Joint Diseases and Related Surgery (JDRS), the official journal of the Turkish Joint Diseases Foundation, is an international, peer-reviewed, immediate open access journal. All published articles in JDRS has been free for everyone, without embargo, since 1990.

Periprosthetic joint infections (PJIs) are important factors in decreasing the success of hip and knee arthroplasties. It is a necessity to explore the epidemiological data and develop applications for rational antibiotic use, to address future infection control concerns. We aimed to investigate the microorganisms that were responsible and the related antibiograms in 121 patients with PJI, who were managed by two-stage revision surgery. Patients’ data records, demographics, comorbidities, sites of arthroplasty, synovial fluid and deep tissue culture results and antibiotic treatment were summarized on a standardized case report form. There were 43 (35.5%) culture-negative PJI cases and 12 (9.9%) polymicrobial growths. The causative pathogens included Gram-positive (50.4%) and Gram-negative microorganisms (23.1%) and fungi (0.8%). Methicillin resistance was 64.3% for S. aureus and 89.5% for coagulase-negative staphylococcus (CoNS). The extended spectrum beta lactamase (ESBL) rate for Enterobacteriaceae was 68.4%. This study shows that antibiotic resistance is encountered in more than half of the cases, which is valid for all microorganisms most common in PJI. The success of treatment decreases significantly in cases where antibiotic-resistant microorganisms are isolated or in cases where the culture is negative.

Background/Objectives: In patients with varus knee osteoarthritis, compensatory changes occur in the foot and ankle joints to compensate for the varus deformity of the knee. The aim of the study was to investigate the changes in the ankle of patients whose knee alignment was corrected with total knee arthroplasty (TKA) and to explore the clinical implications of these findings. Methods: In this retrospective observational study, we analyzed 204 knees of 179 patients who had regular follow-ups out of 431 patients who underwent TKA for varus knee osteoarthritis between January 2019 and July 2021. Patient demographics, body mass index, follow-up time, and radiographs were studied. The hip–knee–ankle (HKA) angle, joint line convergence angle (JLCA), talar tilt (TT) angle, ground talar dome (GT) angle, ground tibia plafond (GP) angle, and the American Orthopaedic Foot & Ankle Society (AOFAS) score were assessed preoperatively and at the last follow-up. Results: A total of 204 knees of 179 patients with a mean follow-up time of 32.50 ± 6.68 months were evaluated. It was found that the change in the HKA had a positive effect on the AOFAS score and a negative effect on the TT, GT, and GP angles. While the clinical score improved in 82 patients, it worsened in 8 patients. The age difference between the groups whose AOFAS score improved and worsened was statistically significant. Conclusions: The correction of the varus malalignment in the knee was shown to also improve the compensatory valgus in the foot and ankle over the mid-term, with a statistically significant improvement in the patients’ clinical ankle scores.

Background: The etiology of rotator cuff tears (RCTs) have been investigated for years and many underlying causes have been identified. Shoulder joint morphology is one of the extrinsic causes of RCTs. Aim: Morphometric measurements on MRI sections determined which parameters are an important indicator of RCT in patients with shoulder pain. The aim of this study was to determine the risk factors in the etiology of RCTs by evaluating the shoulder joint morphology with the help of previously defined radiological parameters. Methods: Between January 2019-December 2020, 408 patients (40-70 years old) who underwent shoulder MRI and met the criteria were included in the study. There were 202 patients in the RCT group and 206 patients in the control group. Acromion type, acromial index (AI), critical shoulder angle (CSA), acromiohumeral distance (AHD), lateral acromial angle (LAA), acromial angulation (AA), acromion-greater tuberosity impingement index (ATI), and glenoid version angle (GVA) were measured from the MRI images of the patients. Results: AI (0.64 vs. 0.60, P = 0.003) CSA (35.3° vs. 32.4°, P = 0.004), ATI (0.91 vs. 0.83, P <0.001), and AA (13.6° vs. 11.9°, P = 0.011) values were higher in the RCT group than in the control group and the difference was significant. AHD (AHD: 8.1 mm vs. 9.9 mm, P <0.001), LAA (77.2° vs. 80.9°, P = 0.004) and GVA (-3.9° vs. -2.5°, P <0.001) values were lower in the RCT group than in the control group, and again the difference was significant. According to the receiver operating characteristic curve analysis, the cutoff values were 0.623 for AI and 0.860 for ATI. Conclusion: Acromion type, AI, CSA, AHD, LAA, AA, ATI, and GVA are suitable radiological parameters to evaluate shoulder joint morphology. High AI, CSA, AA, ATI, GVA and low AHD and LAA are risk factors for RCT.

Background/Objectives: Periprosthetic joint infection (PJI) is a severe complication following both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA). While the microbiological profile of TKA PJI has been well characterized, limited data exist regarding UKA PJIs. This study aimed to compare the causative microorganisms and surgical treatment outcomes in PJI cases following UKA and TKA. Methods: This retrospective cohort study included 82 patients (71 TKA and 11 UKA) who underwent surgical treatment for PJI between January 2017 and May 2024. PJI was diagnosed based on the Musculoskeletal Infection Society (MSIS) criteria. Treatment strategies included debridement, antibiotics, and implant retention (DAIR) or two-stage revision arthroplasty. Microbiological data were extracted from intraoperative cultures. Fisher’s exact test and the Mann–Whitney U test were used for statistical comparisons. Results: Gram-positive organisms, primarily Staphylococcus aureus and coagulase-negative staphylococci, were isolated in all UKA PJIs. In contrast, the TKA group demonstrated greater microbial diversity, including Gram-negative bacilli, polymicrobial infections, and a higher rate of culture-negative cases (33.8% vs. 18.2%). DAIR was performed more frequently in UKA cases (72.7% vs. 28.2%, p = 0.002). Recurrence rates following DAIR were similar in both groups (12.5% in UKA, 20.0% in TKA, p = 1.000). Two-stage revision resulted in no recurrence in UKA and a 9.8% recurrence rate in TKA patients. Conclusions: UKA PJIs appear to be microbiologically less complex than TKA PJI cases, with Gram-positive organisms predominating. Despite these differences, the outcomes of surgical treatment—both DAIR and two-stage revision—were comparable between groups. Standard PJI treatment principles may be applicable to both arthroplasty types; however, larger prospective studies are needed to confirm these findings.