I. Canbeyli, M. Kabalcı, Meriç Çırpar, M. Tiryaki, B. Oktaş
OBJECTIVES This study aims to evaluate the effects of mesenchymal stem cell (MSC) implantation on vascular graft infections caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and compare with antibiotic treatment. MATERIALS AND METHODS Healthy adult 56 Wistar rats (age, over 5 months; weighing, 300-350 g) were divided into eight groups. Group 1 was defined as the control group and group 2 was defined as the infected control group. Groups 3 and 4 were defined as Dacron grafted and MRSE infected groups, treated with tigecycline and MSCs, respectively. Groups 5 and 6 were performed polytetrafluoroethylene (PTFE) graft and infected with MRSE. These groups were also administered tigecycline and MSC treatment, respectively. Groups 7 and 8 were infected with MRSE without graft administration and were also performed tigecycline and MSC treatment, respectively. Grafts and soft tissue specimens were collected at 13 days postoperatively. Colony counts of peri-graft tissue were performed. All samples were evaluated by enzyme-linked immunosorbent assay (ELISA) for the markers that determine stem cell activity. RESULTS The overall success of the treatments was assessed by the number of rats with MRSE recurrence, regardless of graft used. The difference between the untreated group 2, tigecycline groups (3, 5 and 7) and MSCs groups (4, 6 and 8) were statistically significant. Success of MSC and tigecycline treatments was similar in Dacron, PTFE, and non-grafted groups. There was a resistance of MRSE infection in Dacron groups to MSC and tigecycline treatments. This was considered to be indicative of the susceptibility of the Dacron grafts to infection. However, there was no significant difference between group 2 and Dacron groups in terms of bacterial colonization. ELISA results were significant in three cytokines. CONCLUSION Mesenchymal stem cells can be considered as an alternative treatment option on its own or part of a combination therapy for control of vascular graft infections.
{"title":"Mesenchymal stem cells have significant anti-infective effect on methicillin-resistant Staphylococcus epidermidis vascular graft infections.","authors":"I. Canbeyli, M. Kabalcı, Meriç Çırpar, M. Tiryaki, B. Oktaş","doi":"10.5606/ehc.2019.66162","DOIUrl":"https://doi.org/10.5606/ehc.2019.66162","url":null,"abstract":"OBJECTIVES\u0000This study aims to evaluate the effects of mesenchymal stem cell (MSC) implantation on vascular graft infections caused by methicillin-resistant Staphylococcus epidermidis (MRSE) and compare with antibiotic treatment.\u0000\u0000\u0000MATERIALS AND METHODS\u0000Healthy adult 56 Wistar rats (age, over 5 months; weighing, 300-350 g) were divided into eight groups. Group 1 was defined as the control group and group 2 was defined as the infected control group. Groups 3 and 4 were defined as Dacron grafted and MRSE infected groups, treated with tigecycline and MSCs, respectively. Groups 5 and 6 were performed polytetrafluoroethylene (PTFE) graft and infected with MRSE. These groups were also administered tigecycline and MSC treatment, respectively. Groups 7 and 8 were infected with MRSE without graft administration and were also performed tigecycline and MSC treatment, respectively. Grafts and soft tissue specimens were collected at 13 days postoperatively. Colony counts of peri-graft tissue were performed. All samples were evaluated by enzyme-linked immunosorbent assay (ELISA) for the markers that determine stem cell activity.\u0000\u0000\u0000RESULTS\u0000The overall success of the treatments was assessed by the number of rats with MRSE recurrence, regardless of graft used. The difference between the untreated group 2, tigecycline groups (3, 5 and 7) and MSCs groups (4, 6 and 8) were statistically significant. Success of MSC and tigecycline treatments was similar in Dacron, PTFE, and non-grafted groups. There was a resistance of MRSE infection in Dacron groups to MSC and tigecycline treatments. This was considered to be indicative of the susceptibility of the Dacron grafts to infection. However, there was no significant difference between group 2 and Dacron groups in terms of bacterial colonization. ELISA results were significant in three cytokines.\u0000\u0000\u0000CONCLUSION\u0000Mesenchymal stem cells can be considered as an alternative treatment option on its own or part of a combination therapy for control of vascular graft infections.