Acta orthopaedica et traumatologica turcica最新文献

{"title":"From the Editor.","authors":"Haluk Berk","doi":"10.5152/j.aott.2025.250310","DOIUrl":"https://doi.org/10.5152/j.aott.2025.250310","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053603","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":"Knowledge and Awareness of Family Physicians as Key Stakeholders Regarding Developmental Dysplasia of the Hip and the Nationwide Screening Program.","authors":"Edip Şükrü Gönen, Memet Taşkın Egici, Emel Gönen","doi":"10.5152/j.aott.2025.24034","DOIUrl":"https://doi.org/10.5152/j.aott.2025.24034","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the knowledge levels and awareness of family physicians about Developmental Dysplasia of the Hip (DDH) and the Nationwide Newborn Hip Screening Program in Turkey.</p><p><strong>Methods: </strong>This observational, cross-sectional study was conducted between May and August 2021, involving 401 family physicians working at Family Health Centers (FHC) in Istanbul. A face-to-face survey, developed based on the literature and validated by experts, assessed participants' knowledge, awareness, and practices regarding DDH and the nationwide screening program. The survey consisted of two sections: a Participant Information Form (14 socio-demographic and professional questions) and 30 knowledge-based questions (8 using a Likert scale).</p><p><strong>Results: </strong>Among the 401 family physicians who participated in the study, 109 (27.2%) reported actively managing patients diagnosed with DDH. Over the past year, 20,124 babies were stated to be screened, with 2.98% identified as having pathological ultrasonography results. The overall knowledge and awareness score (for DDH, program details and practices) was 66.59 ± 8.4%, positively associated with following babies with DDH (p=0.042), attending congresses/symposiums (p=0.008), specialty training (p=0.022; r=0.156), receiving in-service training and online education on hip screening program (p=0.002; r=0.167), and screening a higher number of babies (p<0.001). 71.3% of participants recommended double diapering for babies with high risk factors, while 70.3% used provocative tests such as the Barlow-Ortolani. Knowledge awareness scores about the hip screening program were significantly higher in those who followed DDH patients (p<0.001), attended congress and symposiums (p=0.006), screened higher number of babies (r=0.216, p<0.001), had specialty training (p=0.005), female physicians (p=0.012), used multiple training resources (p=0.002), and considered themselves competent in DDH (p<0.001). Awareness of DDH risk factors and treatment remained relatively low (49.2% and 64.1%, respectively). Perception of self-competency scores were significantly higher in family medicine specialists (p=0.020), those with 10+ years of experience (p=0.003), and those managing DDH cases (p<0.001).</p><p><strong>Conclusion: </strong>Family physicians in Istanbul demonstrate adequate knowledge and awareness regarding DDH and the nationwide screening program, influenced by factors such as managing DDH cases, postgraduate training, access to educational resources, and participation in professional events. Female physicians have greater knowledge and awareness about the hip screening program. Higher perception of self-competency levels were observed in family medicine specialists, and those with over 10 years of experience or active involvement in DDH care. Addressing gaps in knowledge about risk factors, diagnostic methods, and treatments is critical. Targeted educ","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"59 1","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045856","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":"Efficacy of tranexamic acid in improving visual clarity and operative time of arthroscopic rotator cuff repair: A systematic review and meta-analysis.","authors":"Yushun Qian, Anqing Jiang, Jun Yan, Shouchun Zhang, Siqiang Zhu","doi":"10.5152/j.aott.2024.24008","DOIUrl":"10.5152/j.aott.2024.24008","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR).</p><p><strong>Methods: </strong>The databases of PubMed, Embase, Web of Science, CENTRAL, and Scopus were searched for all types of studies examining the e\"cacy of TXA for arthroscopic RCR. Twelve studies, 10 randomized controlled trials (RCTs), and 2 retrospective studies were considered eligible.</p><p><strong>Results: </strong>Meta-analysis of only 2 studies using a visual clarity grading system showed better visualization with the use of TXA. A similar di!erence was noted for studies using the visual analog scale. Operating time was not significantly di!erent between the groups, but subgroup analysis of RCTs demonstrated reduced operating time with TXA. Meta-analysis showed no di!erence in 24-hour pain scores between TXA and control groups. Qualitative assessment of studies for blood loss showed no significant e!ect of TXA. No major complications were reported in any of the studies.</p><p><strong>Conclusion: </strong>This study has pooled evidence suggesting that TXA can improve visual clarity in arthroscopic RCR and may also result in a reduction in operating time. TXA does not seem to reduce blood loss or 24-hour postoperative pain scores.</p><p><strong>Level of evidence: </strong>Level II, Therapeutic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"318-325"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054670","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":"Erratum.","authors":"","doi":"10.5152/j.aott.2024.243012","DOIUrl":"10.5152/j.aott.2024.243012","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"358"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054671","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":"Simultaneous total hip and knee arthroplasties in hemophilic arthropathy: series of 5 cases.","authors":"Özgür Mert Bakan, Arman Vahabi, Elcil Kaya Biçer, Fahri Şahin, Kaan Kavaklı, Semih Aydoğdu","doi":"10.5152/j.aott.2024.24044","DOIUrl":"10.5152/j.aott.2024.24044","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare preoperative and postoperative measures in haemophiliacs who had simultaneous total hip and knee arthroplasties.