Acta Orthopaedica Et Traumatologica Turcica[JOURNAL]
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200 papers
Intervertebral disc regeneration - Is it possible?
Schiopu D, Devriendt A, Van Vyve C … +1 more , Illes TS
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39876574 · Full text
OBJECTIVE: 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 magnet...
OBJECTIVE: 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). METHODS: 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. RESULTS: 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). CONCLUSION: 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. LEVEL OF EVIDENCE: Level IV, Therapeutic study.
Knee phenotypes distribution according to CPAK classification in Turkish population.
Özden VE, Dikmen G, Karaytuğ K … +3 more , Mavi A, Köylüoğlu YO, Tözün İR
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39876541 · Full text
OBJECTIVE: This study aimed to investigate the distribution of knee phenotypes based on the CPAK classification in healthy nonarthritic subjects and osteoarthritic patients in Türkiye. METHODS: Radiological EOS analysis...
OBJECTIVE: This study aimed to investigate the distribution of knee phenotypes based on the CPAK classification in healthy nonarthritic subjects and osteoarthritic patients in Türkiye. METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: Level III, Diagnostic Study.
Simultaneous total hip and knee arthroplasties in hemophilic arthropathy: series of 5 cases.
Bakan ÖM, Vahabi A, Kaya Biçer E … +3 more , Şahin F, Kavaklı K, Aydoğdu S
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39876488 · Full text
OBJECTIVE: This study aimed to compare preoperative and postoperative measures in haemophiliacs who had simultaneous total hip and knee arthroplasties. METHODS: A retrospective database search identified five patients wi...
OBJECTIVE: This study aimed to compare preoperative and postoperative measures in haemophiliacs who had simultaneous total hip and knee arthroplasties. METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: Level IV, Therapeutic study.
The effect of arthroscopic Bankart repair and remplissage procedure on joint range of motion and functional outcomes in anterior shoulder instability.
Öktem U, Özaltın GE, Yılmaz S … +2 more , Bozkurt İ, Öçgüder DA
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39873592 · Full text
OBJECTIVE: 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 s...
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: Level III, Therapeutic study.
Efficacy of tranexamic acid in improving visual clarity and operative time of arthroscopic rotator cuff repair: A systematic review and meta-analysis.
Qian Y, Jiang A, Yan J … +2 more , Zhang S, Zhu S
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39873591 · Full text
OBJECTIVE: The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR). METHODS: The databases of PubMed, Embase, Web of Science, CENTRAL, and S...
OBJECTIVE: The aim of this study was to examine if tranexamic acid (TXA) can assist in improving outcomes of arthroscopic rotator cu! repair (RCR). METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: Level II, Therapeutic Study.
Biomechanical comparison of locking femoral neck plate versus cannulated screws with or without a medial buttress plate in Pauwels type 3 femoral neck fractures.
Onder Y, Bulut T, Eroglu ON … +2 more , Ciklacandir S, Isler Y
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39873590 · Full text
OBJECTIVE: 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 bi...
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Erratum.
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39873553 · Full text
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From the Editor.
Berk H
Acta Orthop Traumatol Turc · 2024 Dec · PMID 39873552 · Full text
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Assessment of factors implicated in bone fusion after percutaneous endoscopic lumbar intervertebral fusion.
Huang Z, Li X, Yi W … +3 more , Gong J, Zhou Y, Tang Y
Acta Orthop Traumatol Turc · 2024 Oct · PMID 39660672 · Full text
OBJECTIVE: Lumbar spinal fusion is a common procedure for treating spinal degenerative diseases. Percutaneous endoscopic lumbar interbody fusion (PELIF) is a minimally invasive technique that has gained popularity. Howev...
