bluuebunny/crossref_metadata_2025_split huggingface dataset:
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 PointsBCL2 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.