BACKGROUND Septic and aseptic loosening are the most common indications for revision hip arthroplasty (RHA), and infection-related revisions pose significant diagnostic and management challenges. This study aims to compare septic and aseptic RHA cases in terms of inflammatory markers, prevalence of diabetes mellitus (DM), surgical time, blood transfusion requirements, soft tissue thickness, and mortality rates. MATERIAL AND METHODS This retrospective study included 49 patients who underwent RHA between 2015 and 2020. Patients were divided into aseptic (n=34) and septic (n=15) groups. Demographic characteristics, comorbidities, preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, soft tissue thickness, and revision surgery time were compared. RESULTS ESR and CRP levels were significantly higher in the septic group (p=0.002, p=0.001), soft tissue thickness was lower (p=0.003), blood transfusion requirements (p<0.001) and surgical times (p<0.00001) were higher, while no significant difference was found in mortality rates between the groups (p=0.576). CONCLUSIONS This study examined septic and aseptic loosening in revision hip arthroplasty, finding higher inflammatory markers, increased transfusion needs, longer operative times, and greater infection risk with diabetes in septic cases. In our study, soft tissue thickness was found to be lower in infected cases, unlike the literature. While previous studies suggested that soft tissue thickness was the cause of infection, our study indicates that the decrease in skin thickness is a consequence of infection.

The aim of this study was to compare preoperative magnetic resonance imaging (MRI) findings, shoulder tests, and intraoperative observations in patients who underwent arthroscopic rotator cuff (RC) repair at a single center in Turkey. A total of 162 patients diagnosed with rotator cuff tears (RCTs) were included in this study. The physical examination involved the Jobe, Neer, and drop-arm tests. For patients undergoing shoulder arthroscopy, tear type and stage were evaluated intraoperatively and classified as partial-thickness or full-thickness tears. Preoperative assessments using MRI documented tear types and stages. Test results and imaging findings were compared to intraoperative observations to ensure diagnostic accuracy. A study of shoulder arthroscopy patients (129 right, 33 left; mean age 58.19 ± 9.20 years) found that 77.2% had full-thickness tears and 22.8% had partial tears on preoperative MRI. Significant differences were noted in the drop-arm test results (p = 0.003). MRI proved less reliable in localizing partial RCTs. Grade changes in full-thickness tears (Patte classification, p < 0.001) and partial tears (Ellman classification, p = 0.018) were statistically significant between preoperative and intraoperative evaluations. Certain specialized shoulder tests demonstrate strong diagnostic accuracy for specific conditions; however, their effectiveness may be limited when applied in isolation. MRI is a reliable tool for diagnosing RCTs; however, its sensitivity is reduced when detecting partial tears. This discrepancy suggests that both full-thickness and partial tears may exhibit more advanced pathology at the time of surgical intervention than initially indicated by preoperative imaging.

Objective: This study aimed to find out the level of the gracilis and semitendinosus tendons that would provide the closest information about the size of the quadruple-stranded hamstring autograft using magnetic resonance images before anterior cruciate ligament reconstruction. Methods: Ninety-six patients (44 males, 52 females) who underwent anterior cruciate ligament reconstruction with quadruple hamstring tendon autografts between January 2015 and March 2020 were retrospectively analyzed. The cross-sectional areas of the gracilis and the semitendinosus tendons at 6 different levels (pes anserinus insertion site, tibial tuberosity, fibular head, tibial plateau, and the proximal insertion sites of the anterior cruciate ligament and the medial collateral ligament were measured on the magnetic resonance images. In addition, the harvested hamstring tendons were measured together (quadrupled) using a standardized graft-sizing block. Results: There was no significant difference between genders in terms of the tendon sizes measured in all levels using magnetic resonance images. There was a strong correlation between the graft size and the measurements made at the tibial plateau level (P <.0001, r = 0.590). Conclusion: Intraoperative quadruple hamstring tendon sizes were most correlated with the magnetic resonance image measurements at the tibial plateau level. To use a hamstring autograft with a diameter of at least 8 mm for anterior cruciate ligament reconstruction, the total area of the 2 tendons should be at least 18.11 mm2 in the magnetic resonance image measurements made at the tibial plateau level.