OBJECTIVE: Lumbar spinal fusion is a common procedure for treating spinal degenerative diseases. Percutaneous endoscopic lumbar interbody fusion (PELIF) is a minimally invasive technique that has gained popularity. However, the factors influencing fusion success rates after PELIF have not been well-studied. METHODS: This single-center retrospective study reviewed the medical records of 96 patients who underwent single-level PELIF for degenerative pathologies between 2018 and 2020. Fusion was evaluated using thin-slice computed tomography scans at 12 months by 2 independent radiologists and defined as no detectable lucency between bone and graft. Patients were categorized into fusion and non-fusion groups. Data on age, operative time, blood loss, drainage, hospital stay, surgical level, osteoporosis, endplateitis, body mass index, lumbar curvature, and bone morphogenetic protein (BMP) use were collected. Univariate tests (chi-square, Student’s t-test, and analysis of variance) were employed to compare factors between groups. Significant factors were included in a multivariate logistic regression model with fusion as the dependent variable. RESULTS: The overall fusion success rate was 85.6% (86 fusion and 10 non-fusion). Univariate analysis revealed significant di!erences in age, osteoporosis, hypertension, diabetes, endplateitis, and BMP use between groups. Multivariate analysis identified osteoporosis (odds ratio (OR)=5.44, 95% CI, P < .05) and end-plate osteochondritis (OR=10.449, 95% CI, P < .05) as independent risk factors for non-fusion. CONCLUSION: The use of BMP and endplateitis are significant factors that a!ect bone fusion outcomes after the PELIF procedure. These factors should be taken into account in order to improve postoperative bone fusion. LEVEL OF EVIDENCE: Level IV, Therapeutic Study
Enhancing accuracy and efficiency in upper extremity disability assessments: development and testing of a desktop application.
Ozmen E, Güleç GG, İzol Özmen H … +4 more , Civan M, Circi E, Yuksel S, Baris A
Acta Orthop Traumatol Turc · 2024 Oct · PMID 39660670 · Full text
OBJECTIVE: This study aimed to validate a software application (app) developed by the authors to streamline and enhance the accuracy of disability assessments, specifically for musculoskeletal system disabilities in the...
OBJECTIVE: This study aimed to validate a software application (app) developed by the authors to streamline and enhance the accuracy of disability assessments, specifically for musculoskeletal system disabilities in the upper extremities. METHODS: A software was developed under a TÜB!TAK-funded project to aid in the disability assessment process. This tool, designed for Windows operating systems and developed in Visual Basic (VB.NET), was tested using archive data from 50 patients, focusing on upper extremity physical evaluations. Statistical analysis, including the Shapiro–Wilk and Independent t-test/Mann–Whitney U-tests, was conducted using IBM SPSS Statistics to compare the app-assisted and manual assessment methods regarding time and rating’. RESULTS: Significant time-saving was observed with the app-assisted method, which was 328.3 seconds faster on average than the manual method. The average rating di"erence between the 2 methods was minor (0.40 points, 0.92% di"erence) and not statistically significant (P=.931). The app-assisted method showed e#ciency in disability assessment with comparable accuracy to the manual methods. CONCLUSION: This application was developed for physicians who examine patients with musculoskeletal system disabilities in the upper extremities for the Health Board. Our results show that the application reduces the average evaluation time by 5 minutes while maintaining accuracy comparable to the manual method. It could be a helpful tool for physicians in a clinical setting. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.
Asymptomatic iatrogenic bilateral occlusion of vertebral artery after atlantoaxial fusion: a case report.
Jung JH, Lee JK, Ju Moon B … +1 more , Hong JH
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560977 · Full text
Vertebral arterial injury (VAI) remains a fatal complication of C1-C2 posterior screw fixation. Herein, we report asymptomatic bilateral VAI that was caused by screws following C1-C2 posterior fixation. A 34-year-old wom...
