Objective: The purpose of our study was to evaluate aortic stiffness and distensibility changes and the presence of aortic and mitral valve calcifications in patients with primary knee osteoarthritis (OA), using 2-dimensional and Doppler transthoracic echocardiography. Methods: This case-control study included 115 participants with OA and a control group between May 2019 and November 2019. The Kellgren-Lawrence classification was used for the diagnosis and classification of knee OA, based on radiological images. We compared the demographic data, 2-dimensional and Doppler transthoracic echocardiography results, and laboratory findings between the OA patient group and the control group. Results: There was a significant difference between aortic strain, aortic distensibility, aortic stiffness, and C-reactive protein values between the OA patient group and the control group (p < 0.001 for all). Post hoc analyses revealed that aortic strain and aortic distensibility values were significantly lower, and aortic stiffness values were significantly higher in the grade 4 OA group than those of other groups (p < 0.05 for all). In addition, the C-reactive protein values of the grades 3 and 4 patients were significantly higher than those of other groups (p < 0.05 for all). No significant difference was observed between the groups in terms of aortic and mitral valve calcifications (p > 0.05 for all). Conclusion: Aortic strain and distensibility values were lower in the advanced grades of primary knee OA, whereas aortic stiffness values and the frequency of valve calcifications were higher.

BACKGROUND: Various surgical techniques have been defined for hip hemiarthroplasty (HA), including metaphyseal vs. diaphyseal and short stem vs. long stem. The present study aims to compare outcomes of metaphyseal fixed short-stem vs. diaphyseal fixed long-stem HA in treating unstable intertrochanteric fractures in elderly patients. METHODS: This study was conducted retrospectively and included 129 patients >= 65 years of age, having unstable intertrochanteric fractures and undergoing HA. Outcome measures were the 2-year Harris hip score and the mobility score of Parker and Palmer; comorbidities as well as mortality rates of the groups were compared. RESULTS: Mean operation time and median full weight-bearing time were significantly shorter in group B (p<0.05 for both). As for the Harris hip scores, group B showed better outcomes for the third-month evaluation (p=0.006). However, 2-year assessments were similar (p=0.067). In addition, higher Parker and Palmer mobility scores were obtained in group B at the 2-year assessment (p<0.001). The frequencies of prosthetic dislocation, cortical porosis and subsidence were higher in group A (p<0.05 for all). CONCLUSION: The findings obtained in this study suggest that diaphyseal fixed long-stem HA seems to be superior to the metaphyseal fixed short-stem HA because the former is related to better functional scores, earlier mobilization, and lower complication rates.

Objective: The aim of this study was to compare the number of deep vein thrombosis (DVT) cases during the quarantine period for COVID-19 to that of the last year. Methods: This study was conducted as a single-center and retrospective study. All hospital admissions during April 2020 and May 2020 were screened from the hospital records, and DVT cases were recorded. Likewise, all hospital admissions during April 2019 and May 2019 were screened, and DVT cases were noted. DVT cases of both years were compared. Results: Among 480931 patients admitted to our hospital in April 2019 and May 2019, DVT was detected in 82 patients (0.017%) (47 males, 35 females) with a mean age of 56.99 ± 9.1 years (ranges 39 to 79 years). Besides, among 145101 patients admitted to our hospital in April 2020 and May 2020, DVT was detected in 123 patients (0.084%) (51 males, 72 females) with a mean age of 58.64 ± 8.9 years (ranges 40 to 83 years). Despite the decrease in the total number of patients admitted to the hospital, there was a significant increase in the number of DVT patients. Interestingly, there were only two symptomatic pulmonary-embolism cases in the 2019 period, whereas there were seven symptomatic pulmonary embolisms secondary to DVT in the 2020 period. Unfortunately, one patient died due to pulmonary embolism secondary to DVT in 2020. The previous history of DVT was remarkable in patients admitted during the COVID-19 confinement. Conclusion: In conclusion, COVID-19 confinement seems to be associated with increased rates of DVT. Strict preventive measures such as exercise training or prophylactic drug use should be considered to prevent immobility-related DVT during the COVID-19 quarantine.

