bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Ankle Sprain on Balance Tests in Adolescent Volleyball Players with Previous History of Ankle Sprain
Authors: Sarıal Ceyda , Tayfur Abdulhamıt , Kap Beyza , Donder Dılara , Ertuzun Ozum Melıs , Tunay Volga Bayrakcı
Published: December 2014

Objectives:

To investigate the impact of having previous history of inversion ankle sprain on balance tests in adolescent volleyball players.

Methods:

Fourty-five adolescent volleyball players with mean age of 15.26±1.03 participated in our study. Twenty-nine were uninjured (control group) and sixteen had previously experienced inversion injuries on right ankle. 9 players had the injury more than than one year ago and 7 players had it before six to twelf months. Balancing abilities were evaluated by Star Excursion Balance Test (SEBT) and Single Limb Hurdle Test (SLHT). The fact that players with history of injury had the ankle sprain at right foot led us to perform the measurements in the control group also for the right foot. We compared the results of injured and uninjured players on both tests.

Results:

Uninjured players' reaching distance on right foot was found out to be significantly more than in players with ankle sprain at medial and posteromedial directions of SEBT(p<.05), whereas there were no differences detected for the other directions (p>.05). For comparing athletes' performances with SLHT, finishing time was found significantly better in uninjured players (p<.05).

Conclusion:

Adolescent volleyball players with history of injury show lower performance on balance tests compared to uninjured players. This demonstrates that they should be given a training including balance and stabilization programs.
The Comparison of Trunk Stabilization, Flexibility, Endurance and Quality of Life Between Disabled and Healthy Shooter Athletes
Authors: Arık Asude , Erden Zafer , Can Filiz , Öksüz Çiğdem
Published: December 2014

Objectives:

Disabled athletes need proper trunk control and balance, enough flexibility and better muscle endurance to carry on activity of daily life and sports activity. In the literature, the studies which compare these parameters in disabled shooters are quite few. The purpose of this study was to compare trunk stabilization, flexibility, endurance and quality of life between disabled and healthy shooter athletes.

Methods:

15 disabled and 15 healthy athletes (aged between 18-55 years) who perform shooting at least one year were included in the study. Disabled athletes suffered from unilateral and bilateral poliomyelitis, bilateral congenital hip dislocation or paraplegia. The athletes’ demographic charecteristics, muscular endurance, flexibility, sitting balance and quality of life were evaluated. Sit-ups and Modified Push-ups Test have been used for evaluation of trunk flexion and extansion endurance, Sit and Reach Test has been used for evaluation of flexibility. Upper extremity flexibility has been measured by shoulder internal rotation. Sitting balance has been evaluated by Modified Functional Reach, Bilateral and Lateral Reach Tests. Quality of life has been evaluated by Nottingham Health Profile. Mann-Whitney-U Test was used for the statistical analysis.

Results:

Results of Sit-Ups and Modified Push-Ups Tests were lower in the disabled group (z1= -3.84, z2= -3.76; p<0.05). It has been found that the disabled athletes were more flexible according to Sit and Reach Test(z= -2.22; p<0.05). No difference in right and left shoulder internal rotation was found between the healthy and the disabled group(z1= -0.56, z2= -0.91; p>0.05). Differences were found in favour of the healthy group at Modified Functional Reach, Bilateral Reach, Right and Left Lateral Reach Tests to evaluate sitting balance (eyes-open and eyes-closed) (z1=-3.38, z2=-3.86, z3=-3.42, z4=-3.51, z5=-3.40, z6=-3.55, z7=-3.13, z8=-3.65; p<0.05). Differences were found in favour of the healthy group at Nottingham Health Profile total point, energy level, pain and physical activity parameters(z1= -3.17, z2=-3.09, z3= -3.48, z4=-4.63; p<0.05). Emotional reactions, social isolation and sleep parameters were similar(z1=-0.24, z2=-0.89, z3=-0.83;p>0.05).

Conclusion:

It has been concluded that disabled shooters have weak trunk flexion and extansion endurance level and sitting balance according to healthy athletes; but their flexibility is better. While their energy level, pain and physical activity level related to quality of life were less than healthy athletes, their emotional reactions, social isolation and sleep level were similar. Quality of life as total score was less in disabled shooters. All these results are quite important to determine both sport performance level and planning of rehabilitation program for increasing performance level in disabled shooters.
Surgical Treatment of Synovial Chondromatosis of the Long Biceps Tendon Sheath
Authors: Abay Burak , Aksu Neslihan , Soydan Ramazan , Ercan Ertuğrul , Kopuz Cengiz
Published: December 2014

Objectives:

Primary synovial chondromatosis (PSC) is a rare benign neoplasm that affects diarthrodial joints. The reported cases of PSC in the literature are mostly localized in the knee, followed by the hip, elbow, wrist and shoulder. We report the surgical treatment of a rare case of PSC localized in the long biceps tendon sheath.

Methods:

A 66-year-old woman presented severe pain in her left shoulder without any traumatic event. The pain was rated on Visual analog scale (VAS) as 4 to 7. At the physical examination, a palpable mass was found medial to the bicipital groove of the left shoulder. Functional examination of the left shoulder revealed painful limitation at 150 abduction, at 130 forward elevation and at 40 external rotation. Constant Murley Score was measured as 65. A magnetic resonance image (MRI) revealed the presence of 2x2x1.8 cm lesion within the biceps tendon sheath, rotator cuff tear and a bone cyst in the great tubercule. The treatment of choice was the open surgical treatment with excision of the lesion, curettage and spongious allografting of the bony cyst and repair of the rotator cuff with two suture anchors. The histological examination was consistent with PSC without any malignant transformation. The shoulder was immobilized postoperatively for 2 days in a sling. Immediate passive ROM exercises were started at third day for 6 weeks.