Vertebral arterial injury (VAI) remains a fatal complication of C1-C2 posterior screw fixation. Herein, we report asymptomatic bilateral VAI that was caused by screws following C1-C2 posterior fixation. A 34-year-old woman with cerebral palsy experienced quadriplegia after a fall. Cervical computed tomography (CT) showed increased ADI, with os odontoideum, for which C1 pedicle screw and C2 pedicle-lamina screw fixation were performed. Cervical magnetic resonance imaging (MRI) conducted for postoperative weakness in shoulder elevation demonstrated a well-decompressed spinal cord. However, neck CT angiography revealed bilateral vertebral artery (VA) violations by the C1 pedicle screw that induced occlusion of the V2 and V3 segments of both VA, with intact V4 segments. Diffusionweighted imaging showed no evidence of infarction. Cerebral angiography showed reconstitution of posterior circulation via the left fetal posterior communicating artery. Steroid treatment-induced improvement in shoulder elevation to the preoperative level, and no neurological deterioration has been detected for 3 years postoperatively. Prevention of VAI is one of the most important objectives when performing posterior cervical screw fixation. The screw should be inserted considering the rotation of C1 and C2. Notably, variations in cerebral circulation, which enable collateral blood flow to the posterior circulation, can lead to different sequelae in patients with iatrogenic VAI.
Comparison of autologous matrix-induced chondrogenesis and mosaicplasty in the treatment of osteochondral defects of the talus.
Gedikbas M, Ozturk T, Asci M … +3 more , Erpala F, Sobay U, Güneş T
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560972 · Full text
OBJECTIVE: This study aimed to compare the medium- to long-term results of mosaicplasty and autologous matrix-induced chondrogenesis (AMIC) in treating osteochondral defects of the talus (OCD). METHODS: Fifty patients tr...
OBJECTIVE: This study aimed to compare the medium- to long-term results of mosaicplasty and autologous matrix-induced chondrogenesis (AMIC) in treating osteochondral defects of the talus (OCD). METHODS: Fifty patients treated for talus OCD were evaluated between 2010 and 2020. Patients were divided into 2 groups: patients who underwent mosaicplasty (Group I) and those who underwent AMIC (Group II). The OCD was graded according to the Berndt-Hardy and Hepple classification systems. The size of the OCD area, the number of osteochondral plugs, and the size of the collagen matrix were determined from the surgical data. The effects of patients aged below and above 45, defect areas smaller or larger than 1.5 cm2 , and gender on functional outcomes were analyzed in both groups. Range of motion (ROM), The American Orthopaedic Foot & Ankle Society score (AOFAS), the Freiburg ankle Index score (FAI), the Tegner activity scale, and the visual analog scale (VAS) were used for the functional evaluations. RESULTS: Group I included 28 patients, and group II included 22 patients. The mean age was 41.6 years; the mean follow-up period was 69.9 months. In the final examination of the patients, both methods could provide significant improvement in all functional scores (P < .001). Although it was not statistically significant, group II had better functional values. The size of the defect area independently negatively affected the preoperative AOFAS (P=.001 and P=.011, respectively) and FAI (P=.001 and P=.008, respectively) scores. Besides that, age and gender did not affect the results (P > .05). CONCLUSION: Both methods can provide successful results; however, the AMIC method can achieve better results than mosaicplasty in similarly sized defects without causing additional morbidity.
Assessment of spinopelvic relationship among Turkish orthopedic surgeons in total joint replacement: a survey.
Bostancı B, Azboy N, Yılmaz MK … +2 more , Çaçan MA, Azboy İ
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560971 · Full text
OBJECTIVE: This study aims to investigate the preferences of orthopedics and traumatology specialists in evaluating the spinopelvic relationship in primary total hip arthroplasty (THA) in Türkiye. METHODS: Members of the...