</p><p><strong>Methods: </strong>A retrospective database search identified five patients with severe factor 8 deficiencies who underwent simultaneous hip and knee joint replacement surgery between 2002-2018. Preoperative and postoperative evaluations included Harris Hip Score (HHS), Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, flexion contracture (FC), Visual Analog Scale (VAS), hip-knee angle, and leg length discrepancy.</p><p><strong>Results: </strong>The mean age of the patients was 50.8 years, with a mean follow-up duration of 60 months. Preoperative knee ROM was 55 degrees, improving to 73.8 degrees postoperatively. Preoperative knee FC was 13.7 degrees, improving to 10 degrees postoperatively. HHS increased from 45.6 to 75.7, KSS increased from 36 to 69.3, and KOOS total score increased from 34.4 to 82.7. VAS scores decreased from 6.3 to 1.3. One patient experienced prolonged bleeding and subsequent complications, while the others showed significant improvements.</p><p><strong>Conclusion: </strong>Simultaneous hip and knee arthroplasties in hemophiliacs may provide benefits in terms of physical and functional gains. However, the increased risk of complications necessitates careful patient selection. For patients with comorbidities, staged surgeries may be advisable to avoid potential complications.</p><p><strong>Level of evidence: </strong>Level IV, Therapeutic study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"336-340"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061734","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":"Intervertebral disc regeneration - Is it possible?","authors":"Dragos Schiopu, Arnaud Devriendt, Clara Van Vyve, Tamas S Illes","doi":"10.5152/j.aott.2024.24034","DOIUrl":"10.5152/j.aott.2024.24034","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate disc metabolism after decreasing the axial load through surgery by assessing the glycosaminoglycan content through a non-invasive method-delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC).</p><p><strong>Methods: </strong>Sixteen patients with mono-segmental disc degeneration (L4-L5 or L5-S1) who underwent posterior lumbar spine fixation with intervertebral distraction of 2 consecutive vertebrae using monoaxial transpedicular screws and lyophilized allograft to achieve segmental fusion, and who had a follow-up period of at least 2 years, were included in this study. The first lumbar disc was used as the control group. The dGEMRIC studies in degenerative and control discs, visual analogue scale (VAS), Oswestry disability index (ODI), lumbar lordosis, and disc thickness were reviewed before and after surgery.</p><p><strong>Results: </strong>Visual analogue scale and ODI showed significant improvements (P=.003, P=.0004, respectively). The thickness of the operated discs was increased by an average of 2.41 mm (P=.0004) while maintaining lumbar lordosis (P=.35). In pre- and post-surgery dGEMRIC studies, the operated discs showed a significant di!erence (P=.0013), while the control groups remained approximately unchanged (P=.87).</p><p><strong>Conclusion: </strong>We have demonstrated that by restoring the disc height and reducing the associated pressure, the glycosaminoglycan content can be increased in the discs, as indicated by a decrease in gadolinium binding. Our results suggest that eliminating pressure on intervertebral discs can prevent their degeneration and initiate the regeneration process.</p><p><strong>Level of evidence: </strong>Level IV, Therapeutic study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"346-357"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061731","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":"Biomechanical comparison of locking femoral neck plate versus cannulated screws with or without a medial buttress plate in Pauwels type 3 femoral neck fractures.","authors":"Yilmaz Onder, Tugrul Bulut, Osman Nuri Eroglu, Samet Ciklacandir, Yalcin Isler","doi":"10.5152/j.aott.2024.24076","DOIUrl":"10.5152/j.aott.2024.24076","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate whether the locking femoral neck plate (LFNP) can be an alternative fixation method to the cannulated screws with a medial buttress plate. For this purpose, we compared biomechanically the LFNP and cannulated screws with or without a medial buttress plate in Pauwels type 3 femoral neck fractures.</p><p><strong>Methods: </strong>A vertical fracture model was created at an 80-degree angle to the femoral neck in 28 synthetic bone models. The models were randomly divided into 4 groups, each containing 7 bones each. The bone fracture models were fixed with 3 parallel cannulated screws in group 1, 3 parallel cannulated screws combined with a medial buttress plate in group 2, LFNP in group 3, LFNP combined with a medial buttress plate in group 4. The stability of the specimens was tested biomechanically at a 7° valgus inclination to simulate normal 2-legged weight-bearing through an anatomical femur. The forces corresponding to 0.5 mm, 1 mm, 1.5 mm, and 2 mm displacement and failure loads were calculated in all groups.</p><p><strong>Results: </strong>The axial load values corresponding to 4 di!erent fracture displacements and the failure load values of the groups were compared, group 1 was significantly weaker (P < .05 for each) while group 4 was significantly stronger (P < .05 for each) compared to the other groups. There was no statistically significant di!erence between group 2 and group 3 (P > .05 for each).