterprets the biomechanical behavior of the forefoot and MTA during the push-off phase, potentially aiding in the understanding of forefoot pathologies. Future research on children and adolescents could further illuminate forefoot biomechanics. Level of Evidence: Level III.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 3","pages":"164-169"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and influencing factors in hand surgery subspecialty training: a nationwide survey of orthopedic, plastic, and hand surgery residents in Türkiye.","authors":"Muhammet Okkan, İbrahim Çaltıner, Anıl Tarık Saygılı, Gökçe Yıldıran, Melih Bağır","doi":"10.5152/j.aott.2025.24040","DOIUrl":"10.5152/j.aott.2025.24040","url":null,"abstract":"<p><p>Objective: This study aimed to identify the factors influencing the decisions of orthopedic and plastic surgery residents in Türkiye regarding their pursuit of a subspecialty in hand surgery, as well as to evaluate the challenges faced during hand surgery training. Methods: A national survey was conducted among residents in orthopedic and trauma surgery (n=92), plastic surgery (n=84), and hand surgery (n=12). The survey, developed from literature reviews and previous studies, was distributed online, and responses were collected via Google Forms. Orthopedic and plastic surgery residents responded using a 4-point Likert scale, while hand surgery residents answered multiple-choice questions. The collected data were analyzed to determine factors influencing career choices, training adequacy, and the challenges faced by residents. Results: The analysis revealed a negative correlation between the high volume of emergency hand surgery cases and residents' inclination toward the subspecialty (r=-0.217, P < .05). Theoretical training was significantly linked to enhanced hand surgery knowledge and skills (r=0.213, P < .05), whereas the lack of adequate training infrastructure negatively affected residents' experience (r=0.390, P < .05). Financial concerns and heavy workloads were identified as major challenges, with 33.3% of hand surgery subspecialty residents considering quitting their program. The study also highlighted a lack of continuity in training, insufficient exposure to elective hand surgery cases, and limited access to international educational opportunities. Conclusion: The findings indicate a need to enhance both the theoretical and practical aspects of hand surgery training in Türkiye. By addressing financial and workload-related concerns, improving clinical exposure, and expanding access to microsurgical tools and training resources, it may be possible to increase interest in the subspecialty and ensure a sustainable workforce of hand surgeons in the future. Level of Evidence: N/A.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 3","pages":"141-145"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between pain and activity participation, quality of life and depression symptoms in traumatic hand injuries.","authors":"Serkan Kablanoğlu, Selime Ilgın Sade","doi":"10.5152/j.aott.2025.24094","DOIUrl":"10.5152/j.aott.2025.24094","url":null,"abstract":"<p><p>Objective: This study aimed to investigate the relationship between post-traumatic pain levels in patients with hand-wrist injuries and symptoms of depression, activity participation, and quality of life. Methods: The study included 44 patients who presented to the Physical Therapy and Traumatic Hand Injury Outpatient Clinic with various diagnoses of traumatic hand injuries. Eligible patients had sustained traumatic hand injuries up to 10 cm proximal to the wrist, had no prior diagnosis of depression, and presented to the clinic for the first time between postoperative days 3 and 10. Pain severity was assessed using the Visual Analog Scale (VAS), activity participation was evaluated with the Quick Disability of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), health-related quality of life was measured with the European Quality of Life Five Dimension Five Level Scale (EQ-5D-3L), and depression symptoms were assessed using the Beck's Depression Inventory (BDI). Results: All patients included in the study had at least one injured structure. The majority of the patients were male and worked in blue-collar occupations. The depressive symptoms were classified as moderately severe (BDI score ≥ 17). Among the injured structures, tendon injuries were the most common, and post-traumatic injuries were the most frequently observed type. Visual Analog Scale scores were significantly higher in tendon-fracture and tendon-nerve injuries compared to tendon injuries alone (P=.038 and P < .001, respectively). Quick Disability of the Arm, Shoulder, and Hand Questionnaire scores were significantly higher in tendon-nerve injuries than in tendon injuries (P < .001). Beck's Depression Inventory scores were significantly higher in tendon-nerve injuries than in bone and tendon injuries (P=.006 and P < .001, respectively). European Quality of Life Five Dimension Five Level Scale index scores were significantly lower in tendon-nerve injuries compared to bone and tendon injuries (P=.002 and P < .001, respectively). Correlation analysis revealed that VAS, QuickDASH, and BDI scores were not correlated with age. However, there was a strong positive correlation between VAS and QuickDASH scores, VAS and BDI scores, and QuickDASH and BDI scores. Conclusion: The findings suggest that pain management and psychological support interventions should be integrated into the rehabilitation process for patients with traumatic hand injuries. Addressing both pain and depressive symptoms during recovery may help minimize their negative impact on quality of life and improve activity participation. Level of Evidence: Level IV, Prognostic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 3","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of general and spinal anesthesia on outcomes of direct anterior approach total hip arthroplasty: a prospective observational study.","authors":"Mustafa Alper Incesoy, Cemil Burak Demırkıran, Orkhan Aliyev, Anil Pulatkan, Aysegul Yabaci Tak, Serdar Yesıltas, Ibrahim Tuncay, Fatih Yıldız","doi":"10.5152/j.aott.2025.24091","DOIUrl":"10.5152/j.aott.2025.24091","url":null,"abstract":"<p><p>Objective: This study aimed to evaluate the impact of spinal anesthesia (SA) compared to general anesthesia (GA) on clinical outcomes in patients undergoing direct anterior approach total hip arthroplasty (DAA-THA) at a single institution. Methods: This prospective observational study was conducted at a single institution between 2014 and 2017. A total of 437 patients who underwent primary elective DAA-THA were included. Among them, 363 patients received SA, and 74 patients received GA. Demographic characteristics (age, sex), comorbidities, American Society of Anesthesiologists (ASA) scores, and preoperative hematocrit levels were recorded. The mean age was 59.4 years (range, 26-82 years), and 67.3% of the patients were female. The primary outcome measures included complication rates, estimated blood loss (EBL), changes in hematocrit, length of hospital stay (LOS), duration of surgery, acetabular and femoral component orientation, and stem subsidence. Results: No significant differences were found between the GA and SA groups regarding median EBL (0.9 L vs. 0.9 L, P=.675), hematocrit change (-8.12% vs. -7.70%, P=.727), mean duration of surgery (103 min vs. 105 min, P=.999), and LOS (3.5 days vs. 3.6 days, P=.462). Radiological outcomes, including femoral stem varus/valgus alignment (0.2° vs. 0.3°, P=.877), stem subsidence (0.9 mm vs. 1.0 mm, P=.111), and acetabular component abduction angles (42° vs. 43°, P=.475), were also comparable. The overall complication rates were 8% in the GA group and 5% in the SA group (P=.400). Conclusion: Both general and spinal anesthesia can be safely utilized in DAA-THA, providing comparable clinical and radiological outcomes. The choice of anesthesia did not significantly affect surgical time, blood loss, or complication rates. These findings are clinically relevant for optimizing anesthesia strategies in DAA-THA, offering flexibility for both surgeons and anesthesiologists without compromising patient outcomes. Level of Evidence: Level II, Therapeutic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 3","pages":"152-155"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}