OBJECTIVE: This study aims to investigate the preferences of orthopedics and traumatology specialists in evaluating the spinopelvic relationship in primary total hip arthroplasty (THA) in Türkiye. METHODS: Members of the Turkish Orthopedics and Traumatology Association (n=2485) were invited to fill out the questionnaire. The survey was created using Google Forms and distributed to participants via WhatsApp and Gmail by sharing the link. A total of 205 orthopedic surgeons responded and completed the questionnaire. The survey included 13 questions about the duration of their experience, the number of THA and spinal instrumentation procedures they performed, the dislocation rates they encountered after surgery, and the radiological assessments they performed for the spinopelvic relationship. RESULTS: Sixty-three percent of the participants evaluated spinopelvic parameters in patients undergoing THA. Forty-seven percent of surgeons state that in their daily practice, they determine the angle of the acetabular component according to whether the spinal deformity is rigid, flexible, balanced, or unstable. While 88% of the participants stated the rate of encountering dislocation after primary THA as less than 2%, 12% of the participants stated it as more than 2%. It was observed that 40% of the surgeons with a prosthetic dislocation rate of more than 2% evaluated the spinopelvic relationship, while 67% of the surgeons with a dislocation rate of less than 2% evaluated the spinopelvic relationship. CONCLUSION: Approximately half of the orthopedic surgeons in Türkiye plan component placement in primary THA cases by considering the spinopelvic relationship. In order to increase awareness about the spinopelvic relationship, it would be beneficial to give more space to this subject in training programs and conferences. LEVEL OF EVIDENCE: N/A.
Comparison of the effects of ultrasound-guided steroid injection and anatomic landmark-guided injection on pain and disability in greater trochanteric pain syndrome.
Topaloglu M, Gedik CC, Sarikaya D … +4 more , Kolsuz S, Turan Z, Aslan L, de Sire A
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560963 · Full text
OBJECTIVE: Greater trochanteric pain syndrome (GTPS) is a prevalent condition that can significantly affect patient comfort and function. This study aims to compare the effectiveness of ultrasound (USG)-guided and anatom...
OBJECTIVE: Greater trochanteric pain syndrome (GTPS) is a prevalent condition that can significantly affect patient comfort and function. This study aims to compare the effectiveness of ultrasound (USG)-guided and anatomic landmark-guided corticosteroid injections in managing GTPS. METHODS: Patients diagnosed with GTPS received either USG or anatomic landmark-guided corticosteroid injections. Pain scores (Visual Analog Scale, VAS) and functional outcomes (modified Harris Hip Score, HHS) were assessed at baseline, 1 month, and 1 year postinjection. Cost-effectiveness was calculated using public and private payor pricing from June 2024. RESULTS: Both treatment groups exhibited significant improvements in pain and function. The USG group demonstrated greater initial improvements at the 1-month mark, particularly in VAS activity and HHS. However, these differences between the groups converged over time, with similar long-term outcomes observed in these parameters. The USG-guided injections showed more pronounced initial benefits, especially for patients with higher initial pain levels and lower functional scores. USG was found to be more cost-effective in terms of HHS, but not VAS measures. CONCLUSION: While both USG and anatomic landmark-guided injections are effective for managing GTPS, USG-guided injections may provide greater initial relief in pain and function, particularly for patients with higher initial pain levels. USG does not demonstrate longterm superiority over anatomic injections. The study underscores the importance of evaluating long-term outcomes to comprehensively assess the sustained effectiveness of different treatment strategies for GTPS. LEVEL OF EVIDENCE: Level III, Therapeutic study.
The Turkish version of the brief Michigan hand outcomes questionnaire: cross-cultural adaptation, validity, and reliability testing.
Ergen Hİ, Yiğit S, Maden T … +1 more , Keskinbıçkı MV
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560813 · Full text
OBJECTIVE: This study aimed to develop the Turkish version of the Brief Michigan Hand Outcomes Questionnaire (B-MHQ) and to demonstrate its reliability and validity for evaluating hand function in the Turkish population...
