Background and Objectives: This study aimed to investigate the effect of intraoperative hyaluronic acid (HA) application on short-term functional outcomes after open surgical repair of Achilles tendon rupture. Materials and Methods: This retrospective cohort study included 102 patients screened at three tertiary centers (January 2023–October 2024). After applying the exclusion criteria, 64 patients were analyzed (32 HA, 32 control), with group allocation based on the intraoperative use of HA. The primary outcomes were the American Orthopaedic Foot and Ankle Society (AOFAS) Score and the Achilles Tendon Total Rupture Score (ATRS), evaluated at 3, 6, and 12 months; the Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, assessed at 6 and 12 months; and physical-performance tests (heel-rise endurance, single-leg hop distance, and calf muscle strength), performed at 6 and 12 months. Complications, including re-rupture, wound infection, and delayed wound healing, were also recorded. Results: At 6 months, the HA group had higher AOFAS scores (mean difference: 9.0, 95% CI: 6.3–11.7, p = 0.008) and ATRSs (mean difference: 7.0, 95% CI: 3.8–10.2, p = 0.008) than the controls. The differences were smaller but remained significant at 12 months (AOFAS mean difference: 5.0, 95% CI: 2.5–7.5, p = 0.034; ATRS mean difference: 4.0, 95% CI: 1.1–6.9, p = 0.034). The SF-36 PCS and MCS scores were also superior in the HA group at 6 and 12 months (all p < 0.05). The physical-performance tests (heel-rise endurance, single-leg hop, calf strength) showed significant mean differences, with the HA group scoring higher at both timepoints (all p < 0.05). Complication rates were low and not significantly different between groups (all p > 0.05). Conclusions: Intraoperative HA application during open Achilles tendon repair was associated with improvements in short-term functional recovery, general health status, and physical performance without increasing complication rates. These findings support the use of HA as a safe adjunct to optimize tendon gliding; however, prospective randomized controlled trials are needed to confirm these results.

Background/Objectives: Subchondral bone marrow edema (BME) of the knee often causes persistent pain despite conservative treatment, and evidence supporting oral bisphosphonates is limited. We compared conservative treatment alone with conservative treatment plus oral alendronate. Methods: This retrospective cohort study included 82 patients with MRI-confirmed subchondral BME of the knee treated between January 2020 and January 2025. Patients received conservative treatment alone (n = 44) or conservative treatment plus alendronate 70 mg weekly for three months (n = 38). Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were assessed at baseline and three months. Radiological response was assessed on follow-up MRI as the percentage reduction in BME area. Results: Both groups improved significantly at three months. The alendronate group showed greater reductions in VAS (4.0 ± 1.4 vs. 3.2 ± 1.3 points, p = 0.009) and total WOMAC scores (25.5 ± 8.9 vs. 19.8 ± 8.6 points, p = 0.002). Median time to full weight-bearing was shorter with alendronate (7 vs. 9 weeks, p = 0.021), and complete BME regression was more frequent (42.1% vs. 18.2%, Fisher’s exact p = 0.028). After adjustment for Kellgren–Lawrence grade, alendronate was associated with a favorable radiological response (OR = 3.66, 95% CI: 1.18–11.31, p = 0.024). No serious adverse events were recorded. Conclusions: Adding oral alendronate to conservative treatment was associated with greater clinical improvement, earlier full weight-bearing, and a more favorable radiological response at three months. Prospective randomized studies are needed to confirm these findings.

Background: The Neurocore‐SENSED framework, derived from a three‐round modified Delphi process involving 77 international spine surgeons, provides a structured reference standard for reporting in endoscopic spine surgery (ESS) for disc disease. The ability of large language models (LLMs) to reproduce graded levels of expert agreement within a reporting framework has not been examined in ESS. Objective: To evaluate the extent to which three contemporary LLMs align with the Neurocore‐SENSED consensus and whether they discriminate between items of differing consensus level. Methods: In January 2026, each of the 166 framework items with published item‐level endorsement data was submitted once to GPT‐5.2, Gemini 3 Pro, and Claude Sonnet 4.6, in independent sessions with web retrieval disabled. Models selected one of five ordered response options directly. Alignment was assessed by Spearman correlation with panel endorsement and by four measures of categorical agreement, each with bootstrap 95% confidence intervals. Separate protocols examined response stability, response format, and prior exposure to the consensus. Results: All three models correlated significantly with panel endorsement. Gemini 3 Pro aligned most closely ( r _s = 0.709, 95% CI 0.627–0.776), exceeding Claude Sonnet 4.6 ( r _s = 0.622; p = 0.009) and GPT‐5.2 ( r _s = 0.565; p < 0.001), which did not differ. Categorical agreement was limited and equivalent across models, with observed agreement of 0.506–0.518 and overlapping confidence intervals for all marginal‐robust statistics. Between 81.3% and 95.8% of responses fell in the top two categories, and discordance was almost entirely unidirectional: 31 items were endorsed by every model but by fewer than half the panel, against one item in the opposite direction. Weighted kappa was not interpretable in this setting. Conclusion: Current LLMs reproduce the broad rank ordering of expert endorsement in ESS reporting but cannot reliably distinguish endorsed from contested propositions, principally because of a positive response bias.