Results:

At the 6 week follow-up, the patient achieved full symmetric restoration of motion. She had returned to full activity. Visual analog scale was rated 0 to 1 and Constant Murley Score was measured as 92. Functional examination of the left shoulder reveled 170 of abduction, at 160 forward elevation and at 40 external rotation. At 1-year follow-up, clinical findings were unremarkable, with no sign of recurrence.

Conclusion:

PSC is a benign, idiopathic lesion of the synovial membranes of the diarthrodial joints. PSC is observed rarely in extra-articular shoulder involvement. Although the diagnosis of PSC is often clear with the results of radiological and intraoperative findings, it needs to be verified histologically. Surgical treatment is preferred to avoid the risk of malignant transformation, possible damage to the neighboring anatomical structures and functional disability as seen in our patient.
How Does Delayed Excision of Symptomatic Medial Plica Affect the Outcomes?
Authors: Bombaci Hasan , Kuyumcu Mehmet , Coskun Tamer , Kaya Emre
Published: December 2014

Objectives:

Medial plica (MP) is usually asymptomatic, however has the potential to cause impingement on the medial femoral condyle when it is prominent or thickened. The incidence of MP has been reported up to 79.9%. Very few of them become symptomatic over time. Due to delay in seeking medical assistance or extended conservative treatment, surgery may be delayed in some of the patients and this might cause increased chondral damage. The purpose of this study is to compare the outcomes of patients who received early surgery with patients undergoing delayed surgery one year after the onset of symptoms.

Methods:

Sixteen knees of the 14 patients (7 male, 7 female), who underwent arthroscopic MP excision between 2007 and 2011 were included in this retrospective study. In six patients had right, six patients had left and in two patients had both knees involved. Plicas, which were seen in patients with ligament injury were excluded from the study. Mean age was 42.9 years (range; 23-62). All patients complained of pain but some had mechanical symptoms such as friction during flexion-extension. Patients were evaluated with visual analogue scale (VAS) and Lysholm scores pre-operatively and at the last examination. The knees which were operated on within the first year (range; 1-12 months) after being symptomatic were grouped as Group 1 and the ones operated on after that time (range; 18-180 months) Group 2. More advanced chondral lesions were in the second group. Two groups were compared statistically by using “paired t test” in terms of VAS and Lysholm scores at the last control examination.

Results:

All patients had cartilaginous degeneration of various degrees on the surface medial femoral condyle facing the MP. Pre-operative (5.62±1.66) and final follow-up mean VAS (2.31±2.02) scores and mean Lysholm scores (65.62±13.82 and 83.43±15.51, respectively) were significantly different (p<0.005). Mean VAS score was 2.00 (±2.39) in Group 1 and 2.62 (±1.68) in Group 2 at final evaluation. Mean Lysholm scores were 81.25 (±20.04) and 85.62 (±10.16) respectively for Groups 1 and 2. Both of these differences were not statistically significant(p>0.05).

Conclusion:

All patients obtained satisfactory outcomes after arthroscopic MP excision. MP is usually asymptomatic but, when it is large and its free edge impinges on the superior anteromedial and medial portion of the medial femoral condyle, it might cause chondral damage leading to full thickness cartilage lesions. When it becomes symptomatic, chondral damage quite often is already advanced. This small series revealed that, even late arthroscopic excision of the MP relieves symptoms but, chondral damage persists even though the patient becomes asymptomatic. The reasons of this might be; 1) the region of lesion is outside of weight bearing zone or 2) the origin of pain might be stretched MP before excision.
Unexpected Injury During Jumping Exercise
Authors: Kemah Bahattin , Özkut Afşar Timuçin , Esenkaya İrfan , Akan Kaya Hüsnü , Türkmen İsmail
Published: December 2014

Objectives:

The purpose of this case presentation is to report the results of physical therapy and conservative treatment of a rare clinical entity, isolated subtalar dislocation that occurred during triple jumping during which maximum compression forces act on the foot.

Methods:

A 20 years old national triple jumping athlete fell during daily sports exercises which consist of jumping to the medial and lateral side trying to catch a sports ball bouncing from the wall while his right foot was inverted and in plantar flexion. The patient was admitted to our emergency service. The physical examination revealed that the hindfoot was displaced medially. The neurological examination was intact and there was no sign of dermal injury. After the radiological examination the diagnosis was isolated subtalar dislocation. The dislocation was reduced with longitudinal traction with the knee was in flexion. The MR imaging did not reveal any chondral damage. The choice of treatment was conservative. After 4 days as the edema subsided, a short leg cast was applied for four weeks. Then, the cast was removed and active range of motion exercises were initiated. The first 25 days consisted of exercises with rubber band, bottle rolling under the foot. The second phase included walking in the pool and the patient was asked to start weight bearing partially. The patient went on with proprioception and strengthening exercises. Later, kinesiologic taping was also added to the therapy. He changed his jumping foot and started his routine training program with the team after 170 days. He participated in his first official competition 16 months after the injury. At the 28. month, he broke the national record in the National Interuniversities Athletics Games. 2 months later, he got the third place in the World Athletics Championship.