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"9 3 1","pages":"201-11"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78411877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVES This study aims to define the first web space length (FWSL) as a new radiologic parameter, which may reflect patients' subjective satisfaction and be associated with American Orthopedic Foot and Ankle Society (AOFAS) score as an objective parameter. PATIENTS AND METHODS One hundred and fourteen patients (11 males, 103 females; mean age 43.4±13.2 years; range, 18 to 70 years) who underwent distal osteotomy between April 2010 and January 2018 were retrospectively reviewed. Patients were radiographically evaluated with pre- and postoperative standing foot anteroposterior and lateral X-rays. Hallux valgus angles (HVAs), intermetatarsal angle (IMA), and FWSL were measured. AOFAS scores were used for clinical evaluation. Satisfaction scores were obtained using a visual analog scale at the final follow-up. RESULTS The relationship between postoperative AOFAS score changes and postoperative HVA changes was statistically significant (p=0.001, p<0.1). The relationship between postoperative AOFAS values and postoperative FWSL changes was statistically significant (p<0.001, p<0.1). No statistically significant relationship was detected between postoperative AOFAS values and IMA changes (p=0.101, p>0.05). The relationship between AOFAS scores and satisfaction scale was statistically significant (r=0.695; p<0.001, p<0.01). The relationship between the satisfaction scale and FWSL was statistically significant (p=0.005, p<0.01). CONCLUSION The FWSL has an influence on patient satisfaction. It is correlated both with AOFAS scores and satisfaction scale. It can be used as a measurable parameter to detect patient satisfaction.
目的本研究旨在将第一网腔长度(FWSL)定义为一个新的放射学参数，该参数可以反映患者的主观满意度，并与美国骨科足踝学会(AOFAS)评分作为客观参数相关联。患者与方法114例患者(男性11例，女性103例;平均年龄43.4±13.2岁;对2010年4月至2018年1月期间接受远端截骨术的患者进行回顾性分析。通过术前和术后站立足正位和侧位x线对患者进行影像学评估。测量拇外翻角(HVAs)、跖间角(IMA)和FWSL。采用AOFAS评分进行临床评价。在最后的随访中使用视觉模拟量表获得满意度评分。结果术后AOFAS评分变化与术后HVA变化的关系有统计学意义(p=0.001, p0.05)。AOFAS评分与满意度量表的关系有统计学意义(r=0.695;p < 0.001, p < 0.01)。满意度量表与FWSL的关系有统计学意义(p=0.005, p<0.01)。结论FWSL对患者满意度有影响。它与AOFAS分数和满意度量表均有相关性。它可以作为检测患者满意度的可测量参数。
{"title":"Can radiology reflect patient satisfaction after hallux valgus surgery?","authors":"E. Baca, Ergin Tuy, K. M. Çelen","doi":"10.5606/ehc.2019.66568","DOIUrl":"https://doi.org/10.5606/ehc.2019.66568","url":null,"abstract":"OBJECTIVES\u0000This study aims to define the first web space length (FWSL) as a new radiologic parameter, which may reflect patients' subjective satisfaction and be associated with American Orthopedic Foot and Ankle Society (AOFAS) score as an objective parameter.\u0000\u0000\u0000PATIENTS AND METHODS\u0000One hundred and fourteen patients (11 males, 103 females; mean age 43.4±13.2 years; range, 18 to 70 years) who underwent distal osteotomy between April 2010 and January 2018 were retrospectively reviewed. Patients were radiographically evaluated with pre- and postoperative standing foot anteroposterior and lateral X-rays. Hallux valgus angles (HVAs), intermetatarsal angle (IMA), and FWSL were measured. AOFAS scores were used for clinical evaluation. Satisfaction scores were obtained using a visual analog scale at the final follow-up.\u0000\u0000\u0000RESULTS\u0000The relationship between postoperative AOFAS score changes and postoperative HVA changes was statistically significant (p=0.001, p<0.1). The relationship between postoperative AOFAS values and postoperative FWSL changes was statistically significant (p<0.001, p<0.1). No statistically significant relationship was detected between postoperative AOFAS values and IMA changes (p=0.101, p>0.05). The relationship between AOFAS scores and satisfaction scale was statistically significant (r=0.695; p<0.001, p<0.01). The relationship between the satisfaction scale and FWSL was statistically significant (p=0.005, p<0.01).\u0000\u0000\u0000CONCLUSION\u0000The FWSL has an influence on patient satisfaction. It is correlated both with AOFAS scores and satisfaction scale. It can be used as a measurable parameter to detect patient satisfaction.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"21 1","pages":"241-5"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79158594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brucellosis is a zoonosis seen all over the world and is still endemic in certain parts of the world. Brucellosis is a systemic infection which involves multiple organs and tissues. Although musculoskeletal system involvement is frequent in brucellosis, bursal involvement is seen rarely. In this article, we present a case of subacromial and subdeltoid brucellar bursitis with positive serology and aspiration culture. Patient achieved complete recovery with rifampicin and doxycycline treatment, without any evidence of relapse. A high clinical suspicion is required for the diagnosis of brucellar bursitis.
