Objective: Videos uploaded to YouTube do not go through a review process, and therefore, videos related to patellofemoral instability may have little educational value. The purpose of this study was to assess the educational quality of YouTube videos regarding patellofemoral instability. Methods: A standard search was performed on the YouTube database using the following terms: “unstable kneecap,” “patellar instability,” “patellofemoral instability,” “kneecap dislocation,” and “patellar dislocation,” and the top 50 videos based on the “relevance” assignment of the YouTube algorithm were included for analysis. The properties, content, and source of each video were recorded. The educational quality of videos was analyzed according to scores obtained using DISCERN, the criteria of Journal of the American Medical Association, Global Quality Score, and Patellofemoral Instability Specific Score, and the quality of the videos was evaluated according to the groupings of these scoring systems. Results: A total of 250 videos were identified, of which 89 were included in the study for analysis. The mean video duration was 11.72 ± 22.03 minutes. The median number of views was 4516.5 (range, 3-6 044 971). The content of the videos was disease-specific in 60%, 20% were related to surgical technique or approach, and 14.1% were exercise videos. Most of the videos were uploaded by physicians (33.7%). The Global Quality Score and DISCERN scores were significantly correlated with video duration. The Patellofemoral Instability Specific Score was significantly correlated with video duration, number of views, view rate, likes, and Video Power Index. According to the DISCERN classification, 69.9% of the videos were very insufficient or insufficient. According to the Patellofemoral Instability Specific Score, 65.2% of videos were evaluated as very low or low. According to the Global Quality Score, 60.7% of videos were rated as poor quality. Conclusion: The quality of YouTube videos about Patellofemoral instability is insufficient. It was found that viewers tend to watch short and low-quality videos. Cite this article as: Yüce A, İğde N, Ergün T, Mısır A. YouTube provides insufficient information on patellofemoral instability. Acta Orthop Traumatol Turc. 2022;56(5):306-310.

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.

Comparison of Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty for Patients Aged Over 75 Years: Implications for Postoperative Rehabilitation and Early Mobilization - Article abstract #952375

Background: The impact of thoracolumbosacral orthosis (TLSO) bracing on sagittal spinopelvic alignment and psychosocial outcomes in adolescent idiopathic scoliosis (AIS) remains debated. Methods: This retrospective comparative study included 120 girls (10–18 years) with AIS (baseline Cobb angle 20–40°) and skeletal immaturity (Risser 0–1). Patients were managed with a thoracolumbosacral orthosis (TLSO) brace (n = 60) or observation alone (n = 60). Standing posteroanterior and lateral full-spine radiographs were obtained at baseline and at 24 ± 6 months; follow-up radiographs were acquired out of brace after a standardized 48 h brace-free interval. They were used to measure coronal and sagittal spinopelvic parameters. Patient-reported outcomes included the Scoliosis Research Society-22r (SRS-22r), Pediatric Quality of Life Inventory (PedsQL), Spinal Appearance Questionnaire (SAQ), Trunk Appearance Perception Scale (TAPS), and Beck Depression Inventory (BDI). The primary endpoint was curve progression (≥5° increase or exceeding 40°) at 24 months. Multivariable regression was used to adjust for baseline Cobb angle and maturity. Mean follow-up was 24 ± 6 months. Results: Mean Cobb change was +1.2° in the brace group vs. +7.3° in the observation group (group × time interaction p < 0.001). Progression (≥5°) occurred in 15% vs. 45%, respectively, and 18% of observed patients exceeded 40° (risk ratio 0.33, 95% CI 0.17–0.65; number needed to treat 4, 95% CI 3–7). Sagittal spinopelvic parameters showed no significant group-by-time interaction. No significant between-group differences were observed in SRS-22r, PedsQL, SAQ, TAPS, or BDI at baseline or follow-up. Patients with curve progression exhibited worse appearance-related scores. In multivariable analysis, depressive symptoms were the strongest determinant of PedsQL (β = −0.55, p < 0.001). Conclusions: Brace treatment was associated with reduced curve progression in girls with moderate AIS. Over approximately two years of follow-up, we did not observe clinically relevant between-group differences in sagittal spinopelvic alignment or psychosocial patient-reported outcomes. Given the retrospective, non-randomized design and self-reported adherence, psychosocial findings should be interpreted cautiously and require confirmation in prospective, objectively monitored, psychologically informed bracing studies.

Background: Osteoporotic distal femur fractures are associated with high mechanical complication rates. This study used finite element analysis to compare three fixation methods—lateral plate, intramedullary nail, and nail–plate combination—in an osteoporotic distal femur model. Fracture displacement, implant stress, and fatigue behavior were examined under two loading conditions.Methods: A 3D femur model was created using Materialise Mimics Medical 21.0®. Models of intramedullary nails, lateral plates, and screws were designed with SolidWorks 2021 SP4.1®. Three fixation groups were formed by combining the fracture model with either a lateral plate, intramedullary nail, or nail–plate combination. Total deformation under loading was measured, implant stress distribution was evaluated, and fatigue failure was defined as breakage under cyclic loading.Results: In compression analysis, maximum total deformation was 101.1 mm for the nail, 110.4 mm for the lateral plate, and 50.3 mm for the nail–plate combination. Maximum implant stress values were 1132 MPa for the nail, 1278 MPa for the plate, 671 MPa for the nail, and 595 MPa for the plate in the combined model. Fatigue failure occurred after 4110 cycles for the nail, 2523 cycles for the plate, and 1692900 cycles for the nail–plate combination.Conclusion: The nail–plate combination may reduce mechanical complications in osteoporotic distal femur fractures by lowering fracture displacement, reducing implant stress, and improving cyclic strength. Randomized clinical studies are needed to further evaluate these findings.