Results:

The follow up period was 4 years. AOFAS score was 76 at second month and 83 at the fourth. At the first and at the fourth year, AOFAS score was 100. No dermal lesions or joint stiffness or signs of arthritis was observed. Avascular necrosis of talus or complex regional pain syndrome was not encountered.

Conclusion:

Early return to sports activities is of tantamount importance as early reduction. Reduction can be carried out in an open or closed manner. For prevention of joint stiffness, immobilization period has to be short and active ROM exercises has to be initiated with partial weight bearing as soon as the joint stability and strength is adequate.
Single Dose of Intra-Muscular Platlet Rich Plasma Reverses the Increase in Plasma Iron Levels in Exercise Induced Muscle Damage
Authors: Pündük Zekine , Oral Onur , Özkayın Nadir , Rahman Khalid
Published: December 2014

Objectives:

Autologous Platelet Rich Plasma (PRP) therapy, is considered to be a promising solution in accelerating the healing process of injured skeletal muscle tissue. In addition to the release of growth factors, PRP also promotes concentrated anti-inflammatory signals, including interleukins. However, the impact of the intramuscular administration of the PRP on hematologic and biochemical responses has not been fully elucidated in exercise induced muscle damage.

Methods:

Twelve healthy moderately active male volunteers, without previous experience with eccentric/concentric elbow flexors exercise, participated in this study. They were divided into two groups: control group (CONTROL, n=6) and platelet rich plasma administration group (PRP, n=6) group. To induce muscle damage, subjects in both groups performed concentric/eccentric contractions with load of (80 % 1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm. The non-dominant arms of the PRP group were treated with autologous PRP (Regen ACR-C, Regen Lab, Switzerland) post-24h exercise induced damage (DOMS). Subsequently, 4 ml PRP samples was injected using a 20-gauge needle into the region of the biceps brachii of the non-dominant arm under sterile aseptic conditions. Venous blood samples were collected pre-, and 4 days post-exercise, and analyzed for complete blood counts, serum ferritin, iron, iron binding capacity (IBC), creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT) as markers of muscle damage and inflammation.

Results:

We found that the baseline levels of iron, ferritin, IBC, CK, LDH, AST and ALT were similar in control and PRP groups. However, 24 h following exercise induced muscle damage a significant increase in these parameters was observed in both groups. Interestingly, PRP administration decreased plasma iron levels compared to the control group but this was only achieved on the second day of post-exercise induced muscle damage. In addition, the plasma IBC levels increased in PRP group from day 2 to 4 post exercise compared to control group. PRP administration had no effect on plasma ferritin, CK, LDH, AST, and LDH levels.

Conclusion:

Acute exhaustive exercise increased muscle damage markers, including plasma iron, IBC and ferritin levels, indicating metabolic stress due to exercise induced muscle damage. PRP administration decreased the iron levels post-exercise and may have a role to play in the recovery of exercise induced muscle damage.
Bone Contusion on the Medial Compartment is a Predictive Factor for more Associated Injuries After ACL Rupture
Authors: Mouzopoulos Georgios , Nomikos Georgios , Mouzopoulos Dimitrios , Tsembeli Anastasia , Vasiliadis Vasilios
Published: December 2014

Objectives:

Determine the frequency of bone contusion and associated injuries, observed in patients with anterior cruciate ligament (ACL) rupture.

Methods:

Seventy two patients with an ACL rupture were enrolled in our prospective study. Magnetic resonance images (MRI) and arthroscopic findings of all patients were examined in order to detect bone contusions and associated injuries, such as meniscal lesions and medial collateral ligament (MCL) injury. ACL rupture and meniscal lesions were also verified with knee arthroscopy. Correlation between bone contusions and meniscal lesions or MCL injury was performed. Statistical packet STATA 8.0 was used for data analysis and significance was set at p<0.05.

Results:

Fifty eight (80.5%) patients presented with associated bone contusions observed on magnetic resonance imaging. Lateral aspect of the tibia plateau (71%) and lateral femoral condyle (69%) were the most common sites with contusions. Medial compartment was associated with contusions of medial aspect of the tibia plateau and medial femoral condyle in 25% and 22% of patients respectively. The frequency of lateral meniscus (p = 0.022), medial meniscus (p = 0.036) and MCL (p = 0.05) injuries, significantly increased in patients with bone contusions of medial and lateral compartments compared to those with bone contusions on lateral only compartment or without bone contusions.

Conclusion:

Bone contusion on the medial compartment is a predictive factor for more associated injuries, seen after ACL rupture and it suggest a higher energy trauma.
The Groin Pain in the Gymnasts and its Possible Reasons
Authors: Bombaci Hasan , Erdogan Ozgur , Tanyu Ozan
Published: December 2014

Objectives:

The overuse injury in gymnasts due to overstretching of the joints is quite frequent. One of the most frequent complaints due to overuse injuries is pain on the insertion region of rectus femoris at the iliac apophysis. In the present study the possible reasons of the groin pain in the gymnasts were evaluated.

Methods:

Twenty-two amateur athletes from the gymnastic club aged between 8-12 years, were included in this study. Twenty were female and two male, Athletes have been training for 2-4 hours in 5-6 days a week, for 3 to 10 years, performing floor exercises (17 rhytmic gymnasts and five artistic gymnasts,). Gymnasts, who have groin pain and the ones have not, were evaluated according to the ligament laxity, the range of internal and external rotation of the hip joint and gymnastic discipline, which has been performed. The results were compared with Fisher’s Exact test and unpaired t-test.

