Technological innovations in medicine are increasingly expected to replicate the diagnostic, decision-making, and procedural skills of experienced physicians. This review explores the evolution, current status, and limitations of artificial intelligence (AI) and robotic surgery in clinical practice. Radiology and pathology have led the way in digital transformation, enabling AI applications through standardized datasets and electronic health records. However, limitations such as algorithmic opacity, legal-ethical uncertainties, and fragmented digital infrastructures continue to hinder broader implementation. In robotic surgery, soft tissue procedures have not yet demonstrated significant advantages over conventional laparoscopy in terms of cost or operative efficiency. Orthopedic applications, particularly in arthroplasty, are promising but still lack long-term validation. Importantly, for any technology to create true value in healthcare, its benefits must clearly outweigh its costs. As healthcare systems face mounting pressure from aging populations and rising procedural demand, particularly for cholecystectomy, prostatectomy, and arthroplasty, the development of efficient and scalable technologies becomes inevitable. While neither AI nor robotic surgery has yet fulfilled its transformative promise, historical trends suggest that innovation will persist toward overcoming these barriers.

Objective: This study aimed to investigate the clinical, electrophysiological, and histomorphological effects of local use of coenzyme Q10 and vitamin E combination in a rat model of peripheral nerve injury. Methods: Forty adult female Wistar-Albino rats weighing 250-350 g were kept in a room with a temperature of 20-22°C and a light/dark cycle of 12 hours. They had free access to food and water. The right sciatic nerves of 40 rats were transected and repaired. Subjects were divided into 4 groups: controls (control-4 weeks and control-8 weeks) and treatments (treatment-4 weeks and treatment-8 weeks). A combination of coenzyme Q10 and vitamin E was applied to the repair site by a catheter placed subcutaneously in the treatment group. Only transection-repair was done in the control group. All groups were divided into 2 subgroups for histomorphological, clinical, and electrophysiological experiments because of concerns about possible interference with histomorphological preparation (5 rats in each group). The experiment results were examined by the thermal plantar test, action potential and latency time measurements, and electron microscopy at the end of 4 and 8 weeks. The intact group was studied as the uninterrupted 10 left sciatic nerves of control for 4 weeks. Results: The mean thermal plantar test results of the intact group were better than those of the control groups (P < .05). However, there was no significant difference between the intact and treatment groups. In the histomorphological examination, the number of myelinated axons increased significantly, and the myelin structure was closer to that of the intact group, especially when the treatment-8 group was compared with the control groups (control-4: P < .0001, control-8: P < .01). Conclusion: Local use of coenzyme Q10 and vitamin E seems useful in the experimental rat sciatic nerve transection-repair model. Cite this article as: Ölke HC, Biçer ÖS, Mirioğlu A, Şaker D, Öcal I, Özkan C. Clinical, electrophysiological, and histomorphological effects of local coenzyme Q10 and vitamin E use in a rat model of peripheral nerve injury. Acta Orthop Traumatol Turc., 2023;57(1):23-29.

Background: Osteoid osteoma (OO) is a benign osteogenic tumor that causes severe pain despite its small size. Minimally invasive image-guided thermal ablation has replaced surgery as the treatment of choice. While radiofrequency ablation (RFA) is considered the gold standard, microwave ablation (MWA) offers faster and more homogeneous heating, though comparative evidence remains limited. Methods: We retrospectively analyzed 53 patients with OO treated with RFA (n = 27) or MWA (n = 26) between 2014 and 2023. All procedures were CT-guided. Technical success, clinical success, recurrence, complications, and prognostic factors—including the nidus diameter and eccentricity index—were evaluated over a minimum 24-month follow-up period. Results: Technical success was achieved in all cases. Overall clinical success was 94.3% (96.2% MWA vs. 92.6% RFA, p = 1.000). Two recurrences (4%) occurred, unrelated to device type. One major complication (1.9%, third-degree skin burn after MWA) was noted. Median nidus diameter was 7 mm; lesions ≥10 mm were significantly linked to failure (p = 0.009). Logistic regression identified nidus size as the strongest outcome predictor, with the eccentricity index showing a borderline effect. Conclusions: Both RFA and MWA are safe and effective for OO, with comparable outcomes and low recurrence rates. Treatment selection should prioritize lesion-specific factors—particularly nidus size ≥ 10 mm and geometry—rather than device type. Lesion size (≥10 mm) and geometry—not ablation modality—were the principal determinants of treatment success. Individualized modality selection based on these features may optimize outcomes.