OBJECTIVE: This study aimed to develop the Turkish version of the Brief Michigan Hand Outcomes Questionnaire (B-MHQ) and to demonstrate its reliability and validity for evaluating hand function in the Turkish population with hand/wrist disorders. METHODS: This study was conducted in accordance with Beaton et al.'s Guidelines for the Process of Cross-Cultural Adaptation of SelfReport Measures. A total of 54 patients with various hand and wrist problems were included in the study. The B-MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (Q-DASH) were used to evaluate hand function, and the visual analog scale (VAS) was used for the assessment of pain, which were completed by the subjects at baseline and 7 days later. RESULTS: The Turkish version of the B-MHQ showed good internal consistency, as evidenced by Cronbach alpha coefficients ranging from 0.895 to 0.876, and excellent test-retest reliability with an intraclass correlation coefficient of 0.968. In addition, B-MHQ was strongly correlated with Q-DASH (r=-0.878) and moderately correlated with VAS (r=-0.445). CONCLUSION: The Turkish version of the B-MHQ seems to be a reliable and valid tool for assessing hand function in Turkish-speaking patients with hand disorders. LEVEL OF EVIDENCE: Level III, Diagnostic Study.
Reliability and validity of the Turkish version of lumbar stiffness disability index.
Yapar A, Yapar D, Selçuk H … +3 more , Kılıçaslan ÖF, Eğerci ÖF, Karataş Ö
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560738 · Full text
OBJECTIVE: Post-lumbar fusion surgery often restricts daily activities due to lumbar stiffness. The validity and reliability of the lumbar stiffness disability index (LSDI) in Türkiye, which measures the impact of lumbar...
OBJECTIVE: Post-lumbar fusion surgery often restricts daily activities due to lumbar stiffness. The validity and reliability of the lumbar stiffness disability index (LSDI) in Türkiye, which measures the impact of lumbar stiffness on functional abilities, have not yet been confirmed. This study aims to test the validity and reliability of the Turkish version of LSDI (Tr-LSDI). METHODS: Sixty-six patients who underwent lumbar fusion surgery were included in this methodological study. The Tr-LSDI was developed using a forward-backward translation. Using the Davis technique and expert feedback, we confirmed the content validity (CV) of the Tr-LSDI. The construct validity of the Tr-LSDI was assessed with exploratory factor analysis (EFA) and convergent validity. Convergent validity was examined by correlation analysis between Tr-LSDI, the Oswestry disability index (ODI) scores, and the number of fusion levels. Internal consistency was determined using Cronbach's alpha coefficients, and test-retest reliability was assessed with the intraclass correlation coefficient (ICC). RESULTS: Expert evaluation yielded CV indexes > 0.8 for all items. Exploratory factor analysis revealed a one-factor structure for Tr-LSDI, comprising 10 items that accounted for 63.7% of the variance. Factor loadings spanned from 0.371 to 0.926. Notably, the Tr-LSDI score correlated with fusion levels (r=0.386, P=.001) and demonstrated a robust correlation with ODI (r=0.899, P < .001), affirming its convergent validity. The Tr-LSDI displayed excellent internal consistency with a Cronbach's alpha coefficient of 0.934. The ICC was 0.980. CONCLUSION: The Tr-LSDI is a validated, reliable tool for measuring lumbar stiffness in Türkiye. Its consistency, validity, and alignment with the original LSDI make it suitable for clinical and research use. LEVEL OF EVIDENCE: Level II, Diagnostic Study.
Comparison of mechanical stability of modified pedicle screw fixator and unilateral lumbopelvic fixation for treating sacroiliac joint disruption: A finite element analysis study.
Zhang J, Wei Y, Yu B … +2 more , Wang J, Yin W
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560711 · Full text
OBJECTIVE: This study aimed to investigate the mechanical stability of a modified pedicle screw fixator and compare it with unilateral lumbopelvic fixation for treating sacroiliac joint disruption using finite element si...
