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.
Introduction: This study aimed to retrospectively analyze patients who presented to the orthopedic and traumatology clinic following the 2023 Kahramanmaraş earthquakes. Patients and Methods: Over a week after the earthquakes, two hundred and sixty patients were consulted at our clinic. Demographic data of the patients, duration of being under the rubble, fracture locations, types of surgeries performed, number of surgical sessions attended by individuals, and early mortality rate within one month were determined. Results: The mean age of the patients was 40.2 ± 22.4 years. One hundred thirty-eight (53.1%) were female, and 122 (46.9%) were male. The average duration of being under the rubble was determined as 27.1 ± 28.0 hours. Sixteen patients died within one month after the earthquake. The one-month mortality rate among patients with orthopedic injuries was 6.15%. Forty-seven fasciotomies were performed in 35 patients, and 22 amputations were performed in 19 patients. The most injured region was the lower extremity (78 cases, 40%). The ratio of external and internal fixation in extremity fractures was 22%. Conclusions: The management of musculoskeletal injuries can be successful with proper triage and treatment plans. Decisions regarding fasciotomy and amputation in patients with crush syndrome following an earthquake should be individualized. Implant sets should be planned accordingly, especially considering the higher occurrence of lower extremity injuries.
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.
Objective: High-intensity laser therapy (HILT) is a relatively new form of Nd: YAG laser. The aim of the study is to investigate the additional benefits of HILT with conventional physiotherapy, related to pain and function, in patients with knee osteoarthritis (KOA). Method: The study comprised 43 knees from 31 patients of both genders with mean age 54.6 ± 6.22 (41–64) years. 53.49% of the knees were Kellgren Lawrence (KL) grade 2, and rest were KL grade 3 KOA. Group 1 ( n = 21) received transcutaneous electrical nerve stimulation (TENS), hot packs (HP), exercises (EX), and HILT (Nd: yag-laser, 10 W). Group 2 ( n = 22), received the same interventions but placebo HILT. All interventions were applied for 10 sessions. The Visual Analog Scale (VAS), Western Ontario & McMaster Universities Osteoarthritis Questionnaire (WOMAC), and Lequesne Algofunctional Index (LAI) were administered before, after, and at 12-week follow-up. Results: Baseline VAS, WOMAC, and LAI scores of the groups were similar ( p > 0.05). After treatment and 12 weeks of follow-up, both groups had significant relief for VAS, WOMAC, LAI pain (respectively, p < 0.001) and function ( p < 0.012), except LAI-walking distance ( p = 0.415). Post-hoc analyses and mixed-effects models showed no significant differences between groups over time for all variables. Conclusions: HILT did not provide additional short- or mid-term benefits in pain or function when added to a conventional physiotherapy and exercise program in patients with stage 2 or 3 knee osteoarthritis under 65 years of age.
Objectives: Diabetic foot infections are a major cause of morbidity and amputation, and increasing antibiotic resistance complicates their management. This study aimed to evaluate longitudinal changes in antibiotic resistance among bacterial pathogens isolated from patients undergoing toe amputation due to diabetic foot infections. Methods: This retrospective, single-center study included patients who underwent toe amputation for diabetic foot infections between 2013 and 2024. Microbiological culture results and antimicrobial susceptibility data were analyzed across three consecutive time periods: 2013–2016, 2017–2020, and 2021–2024. Results: A total of 351 patients were included (mean age, 64.1 years; 64% male). A history of dialysis was present in 30% of patients, and 54% had a history of prior hospitalization. A total of 351 patients were included in the study. A total of 378 bacterial isolates recovered from positive microbiological cultures were included in the antimicrobial susceptibility analysis. The most frequently isolated microorganisms were Escherichia coli, Enterococcus spp., coagulase-negative Staphylococcus, and Staphylococcus aureus. Among Enterobacterales isolates, statistically significant increases in resistance across the three consecutive time periods were observed for amoxicillin–clavulanate (p = 0.009), piperacillin–tazobactam (p = 0.002), trimethoprim–sulfamethoxazole (p = 0.012), and meropenem (p = 0.027), whereas the increase in imipenem resistance did not reach statistical significance (p = 0.054). Within Staphylococcus spp., a statistically significant increase in resistance across the three consecutive time periods was observed only for ciprofloxacin (p = 0.047). Conclusions: Changes in antimicrobial resistance rates were observed among bacterial isolates recovered from diabetic foot infections across the three consecutive time periods, highlighting the importance of regional surveillance and up-to-date local resistance data for guiding empirical antibiotic therapy.