Objective: The purpose of this experimental study was to analyze the effects of local autologous platelet-rich plasma (PRP) injection on tendon-to-bone healing in a rotator cuff repair model in rats.\r\nMethods: Rotator cuff injury was created in 68 left shoulders of rats. PRP was obtained from the blood of an additional 15 rats. The 68 rats were divided into 4 groups with 17 rats in each group; PRP group (Week 2), control group (Week 2), PRP group (Week 4), and control group (Week 4). Platelet-rich plasma or saline was injected to the repair area intraoperatively. Rats were sacrificed 2 and 4 weeks after the surgery. Histological analysis using a semiquantitative scoring was performed on 7 rats per group. Tendon integrity and increases in vascularity and inflammatory cells and the degree of new bone formation were evaluated and compared between the groups. The remaining tendons (n=10) were mechanically tested.\r\nResults: Degree of inflammation and vascularity were less in the study group at both time intervals (p<0.05). Tendon continuity was better in the study group at 2 weeks (p<0.05). Obvious new bone formation was detected in the control group at 4 weeks (p<0.05). Biomechanically, platelet-rich plasma-treated specimens were stronger at 2 weeks (p<0.05).\r\nConclusion: Local autologous PRP injection may have beneficial effects on initial rotator cuff tendon-to-bone healing and enhance initial tendon-to-bone healing remodeling. This may represent a clinically important improvement in rotator cuff repair. Özet Amaç: Bu çalışmanın amacı sıçan rotator manşet yaralanması modelinde lokal otolog trombositten zengin plazma (TZP) enjeksiyonunun tendon-kemik iyileşmesine etkisini incelemekti. \r\nÇalışma planı: Altmış sekiz sıçanın sol omuzunda rotator manşet yaralanması oluşturuldu. On beş sıçan ise trombositten zengin plazma oluşturmak için kullanıldı. Sıçanlar her grupta 17 adet olmak üzere 4 gruba ayrıldı; TZP grubu (2. hafta), kontrol grubu (2. hafta), TZP grubu (4. hafta), ve kontrol grubu (4. hafta). Trombositten zengin plazma veya serum fizyolojik operasyon sırasında onarım bölgesine enjekte edildi. Cerrahiden iki ve dört hafta sonrasında fareler sakrifiye edildi. Semikantitatif skorlamayla her gruptan 7 sıçan üzerinde histolojik değerlendirme yapıldı. Damarlanma artışı, iltihabi hücre miktarı, yeni kemik oluşum miktarı ve tendon devamlılığı değerlendirildi. Geri kalan tendonlar mekanik olarak test edildi (n=10). \r\nBulgular: İltihaplanma miktarı ve damarlanma çalışma grubunda her iki zaman diliminde de daha azdı (p<0.05). Tendon devamlılığı ikinci haftada çalışma grubunda daha iyiydi (p<0.05). Kontrol grubunda 4. haftada daha fazla yeni kemik oluşumu gözlendi (p<0.05). Biyomekanik olarak TZP uygulanmış 2. hafta tendonlarının daha dayanıklı olduğu görüldü (p<0.05). \r\nÇıkarımlar: Lokal otolog TZP uygulamasının başlangıç rotator manşet tendon-kemik iyileşmesine katkıda bulunduğu ve başlangıç tendon-kemik iyileşmesinde remodelizasyonu olumlu etkilediği söylenebilir. Bu etki rotator manşet onarımı sonrası klinik sonuçları da iyileştirecektir.

Objectives The aim of this study was to evaluate the clinical and radiological results of the surgical treatment of acetabular fractures using modified Stoppa approach. Methods A total of 57 patients (mean age 37.8 years; range 15–84) who underwent surgical treatment for acetabular fracture with modified Stoppa approach from February 2013 to June 2016 were included into the study. The mean follow-up time was 28.1 months (range 24–35). The records were reviewed for fracture patterns, time to surgery, operative time, blood loss, reduction quality, and perioperative complications. Reduction quality was graded as anatomic, imperfect, or poor. The Harris Hip Score (HHS) and Merle d'Aubigné score were used for functional evaluation. Results Among the 63 acetabulum fractures of the 57 patients, 27 were associated with both columns, 12 were T-type fractures, 10 were transverse, 7 were anterior column/posterior hemitransverse, 5 were anterior column, and 2 were anterior wall fracture. A single surgeon performed all operations. Pfannenstiel incision was used in the first 19 cases while vertical midline incision in the remaining 38 cases. Average time to operation was 5.5 days, and supplemental lateral windows were used in 17 (29.8%) patients. Average blood loss and operation times were 660 mL and 152 min, respectively. Radiological outcomes were anatomic, imperfect, and poor in 52 (82.5%), 9 (14.2%), and 2 (3.2%) of the acetabulum fractures, respectively. Clinical outcomes at 2 years with HHS and Merle d’Aubigné scores were mean 86.6 (range 66–96) (Excellent in 27, good in 23, fair in 4, poor in 3 patient) and 16.7 (range 10–18) (Excellent in 25, very good in 18, good in 6, fair in 5, poor in 3 patient), respectively. There was a significant relation between the reduction quality and clinical outcome (p < 0.001), while there was no significant relation between the clinical outcome and the fracture type (p > 0.05). Iatrogenic external iliac vein damage was noted in 2 patients. Obturator nerve palsy was noted in 3 patients, who recovered spontaneously at mean time of 3.7 months (range 3–5). Rectus abdominus paralysis was noted in 2 of the 19 (10.5%) Pfannenstiel-incision patients but not in the vertical-incision patients. Conclusion Our experience in 57 patients shows that satisfactory results can be obtained, even in bilateral fractures with vertical midline incision. Level of evidence Level IV Therapeutic Study ER -