{"title":"Rare form of brucellosis, subacromial and subdeltoid bursitis: A case report and literature review.","authors":"Bilgehan Çatal","doi":"10.5606/ehc.2019.70215","DOIUrl":"https://doi.org/10.5606/ehc.2019.70215","url":null,"abstract":"Brucellosis is a zoonosis seen all over the world and is still endemic in certain parts of the world. Brucellosis is a systemic infection which involves multiple organs and tissues. Although musculoskeletal system involvement is frequent in brucellosis, bursal involvement is seen rarely. In this article, we present a case of subacromial and subdeltoid brucellar bursitis with positive serology and aspiration culture. Patient achieved complete recovery with rifampicin and doxycycline treatment, without any evidence of relapse. A high clinical suspicion is required for the diagnosis of brucellar bursitis.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"67 1","pages":"333-7"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81079630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The orthopedic literature is abundant in studies on use of tranexamic acid (TXA); most showing its effectiveness in reducing blood loss and transfusion requirement leading to better outcome, shorter length of hospital stay and reduced costs.[1,2] History of TXA dates back to 1960s and TXA is a relatively cheap agent. However, being old and cheap have not restrained TXA to revolutionize the perioperative blood management in the last decade of orthopedic practice, particularly in arthroplasty procedures which make up for a big portion of elective surgeries.[3-5] However, despite the great interest in and the enthusiasm surrounding this agent, its pharmacokinetic characteristics, dosing and optimal modality of administration for different clinical scenarios still remain largely unknown. Tranexamic acid is a fibrin clot stabilizer and not actually a pro-coagulant agent, but it is still commonly associated with increased risk of venous thromboembolic events (VTEs) (e.g. stroke, deep venous thromboembolism, pulmonary embolism), myocardial infarction and to a lesser extent, retinal injury, seizures and nausea. Although this increased risk profile has not been demonstrated, neither it has been totally ruled out in arthroplasty procedures. Considering that even the meta-analyses including data from highest quality randomized controlled trials struggle to provide concrete evidence on safety of TXA use and, for prospective studies, there is need for at least 5,000 patients in each group even to detect a 1% difference with an 80% power, TXA’s widespread adoption seems to continue lacking strong scientific background.[6,7] It has also not been approved by the U.S. Food and Drug Administration for uses other than dental bleeding prophylaxis in hemophilic patients and menorrhagia.[8,9]
{"title":"Are we scientifically ready to adopt tranexamic acid as a routine in arthroplasty?","authors":"E. A. Sezgin, O. Atik","doi":"10.5606/ehc.2019.19003","DOIUrl":"https://doi.org/10.5606/ehc.2019.19003","url":null,"abstract":"The orthopedic literature is abundant in studies on use of tranexamic acid (TXA); most showing its effectiveness in reducing blood loss and transfusion requirement leading to better outcome, shorter length of hospital stay and reduced costs.[1,2] History of TXA dates back to 1960s and TXA is a relatively cheap agent. However, being old and cheap have not restrained TXA to revolutionize the perioperative blood management in the last decade of orthopedic practice, particularly in arthroplasty procedures which make up for a big portion of elective surgeries.[3-5] However, despite the great interest in and the enthusiasm surrounding this agent, its pharmacokinetic characteristics, dosing and optimal modality of administration for different clinical scenarios still remain largely unknown. Tranexamic acid is a fibrin clot stabilizer and not actually a pro-coagulant agent, but it is still commonly associated with increased risk of venous thromboembolic events (VTEs) (e.g. stroke, deep venous thromboembolism, pulmonary embolism), myocardial infarction and to a lesser extent, retinal injury, seizures and nausea. Although this increased risk profile has not been demonstrated, neither it has been totally ruled out in arthroplasty procedures. Considering that even the meta-analyses including data from highest quality randomized controlled trials struggle to provide concrete evidence on safety of TXA use and, for prospective studies, there is need for at least 5,000 patients in each group even to detect a 1% difference with an 80% power, TXA’s widespread adoption seems to continue lacking strong scientific background.