Lumbar spinal stenosis (LSS) frequently coexists with degenerative spondylolisthesis (DS) in the elderly population, and the standard treatment commonly involves decompression with fusion. However, fusion procedures are associated with increased morbidity and may not always be necessary, particularly in Grade I DS. Full-endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) has gained attention as a motion-preserving alternative, yet its impact on postoperative stability remains insufficiently studied. Primary objective was to evaluate 12-month improvements in patient-reported outcomes (leg-pain VAS, ODI) after LE-ULBD; radiographic stability was assessed as a key secondary endpoint. This retrospective cohort study included 32 patients with Meyerding stable Grade I DS and symptomatic LSS who underwent single-level lumbar LE-ULBD between January 2023 and October 2024. Pre- and 12-month postoperative radiographs were analyzed for segmental instability, defined as sagittal translation > 4 mm or angular motion > 10°. Clinical outcomes were assessed using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Macnab’s criteria. Subgroup analysis was performed based on slip progression. Mean vertebral slip percentage showed no significant change postoperatively (13.4% ± 3.1 vs. 13.8% ± 3.4; p = 0.27). Only one patient (3.1%) developed new radiographic instability. VAS improved from 7.1 ± 1.2 to 1.4 ± 0.8 and ODI from 64.3% ± 9.1 to 18.5% ± 4.7 (p < 0.001 for both). According to Macnab’s criteria, 90.6% of patients reported Excellent or Good outcomes. Slip progression was observed in 9 patients (28.1%), but this was not associated with inferior clinical results. Complications occurred in 2/32 (6.3%) one incidental durotomy and one epidural hematoma with reoperation in 1/32 (3.1%); new radiographic instability in 1/32 (3.1%). LE-ULBD appears to be a safe and effective treatment option for selected patients with Grade I DS and LSS, achieving significant symptomatic relief while preserving segmental stability in the majority of cases. These findings support its consideration as an alternative to fusion in carefully selected individuals. LE-ULBD short-term (12-month) radiographic stability and clinically meaningful improvement in patients with stable grade-I degenerative spondylolisthesis; longer-term follow-up is required to determine durability and late instability risk.

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 purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN). A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria. The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29–55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60–92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a “bone ingrowth” in 16 (89%) hips, “suspected in-growth” in 1 (5.6%) hip and “suboptimum but stable” femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842). Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.

Objective: Neural tube defects are the most common congenital disorders after cardiac anomalies. Lumbar kyphosis deformity is observed in 8–15% of these patients. This deformity severely limits the daily lives of these patients. In our study, we aimed to correct the kyphosis angle of the patients with lumbar kyphosis associated with myelomeningocele (MMC) and allow them to continue their growth without limiting their lung capacity by applying kyphectomy and sliding growing rod technique. Patients and methods: In this study, we retrospectively evaluated 24 patients with congenital lumbar kyphosis deformity associated with MMC, aged between 4 and 9 years, and who applied to Umraniye Training and Research Hospital between the dates of 2018 and 2021. We evaluated preoperative and postoperative kyphosis angles, correction rates, bleeding during operations, operation time, level of instrumentation, number of the resected vertebrae, initial levels of the posterior defects, duration of hospital stays, annual lengthening, and weight of the patients. Results: Mean age was 5.04 (between 4 and 9). Mean preoperative and early postoperative kyphosis angles were 129.8° (87–175°) and 0.79° (− 20–24°), respectively. The kyphotic deformity correction rate was 99.1%. A difference was found regarding kyphosis measurements between preoperative and early period values (p < 0.05). The annual height lengthening of patients was calculated as 0.74 cm/year and 0.77 cm/year between T1–T12 and T1–S1, respectively. Mean preoperative level of hemoglobin (Hgb) was 11.95, postoperative Hgb value was 10.02, and the decrease was significant (p < 0.05). In terms of complications, 50% (12) had broken/loosen screws, 50% (12) had undergone debridement surgery, 37.5% (9) had vacuum-assisted closure therapy, and 33.3% (8) had to get all of their implants removed. Conclusion: We believe that our sliding growing rod technique is a new and updated surgical method that can be applied in these patient groups, facilitating the life, rehabilitation process, and daily care of MMC patients with lumbar kyphosis. This technique seems to be a safe and reliable method which preserves lung capacity and allows lengthening.

Background/Objectives: Osteochondral lesions are common after acute patellar dislocation, particularly in young, active individuals. Although fixation of osteochondral fragments is a preferred treatment to restore joint congruence and prevent cartilage degeneration, the prognostic effect of lesion localization and size on postoperative outcomes remains unclear. Methods: This retrospective clinical study included 75 patients (mean age 23.8 ± 6.1 years) who underwent osteochondral fixation after patellar dislocation between 2018 and 2024. Lesions were classified by location—medial patellar facet, lateral facet, trochlear groove/lateral femoral condyle, or multiple regions—and measured on preoperative MRI for size and depth. Functional outcomes were assessed using Kujala, Lysholm, Tegner, and VAS pain scores preoperatively and 12 months postoperatively. Associations between lesion characteristics and postoperative results were analyzed using t-tests, ANOVA, and Pearson correlation. Results: Lesions were most frequently located on the medial patellar facet (42.7%), followed by the trochlear groove/lateral femoral condyle (34.7%). Larger and deeper lesions were more common in trochlear or multiple-site involvement (p = 0.002 and p = 0.031, respectively). At final follow-up, all functional scores improved significantly (Kujala: 62.4 ± 11.3 to 86.7 ± 9.1; Lysholm: 64.1 ± 12.0 to 88.2 ± 8.3; VAS: 6.2 ± 1.3 to 2.1 ± 1.1; all p < 0.001). Patients with smaller lesions (<100 mm²) and medial facet involvement achieved higher Kujala scores (p = 0.020) and lower postoperative pain (p = 0.001). The overall return-to-sport rate was 78.7%, and postoperative complications occurred in 10.7% of cases, mainly recurrent dislocation or implant irritation. Conclusions: Lesion localization and size significantly affect postoperative outcomes after osteochondral fixation for patellar dislocation. Medial facet and smaller lesions are associated with better pain relief and functional recovery, whereas large or trochlear lesions carry a less favorable prognosis. Morphological assessment of lesion characteristics should therefore guide surgical planning, fixation strategy, and postoperative rehabilitation to optimize clinical outcomes.