OBJECTIVE: This study aimed to investigate the mechanical stability of a modified pedicle screw fixator and compare it with unilateral lumbopelvic fixation for treating sacroiliac joint disruption using finite element simulation technology. METHODS: The digital model of a normal spine-pelvis-femur containing the main pelvic and lumbar ligaments was established based on computed tomography images. A sacroiliac joint disruption model was built and validated, which was stabilized with the models of a modified pedicle screw fixator or unilateral lumbopelvic fixation. A 400 N follower loading was applied to the lumbar vertebrae for the 2 fixation models to analyze displacement and stress distribution. In addition, the construct stiffness was calculated. RESULTS: The peak amounts of sacral vertical displacement, horizontal displacement, posterior displacement, and overall displacement were 0.70 mm, 0.17 mm, 0.73 mm, and 0.88 mm, respectively, in the modified pedicle screw fixator model, which were less than those in the unilateral lumbopelvic fixation model (1.17 mm, 0.31 mm, 2.21 mm, and 2.29 mm, respectively). Compared with unilateral lumbopelvic fixation, the percentage decreases of the modified pedicle screw fixators were 40.2%, 45.2%, 67.0%, and 61.6%, respectively. The peak stress of the internal fixation and pelvis in the modified pedicle screw fixator model was 351.23 MPa and 39.91 MPa, which has 15.5% and 70.4% lower than in the unilateral lumbopelvic fixation model. The construct stiffness of the modified pedicle screw fixator (571 N/ mm) was 67% better than that of unilateral lumbopelvic fixation (342 N/mm). CONCLUSION: The finite element simulation results showed that the modified pedicle screw fixator model demonstrated smaller sacral displacement, fewer stresses on the internal fixation and bone, and higher construct stiffness compared with the unilateral lumbopelvic fixation model. Thus, the modified pedicle screw fixator may provide biomechanical advantages over unilateral lumbopelvic fixation in the treatment of sacroiliac joint disruption.
Outcomes of repaired and intact rotator cable in large posterosuperior rotator cuff ruptures.
Yaka H, Özer M, Türkmen F … +3 more , Kaçıra BK, Başbuğ V, Kanatlı U
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560693 · Full text
OBJECTIVE: This study aimed to compare the clinical and functional outcomes of patients with large posterosuperior rotator cuff tears between those with intact rotator cables (crescent-shaped tears) and those with repair...
OBJECTIVE: This study aimed to compare the clinical and functional outcomes of patients with large posterosuperior rotator cuff tears between those with intact rotator cables (crescent-shaped tears) and those with repaired rotator cables (U-, V-, or L-shaped tears). METHODS: Eighty-two patients with a mean age of 64.05 ± 9.06 years who underwent arthroscopic repair due to large posterosuperior rotator cuff tears were evaluated with a follow-up period of 32 ± 5.9 months. Forty-two patients with an intact rotator cable and 40 patients with a repaired rotator cable (rotator cable restored with tendon-tendon sutures) were evaluated regarding preoperative and postoperative pain and functional outcomes. RESULTS: There was no significant difference in the constant score between the rotator cable repaired and the intact group (P=.22). However, when the sub-dimensions of the Constant score were compared separately, the forward flexion was significantly higher in the group with the intact rotator cable (P=.002). When the postoperative visual analog scale (VAS) scores were compared, lower scores were observed in the group with the repaired rotator cable (P < .001). CONCLUSION: In large posterosuperior rotator cuff tears, patients with a repaired rotator cables experienced more significant pain relief compared to those with intact rotator cables, although their forward flexion was lower. Therefore, a detailed analysis of the tear type and the rotator cable condition in large posterosuperior rotator cuff tears may help predict postoperative pain and functional outcomes. LEVEL OF EVIDENCE: Level III case-control study.
The impact of acromial morphology on the localization and size of calcific tendonitis in the rotator cuff.
Birsel O, Çalışkan E, Eren İ … +3 more , Yürük B, Özben H, Demirhan M
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560675 · Full text
OBJECTIVE: This study aimed to investigate the association between acromial morphology and the incidence and extent of calcific tendonitis. METHODS: Ninety-two patients (33 male, 59 female; mean age: 47 ± 9.7) with calci...