[6,7] It has also not been approved by the U.S. Food and Drug Administration for uses other than dental bleeding prophylaxis in hemophilic patients and menorrhagia.[8,9]","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"3 1","pages":"338-9"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83159393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Durusoy, A. Paksoy, M. Korkmaz, A. Solak, B. Daglar
OBJECTIVES This study aims to investigate if pelvic mapping is applicable in iliosacral screw fixation to determine screw entry point and screw trajectory. PATIENTS AND METHODS Clinical files and images of 16 patients (10 males, 6 females; mean age 35 years; range, 20 to 57 years) who underwent iliosacral screw fixation due to sacroiliac joint injury and sacrum fracture were retrospectively reviewed. Pelvic mapping was performed using preoperative tomography images of the patients and appropriate screw entry point and trajectory were determined. Postoperative computed tomography scans of all patients were obtained and these were used to evaluate the accuracy of the screw position. RESULTS No intraoperative complications occurred. The entry points and trajectory of the screws were compatible for all patients pre- and postoperatively. CONCLUSION Mapping of the pelvis is a method that can be used for preoperative planning of iliosacral screwing.
{"title":"Is pelvic mapping applicable in iliosacral screw fixation to determine screw entry point and screw trajectory?","authors":"S. Durusoy, A. Paksoy, M. Korkmaz, A. Solak, B. Daglar","doi":"10.5606/ehc.2019.66489","DOIUrl":"https://doi.org/10.5606/ehc.2019.66489","url":null,"abstract":"OBJECTIVES\u0000This study aims to investigate if pelvic mapping is applicable in iliosacral screw fixation to determine screw entry point and screw trajectory.\u0000\u0000\u0000PATIENTS AND METHODS\u0000Clinical files and images of 16 patients (10 males, 6 females; mean age 35 years; range, 20 to 57 years) who underwent iliosacral screw fixation due to sacroiliac joint injury and sacrum fracture were retrospectively reviewed. Pelvic mapping was performed using preoperative tomography images of the patients and appropriate screw entry point and trajectory were determined. Postoperative computed tomography scans of all patients were obtained and these were used to evaluate the accuracy of the screw position.\u0000\u0000\u0000RESULTS\u0000No intraoperative complications occurred. The entry points and trajectory of the screws were compatible for all patients pre- and postoperatively.\u0000\u0000\u0000CONCLUSION\u0000Mapping of the pelvis is a method that can be used for preoperative planning of iliosacral screwing.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"4 1","pages":"252-8"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89753020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brachial plexus injury due to prolonged immobilization of the arms in a hyper-abducted position during intensive care unit (ICU) follow-up is uncommon. In this article, we present an unusual case of a 20-year-old male drug addict who sustained unattended brachial plexus injury in left upper extremity after being bound over the axilla tightly during ICU follow-up. He had progressive numbness and near-total immobility of the left upper extremity. Atrophy, loss of muscle strength, and absence of deep tendon reflexes were observed in left upper extremity. Electrodiagnostic studies showed lower trunk partial axonal involvement. After aggressive physical therapy, patient's muscle function improved, showing full strength in all muscles innervated by median, ulnar, musculocutaneous, axillary and radial nerves. During follow-up of unconscious patients in ICU, clinicians and other staff should be more careful about restraining such patients by considering complications such as nerve injuries.
