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.

The posterior cruciate ligament (PCL) is a vital knee stabilizer. While PCL injuries are rare, high-energy traumas can lead to total ruptures, with accompanying injuries requiring surgery. This study aims to investigate the demographics, concomitant injuries, and postoperative complications of patients who underwent PCL reconstruction due to high-energy trauma in a large patient sample. Patients who underwent PCL reconstruction from 2016 to 2022 were retrospectively evaluated using data from a nationwide personal health recording system. Patient demographics, injury mechanisms, associated fractures, soft tissue injuries, and postoperative complications were collected from patient notes, clinical visits, and surgical notes. Individuals with a PCL injury following high-energy trauma (car accident, falls from height, motorcycle accident) with a minimum follow-up of 1 year were included in the study. The study included 416 patients with a mean age of 32.4 years. Isolated PCL injuries (n = 97, 23.3%) were observed less frequently than multiple-ligament injuries (n = 319, 76.7%). Most cases were treated with single-stage surgery (86.8%), while staged surgeries were performed in a minority of cases (13.2%). There was no relationship between trauma mechanisms and multiple-ligament involvement, accompanying injuries, or postoperative complications. Surgeries following car accidents were more likely to occur as staged surgeries (p = 0.014). Additionally, the complication rates for staged surgeries and younger patients (≤ 18 years) were significantly higher (p = 0.009). High-energy trauma-induced PCL injuries are often associated with severe concurrent knee injuries with multiple ligament involvement. PCL reconstructions following car accidents are more likely to be staged. These findings highlight the importance of careful consideration in managing these cases to minimize complications, particularly in younger age groups. Level III.

Purpose: Hip fractures are a common cause of mortality in elderly patients. This study aimed to determine the predictive factors affecting mortality among patients over the age of 80 who underwent surgical treatment for hip fractures. Methods: We searched the Turkish Ministry of Health’s e-health database to identify patients over 80 years old who had undergone surgery for proximal femoral fractures from 2016 to 2022. This process yielded 53,495 patients. Demographic data as well as comorbidities, blood transfusions, postoperative 90 days medical complications, and mortality was investigated. Multivariate logistic regression analysis was performed to identify risk factors for one year mortality in patients undergoing surgical treatment for proximal hip fractures. Results: The mortality rate was 37.2% in the first year. The mean Charlson comorbidity index(CCI) was 6.8 (range: 4–22). In the postoperative period, 68.6% of the patients received blood transfusions. Logistic regression analysis identified significant predictors of one-year mortality in surgical patients, including male gender, increased age, higher CCI scores, AKI, PE, pneumonia, electrolyte imbalance, gastrointestinal bleeding, blood transfusion, and increased mortality risks with hemiarthroplasty and internal fixation compared to total hip arthroplasty. (p < 0.001 for all). Conclusions: This large cohort study demonstrated that the mortality rate is high and that the type of surgery, male gender, older age, blood transfusion requirements, and high CCI score are associated with mortality in patients over 80 years of age who have undergone surgery for hip fractures. Preoperative optimization and postoperative care are critical for these vulnerable elderly patients.

Anterior cruciate ligament injury is one of the pathologies that affect the daily and professional life of the majority of athletes. When the treatment options are examined, there are two options surgical treatment and conservative treatment. Rehabilitation is essential in both cases, with or without surgery. Especially for returning to sports, long-term rehabilitation after surgery has become essential. While many different exercise methods have been tried in the prevention of anterior cruciate ligament injury and rehabilitation after reconstructive surgery, many have focused on strength training. The abnormal movement pattern that occurs with the somatosensory loss seen after anterior cruciate ligament injury results in a functional loss in the injured extremity and the contralateral extremity in the long term. Considering the incidence of injury, studies to establish the normal movement pattern and restore motor control are very important. For this reason, motor learning-based interventions that support neuroplasticity are of great interest today. This review aims to examine the functional results of current motor learning-based interventions in anterior cruciate ligament rehabilitation in line with the literature.

Medial opening wedge high tibial osteotomy aims to correct coronal plane deformities and redistribute the load in varus-aligned knees. However, changes in the sagittal plane during medial opening wedge high tibial osteotomy can influence the posterior tibial slope, potentially affecting knee biomechanics. The sagittal inclination angle of the osteotomy, which is the angle between the medial joint line and the osteotomy line on lateral view, is a relatively new parameter that has been discussed in the literature, as a factor influencing the posterior tibial slope. The aim of this study is to investigate success rates in achieving the targeted postoperative slope, which is to avoid increasing the slope, with posteriorly inclined sagittal osteotomy. This research was designed as a retrospective single-center case-series study. In order to avoid increasing the posterior tibial slope, our modified surgical technique involves adjusting the sagittal inclination angle to be 10o posteriorly inclined. This angle was considered to be posteriorly inclined if the anterior portion of the osteotomy was inclined proximally. Pre- and postoperative posterior tibial slope measurements were recorded. Changes in postoperative tibial slope compared to preoperative tibial slope were statistically evaluated using the paired t-test. Changes were categorized as decreases, no change, or increases, and these three groups were compared using the one-sample binomial test. Ninety-five patients (77 women and 18 men) with a mean age of 52.8 ± 7.0 were included in this study. The preoperative mean posterior tibial slope was measured as 12.5 ± 3.9° and the postoperative mean PTS was 10.6 ± 4.3°. A paired t-test revealed a statistically significant difference of 1.9 ± 3.8° (95% confidence interval: 1.13–2.71; p < .01). In four cases (4.2%), the PTS remained the same, while for 67 patients (70.5%) the PTS decreased and for 24 patients (25.3%) the posterior tibial slope increased. Therefore, a decrease or no change in the posterior tibial slope was achieved in 74.7% of all cases (p < .01). Modifying the sagittal inclination angle to achieve a posteriorly inclined osteotomy during medial opening wedge high tibial osteotomy may prevent increasing the posterior tibial slope in the majority of cases.