Results:

Athletes, who have groin pain complaint and have not, were compared according to the age, the distance between thumb-forearm, hyperextension range in the elbow and the sum of internal and external rotation angle of the hips. Furthermore, the athletes, whose external rotation is more than internal rotation, were compared with the ones whose internal rotation is more than external rotation, to evaluate anteversion angle of the hip clinically. The difference was not statistically significant (p>0.05). On the other hand, while 7 of the 17 gymnast, who perform rhythmic gymnastics, had groin pain and none of the 5 athletes, who perform artistry gymnastic, has groin pain.

Conclusion:

Overuse injuries are more common in the gymnastic sport. Repetitive microtrauma with thwarted repair might cause persistent injury in the tendon-bone junction. The anatomic factors (i.e malalignement) and overtraining predispose the athletes to overuse injuries most frequently. During adolescent growth spurt while the growth of long bones proceeds, the rectus femoris muscle, that cross more than one joint, might not gain flexibility enough and leads to excessive tensile stress on the iliac apophysis. Also, the gymnasts with generalized ligamentous laxity are more prone to the overuse injuries. Because lax ligaments fail to provide ligament stability and under further stress on the tissues neighbourhood of joint might cause overuse injuries. However, we were not able to find any difference between the athletes, who have groin pain and the ones have not, from the age, ligament laxity and hip rotation angles points of view. On the other hand, the high prevalence of groin pain complaint in the athletes, who perform rhythm gymnastic, might be related to the discipline specific exercises. So, the overuse injuries might be prevented by the well-planned training program in each particular discipline including strengthening and balance.
Pulmonary Embolism after Knee Arthroscopy in 57-Year-Old Woman
Authors: Karaarslan Ahmet Adnan , Varol Sevinç , Karcı Tolga , Aycan Hakan , Sesli Erhan
Published: December 2014

Objectives:

Pulmonary embolism (PE) after knee arthroscopy is even a rare occurrence in older patients. In this report, we present an unusual case of PE following knee arthroscopy.

Methods:

A 57-year-old woman normally active patient presented to the orthopaedic clinic has been suffering a right knee pain responseless to the medical treatment for a year. Hystory was unremarkable with the exception of hypertension and cervical biopsy.

Results:

An arthroscopic meniscectomy was received under spinal anesthesia after the application of an Esmarch and pneumatic tourniquet. Post-operatively first day, she was discharged. While transporting, she developed dyspnea, weakness and low-right breast pain. An immediate pulmonary angiography and cardiac echograpy demonsrated the obstruction in the right common pulmonary artery and subsegmentary occlutions in the left side.

Conclusion:

After a 24-hour streptokinase therapy(ST), coumadine was started. Near the end of ST, she complained a severe knee pain healed by the punctures. Because of a severe epigastric pain unable to control by gastric prophilaxy and therapy.The patient was consulted by a gastroenterology specialist and gastric endoscopy showed an acute gastritis. A control pulmonary angiography on eighth day demonstrated no thrombus including right common pulmonary artery. The patient was successfully discharged on the 11th day.
Arthroscopic Repair of Separation of Anterior Intermeniscal Ligament
Authors: Güney Ahmet , Argün Ali Saltuk , Kahraman Murat , Kafadar İbrahim , Bilal Ökkeş
Published: December 2014

Objectives:

Aim of this article is to present and discuss a patient with separation of anterior intermeniscal ligament which was repaired arthroscopically.

Methods:

Anterior intermeniscal ligament (AIML) (transverse geniculate ligament or anterior transvers ligament) is an intraarticular structure connecting anterior convex edge of lateral meniscle to anterior tip of medial meniscle; limits anterior movement of menisci during extension and prevents pressure application of condylar surfaces onto menisci; and also limits anterior-posterior separation of anterior horn of medial meniscus during low degrees of flexion. AIML was found in 69 to 94 percent in different studies.

Results:

A thirty-eight year-old female patient referred our clinic with complaints of pain in right knee for a year that responds to pain killers, increasing with climbing stairs and decreasing with rest. Synovium origined mass was seen on MRI with contrast applied after an intraarticular mass seen on MRI. She undervent surgery and the mass in the medial of joint space considered as pigmented villonodular sinovitis was resected arthroscopically. During arthroscopy, separation of anterior marge of AIML and elevation of anterior horns of both medial and lateral were noticed. Using no 1 PDS suture AIML was pulled downwards from anterior marge and fixed. After fixation AIML and anterior horns of menisci replaced on tibial plateu again.

Conclusion:

As injuries of AIML which has an important role at stabilization of menisci during knee motions are seen very rarely, freuquency of AIML was reported 9.75 percent in a cadaver study and 75 percent of them was accompanied by medial meniscal tear. We could not find any other clinical study reporting AIML injury in the literature. As we apply arthroscopical intervention in order to resect intraarticular mass considered as pigmented villonodular synovitis, anterior separation of AIML and elevation of anterior horn of both menisci were noticed coincidentally and then were repaired. As the arthroscopical evaluation due to injuries of intraarticular structures is performed, AIML should also be evaluated, if necessary, repair should be performed in order to obtain stabilization of anterior horns of menisci.
Long Term Follow up Results of the Arthroscopic Treatment of the Talus Osteochondral Lesions (Tol) and the Factors that Effect Results
Authors: Gökkuş Kemal , Aydın Ahmet Turan
Published: December 2014

Objectives:

The arthroscopic debritment, curettage and multidrilling /microfracture is well known and established method of treatment. However the factors that effect prognosis is still controversy at recent literature. The aim of this study is to present and evaluate the factors that effects the long term follow up results of our patients.