{"title":"Brachial plexus injury: An unusual devastating complication during hospitalization in intensive care unit.","authors":"Y. Erdem, Çağrı Neyişci, A. Bilekli","doi":"10.5606/ehc.2019.66707","DOIUrl":"https://doi.org/10.5606/ehc.2019.66707","url":null,"abstract":"Brachial plexus injury due to prolonged immobilization of the arms in a hyper-abducted position during intensive care unit (ICU) follow-up is uncommon. In this article, we present an unusual case of a 20-year-old male drug addict who sustained unattended brachial plexus injury in left upper extremity after being bound over the axilla tightly during ICU follow-up. He had progressive numbness and near-total immobility of the left upper extremity. Atrophy, loss of muscle strength, and absence of deep tendon reflexes were observed in left upper extremity. Electrodiagnostic studies showed lower trunk partial axonal involvement. After aggressive physical therapy, patient's muscle function improved, showing full strength in all muscles innervated by median, ulnar, musculocutaneous, axillary and radial nerves. During follow-up of unconscious patients in ICU, clinicians and other staff should be more careful about restraining such patients by considering complications such as nerve injuries.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"12 1","pages":"329-32"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84693687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Öztürk, I. B. Atalay, A. Yapar, Galip Beltir, Sefik M Arıkan, B. Ş. Güngör
OBJECTIVES This study aims to define the demographic and clinical findings of patients with talus localized osteochondroma, to present treatment management and mid-term results. PATIENTS AND METHODS The study included 10 patients (4 males, 6 females; mean age 31.9+19.5 years; range, 11 to 70 years) with osteochondroma of the talus who were admitted to our center between January 2008 and December 2015. Clinical findings, treatment methods, and clinical outcomes were retrospectively evaluated. All patients were followed-up for at least two years. RESULTS The most frequent localization was anterior of the talus (70%, n=7). The mean tumor size was 2.4±1.4 cm (range, 1-5 cm). When the relationship between tumor diameter and age was analyzed, no statistically significant correlation was detected (p=0.973). Besides, no statistically significant difference was found between the genders in terms of tumor diameters (p=0.584). The most common symptoms were pain, swelling, and restricted movements. The mean duration of postoperative follow-up was 48.1±27.7 months (range, 24-114 months). All patients underwent complete surgical excision. None of the patients developed recurrence or complication related to the treatment of osteochondroma. CONCLUSION Talus localized osteochondromas are often symptomatic and more common in adults. Also, they are more common in females. The ideal treatment approach is resection of the tumor. When rigorous surgical excision is performed, recurrence rates are low with satisfactory outcomes.
{"title":"Talus localized osteochondromas: Treatment management and mid-term outcomes - Case series.","authors":"R. Öztürk, I. B. Atalay, A. Yapar, Galip Beltir, Sefik M Arıkan, B. Ş. Güngör","doi":"10.5606/ehc.2019.66769","DOIUrl":"https://doi.org/10.5606/ehc.2019.66769","url":null,"abstract":"OBJECTIVES\u0000This study aims to define the demographic and clinical findings of patients with talus localized osteochondroma, to present treatment management and mid-term results.\u0000\u0000\u0000PATIENTS AND METHODS\u0000The study included 10 patients (4 males, 6 females; mean age 31.9+19.5 years; range, 11 to 70 years) with osteochondroma of the talus who were admitted to our center between January 2008 and December 2015. Clinical findings, treatment methods, and clinical outcomes were retrospectively evaluated. All patients were followed-up for at least two years.\u0000\u0000\u0000RESULTS\u0000The most frequent localization was anterior of the talus (70%, n=7). The mean tumor size was 2.4±1.4 cm (range, 1-5 cm). When the relationship between tumor diameter and age was analyzed, no statistically significant correlation was detected (p=0.973). Besides, no statistically significant difference was found between the genders in terms of tumor diameters (p=0.584). The most common symptoms were pain, swelling, and restricted movements. The mean duration of postoperative follow-up was 48.1±27.7 months (range, 24-114 months). All patients underwent complete surgical excision. None of the patients developed recurrence or complication related to the treatment of osteochondroma.\u0000\u0000\u0000CONCLUSION\u0000Talus localized osteochondromas are often symptomatic and more common in adults. Also, they are more common in females. The ideal treatment approach is resection of the tumor. When rigorous surgical excision is performed, recurrence rates are low with satisfactory outcomes.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"71 1","pages":"309-15"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90959503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patellar instability in skeletally immature patients must be approached with concern of potential damage to physes. In this article, we present a case of combined knee deformity consisting of genu recurvatum, genu valgum and patella baja which arose subsequent to a pediatric tibial tubercle ventromedialization. Patient was a female who was 22 years old upon first admission. After confirming cartilage to be in good health, the deformity was corrected with a single supratubercular posteriorly and medially based proximal tibial closing wedge osteotomy. At the seventh year follow-up, patient was pain free, functionally satisfied and radiographic evaluation showed correct alignment. This case illustrates the consequent difficulties faced if physeal damage occurs during treatment of patellar instability as well as effectiveness of a single well-planned supratubercular proximal tibial osteotomy treating combined genu recurvatum, genu valgum and patella baja deformities; although anatomic and clinical studies are required to generalize its use.