Omuz Anatomisi ve Biyomekaniği Tamer ERENER Omuz Eklemi Muayenesi ve Klinik Değerlendirilmesi Göker YURDAKUL Omuz Çevresi Kırıkları İbrahim ALTUN Glenohumeral Çıkıklar İbrahim ALTUN Omuz Eklem Patolojilerinde Tanı ve Görüntüleme Abdulaziz TEMİZ Rotator Manşet Yaralanmaları Salih ERGÜN Akromiyoklaviküler Eklem Yaralanmaları Gökhan PEKER Labral Patolojiler Emre ATMACA Omuz İnstabiliteleri Ve Tedavi Yöntemleri Kadir Eren BİÇER Donuk Omuz (Adheziv Kapsülit) Bilgehan TAĞRİKULU Donuk Omuzda Rehabilitasyon Pınar KAYA SUBAŞI Kalsifik Tendinopatiler İsmail YÜKÜNÇ Omuz Artroskopisi Endikasyonları Abdullah İYİGÜN Omuz Artriti Ve Artroplastisi Eren İMAMOĞLU Omuz Bölgesinin Sinir Yaralanmaları Onur Serdar GENÇLER

Omuz artroskopisi, glenohumeral eklem içi ve subakromiyal patolojilerin mükemmel şekilde görüntülenmesini, teşhisini ve tedavisini sağlayan, açık cerrahiye üstünlük sunan modern bir yöntemdir. Cerrahi dışı tedavilere yanıt vermeyen şüpheli vakalarda tanısal amaçla veya bursoskopi eşliğinde rutin olarak uygulanabilir. Temel endikasyonları arasında, medikal tedaviye dirençli sekonder ve bazı primer adeziv kapsülit olguları, tenotomi veya tenodez gerektiren kronik biseps tendiniti ve akut tendon rüptürleri yer alır. Ayrıca, işlevsel bozukluğa yol açan SLAP lezyonları, adeziv kapsülitle karışabilen subakromiyal sıkışma sendromu ve ayak izinin en az yarısını içeren, konservatif tedaviye yanıtsız kısmi ya da tam kat rotator manşet yırtıkları bu yöntemle başarıyla tedavi edilir. Özellikle gençlerde sık görülen travmatik anterior çıkıklar sonucu gelişen Bankart lezyonları, eşlik eden Hill-Sachs kemik kayıpları, sporcularda görülen posterior instabilite ve eklem hipermobilitesinin eşlik ettiği çok yönlü omuz instabilitesi (ÇYOİ) durumlarında doğru hasta seçimiyle artroskopik stabilizasyon ve gevşetme prosedürleri uygulanarak cerrahi başarı elde edilir. Shoulder arthroscopy is a modern method that provides excellent visualization, diagnosis, and treatment of glenohumeral intra-articular and subacromial pathologies, offering superiority over open surgery. It can be applied for diagnostic purposes in suspicious cases unresponsive to non-surgical treatments or routinely accompanied by bursoscopy. Its main indications include medical treatment-resistant secondary and certain primary adhesive capsulitis cases, chronic biceps tendinitis requiring tenotomy or tenodesis, and acute tendon ruptures. Additionally, functional SLAP lesions, subacromial impingement syndrome that can be confused with adhesive capsulitis, and partial or full-thickness rotator cuff tears involving at least half of the footprint and unresponsive to conservative treatment are successfully treated with this method. Especially in young individuals, Bankart lesions developing after traumatic anterior dislocations, accompanying Hill-Sachs bone losses, posterior instability seen in athletes, and multidirectional shoulder instability (MDSI) accompanied by joint hypermobility are treated with arthroscopic stabilization and release procedures through correct patient selection to achieve surgical success.