Methods:

56 patients who admitted to our clinic with chronic ankle pain and diagnosed as TOL treated with arthroscopic debritement, curettage and multidrilling /microfracture between the period of 2005-2010 were evaluated. Arthroscopy performed through the standart portals with knee arthroscopy instruments. The instruments that used for multİdrilling and microfracture were custom maded. The clinical results were evaluated in retrospective manner with face to face and telephone interview.The AOFAS questionary and satisfaction question (subjective ) were asked on patients.

Results:

The female / male ratio was 29/27. The mean age was 40.5 (Min. 17- Max.70), the mean follow period was 5.9 year. (Min. 4 year – Max. 8 year).The distrubition of stages on our group were , seven patients were stage I , five patients were stage II , twenty one patients were stage III , eight patients were stage IV , fifteen patient were stage V. The lateral location exists on 7 patients, the medial location exists on 49 patients. 40 patients had middle lesion and other 9 patients had posterior lesions. The clinical results were: the mean preoperative AOFAS score was 46.1 (Min. 34- Max.. 65), the mean post operative AOFAS score was 90.8 (Min. 41- Max. 100). The unsatisfactory results were taken from 2 patients. The moderate satisfaction results were taken from 5 patients . The most frequent trauma mechanism were ankle sprain . The duration of symptoms before admitting to our clinic was maximum 10 years and the minimum 2 months. The mean value was 22.7 months.

Conclusion:

The coexistence of other pathologies were local synovitis, pes cavus and pes planovalgus, degenerative arthritis (mild) , bone marrow edema, posterior talar process fracture and hallux valgus respectively. Duration of period before admitting to our clinic and being classified as higher stages detected as most important factors that negatively effects the results. The unsatisfied patients (2 patients ) had also coexisting with loose bodies and pes cavus at the same time. In Stage 5 group the postoperative AOFAS increase an average of 41, while in patients with lower than stage 5 the mean increase was 48. The older age was not significant negative factor on results. Our long term results of arthroscopic debridement, curettage and multidrilling /microfracture were succcesfull at the rate of %88; while the unsuccesfull at 2 (%3) patients (unsatisfied and post- operative AOFAS score was 41 and 56), 5 patients (%9) had moderate satisfaction (pain with long standing and disability in long distance walking and AOFAS scores were between 72-80 ).
The Effect of The Intercondyler Notch Width Index on Anterior Cruciate Ligament Injuries
Authors: Görmeli Cemile Ayşe , Görmeli Gökay , Öztürk Yağmur Burak , Özdemir Zeynep , Kahraman Ayşegül
Published: December 2014

Objectives:

To evaluate the relationship of the intercondylar notch width with unilateral and bilateral ACL injury by using MR images.

Methods:

The intercondylar notch width index was measured on the MR images of 18 patients with a bilateral ACL injury, 38 patients with a unilateral ACL injury and 53 healthy subjects with a normal ACL and the results of all groups were compared with each other.

Results:

The mean NWI values were 0.227 (±0.008) in bilateral injured; 0.245 (±0.009) in unilateral injured and 0.272 (±0.01) in control groups and 0.251(±0.01) in unaffected side of the unilateral group. There were statistically significant differences in intercondylar notch width index (NWI) values between all groups and there was a significant difference between the affected and the unaffected sides in group with unilateral ACL injury. A cutoff value of 0.25 for NWI gave an odds ratio of 26.5 for bilateral and 3.23 for unilateral ACL injuries.

Conclusion:

The finding that NWI is significantly narrowed in patients with bilateral and unilateral ACL tears compared with the healthy controls suggest a relationship between a narrow NWI and an increased risk of ACL injury. The patients with a narrow NWI should also be screened contralaterally for assessment of ACL injury risk on the other knee. So, specialized training programmes for the people with narrow NWI can be prepared for preventing ACL injuries.
Transtibial Aperfix System in Reconstruction of ACL Injuries
Authors: Görmeli Gökay , Görmeli Cemile Ayşe , Karakaplan Mustafa , Korkmaz Mehmet Fatih , Diliçıkık Uğur , Gözükara Harika
Published: December 2014

Objectives:

The aim of this this study was to assess the clinical outcomes and fixation durability of the AperFix (Cayenne Madical, Scottsdale, Arizona) system and to determine the effect of patient’s age in arthroscopic reconstruction of the anterior cruciate ligament.

Methods:

Patients with symphtomatic anterior cruciat ligament rupture underwent arthroscopic reconstruction. Patients were evaluated in terms of range of motion values; Lysholm, Cincinati and Tegner activity scales; laxity testing and complications. Tunnel widening was assessed by AP and lateral radiographs. Early postoperative and last follow-up radiographs were compared.

Results:

Fifty-one patients were evaluated at a 29 months (range: 25-34 months) follow-up. Mean age at the surgery was 26.5 ± 7.2 years. Lysholm, Cincinati and Tegner activity scales were significantly higher from preop scores. (Lysholm scores: preop: 51.4 ± 17.2 postop: 88.6 ± 7.7 (p<0.001); Tegner activity scores: preop 3.3 ± 1.38 postop: 5,3 ± 1,6 (p<0,001); Cincinati scores: preop: 44.3±17 postop:81,3 ± 13.9 (p<0.001)). There was no significant difference for knee score, range of motion deficits and femoral tunnel enlargement of the patients with below and above 30 years.