{"title":"Treatment of a combined deformity following tibial tubercle ventromedialization with single proximal tibial closing wedge osteotomy.","authors":"E. A. Sezgin, I. Szerb, Z. Tóth, L. Hangody","doi":"10.5606/ehc.2019.19002","DOIUrl":"https://doi.org/10.5606/ehc.2019.19002","url":null,"abstract":"Patellar instability in skeletally immature patients must be approached with concern of potential damage to physes. In this article, we present a case of combined knee deformity consisting of genu recurvatum, genu valgum and patella baja which arose subsequent to a pediatric tibial tubercle ventromedialization. Patient was a female who was 22 years old upon first admission. After confirming cartilage to be in good health, the deformity was corrected with a single supratubercular posteriorly and medially based proximal tibial closing wedge osteotomy. At the seventh year follow-up, patient was pain free, functionally satisfied and radiographic evaluation showed correct alignment. This case illustrates the consequent difficulties faced if physeal damage occurs during treatment of patellar instability as well as effectiveness of a single well-planned supratubercular proximal tibial osteotomy treating combined genu recurvatum, genu valgum and patella baja deformities; although anatomic and clinical studies are required to generalize its use.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"55 1","pages":"316-21"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89141288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Karaman, A. Günay, S. Doğan, I. Kafadar, Z. Karaman
OBJECTIVES This study aims to assess the effects of the hematopoietic stem cells and endothelial progenitor cells in peripheral blood and monocyte cluster of differentiation (CD) 34, CD133 and CD309 expression levels on maturation at the repair site in patients who underwent forearm arterial repair. PATIENTS AND METHODS This prospective study included 30 patients (23 males, 7 females; mean age 28.9±1.8 years; range, 18 to 49 years) with a well-defined cut at the wrist due to a stabbing injury but no comorbid condition who presented to the emergency department of our hospital between November 2014 and November 2017. Vascular patency was assessed by Doppler sonography in patients who underwent forearm arterial repair via micro-vascular techniques. The relationships between patency and hematopoietic stem and endothelial progenitor cell markers such as CD34, CD133 and CD309 were assessed by flow cytometry. RESULTS The patients were divided into two groups according to presence of sufficient flow in the arteries repaired. The mean CD34 expression level was 72.09±3.00 in the group with maturation whereas it was 54.64±7.34 in the group without maturation, indicating a statistically significant difference (p<0.05). In addition, the likelihood of sufficient flow was increased by 1.075 per one unit increase in CD34 level. Resistive index values were significantly lower in the group with maturation and CD34 level was predictive for maturation of arterial repair. CONCLUSION In the present study, the findings demonstrated that high CD34 expression level has favorable effects on maturation after arterial repair.