Objective: The aim of this study was to conduct a sonographic assessment of sciatic nerve thickness and stiffness following total hip arthroplasty (THA) and to determine the relationship between sonographic characteristics of the sciatic nerve and clinical outcomes. Methods: This prospective study included patients undergoing primary cementless THA due to hip osteoarthritis between January 2018 and January 2019 in a tertiary-level hospital. The thickness, strain elastography, strain ratio (SR), and shear wave elastography (SWE) of the sciatic nerve were measured. The clinical outcome measures included leg lengthening (LL), leg length discrepancy (LLD), Oxford Hip Score (OHS), Visual Analog Scale (VAS) at rest, VAS during activity, and the Leeds Neuropathic Symptoms and Signs Evaluation (LANSS) scale. The data of the patient group were assessed preoperatively and at 3, 6, and 12 months postoperatively. Results: The sciatic thickness and SR values of the operated side were significantly lower than those of the non-operated side (P < 0.05 for all). The sciatic SWE was significantly greater on the operated side compared with the non-operated side (P < 0.001 for all). Sciatic nerve thickness and SR were negatively correlated, and sciatic nerve SWE was positively correlated with OHS, VAS at rest, VAS during activity, and LANSS values. Sciatic nerve thickness and SR values were significantly lower, and SWE was significantly higher in the group with a change in LL > 20 mm. Clinical scores decreased during the following period in mild and moderate lengthening group (< 20 mm). In the severe lengthening group (≥ 20 mm), the clinical score increased over time. The VAS activity score was higher in the mild and moderate LL group (< 20 mm) than the VAS rest score (P < 0.001). However, the VAS rest score was significantly higher in the severe LL group (≥ 20 mm) than the VAS activity score (P < 0.001). Conclusion: The results of this study have shown a significant relationship between thickness and stiffness of the sciatic nerve and LL after THA. The ultrasound parameters were significantly associated with functional outcomes. Level of Evidence: Level IV, Therapeutic Study Cite this article as: Ciloğlu O, Karaali E, Görgülü FF, Toğrul E. Evaluation of the relationship between stiffness and thickness of the sciatic nerve and clinical outcomes after total hip arthroplasty: A prospective case-controlled study. Acta Orthop Traumatol Turc 2021; 55(6): 500–507.

Objective: The aim of the study was to compare postoperative pain, functional recovery, knee stability and complication profiles between the all-inside technique and the conventional full tibial tunnel technique for anterior cruciate ligament (ACL) reconstruction. Methods: This retrospective comparative cohort study included 104 patients who underwent primary ACL reconstruction between 2018 and 2020. Surgical technique allocation was non-randomized. Patients were divided into two groups based on the surgical technique employed; the conventional full tibial tunnel group (n = 58) and all-inside group (n = 46). Hamstring tendon autografts were used in all cases, and the procedures were performed by the same surgical team to ensure consistency. Clinical outcomes were evaluated using the Visual Analog Scale (VAS) for pain, Lysholm knee score and International Knee Documentation Committee (IKDC) score. Knee stability was assessed with the Lachman and pivot-shift test. Additionally, postoperative complications and revision rates were recorded. Results: The study included 104 patients, with 58 treated using the conventional technique and 46 using the all-inside technique. Baseline characteristics, trauma mechanisms, and follow-up duration were comparable between groups (p > 0.05). Four patients in each group underwent revision surgery and excluded from the final analysis. Revision rates were comparable between groups (6.9% vs. 8.6%) and were considered descriptively when interpreting outcomes. The preoperative VAS, Lysholm and IKDC scores were comparable between groups. At 3 months, the all-inside group demonstrated significantly lower VAS pain scores and higher Lysholm and IKDC scores (with moderate-to-large effect sizes) (all p < 0.01). No significant differences were observed at the 12-month or final follow-up. Postoperative knee stability was comparable between groups, whereas anterior knee pain was significantly less frequent in the all-inside group (p < 0.001). Moreover, patients treated with the all-inside technique returned to sports significantly earlier than those treated with the conventional technique (13.25 ± 2.70 vs. 16.40 ± 5.85 months, p < 0.001; Cohen’s d = 0.66). However, the proportion of patients who returned to their preinjury sports level was comparable between the two groups (81.0% vs. 83.3%, p = 0.78). Conclusions: The all-inside ACL reconstruction technique was associated with superior early pain relief and short-term functional outcomes compared with the conventional technique, while achieving comparable knee stability and mid-term clinical results. These advantages occur without increasing complications or revision rates. These findings support the all-inside technique as patient-centered, optimizing early recovery without sacrificing mid-term clinical durability. These findings should be interpreted in the context of the non-randomized retrospective study design.