Background: Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain, and patients increasingly use large language models (LLMs) to obtain general medical information. However, the quality, reliability, and readability of LLM-generated responses to patient-oriented questions regarding PFPS remain uncertain. This study aimed to compare responses generated by four widely used LLMs. Methods: Seventeen frequently asked questions regarding PFPS were identified through Google searches and adapted into lay language. The questions were submitted to OpenAI GPT-5, Google Gemini 2.5 Pro, xAI Grok 4, and DeepSeek-V3.2-Exp using a standardized patient scenario. A total of 68 question-specific responses were independently evaluated by four orthopedic surgeons using the DISCERN instrument. Inter-rater reliability was assessed using the intraclass correlation coefficient. Readability was evaluated using the Gunning Fog Index, Coleman–Liau Index, and Flesch Reading Ease Score. Between-model comparisons were performed using the Friedman test, followed by Bonferroni-adjusted pairwise analyses. Results: The omnibus Friedman test showed a significant between-model difference in DISCERN scores (p = 0.002). In Bonferroni-adjusted pairwise comparisons, GPT-5 had lower DISCERN scores than Gemini 2.5 Pro (adjusted p = 0.006), Grok 4 (adjusted p = 0.021), and DeepSeek-V3.2-Exp (adjusted p = 0.036), whereas no significant differences were observed among the other three models. However, the absolute differences were small, and the between-model difference was not significant in the sensitivity analysis using the median evaluator score (p = 0.381). Inter-rater agreement was moderate for GPT-5 and DeepSeek-V3.2-Exp but poor for Gemini 2.5 Pro and Grok 4. Readability differed significantly among the models across all three indices. DeepSeek-V3.2-Exp generally showed more favorable numerical readability values, whereas Grok 4 tended to produce more difficult text; however, no model was consistently superior across all readability measures. The median Gunning Fog and Coleman–Liau scores for all four models exceeded the commonly recommended sixth- to eighth-grade reading level for patient education. Conclusions: The evaluated LLMs showed small and method-dependent differences in DISCERN-based information quality and variable differences in readability. Their responses may supplement general patient education, but the findings should not be interpreted as evidence of factual accuracy, clinical safety, or suitability for individualized decision-making. LLM-generated information should be critically reviewed and should not replace assessment by a qualified healthcare professional.

Background: Pneumatic tourniquets are widely used in orthopedic surgery to create a bloodless operative field; however, improper use may result in skin, muscle, and nerve injuries, as well as rare but severe systemic complications. Despite their frequent use, the extent of theoretical knowledge and structured training among orthopedic surgeons remains unclear. This study aimed to evaluate knowledge levels, clinical practices, complication awareness, and training needs regarding pneumatic tourniquet use among orthopedic specialists and residents in Türkiye. Methods: This cross-sectional survey was conducted between April 1 and May 1, 2025, using an online questionnaire based on AORN 2007 pneumatic tourniquet safety guidelines. Orthopedic specialists and residents across various hospital types were invited to participate voluntarily. The questionnaire assessed demographic characteristics, training status, knowledge of safe tourniquet practices, and complication experiences. Data were analyzed using SPSS v25.0, with significance set at p < 0.05. Results: A total of 300 physicians participated; 45.3% were senior specialists. Although tourniquet use was frequent (48.7% in almost every surgery), only 35.7% received both theoretical and practical training. Notably, 248 participants reported that their knowledge was gained primarily through residency experience rather than structured education. Skin injuries (41.3%), muscle weakness (37.3%), and nerve injury (30.3%) were the most common complications. Knowledge gaps were prominent, particularly regarding IVRA-related systemic toxicity (24% correct), prolonged tourniquet use complications (48.3% correct), and physiological changes after deflation (68.7% correct). Experience and training level showed limited impact on overall knowledge, except for the question regarding prolonged tourniquet duration ( p = 0.01). Conclusion: Despite widespread use, substantial deficiencies exist in theoretical knowledge and structured training on pneumatic tourniquet application. Reliance on experiential learning during residency appears insufficient and contributes to inconsistent practices and increased complication risk. Standardized, evidence-based training programs are urgently needed to improve safety and reduce variability in clinical practice.

Background: Although cystic fibrosis (CF) mainly affects the respiratory and gastrointestinal systems, it may frequently present with musculoskeletal manifestations including bone fractures, low bone mineral density, and spinal pathologies. Assessment of spinal pathologies in CF patients is of vital importance because the effects on lung capacity and spinal posture are clearly defined. Questions/Purposes: The frequency of vertebral pathologies in CF patients has yet to be determined. The aim of this study was to investigate the frequency of scoliosis and hyperkyphosis and the relationship of coronal, sagittal, and spinopelvic parameters with disease severity in CF patients. Methods: Patients were tested with forced expiratory volume in 1 second (FEV1), dual-energy x-ray absorptiometry (DEXA), and full spine radiographs. Measurements were taken of the major coronal curve in the coronal plane, cervical and lumber lordosis, thoracic kyphosis, and C7 plumb line values. Patients were categorized into 3 groups based on the FEV1 values (severity) from respiratory function tests (severe: group 1 FEV 1≤40, moderate: group 2 FEV1 40 to 80, mild: group). Results: This cross-sectional study included 208 CF patients aged 5 to 21 years. The rates of scoliosis and thoracic hyperkyphosis were 31% (n=64) and 24% (n=50), respectively. The highest rates of scoliosis (63%) and thoracic hyperkyphosis (56%) were found in the severe CF group (P=0.016 and P=0.006, respectively). FEV1 and thoracic kyphosis were weakly and inversely but significantly correlated (rho: −0.200 and P=0.004). There was no difference in BMD between patients with and without scoliosis and between patients with and without hyperkyphosis. There was no significant difference in DEXA Z-score between patients with and without hyperkyphosis. The L1-L4 DEXA Z-score of patients without scoliosis was significantly higher (P=0.017). Conclusions: Scoliosis and hyperkyphosis were more prevalent in the severe CF patients group, although the proportion of patients requiring treatment was relatively low. Understanding the relationship between disease severity and coronal and sagittal spinal balance, and spinopelvic parameters is crucial, as it guides the early detection and management of scoliosis in CF patients. Level of Evidence: Level II.