{"title":"Is there an association of hematopoietic stem cell and endothelial progenitor cell markers with maturation in forearm arterial repair?","authors":"I. Karaman, A. Günay, S. Doğan, I. Kafadar, Z. Karaman","doi":"10.5606/ehc.2019.65584","DOIUrl":"https://doi.org/10.5606/ehc.2019.65584","url":null,"abstract":"OBJECTIVES This study aims to assess the effects of the hematopoietic stem cells and endothelial progenitor cells in peripheral blood and monocyte cluster of differentiation (CD) 34, CD133 and CD309 expression levels on maturation at the repair site in patients who underwent forearm arterial repair. PATIENTS AND METHODS This prospective study included 30 patients (23 males, 7 females; mean age 28.9±1.8 years; range, 18 to 49 years) with a well-defined cut at the wrist due to a stabbing injury but no comorbid condition who presented to the emergency department of our hospital between November 2014 and November 2017. Vascular patency was assessed by Doppler sonography in patients who underwent forearm arterial repair via micro-vascular techniques. The relationships between patency and hematopoietic stem and endothelial progenitor cell markers such as CD34, CD133 and CD309 were assessed by flow cytometry. RESULTS The patients were divided into two groups according to presence of sufficient flow in the arteries repaired. The mean CD34 expression level was 72.09±3.00 in the group with maturation whereas it was 54.64±7.34 in the group without maturation, indicating a statistically significant difference (p<0.05). In addition, the likelihood of sufficient flow was increased by 1.075 per one unit increase in CD34 level. Resistive index values were significantly lower in the group with maturation and CD34 level was predictive for maturation of arterial repair. CONCLUSION In the present study, the findings demonstrated that high CD34 expression level has favorable effects on maturation after arterial repair.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"65 1","pages":"289-95"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85798216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVES This study aims to evaluate the effects of locally applied icariin on bone fracture healing in femur fractured rat model. MATERIALS AND METHODS The study included 64 male Sprague-Dawley rats (mean age 6 months; weighing, 280-490 g) in eight main study groups. Fracture healing process and level were evaluated with radiography, histopathology and dual energy X-ray absorptiometry to investigate the effects of local administration of icariin at varying doses, which is an exogenous osteo-inductive substance. Activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) were measured in the peripheral blood in addition to glutathione (GSH) and myeloperoxidase (MPO) levels to investigate the effects of icariin on the oxidant-antioxidant systems. RESULTS Radiological bone mineral density measurements and histopathological findings revealed that icariin improved all these parameters in the two healing periods tested. Superoxide dismutase activity decreased in association with local icariin application to the fractured side whereas GPx and GSH increased and MPO remained unchanged. Icariin increased the GPx and GSH levels which are responsible from scavenging hydroxyl radical and hydrogen peroxide. CONCLUSION Locally administered icariin to the fracture accelerated bone healing by reducing the oxidative stress.
{"title":"Icariin promotes early and late stages of fracture healing in rats.","authors":"Kaan Gürbüz, M. Yerer, P. Gürbüz, M. Halıcı","doi":"10.5606/ehc.2019.66796","DOIUrl":"https://doi.org/10.5606/ehc.2019.66796","url":null,"abstract":"OBJECTIVES\u0000This study aims to evaluate the effects of locally applied icariin on bone fracture healing in femur fractured rat model.\u0000\u0000\u0000MATERIALS AND METHODS\u0000The study included 64 male Sprague-Dawley rats (mean age 6 months; weighing, 280-490 g) in eight main study groups. Fracture healing process and level were evaluated with radiography, histopathology and dual energy X-ray absorptiometry to investigate the effects of local administration of icariin at varying doses, which is an exogenous osteo-inductive substance. Activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) were measured in the peripheral blood in addition to glutathione (GSH) and myeloperoxidase (MPO) levels to investigate the effects of icariin on the oxidant-antioxidant systems.\u0000\u0000\u0000RESULTS\u0000Radiological bone mineral density measurements and histopathological findings revealed that icariin improved all these parameters in the two healing periods tested. Superoxide dismutase activity decreased in association with local icariin application to the fractured side whereas GPx and GSH increased and MPO remained unchanged. Icariin increased the GPx and GSH levels which are responsible from scavenging hydroxyl radical and hydrogen peroxide.\u0000\u0000\u0000CONCLUSION\u0000Locally administered icariin to the fracture accelerated bone healing by reducing the oxidative stress.","PeriodicalId":50551,"journal":{"name":"Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery","volume":"130 1","pages":"282-8"},"PeriodicalIF":1.6,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76405337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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