Conclusion:

According to our results with <30 years and above >30 years patient comparison we think that patient’s age is less important than activity level for the surgical treatment decision. The AperFix system performed satisfactory clinical and radiological results with low complication rate. But long-term clinical and radiological results are needed to decide the ideal ACL reconcstruction method.
The Clinical Outcomes of Anterior Cruciate Ligament Reconstruction Surgery Based on Iatrogenic Damage
Authors: Korkmaz Murat , Erkoç Mustafa Fatih , Karaaslan Fatih , Mermerkaya Musa Uğur
Published: December 2014

Objectives:

To examine the degenerative changes of adjacent cartilage and bony structure, after anterior cruciate ligament reconstruction surgery.

Methods:

27 subjects, who had anterior cruciate ligament reconstruction surgery due to various reasons at least 12 months ago, were admitted to study. MRI data of patients were acquired retrospectively. Pre-operative and post-operative MRI images were compared according to retropatellar cartilage thickness, evidence of any new osteophytes formation or any signal intensity change on bony elements. Paired statistical analysis was applied.

Results:

The MRI revelation showed that; there were 14 patients with decrement of retropatellar cartilage thickness, 9 patients with new osteophytes formation and 21 patients with abnormal signal intensity change on bony elements; which were statistically significant (P<0.001).

Conclusion:

These results provide basic information about the degenerative effect of anterior cruciate ligament reconstruction surgery, on adjacent cartilage and bony structure.
High Protein Diet Increases Thickness of Renal Parenchyma in Resistance-Trained-Individuals
Authors: Kantarcı Umut Hasan , Punduk Zekine , Oral Onur , Mert Gulec , Senarslan Omer
Published: December 2014

Objectives:

Commercial protein powder or supplements are particularly consumed by resistance-trained individuals. For these individuals, an estimated requirement and recommended dietary allowance (RDA) of good quality protein are 0.66 g and 0.83 g per kg body weight (BW) per day, respectively. The aim of the present study is to examine the effect of high protein intake on thickness of renal parenchyma in resistance-trained individuals in long term.

Methods:

Thirty six healthy resistance-trained male volunteers participated in this study (mean age 26 ± 3.6 years, body mass index 27.1±3.5). Participants were divided into three groups according to daily protein intake/BW: group 1 (n=8): 1.8 g/kg/day, group 2 (n=16): 2.5 g/kg/day and group 3 (n=12): 4 g/kg/day. They have been regularly resistance training on average of 6.5 ± 3.5 hours per week for the last 6 years. Daily protein intake of the subjects was calculated as the sum of dietary intake plus commercially protein powder. Plasma levels of blood urea nitrogen (BUN) and creatinine were measured in venous blood samples. Renal length, width, thickness and cortical thickness were obtained in longitudinal and transverse ultrasonographic scans in prone position by same radiologist. Cortical echogenicity was graded as less than (0), equal to (1) or greater than (2) liver/spleen parenchyma and loss of cortex medulla differentiation (3).

Results:

Plasma levels of BUN and creatinine were similar in all groups (p > 0.05). Thickness of renal parenchyma in high protein intake (4 g/kg/day) group was significantly higher than in other groups (p < 0.05). There was a significant positive correlation between grade of cortical echogenicity and high protein intake (p < 0.05). There were also a significant positive correlation between renal cortical thickness and high protein intake (p < 0.05). There was no significant correlation between high protein intake and increased levels of creatinine (p > 0.05).

Conclusion:

The results of this study indicate that high protein intake increases the thickness of renal parenchyma in resistance-trained individuals in long term. Daily protein intake in excessive doses and unsupervised protein powder usage can be harmful and irreversible effects on kidney in resistance-trained individuals long term.
Peroneal Tendoscopy
Authors: Gülten İsmail Ayder , Ürgüden Mustafa , Bilbaşar Hakan , Akyıldız Fikri Feyyaz
Published: December 2014

Objectives:

Peroneal tendon pathology should be within the differential diagnoses of patients who are admitted to the hospital with posterolateral ankle pain. Peroneal tendoscopy is a minimally invasive choice for the diagnosis and the treatment of peroneal tendon pathologies. Aim of this study is to discuss the role of tendoscopy within the diagnosis and the treatment of peroneal tendon pathologies.

Methods:

From 2006 to 2012, 18 patients with retrofibular pain are included in this study. This study had been planned prospectively. For the patients who had been pre-diagnosed as ‘’ peroneal tendinopathy’’ with physical examination, X-ray and MRI findings, ‘’peroneal tendoscopy’’had been performed diagnostically. After diagnostic peroneal tendoscopy, patients were definitively treated either with tendoscopy or with open surgery.

Results:

We have included 18 patients with retrofibular pain, 13 were female and 5 were male. The mean age was 46.8 (29-71). Preoperatively taken MRI scans showed talar osteochondral lesions (TOL) in 8 patients, peroneal tenosynovitis in 8 patients (3 of them were with TOL), suspected peroneal tendon rupture in 3 patients (2 of them were with TOL, accessory peroneal tendon in 1 patient). MRI scans of 5 patients were normal regarding peroneal pathology, these patients were operated according to physical examinations and the findings. 13 of 18 patients had accompanying anterior and posterior ankle pathologies. The most common pathology which had been detected in 8 patients with retrofibular pain was talar ostechondral lesion (TOL). The other 5 patients had no concomitant pathology. During peroneal tendoscopy, accessory peroneal tendon in 6 patients and distal insertion of peroneus brevis tendon in 3 patients had been detected and excised minimally invasively. In 4 patients, peroneal tendon rupture had been detected and excision/repair/tenodesis had been performed, in 3 patients tenosynovectomy had been performed for peroneal tenosynovitis, duplication had been performed in 1 patient, tubulisation had been performed in 1 patient and vincula excision had been performed in 1 patient.