</p><p><strong>Conclusion: </strong>The results of this biomechanical study showed that the LFNP fixation system provided su\"cient biomechanical stability for unstable Pauwels type 3 femoral neck fractures. The biomechanical performance of LFNP was similar to that of cannulated screws with medial buttress plate and better than that of cannulated screws alone. This suggests that LFNP can be a promising stable alternative fixation method to cannulated screws with a medial buttress plate in unstable femoral neck fractures.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"313-317"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054669","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 effect of arthroscopic Bankart repair and remplissage procedure on joint range of motion and functional outcomes in anterior shoulder instability.","authors":"Umut Öktem, Gülfem Ezgi Özaltın, Sinan Yılmaz, İbrahim Bozkurt, Durmuş Ali Öçgüder","doi":"10.5152/j.aott.2024.23203","DOIUrl":"10.5152/j.aott.2024.23203","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the e!ect of arthroscopic Bankart repair (ABR) alone and ABR with an additional remplissage procedure on joint range of motion and functional results in patients with anterior shoulder instability.</p><p><strong>Methods: </strong>This retrospective study included patients treated 1 year ago with either ABR alone or the ABR additional remplissage procedure. The Bankart lesion was determined by magnetic resonance imaging, and the amount of glenoid bone loss was determined by computed tomography. Patients with glenoid bone loss <25% and on-track Hill-Sachs lesions (HSLs) were treated with ABR alone (22 females, 8 males; mean age=27.4 ± 6.4 years). Those with o!-track HSL were treated with both ABR and remplissage (20 females, 10 males; mean age=27.5 ± 5.3 years). One year after surgical treatment, the joint range of motion of the patients was determined by a universal goniometer, and functional status was evaluated using the Rowe score.</p><p><strong>Results: </strong>Sixty shoulders of 60 patients were evaluated over an average period of 1 year. There was no di!erence between groups regarding age (P=.767) and gender (P=.779). There were 42 female and 18 male patients, with a mean age=27.5 ± 5.8 years. There was a significant di!erence between the groups in patients' external rotation with arm adduction (ER1) (P=.001), external rotation with arm abduction (ER2) (P=.001), forward flexion (P=.001), and abduction (P=.001) measurements between the groups (P < .05). No significant di!erence was found in internal rotation and Rowe scores between the groups (P=.057, P=.069). A greater improvement was seen in the Rowe score of the ABR+remplissage group (85.2 ± 8.8). No recurrence or complications were observed in any of the patients.</p><p><strong>Conclusion: </strong>The combined procedure of ABR with remplissage may limit joint mobility in patients with anterior shoulder instability. However, it provides satisfactory functional results, with patients in the ABR+remplissage group showing better overall outcomes.</p><p><strong>Level of evidence: </strong>Level III, Therapeutic study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054673","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":"Knee phenotypes distribution according to CPAK classification in Turkish population.","authors":"Vahit Emre Özden, Göksel Dikmen, Kayahan Karaytuğ, Arda Mavi, Yılmaz Onat Köylüoğlu, İsmail Remzi Tözün","doi":"10.5152/j.aott.2024.24053","DOIUrl":"10.5152/j.aott.2024.24053","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the distribution of knee phenotypes based on the CPAK classification in healthy nonarthritic subjects and osteoarthritic patients in Türkiye.</p><p><strong>Methods: </strong>Radiological EOS analysis of nonarthritic 1172 knees and osteoarthritic 571 knees was evaluated to clarify the distribution of CPAK classification. The knees were categorized into 9 subgroups according to the arithmetic hip-knee-ankle (aHKA) angle and joint-line obliquity (JLO). The medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA) were used to calculate aHKA and JLO. The Sectra workstation program was used for all radiological measurements.</p><p><strong>Results: </strong>In the nonarthritic group, CPAK distribution was 20.9% type I (n=245), 2.5% type II (n=30), 0.08% type III (n=1), 46.67% type IV (n=545), 7.7% type V (n=91), 0.7% type VI (n=9), 18% type VII (n=211), 2.9% type VIII (n=35), 0.2% type IX (n=3). The mean JLO was 173.7 ± 4.38, and the mean aHKA was 0.15 ± 3.81 in nonarthritic group. Arthritic group CPAK type distribution was 20.7% type I (n=118), 3.1% type II (n=18), 0.17% type III (n=1), 57.1% type IV (n=326), 8.4% type V (n=48), 0.17% type VI (n=1), 7.8% type VII (n=45), 1.4% type VIII (n=8), and 0.8% type IX (n=5). The mean JLO was 174.2 ± 3.78, and the mean aHKA was !2.21 ± 4.48 in the osteoarthritic group.</p><p><strong>Conclusion: </strong>CPAK type IV and CPAK type I were the most common subgroups in the nonarthritic and arthritic groups. CPAK type 5, which is the target of the mechanical alignment strategy, is only 7.8% in the nonarthritic group and 8.4% in the osteoarthritic group in the Turkish population.</p><p><strong>Level of evidence: </strong>Level III, Diagnostic Study.</p>","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"341-345"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061732","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":"From the Editor.","authors":"Haluk Berk","doi":"10.5152/j.aott.2024.243112","DOIUrl":"10.5152/j.aott.2024.243112","url":null,"abstract":"","PeriodicalId":93854,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":"58 6","pages":"312"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054672","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}