Background: Total hip arthroplasty (THA) in adult patients with developmental dysplasia of the hip (DDH) presents unique surgical challenges due to altered hip anatomy and biomechanics. One of the most critical factors influencing surgical success is correcting femoral anteversion. This study evaluates the effects of different anteversion corrections (increased, unchanged, and decreased) during THA on clinical outcomes in adult Crowe type 3-4 DDH patients. Methods: A retrospective analysis was conducted on 130 patients who underwent THA with anteversion correction between 2008 and 2017 at a tertiary university hospital. Patients were divided into three groups: Group 1 (increased anteversion), Group 2 (unchanged anteversion), and Group 3 (decreased anteversion). Clinical outcomes were assessed using AOFAS and Lysholm scores, Q-angle measurements, and physical examinations, while radiological evaluations were performed to determine implant stability and complications. Results: Postoperative assessments show that increased anteversion is associated with higher rates of instability, knee dysfunction, and pain. Group 1 had significantly lower AOFAS scores (p < 0.001) and fell due to rotational deformity (25.6%). Group 2 exhibited the best clinical outcomes, with the lowest rates of instability and the highest functional scores. Group 3 had moderate functional improvements but a higher dislocation rate (17.1%) than Group 2. Conclusions: Our findings suggest that excessive changes in femoral anteversion during THA, remarkably increasing it, may negatively impact clinical outcomes by causing instability and pain. Preserving the anteversion angle as much as possible is the most favorable approach for optimizing functional recovery and implant stability. Further large-scale, long-term studies are required to confirm these findings and refine surgical strategies for DDH patients undergoing THA.

Amaç: Erişkin tibia cisim kırıklarında uygulanan oymalı kilitli intramedüller çivi kullanımının yerini ve etkisini değerlendirmek. Hastalar ve Yöntem: Tibia diafiz kırığı nedeniyle oymalı kilitli intramedüller çivi uygulaması yapılan toplam 48 erişkin hasta çalışmaya dâhil edildi. Hastaların 27'si (%56,25) erkek, 21’i (%43,75) kadındı. Hastalarımızın yaş ortalaması 42,6(18-59) olarak tespit edildi. 29 kırık vakası sağ bacakta iken 19’u sol bacakta idi. Kırık sınıflamasında AO sınıflaması kullanılmış olup iki vaka dışında tüm vakalara fibula kırığı eşlik etmekteydi. Hastaların yaralanma mekanizması, başvuru zamanı, ameliyat tarihi, kaynama zamanı olarak röntgenogramda 3 kortekste köprüleşme görülmesi, işe geri dönüş zamanı, dizilim bozukluğu ve eklem hareket açıklığına bakıldı. Bulgular: Hastalarda ortalama kaynama zamanı 14,2±2,5 hafta, ortalama işe dönüş zamanı ise 18,4±3,6 hafta olarak bulundu. Açık kırık olan 10 hastadan bir tanesinde yüzeyel enfeksiyon, iki tanesinde psödoartroz, bir tanesinde ise kaynama gecikmesi olmuştur. Dört hastada ise distal kilitleme vidasında kırılma meydana geldi. Yüzeyel enfeksiyon gelişen hastada kaynama 22 ay gecikme şeklinde oldu; dinamizasyon sağlanarak ve parenteral antibiyotik tedavisi verilerek tedavi edildi. Sonuç: Erişkin tibia cisim kırıklarında uygulanan intramedüller çivileme tedavisinin yüksek başarı oranı ve komplikasyon oranının düşüklüğü nedeniyle uygun bir cerrahi tedavi metodu olduğu ve halen altın standart tedavi olarak kabul edilmesi sonucuna varılmıştır.

Background and Objectives: This study compares the biomechanical performance of a new-generation implant designed for patella fracture fixation with the traditional tension band method. Its goal is to assess fracture fixation’s stability and the new implant’s potential advantages in reducing complications such as skin irritation, pain, and implant failure. Materials and Methods: In this experimental study, 20 calf patellae were divided into two groups. The first group was treated with the traditional tension band method, while the second group received the new-generation implant, designed using finite element analysis (FEA) for optimization. Both groups underwent biomechanical testing with axial forces at a 45° flexion angle to simulate real-life load conditions. The maximum forces at which mechanical insufficiency occurred were recorded. Data were analyzed using SPSS for statistical comparison. Results: Finite element analysis revealed that the new-generation implant provided better fracture line stability than the tension band method under applied forces. In the biomechanical tests, the maximum force at which mechanical insufficiency occurred was significantly higher in the new-generation implant group (1130 ± 222 N) compared to the tension band method group (680.5 ± 185.4 N), with a statistically significant difference (p = 0.008). The new implant demonstrated superior fixation, with better resistance to distraction forces. Conclusions: The new-generation implant offers enhanced biomechanical stability compared to the traditional tension band method, particularly regarding fixation strength under applied forces. This study supports the potential of the new implant to improve fixation stability and reduce common complications associated with patella fracture surgeries. Further testing in more extensive human cadaver studies is recommended to confirm these findings and assess long-term clinical outcomes.

Background and Objectives: The study aimed to evaluate a newly designed semicircular implant for the fixation of Vancouver Type B1 periprosthetic femoral fractures (PFFs) in total hip arthroplasty (THA) patients. To determine its strength and clinical applicability, the new implant was compared biomechanically with conventional fixation methods, such as lateral locking plate fixation and a plate combined with cerclage wires. Materials and Methods: Fifteen synthetic femur models were used in this biomechanical study. A Vancouver Type B1 periprosthetic fracture was simulated by osteotomy 5 mm distal to the femoral stem. The models were divided into three groups: Group I (lateral locking plate fixation), Group II (lateral locking plate with cerclage wires), and Group III (new semicircular implant system). All fixation methods were subjected to axial loading, lateral bending, and torsional force testing using an MTS biomechanical testing device. Failure load and displacement were measured to assess stability. Results: The semicircular implant (Group III) demonstrated a significantly higher failure load (778.8 ± 74.089 N) compared to the lateral plate (Group I: 467 ± 68.165 N) and plate with cerclage wires (Group II: 652.4 ± 65.474 N; p < 0.001). The new implant also exhibited superior stability under axial, lateral bending, and torsional forces. The failure load for Group III was more robust, with fractures occurring at the screw level rather than plate or screw detachment. Conclusions: Compared to traditional fixation methods, the newly designed semicircular implant demonstrated superior biomechanical performance in stabilizing Vancouver Type B1 periprosthetic femoral fractures. It withstood higher physiological loads, offered better structural stability, and could be an alternative to existing fixation systems in clinical practice. Further studies, including cadaveric and in vivo trials, are recommended to confirm these results and assess the long-term clinical outcomes.