Conclusion:

Peroneal tendoscopy is a useful procedure to diagnose and to treat the pathology of peroneal tendons. According to our theory, patients could have a sensation of fullness within their ankle joints with the presence of accessory muscle and distal insertion of peroneus brevis tendon within the superior peroneal retinaculum and may put their ankle in slight inversion position. This positional change within the ankle may disturb the ankle biomechanics and may be one of the causes of osteochondral lesions of the talus.
Postural Stability Outcomes after Arthroscopic Cell-Free Osteochondral Scaffold Surgery
Authors: Başar Selda , Hazar Zeynep , Gem Mehmet , Kanatlı Ulunay
Published: December 2014

Objectives:

The purpose of this study was to evaluate the static and dynamic postural stability in patients undergone arthroscopic cell-free osteochondral scaffold surgery due to talus ostekondrol lesions.

Methods:

8 patients diagnosed with osteochondral lesion of the talus urdergone arthroscopic cell-free osteokondral scaffold surgery were included in this study (mean age; 43.2±15.6 years). Only one patient was operated from non-dominant side. Static postural stability (SPS) was evaluated with"Biodex, Biosway Portable Balance System" as bilateral eyes open and closed 1 year after surgery. Dynamic postural stability (DPS) was assessed with the Y Balance Test (anterior, posteromedial, posterolateral directions). Score of static and dynamic postural stability between the operated side and the other side were compared with the Wilcoxon test.

Results:

At the assesment of static postural stability, there was no statistical difference between the operated side and the other side in the anteroposterior, mediolateral and total scores (p>0.05). Similarly, all three directions of Y balance test values did not differ statistically between the two sides (p>0.05).

Conclusion:

It was determined that postural stability of patients who were applied arthroscopic cell-free osteokondral scaffold surgery in the operated side have reached the same level those of other side after 1 year surgery. This situation should be taken into consideration when planning the early stages of rehabilitation programs.
The use of an Accesory Medial Portal in Anatomic ACL Reconstruction a Prospective Ct- Study
Authors: Chouliaras Vasileios Theodore , Bellos Konstantinos , Flevas Dimitris , Tsaggou Vasiliki , Kavalaris George
Published: December 2014

Objectives

The purpose of this study was to evaluate if any differences exist regarding the position and the length of the femoral tunnel between the anterior cruciate ligament (ACL) reconstruction (ACLR) with the use of an accessory medial portal and the ACLR with no use of accessory medial portal using computed tomography (CT) imaging.

Methods

Twenty-five consecutive patients that underwent ACLR with the aid of an accessory medial portal (Group A) and 25 ACL-reconstructed (ACL-R) patients with no use of the accessory medial portal (Group B) formed the two study groups. The femoral tunnel angle (FTA) was measured on CT and the femoral tunnel length (FTL) was measured intraoperatively. Unpaired t-tests were used to examine differences regarding FTA and FTL between the two groups. The level of significance was set at α=0.05.

Results

Mean group values (range, standard deviation) for FTA were 33.9º (30º - 41º, 2.9º) and 48.2º (43º - 59º, 4.4 º) and for FTL 36.2mm (30-39, 2.4) and 44.2mm (39-48, 3) for groups A and B respectively (p<0.005).

Conclusion

With the use of an accessory medial portal the femoral tunnel is placed in a more oblique position in coronal plane as compared to the conventional AM portal technique, closer to the real anatomical position of the posterolateral bundle. Additionally the femoral tunnel length with this new technique is shorter than this with the AM portal but long enough for using the smaller button which has been proposed to reduce the motion of the graft within the tunnel.
Do we Need Ankle Arthoscopy After Malleolar Fractures at the Time of Implant Removal?
Authors: Chouliaras Vasıleios Theodore , Bellos Konstantinos , Flevas Dimitris , Skaltsas Panagiotis , Grastas Anastasios
Published: December 2014

Objectives:

The purpose of this study was to evaluate the status of ankle joint arthroscopically, in patients with an appropriately treated ankle fracture.

Methods:

Arthroscopic examination was performed at the time of implant removal after an average of 12.8 months (range 8 to 16 months) in a series of 40 consecutive patients. There were 24 women and 16 men with an average age of 55.4 years (range 17 to 67 years old). The Danis-Weber classification system was used for these fractures. All the patients were evaluated by the AOFAS Clinical Rating System before and after implant removal.

Results:

In all the patients the fractures were healed without need of a second operation. Synovitis was present in all the patients and was located antero-laterally in 29 patients. Articular cartilage damage was noted in 19 patients, among whom 16 were treated by shaving and 3 were treated with the microfracture technique. In 13 patients we removed loose bodies. The lesions tended to be worse in patients over 60 years of age. The frequency and severity of the lesions also increased in type-B and type-C fractures.

