Objective: This study aimed to evaluate the contents and readability levels of informative texts about anterior cruciate ligament (ACL) on Turkish websites. Methods: In this cross-sectional study, online searches were performed using the Google, Yandex, and Yahoo search engines on 16, 17, and 18 November 2020, respectively. In these three search engines, ‘anterior cruciate ligament’, ‘anterior cruciate ligament surgery’, ‘ACL’, and ‘ACL surgery’ were entered in Turkish. The first 10 pages from each search on the websites were collected. The websites were divided into 3 groups according to their sources. Group 1 was classified as websites prepared by private hospitals or medical centers; group 2, as individual websites of orthopedics and traumatology physicians; and group 3, as non-profit websites providing general health information that does not fall into these two groups. The websites were analyzed based on both the website interface and a specific content scoring guide by two reviewers. The Flesch Kincaid (FK) grade level and the Flesch reading ease (FRE) score were used to determine the readability of information on the websites. Results: Eighty-five unique websites were evaluated. The mean quality score of all the websites was 10.4 ± 4.5 with a maximum score of 25 (range=3–21). No significant difference in quality score was found between the groups. The mean FK grade score of all the websites was 11.2 ± 1.7 (range=7.9–15.3). The mean FRE score of all the websites was 46.8 ± 7.7 (range=24.1–63.7). No statistically significant differences in FK grade and FRE score were found between the groups. Although 59 websites (69%) had a third-party seal indicating the certification of one of the organizations established to provide a standard of health information on the Internet, only 21 websites (25%) were updated in the year before the search. Conclusion: The readability level of the informative texts about the ACL on the Turkish websites was above the educational level in Turkey. In addition, the quality score of the Turkish websites related to ACL was low. The content of the informative texts should be organized while taking into account the patients’ literacy level. Cite this article as: Alper Şahin A, Boz M, Keçeci T, Ünal A, Çıraklı A. Readability and quality levels of websites that contain written information about anterior cruciate ligament injury: A survey of Turkish websites. Acta Orthop Traumatol Turc. 2022;56(2):88-93.

This study aims to biomechanically and histopathologically investigate the effects of methylene blue (MB) on preventing postoperative adhesion in chickens undergoing full- thickness flexor tendon incision. This study was performed between June 2017 and June 2018 on Hubbard JA 57 type chickens (age, 6 months; weight, 2.2±0.3 kg). Sixty-four tendons were studied in 32 chickens, including 16 in the control group and 16 in the experimental group. The second and third finger flexor digitorum profundus tendons of the left foot of each chicken were repaired primarily after a full-thickness incision approximately 1 cm proximal to the distal adhesion area. In the control (n=32) and experimental groups (n=32), 0.25 mL of normal saline and 0.25 mL of 1% MB solutions were applied locally to the surgical site, respectively. The operated limb was immobilized using a circular cast. 16 chickens were randomly selected in each group and examined at the fourth week, and the remaining 16 chickens were examined at the sixth week. Thirty-two of these tendons were evaluated using the Tang histopathological adhesion classification system, and the other 32 were evaluated with a biomechanical pull system. Adhesion was found to be less in the experimental group compared to the control group at the end of the fourth and sixth weeks both histopathologically and biomechanically. Furthermore, adhesion was significantly less in the experimental group at the end of the sixth week compared to the fourth week both histopathologically and biomechanically. Histopathological and biomechanical results show that MB, which has anti-inflammatory, antiseptic, antimicrobial and antioxidant effects, reduces adhesion during the healing process after tendon repair. We think that local MB application, particularly in surgeries performed after this type of injury, will be beneficial on early rehabilitation and functional results.

Evaluation of the Efficacy of Prolotherapy in Patients With Lateral Epicondylitis Using Shear-Wave Elastography - Article abstract #951728

Objective: The foot arch deformation increases plantar fasciitis (PF) and plantar calcaneal spur (PCS) for-mation. As a result, the heel fat pad becomes thinner. This study investigated the relationship between plantar fasciitis and foot arch angles. Methods: We performed a retrospective review of patients who had PF patients (n = 53) and healthy individu-als (n = 71) without PF. We have evaluated the presence of PCS and heel fat pad thickness measurements on magnetic resonance imaging (MRI), and the lateral talus-first metatarsal angle (Meary’s angle), lateral talocal-caneal angle, and calcaneal inclination angle measurements were performed on X-ray images. Results: The mean age of the PF group was significantly higher than the control group (p = 0.001). The degrees of Meary’s angle and calcaneus inclination angle were significantly higher in the PF group (p < 0.001 and p = 0.026, respectively) than in the control group. The incidence of PCS was significantly higher in the PF group (p = 0.028). In the binary logistic regression analysis model, high Meary’s angle and calcaneal pitch angle were found to be associated with the risk of PF. There was also a significant association between age and the pres-ence of PCS and PF. Conclusion: Changes in Meary’s angle and calcaneal pitch angle were significant risk factors for PF.