OBJECTIVE: This study aimed to investigate the association between acromial morphology and the incidence and extent of calcific tendonitis. METHODS: Ninety-two patients (33 male, 59 female; mean age: 47 ± 9.7) with calcific tendonitis were included in this retrospective study. Critical shoulder angle (CSA), slope angle, lateral acromial angle (LAA), acromion index (AI), acromial type according to Bigliani, and the morphology of the calcific deposits according to Gartner and Heyer were assessed on x-rays. The localization and volume of the calcific deposits were assessed using magnetic resonance imaging (MRI). Patients were divided into 2 groups: CSA < 33° (group 1) and CSA ≥ 33° (group 2). RESULTS: The median CSA was 33.5° (range=23°-51°), lateral acromial angle (LAA) was 83.6° (range=60°-106°), acromial index (AI) was 0.7 (range=0.4-0.9), and slope angle was 24.1° (range=3°-40°). Lateral acromial angle (P=.000) and AI (P=.000) were statistically different between the 2 groups. Critical shoulder angle was correlated with LAA (P=.000) and AI (P=.000); deposit volumes were correlated with slope angle (P=.001), Bigliani type of the acromion (P=.009), and deposit stage according to Gartner and Heyer (P=.004). There was a correlation between deposit localization and its volume; the size of the deposit increased anteriorly (P=.000). CONCLUSION: This study has shown that CSA failed to quantify a patient's predisposition to calcific tendonitis. However, the findings demonstrate a relationship between the morphological parameters in the sagittal plane, such as acromial slope and deposit volume, which deserve further research. LEVEL OF EVIDENCE: Level III, Prognostic Study.
Bibliometric analysis of the Acta Orthopaedica et Traumatologica Turcica from 2013 to 2022.
Turgut N, Beyaz S
Acta Orthop Traumatol Turc · 2024 Nov · PMID 39560638 · Full text
OBJECTIVE: This study aimed to analyze the original articles published in Acta Orthopaedica et Traumatologica Turcica (AOTT) between 2013 and 2022 using bibliometric methods to identify their characteristics and examine...
OBJECTIVE: This study aimed to analyze the original articles published in Acta Orthopaedica et Traumatologica Turcica (AOTT) between 2013 and 2022 using bibliometric methods to identify their characteristics and examine the changing trends over the last 10 years. METHODS: The articles were analyzed in terms of publication year, authors, countries, affiliations, citations, study design, subspecialty of orthopedics, sample size, study outcome, presence of statistical methods, time elapsed from submission date to acceptance date, and presence of funding. Periods (2003-2012 and 2013-2022) were compared for trend analysis in the journal. Advanced bibliometric analysis was done using VOSviewer software (version 1.6.19). RESULTS: A total of 976 articles were included in the analysis. The journal's self-citation rate was 2.94%. Retrospective observational studies remained the most frequently published article design, as observed over 2003-2012 (n=411, 42.1%). No review articles were published in the previous period, while 35 review articles were published in this period. Publications from countries outside Türkiye exhibited a significantly higher number of case reports and reviews (P = .001), whereas articles from Türkiye had a significantly greater number of basic science and cross-sectional studies (P = .007, P=.017, respectively). Trauma (n=207), general orthopedics (n=144), and spine (n=105) were identified as the most prominent subspecialties. Spine surgery and adult reconstruction/arthroplasty publications significantly increased, while hand and microsurgery publications significantly decreased (P < .001). Article types were compared regarding citation counts, revealing that case reports and technical notes had significantly lower citation counts (P = .001). There was a significant increase observed in the number of author affiliations (n=2.57 ± 1.40) (P < .001). Management" (n=83), "fixation" (n=78), and "surgery" (n=65) were the most occurring keywords. There was a significant increase in articles with 1 or 2 authors in the latter 2017-2022 period compared to 2013-2016 (P=.001). A significant increase was observed in publications from private clinics and other clinical facilities (P < .001). CONCLUSION: Acta Orthopaedica et Traumatologica Turcica (AOTT) has emerged as one of the leading journals in orthopedics, with a notable increase in international publications in the last decade. Being in the Science Citation Index Expanded (SCI-Expanded) database, increasing impact factor, and having low self-citation rates highlight its high standards and global impact. Acta Orthopaedica et Traumatologica Turcica (AOTT) is a valuable platform for researchers worldwide to share their work and advance orthopedic knowledge. LEVEL OF EVIDENCE: N/A.
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