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.
Osteoarthritis (OA) is a degenerative disease that causes serious damage to joints, especially in elderly patients. The aim of study was to demonstrate the effectiveness of intraarticular therapies that are currently used or recently popularized in the treatment of OA. The baseline values were determined by walking the rats on the CatWalk system. Afterwards, a monosodium iodoacetate (MIA)-induced knee OA model was created with intraarticular MIA, and the rats were walked again on the CatWalk system and post-OA values were recorded. At this stage, the rats were divided into 4 groups, and intraarticular astaxanthin, intraarticular corticosteroid, intraarticular hyaluronic acid, and intraarticular astaxanthin + hyaluronic acid were applied to the groups, respectively. The rats were walked once more and posttreatment values were obtained. Nine different dynamic gait parameters were used in the comparison. Significant changes were measured in 6 of the 9 dynamic gait parameters after the MIA-induced knee OA model. While the best improvement was observed in run duration (P = 0.0022), stride length (P < 0.0001), and swing speed (P = 0.0355) in the astaxanthin group, the results closest to basal values in paw print length (P < 0.0001), paw print width (P = 0.0101), and paw print area (P = 0.0277) were seen in the astaxanthin + hyaluronic acid group. Astaxanthin gave better outcomes than corticosteroid and hyaluronic acid in both dynamic gait parameters and histological examinations. Intraarticular astaxanthin therapy can be a good alternative to corticosteroid and hyaluronic acid currently used in intraarticular therapy to treat OA.
Periprosthetic joint infection (PJI) is one of the most serious complications after joint arthroplasty. The incidence rate of PJI after total joint replacement is 1–3%. Although there are different guidelines and diagnostic criteria used to diagnose PJI, diagnosing PJI is a highly difficult process for orthopedists. The current Musculoskeletal Infection Society (MSIS) criteria are widely used for the diagnosis of PJI. These criteria include results from blood/synovial fluid tests, physical examination, and histological and microbiological analyses of intra-operative samples. However, there is currently no blood or synovial test that can definitively diagnose PJI. To make a more effective diagnosis of PJI, a large number of studies have explored and continue to investigate biomarkers. This review aims to provide general information about serum and synovial markers used for the diagnosis of PJI that may be used to create a database to guide researchers in new studies.
11 January 2021 in Joint Diseases and Related Surgery
Objectives: This study aims to compare clinically and functionally patients who had previously undergone tension band wiring (TBW) or plate fixation (PF) procedure due to the diagnosis of Mayo type 2A olecranon fracture in our clinic. Patients and methods: Data of 92 patients (51 males, 41 females; mean age 42.3 +/- 12.6 years; range, 16 to 75 years) operated on for olecranon fractures between January 2014 and December 2018 were recorded retrospectively. Forty-four patients received TBW and 48 patients received PF treatment. Their Disabilities of the Arm, Shoulder, and Hand (DASH) and Mayo scores and elbow range of motion (ROM) measurements were used for clinical and functional evaluations. Data including the time to return to work, revision rate, and follow-up time were also recorded. Results: The mean follow-up time was 38.2 +/- 17.2 months. Patients returned to work in 9.2 +/- 4.1 weeks in the TBW group and 7.8 +/- 3.6 weeks in the PF group (p=0.279). The revision rate was 14% in the TBW group and 2% in the PF group (p=0.335). The mean DASH score was 10.0 +/- 1.8 in the TBW group and 7.7 +/- 1.2 in the PF group (p=0.001). The mean Mayo score was 84.0 +/- 9.3 in the TBW group and 88.3 +/- 9.1 in the PF group (p=0.049). For elbow flexion-extension ROM, 4 degrees of difference was measured in favor of the PF group (p=0.043). Mean Mayo score, mean DASH score, and mean flexion-extension ROM values were statistically significantly different between the two groups. Conclusion: Both surgical techniques are suitable and reliable in the treatment of olecranon fractures. Although TBW treatment is low-cost and simple to apply, its biggest disadvantage is a high rate of secondary surgery for implant removal due to irritation of the skin.
12 August 2021 in Advances in Clinical and Experimental Medicine
Background. Effects of osteoarthritis (OA) are observed in experimental animal models using different gait analysis systems. Objectives. The aim of this study was to determine whether the Noldus CatWalk XT v. 10.9 gait analysis sys-tem (CatWalk) device can be used effectively in a chemically induced rat OA model and to reveal the strengths and weaknesses of the system compared to manual gait analysis. Materials and methods. Ten Wistar rats were run on a manual walking platform as well as on the CatWalk and the basal values were recorded. For OA induction, monosodium iodoacetate (MIA) was injected into the left knee of all rats under anesthesia. After a period of 4 weeks for OA development, the rats were again run on both the manual and CatWalk gait platforms. For manual gait analysis, the stride length, paw print width and paw print length were measured on both knees. In addition to these parameters, the average run speed, run duration, maximum contact intensity, paw print area, mean stance, and swing speed were measured on the left knee (affected knee) using the CatWalk device. Results. Significant differences were observed in the stride width (p = 0.0272), left stride length (p = 0.0344), and left paw print length (p = 0.0233) recorded before and after OA via the manual walking platform. For CatWalk, a significant difference was detected in the left knee's average run speed (p = 0.0010), maximum contact intensity (p = 0.0155), paw print length (p = 0.0058), paw print width (p = 0.0324), and swing speed (p = 0.0066) based on data obtained before and after OA. Conclusions. The CatWalk gait analysis system is suitable for the evaluation of OA rat models and related interventions. It also provides additional parameters compared to the manual system and minimizes human-related variation.
The stability of the syndesmosis is extremely important in terms of syndesmosis injury, ankle instability, and posttraumatic osteoarthritis development following ankle fractures. The aim of this study is to evaluate 1-year radiographic outcomes after posterior malleolar fixation in lateral and posterior malleolar fractures and trimalleolar fractures without transsyndesmotic screw fixation. Ninety-four patients who underwent posterior malleolar fixation with posterolateral approach between January 2017 and June 2019 were evaluated retrospectively. The patients were evaluated with parameters such as demographic characteristics, fracture type, injury mechanism, physical examination, and radiographic measurements. The stability of the syndesmosis was evaluated by an intraoperative Cotton test and by measuring the tibiofibular overlap, tibiofibular clear space, and medial clear space parameters preoperatively on the immediate postoperative, first-year weightbearing ankle anteroposterior radiographs. In immediate postoperative measurements on radiographs, although the mean tibiofibular overlap (P < .001) increased, the mean tibiofibular clear space (P < .001) and mean medial clear space (P < .001) decreased compared with preoperative radiographs. Immediate postoperative mean tibiofibular overlap, tibiofibular clear space, and medial clear space compared with postoperative first-year mean tibiofibular overlap (P = .39), tibiofibular clear space (P = .23), and medial clear space (P = .43) were not statistically significant. Bone union was completed radiographically at a median of 3.4 ± 1.8 months after surgery. After posterior malleolar fractures, anatomic reduction of the posterior malleolus and posterior inferior tibiofibular ligament complex provides strong syndesmosis stability as measured radiographically at 1 year. Patients may not need additional transsyndesmotic screw fixation. Level IV, case series.