Earthquakes frequently cause injuries to the musculoskeletal system. Studies conducted after earthquakes often report on injured limbs, fractures, and surgeries. This study aimed to enhance preparedness for future earthquakes by acquiring knowledge about the prevalence of fractures and the relationship between fracture types and injury mechanisms. A retrospective analysis was conducted on medical records of patients with fractures admitted to our hospital following the 2023 Kahramanmaraş Earthquake. Patients with fractures resulting from traffic accidents or other causes unrelated to earthquakes were excluded. The recorded data included age, gender, fracture site, fracture type, mechanism of injury, date, duration of surgery, and peak creatine kinase (CK) level. The injury mechanisms were classified into four main categories: injured by falling objects, falling while running, falling from height, and being trapped under rubble. The study investigated the relationship between fractures and other factors. The study included 185 patients with a mean age of 39.62 ± 20.83 years. The most frequent mechanism of injury was being trapped under rubble. In total, there were 214 fractures, with pelvic fractures being the most common (21.50% of all fractures). Tibia fractures were the most common fractures in the lower extremities (15.89%). Women had a significantly higher occurrence of pelvic fractures (33.3%) compared to men (14.5%) (p = 0.003). The frequency of pelvic fractures significantly increased as age decreased (p = 0.007). Patients with pelvic fractures had a significantly greater peak CK concentration (p = 0.006). Open fractures were more common in the first few days, and Kirschner wires were the first treatment applied at a mean of 74 h and external fixators at a mean of 94.3 h. Injuries from falling objects from roofs and jumping from heights are important in earthquakes. In addition to lower extremity fractures, pelvic fractures are common in earthquake disasters. Most pelvic fractures are simple lateral compression fractures and it is important to follow the patients for crush syndrome in the first days instead of focusing on definitive fracture treatment. Open fractures should be prioritized for fracture surgery within the first few days. External fixators and Kirschner wires are recommended. Closed fractures should be treated conservatively and definitive surgical procedures should be postponed to the following weeks.

Objective: This study aimed to assess orthopedic surgeons’ knowledge and protective behaviors related to intraoperative fluoroscopy, and to examine the impact of professional experience and different healthcare setting contexts. Methods: A cross-sectional online survey was distributed between January and March 2024 to actively practicing orthopedic surgeons. The questionnaire included 36 structured items covering demographics, fluoroscopy usage patterns, protective equipment habits, training background, and radiation-related symptoms. Knowledge and behavior scores were calculated and analyzed using appropriate statistical tests. Results: A total of 230 orthopedic surgeons participated. The mean knowledge and behavior scores were 48.7 Å} 11.6 and 70.7 Å} 14.2, respectively. While lead apron use was high (82.2%), the use of thyroid shields (68.7%), lead goggles (12.6%), gloves (5.7%), and dosimeters (7.0%) remained limited. Only 23.9% of participants had received radiation safety training. Surgeons with more than 10 years of experience had significantly higher behavior scores (P = .006). Differences in behavior scores were observed across country of employment, including Türkiye (P < .001). Regression analysis identified age (P = .035), knowledge score (P < .001), and country of employment (P = .001) as independent predictors of behavior score. Age was also independently associated with higher knowledge scores (P = .026). Symptom reporting after fluoroscopy use was not significantly associated with behavior scores (P = .372). Conclusion: Fluoroscopy use in orthopedic surgery remains insufficiently supported by protective behavior, despite moderate knowledge levels. Low use of dosimeters and complementary equipment reflects both individual and systemic shortcomings. Enhancing radiation safety requires not only improved knowledge but also implementation of mandatory, behavior-focused training supported by institutional policies. Cite this article as: Kaya O, Dalkir KA, Olke HC, Mirioglu A, Tekin M. Fluoroscopy use and radiation safety in orthopedic surgery: A cross-sectional survey of knowledge and protective behaviors. Acta Orthop Traumatol Turc. 2026; 60(3), 0521, doi: 10.5152/j.aott.2026.25521.

Objective: Giant cell tumor of the bone (GCTB) is a locally aggressive benign tumor with unpredictable recurrence patterns. While intraos seous recurrences are well-documented, soft tissue recurrence (STR) remains underrecognized. This study aimed to identify risk factors, radiographic features, and histopathological characteristics associated with STR of GCTB. Methods: This retrospective study included 69 patients treated for GCTB between 1996 and 2022. Demographic data, tumor location, sur gical method, recurrence history, and adjuvant treatments were extracted from medical records. Radiologic assessments were performed using a picture archiving and communication system, and lesions were graded by Campanacci classification. Histopathological evalua tion included H3F3A immunohistochemistry in cases with STRs. Statistical analysis was performed using chi square, Fisher’s exact, and Mann–Whitney U-tests. Results: The initial surgical approach was curettage in 55 patients (79.7%), resection in 14 (20.3%). Recurrence occurred in 24 patients (34.8%), and STR was identified in 7 (10.1%). Most STRs were located near the distal femur. Among these, 4 had prior intraosseous recur rence, and 5 had Campanacci grade 3 lesions. No statistically significant association was found between STR and variables including age, sex, tumor volume, Campanacci grade, tumor location, denosumab, or local adjuvant use. H3F3A analysis was performed in 6 out of 7 patients with STR, and positivity was detected in 3 of them. Pulmonary metastasis was documented in 8 patients overall, including 3 of 7 with STR (42.9%) compared with 5 of 62 without STR (8.1%), representing a significant difference. Conclusion: Soft tissue recurrence in GCTB may occur independently or following intraosseous recurrence and is frequently observed in high-grade lesions. Although not statistically significant, the findings suggest a possible association between tumor aggressiveness and STR. Histological features remain consistent with osseous lesions, but the diagnostic value of H3F3A expression in STRs warrants fur ther investigation. Importantly, STR represents a distinct recurrence pattern and may be associated with an increased risk of pulmonary metastasis, underscoring the need for vigilant long-term follow-up and systematic surveillance. Cite this article as: Mirioğlu A, Dalkır KA, Ölke HC, et al. Soft tissue recurrence in giant cell tumor of bone: risk factors and radiological and histopathological features. Acta Orthop Traumatol Turc., 2025;59(6):470-476.