Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically assisted and conventional manual TKA in community-dwelling elderly patients. Methods: This cross-sectional study included 50 elderly patients undergoing TKA, who were divided into robotically assisted (n = 25) and conventional manual (n = 25) groups. Demographic and clinical data, balance performance, and functional outcomes were compared at nearly 1.5 years postoperatively. Outcome measures included balance performance assessed by the Berg Balance Scale (BBS), pain via the Visual Analog Scale (VAS), knee function as measured by the Lysholm Knee Scoring Scale, quality of life using the Short Form-12 (SF-12), joint awareness as evaluated by the Forgotten Joint Score-12 (FJS-12), and surgical satisfaction. Results: The groups had similar demographic and clinical data regarding age, gender, follow-up duration, surgical time, and anesthesia type (p > 0.05). The robotically assisted group demonstrated better balance performance on the BBS (p = 0.043) and had a statistically shorter length of hospital stay (1.22 vs. 1.42 days; p = 0.005). However, no statistically significant differences were observed in VAS activity pain (p = 0.053), Lysholm Knee Scoring Scale (p = 0.117), SF-12 physical and mental scores (p = 0.174 and p = 0.879), FJS-12 (p = 0.760), and surgical satisfaction (p = 0.218). Conclusions: Robotically assisted TKA is associated with advantageous postoperative recovery, particularly in terms of balance performance, showing no clinical difference in other functional outcomes compared to the conventional manual technique. From a physical therapy perspective, these findings emphasize the importance of developing tailored and effective rehabilitation strategies in the medium term for functional recovery in the elderly population.

Background: Greater trochanteric pain syndrome (GTPS) may coexist with lumbar degenerative spine disease (LDSD) and complicate pain attribution. Methods: This retrospective cohort study evaluated the observed frequency and short-term clinical course of GTPS in a selected tertiary-care LDSD population and explored factors associated with a previous surgical recommendation. Among 153 consecutive eligible patients with clinically compatible and MRI-documented LDSD, 63 had clinical suspicion of GTPS; all 63 underwent hip MRI, demonstrated findings consistent with trochanteric bursitis, received ultrasound-guided trochanteric bursa injection plus a two-week non-steroidal anti-inflammatory drug course, and completed one- and three-month follow-up. Results: GTPS-related lateral hip pain decreased from 7.65 ± 0.86 at baseline to 2.62 ± 0.68 at one month and 1.97 ± 1.43 at three months (Friedman p < 0.001; Kendall’s W = 0.896). Twenty-five patients (39.7%) had received an outside-center lumbar surgical recommendation before GTPS recognition. In exploratory multivariable analysis, each additional pre-diagnosis outpatient visit (OR 5.82; 95% CI 2.41–14.07) and prior lumbar surgery (OR 8.75; 95% CI 1.23–62.15) were associated with previous surgical recommendation. Conclusions: These findings support careful assessment of extra-spinal pain generators in LDSD, while the retrospective uncontrolled design precludes causal inference.

Objective: In our study where we examined the effect of tramadol maintenance on VAS score in geriatric patients, we observed until the post-op 60th minute. Investigation of the incidence of pain in patients who underwent knee arthroplasty in the study. We aimed to examine the effect of the *17 allele of the CYP2D6 genome on the post-op tramadol activity. Methods: 110 patients who underwent total knee arthroplasty in our service in Pamukkale University Faculty of Medicine, Department of Orthopedics and Traumatology, and 100 healthy individuals without complaints as the control group were included in this study. Tramadol 100 mg (contramal) was administered intravenously to each patient. The port-op 0-15-30-45-60.min VAS scores of the patients were recorded. Results: The mean age of the patients was 62.36 years. While 86.4% of the patients in our study were female, this rate was 46% in the control group. We found 3.65% (n=14) *17 carriers with the presence of *17 allele in the patient (n=7) and control groups (n=7). The VAS score of the patients in the *1/*1 group at VAS post-op 0th minute was 91.07. The VAS score of the patients in the *1/*17 group was 95.0. There was no statistically significant difference between genomes (p>0.050). Similarly post-op 15., 30., 45. And 60. Min There was no statistically significant difference between the genomes per (p>0.050). We observed a statistically significant decrease in the postoperative VAS score between 0-60 minutes in both groups in time-dependent variation (p=0.000). Conclusion: When we examine the studies with different results in the literature in which tramadol is classified as IM or EM in relation to the *17 allele, according to the results of our study: We think that the *17 allele should be evaluated as EM and NM.