Conclusion:

There is clear evidence that despite anatomic and appropriate reduction postoperative results of ankle fractures are not free of complications. Synovitis is a common finding after ankle fractures, and chondral lesions are commonly found associated especially with the more severe ankle fracture pattern. Our findings show that arthroscopy at the time of implant removal is useful in identifying and in treating intra-articular ankle lesions.
The Osteosynthesis of Unstable Fractures of the Distal Clavicle with Hook Plate
Authors: Aksoy Yusuf , Arazi Mehmet , Şimşek Sezgin
Published: December 2014

Objectives:

The conservative treatment of unstable fractures of the distal clavicle associated with higher nonunion rates. Although many treatment modalities have been described for these unstable fractures, there isn’t a golden standard one. Although osteosynthesis of the fractures with hook plate known a treatment option its special problems regarded the design of the implant. Aim of the study: To show f effectiveness of the hook plate osteosynthesis in treatment of unstable fractures of the distal clavicle with early removal of the implant to prevent possible complications.

Methods:

Between July 2011 and September 2013, seven patients with unstable fractures of the distal clavicle were treated with open reduction and internal fixation with hook plate. The mean age of the patients was 36 (range: 21-58) and there were two female and 5 male. Routine plate removal was planned at six months after the index surgery and the patients were informed for this second surgery. All fractures were unilateral and 5 in dominant extremity. Routine follow up were done after two, six and 18 weeks after the index surgery. The healing of the fracture was evaluated with radiological and clinical examinations. The Constant scoring system was used for functional evaluation of the patients.

Results:

All fractures healed without any mechanical problems related to the plate. The average follow-up of the patients were 22 months (range: 8 - 35). After the complete healing all plates were removed. The mean Constant score was 93 (rang 82 to 98 points) at the final follow up of the patients.

Conclusion:

The osteosynthesis of the unstable fractures of the distal clavicle with hook plate is seems to be an alternative and effective option for surgical treatment. To prevent implant related mechanical problems, we advise to remove the plate after the healing of the fracture as a routine manner.
BCL2 mutations are associated with increased risk of transformation and shortened survival in follicular lymphoma
Authors: Correia Cristina , Schneider Paula A. , Dai Haiming , Dogan Ahmet , Maurer Matthew J. , Church Amy K. , Novak Anne J. , Feldman Andrew L. , Wu Xiaosheng , Ding Husheng , Meng X. Wei , Cerhan James R. , Slager Susan L. , Macon William R. , Habermann Thomas M. , Karp Judith E. , Gore Steven D. , Kay Neil E. , Jelinek Diane F. , Witzig Thomas E. , Nowakowski Grzegorz S. , Kaufmann Scott H.
Published: December 2014

Key Points

BCL2 mutations in FL correlate with activation-induced cytidine deaminase expression and frequently alter the amino acid sequence of the protein. Mutations in the BCL2 coding sequence at diagnosis are associated with shortened time to transformation and earlier death due to lymphoma.
Acute GVHD in patients receiving IL-15/4-1BBL activated NK cells following T-cell–depleted stem cell transplantation
Authors: Shah Nirali N. , Baird Kristin , Delbrook Cynthia P. , Fleisher Thomas A. , Kohler Mark E. , Rampertaap Shakuntala , Lemberg Kimberly , Hurley Carolyn K. , Kleiner David E. , Merchant Melinda S. , Pittaluga Stefania , Sabatino Marianna , Stroncek David F. , Wayne Alan S. , Zhang Hua , Fry Terry J. , Mackall Crystal L.
Published: December 2014

Key Points

Acute GVHD occurred in 5 of 9 patients after major histocompatibility–matched, T-cell–depleted peripheral blood stem cell transplantation plus IL-15/4-1BBL aNK-DLI. GVHD was more common in matched unrelated donor transplants and associated with higher CD3 chimerism, suggesting that aNK-DLI may augment T-cell alloreactivity.
Genetic inactivation of TRAF3 in canine and human B-cell lymphoma
Authors: Bushell Kevin R. , Kim Yukyoung , Chan Fong Chun , Ben-Neriah Susana , Jenks Andrew , Alcaide Miguel , Fornika Daniel , Grande Bruno M. , Arthur Sarah , Gascoyne Randy D. , Steidl Christian , Morin Ryan D.
Published: December 2014

Key Points

TRAF3 is genetically inactivated in a substantial fraction of cBCLs. Focal genetic loss of TRAF3 is recurrent in human DLBCLs.
Strong convergence of iterative algorithms for the split equality problem
Authors: Shi Luo Yi , Chen Rudong , Wu Yujing
Published: December 2014

Let

H
1

,

H
2

,

H
3

be real Hilbert spaces,

C
⊆

H
1

,

Q
⊆

H
2

be two nonempty closed convex sets, and let

A
:

H
1

→

H
3

,

B
:

H
2

→

H
3

be two bounded linear operators. The split equality problem (SEP) is finding

x
∈
C

,

y
∈
Q

such that

A
x
=
B
y

. Recently, Moudafi has presented the ACQA algorithm and the RACQA algorithm to solve SEP. However, the two algorithms are weakly convergent. It is therefore the aim of this paper to construct new algorithms for SEP so that strong convergence is guaranteed. Firstly, we define the concept of the minimal norm solution of SEP. Using Tychonov regularization, we introduce two methods to get such a minimal norm solution. And then, we introduce two algorithms which are viewed as modifications of Moudafi’s ACQA, RACQA algorithms and KM-CQ algorithm, respectively, and converge strongly to a solution of SEP. More importantly, the modifications of Moudafi’s ACQA, RACQA algorithms converge strongly to the minimal norm solution of SEP. At last, we introduce some other algorithms which converge strongly to a solution of SEP.