Background: In this study, the traditional “Anatomical Landmark-Distance Method (AL-DM)” in the formation of joint line (JL) was compared with “Adductor Tubercle-Ratios method” (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated. Materials and methods: 16 revision total knee arthroplasties (rTKAs) were performed by using “AT-RM” (group 1) and 16 rTKA by using “AL-DM” (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations. Results: Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values. Conclusion: “AT-RM” was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.

Objective. The aim of this study was to compare the clinical and radiological results of Mau osteotomy and Scarf osteotomy with a modified McBride procedure to patients with moderate to severe hallux valgus deformity.Methods. The study included 40 feet which patients were separated into 2 groups followed up for 5 months. Scarf osteotomy was applied to 20 patients including 16 females and 4 males (Scarf group)) and a Mau osteotomy to 20 patients including 17 females and 3 males (Mau group). Radiological measurements were taken preoperative, postoperative and at the final follow-up examination of the hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), metatarsocuneiform angle (MCA), the 1st metatarsophalangeal joint congruity, 1st metatarsal length, fibular sesamoid subluxation rate. Clinical evaluation was made according to the American Orthopaedic Foot and Ankle Society (AOFAS) and the severity of pain was assessed with the visual analog scale (VAS).Results. There was no difference between the groups in term of the mean HVA, IMA, MCA and DMAA values in preoperative and postoperative measurements. A significant improvement was determined in all the angle values in Scarf and Mau group (p < 0.001). A significant increase in DMAA and shortening in the metatarsal length were determined in Mau group compared to Scarf group (p < 0.001). An improvement in joint congruity was seen in the goups (p < 0.001). There was a significant improvement in term of the AOFAS and VAS values in the groups (p < 0.001).Conclusion. Scarf and Mau osteotomies can provide the desired level of improvement in the short-term follow-up results of moderate to severe hallux valgus deformity, taking into consideration the clinical importance that complications are not formed.

No consensus has been reached in the treatment of Frieberg disease. Our aim was to evaluate medium- to long-term results of patients with advanced Freiberg disease managed with extensor digitorum brevis tendon interpositional arthroplasty. There were 24 patients (19 females, 5 males) managed with interpositional arthroplasty for advanced Freiberg disease between 2003 and 2015. The mean follow-up was 133.8 (range, 60-198) months. According to Smillie classification, there were 4 grade 3, 13 grade 4, and 7 grade 5 patients. Patients were evaluated preoperatively and at the final follow-up with the American Orthopaedic Foot & Ankle Society (AOFAS) score and metatarsophalangeal joint range of motion and postoperatively with visual analog scale (VAS) and subjective satisfaction evaluation. Joint space was evaluated on x-rays. Mean AOFAS score increased (53.9 to 80.3, P = .001). Eight patients had excellent, 14 had good, and 2 had fair scores. A significant increase was found in dorsiflexion (38.1° [24°-52°] vs 55.3° [34°-65°]; P = .001) and plantarflexion (19.0° [10°-28°] vs 28.6° [19°-39°]; P = .001). Narrowing of the joint space was not seen in any patient, but expansion was determined in all patients (0.39 [0.35-0.47] vs 0.44 [0.41-0.47] cm; P = .002). Of the patients, 9 were very satisfied, 12 were satisfied, 2 were moderately satisfied, and 1 was dissatisfied. The mean postoperative VAS pain score was 1.7 ± 0.9 (0-4). After a minimum 5-year follow-up, most patients with Freiberg disease managed with interpositional arthroplasty using the extensor digitorum brevis tendon had excellent to good functional results with a widening of the joint space. Level IV, retrospective case series.

Objectives: The results of two different methods applied in the surgical treatment of forearm fractures in adults were evaluated.Methods: Thirty-nine patients who applied to our clinic between 2016-2018 and were treated surgically were included in the study. Twenty-three patients out of these were treated with plate osteosynthesis (group 1), and 16 patients were treated with intramedullary locking nail (group 2). While 14 of the patients in group 1 were male, 9 were female, and the average age was 39.8 years (range; 19-74 years); and 11 of the patients in group 2 were male, 5 were female, and the average age was 36.6 years (range; 18-68 years). Patients were called for monthly check-ups until fracture union. Then, radiographic evaluation was done at 3, 6 and 12 months. The average follow-up time was 26 months (range;12-36 months) for group 1 and 25 months (range;12-35 months) for group 2. The loss of the line of fracture through radiographic imaging of trabeculations or callus formation in the cortex on the anteroposterior and lateral radiographs, and clinically loss of sensitivity on fracture were considered fracture union. In the last controls, while the elbow was at 90 degrees of flexion, the amount of rotation of both forearms was measured by using the goniometer. In the functional evaluation, the system described by Grace and Eversmann and used to evaluate fracture union and forearm rotation was used. Patient satisfaction was evaluated by using the DASH (Disabilities of the Arm, Shoulder and Hand) method.Results: While the union duration in group 1 was 12.3 weeks (range; 8-18 weeks), the union duration in group 2 was 12 weeks (range; 9-16 weeks). There was no statistical difference in terms of union durations (p > 0.05). In Group 1, according to the Grace-Eversmann evaluation, 19 (82.6%) patients had excellent and good results, three (13.1%) patients had acceptable results, and 1 (4.3%) patient had poor results. Forearm pronation of the patient with poor results was less than 60% but his bone union was complete. In group 1, the average DASH score was 15.04 (range; 3-28). In group 2, Grace-Eversmann evaluation showed excellent and good results in 13 (81.3%) patients and acceptable results in 3 (18.7%) patients. Average DASH score was found to be 14.6 (range; 2-34). When Grace-Eversmann criteria and DASH values were compared, no significant difference was found between the two groups (p > 0.05). Vascular nerve injury, tendon injury, radioulnar synostosis, and compartment syndrome were not observed in any patient.Conclusions: The results of the two fixation methods in terms of functional recovery and patient satisfaction were similar in the surgical treatment of forearm double fractures in adults.

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.

Dislocation following total knee arthroplasty (TKA) is a rare but serious complication. Here, a 74-year-old woman with posterior dislocation of her right cruciate-retaining TKA and ipsilateral tibia diaphysis fracture was presented. She only slipped down on the ground with a quick twist of her right leg. She underwent revision semiconstrained TKA and osteosynthesis of tibial fracture with plate and screw. Her partially avulsed patellar tendon was repaired as well. She was ambulatory with a cane and satisfied with revision operation at last control. Extensor mechanism and functional posterior cruciate ligament is especially important in patients receiving cruciate-retaining TKA. As far as we know, simultaneous dislocation of TKA with fracture of tibia diaphysis has never been reported before.