The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 (P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups (P = .257 and .242, respectively). Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level III, retrospective comparative study.

Osteochondral lesions of the talus (OCLTs) secondary to ankle fractures have previously been reported in the literature. However, no study has evaluated OCLTs using magnetic resonance imaging (MRI) following ankle fracture treatment. The purpose of our study was to investigate accompanying OCLTs in patients with an ankle fracture and evaluate its relationship with the clinical outcomes. Fifty-six patients with ankle fractures who were treated with either a nonoperative or operative method at our center between June 2016 and February 2017 were included in this prospective comparative study (37 men and 19 women; mean age, 44.6 ± 13 years; range, 20-65 years). The mean American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate the clinical results in all patients in the second month and second year. The second-month ankle MR images were evaluated for OCLTs in all patients. Thirty patients were treated operatively and 26 nonoperatively. Accompanying OCLTs were detected in 19 of 56 patients (34%). Our results showed no statistically significant association between OCLT and fracture type, as well as the treatment type. In the second postoperative month, the mean AOFAS scores were 87.2 ± 10.8 and 77.6 ± 12.0 in patients with and without OCLTs, respectively (P = .005). In the second postoperative year, the mean AOFAS scores were 81.3 ± 6.8 and 86.2 ± 8.4 in patients with and without OCLTs, respectively (P = .031). The mean AOFAS score significantly decreased in the OCLT group in the second-year control, whereas a significant increase was observed in patients without OCLTs (P = .026 and P < .001, respectively). According to our results, the accompanying OCLTs were found in one-third of patients treated for ankle fractures. We observed a significant correlation between OCLT presence and the AOFAS score. According to the AOFAS score, OCLTs statistically significantly affected clinical results at 2 years. Level II, prospective comparative study.

Background and Objectives: This study aimed to investigate the difficulties faced by patients with knee osteoarthritis during the conservative treatment process. Materials and Methods: We included twenty-one patients who were diagnosed with knee osteoarthritis and admitted to the orthopedics and traumatology outpatient clinic of the hospital where the researcher worked between January 2022 and April 2022. We interviewed each patient using semi-structured face-to-face interviews. To analyze the interviews, the researcher used the directed content analysis method. Data were analyzed using the NVIVO 10 software package. The authors and the expert trained in qualitative research who generously supported the authors continued the analysis independently of each other until they reached a consensus. Results: After analysis of the interviews held with the participants, the following three main themes emerged: lack of information about conservative treatment, frequent change of physicians, and non-compliance with lifestyle changes. Two sub-themes were identified within the theme of frequent change of physicians: distrusting health personnel, and not being able to make an appointment. In addition, most of the patients were not knowledgeable enough about either the definition of the disease or the treatment process. These patients stated that they were confused because they had to change physicians frequently; thus, they distrusted physicians because each physician they visited made a different plan for the treatment process. Conclusions: At the end of the study, we determined that during the conservative treatment process of patients with knee osteoarthritis, a multidisciplinary approach should be adopted, and orthopedic surgeons, physical therapy and rehabilitation physicians, dietitians, and physiotherapists should be in harmony with the patient. In addition, health personnel should provide patients with detailed information to eliminate questions they have during the conservative treatment process. In order for healthcare team members to establish a trusting relationship between the patients, they should allocate enough time to the patient.

Objective: Rotator cuff (RC) tears often necessitate surgery, with acromioplasty being frequently performed alongside RC repair. However, the impact of acromioplasty on clinical outcomes remains a subject of discussion. The current study aimed to investigate the effect of acromioplasty during RC repair on clinical outcomes in patients with type 3 acromion. Materials and methods: Eighty-five patients, who underwent RC repair between January 2016 and December 2020, were categorized into two groups: Group 1, comprising 40 patients without acromioplasty, and Group 2, including 45 patients who received acromioplasty. Subacromial distance (SAD) and clinical scores were assessed pre- and post-operatively. Results: Group 1, comprising 40 patients without acromioplasty, had an average age of 59.45±10.43 years. Among them, 27 (67.5%) were female. The mean symptom duration was 10.4±4.3 months, and the mean follow-up period was 16.2±1.9 months. Group 2, which underwent acromioplasty, included 45 patients with an average age of 56.49±8.97 years, with 30 (66.7%) of them being female. The mean symptom duration was 9.5±3.6 months, and the mean follow-up time was 15.78±2.17 months in this group. Group 2 showed a relatively greater improvement in SAD compared to Group 1. The evaluation of clinical outcomes did not reveal any significant differences between the groups. Conclusion: Concomitant acromioplasty does not have a significant effect on clinical outcomes in patients undergoing arthroscopic RC repair.

During the COVID-19 pandemic, the surgical treatment of orthopedic diseases for elective surgical planning was suspended. This study aimed to evaluate patients' experiences with gonarthrosis regarding the postponement of non-urgent orthopedic surgeries during the COVID-19 pandemic. This phenomenological qualitative study was carried out with patients diagnosed with grade 3 or 4 gonarthrosis in the orthopedics and traumatology outpatient clinic of a hospital in western Turkey between February 2021 and March 2021. Interviews with patients were conducted face-to-face using the semi-structured interview guide focusing on patients' feelings, thoughts, and experiences. Each participant was interviewed once. Data collection was halted based on the saturation of data. Data from semi-structured interviews with patients were analyzed using Colaizzi's content analysis method. The analysis of the study data yielded three themes: "lack of knowledge", "desperation" and "lack of opportunity to cure the gonarthrosis disease". Four sub-themes were identified under these three categories. While "not knowing what to do" and "unconscious drug use" were the sub-themes of the theme of lack of knowledge, "hopelessness" and "economic difficulties" were the sub-themes of the theme of desperation. It was determined that patients were helpless due to difficulties accessing health services for other diseases during the COVID-19 pandemic. They experienced severe fear because it was unclear how long this process would continue.