Background and objectives: Cryotherapy is a method of treatment using cold application. This study aimed to evaluate postoperative clinical and hematological parameters and pain associated with total knee arthroplasty in patients and compared cryotherapy to the conventional method of cold ice pack compressions. Materials and Methods: Between January 2015 and January 2016, 90 patients who underwent total knee arthroplasty for grade 4 gonarthrosis were prospectively evaluated. The patients were divided into three groups (n = 30, each): Group 1, cryotherapy was applied in the pre- and postoperative periods; Group 2, cryotherapy was applied only in the postoperative period; and Group 3 (control group), only a cold pack (gel ice) was applied postoperatively. In all groups, pre- and postoperative evaluations at 6, 24, and 48 h, hemorrhage follow-up, knee circumference measurement, visual analog scale pain score, knee circumference, and temperature measured by thermal camera were recorded. Results: Of the 90 patients, 10% were men and 90% were women. The mean age was 64.3 ± 8.1 (range: 46–83) years. The patella upper end diameter values were significantly lower in the postoperative period in Groups 1 and 2 than in Group 3 (p = 0.003). Hemoglobin levels at 24 and 48 h postoperatively were significantly lower in Group 3 than in Group 1 (p < 0.001, each) and Group 2 (p = 0.038, p < 0.001). At 6, 24, and 48 h follow-ups, pain values were significantly lower in Group 2 than in Group 3 (p < 0.001). Preoperative 6, 24, and 48 h temperature values were significantly lower in Group 1 than in Group 3 (p < 0.001 for each). It was found that the difference between preoperative and postoperative knee flexion measurements was significantly different in both groups or the difference between the groups was changed in each period (p < 0.001). Conclusions: Postoperative cryotherapy is a potentially simple, noninvasive option and beneficial for the reduction of reducing pain, bleeding, length of stay, analgesic requirement and swelling after total knee arthroplasty. Moreover, there was no early or late prosthesis infection in cryotherapy groups, which may be considered as an additional measure to prevent prosthesis infection.

This study aims to investigate the effect of tranexamic acid (TXA) on the union of closed femoral fractures using radiological and histological methods in an experimental rat model. This experimental study was conducted between June 2017 and February 2018. Closed femoral fractures were created in 36 male Wistar albino rats (age: three months [range, 2.5-3.5 months], weighing 200 grams [range, 180-220 grams]). Half of the animals randomly divided into two groups were administered intravenous single dose of TXA (30 mg/kg), whereas the animals in the control group did not receive any medication. The animals in the two groups were randomly divided into three groups with six animals each and cervical dislocation was performed at days 15, 30, and 45, and radiological and histopathological healing scores were compared. When the mean radiological scores of the TXA and control groups were compared, a statistically significant difference was found in favor of the TXA group at day 15 (p=0.019), but no significant difference was found in the mean scores on days 30 and 45 (p=0.138 and p=0.269, respectively). Histopathological examination also showed a statistically significant difference between the 15-day mean score values in favor of the TXA group ( p = 0. 017 ). The use of systemic TXA accelerates early bone formation and fracture healing.

Background and objectives: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterized by varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateral deviation of the extensor tendons and sesamoid bones. Several surgical methods have been described for correction of the deformity. Different materials have been used for the fixation of osteotomy. We compared the functional, radiological, and pain results of intramedullary self-locked plates and Herbert screws for the treatment of a hallux valgus deformity. Materials and Methods: Distal metatarsals were treated with self-locking intramedullary plate–screw systems in 18 feet from 12 patients (Group 1) and with Herbert screws in 18 feet from 12 patients (Group 2). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) in patients of Group 1 and 2 were examined radiologically during the pre- and postoperative periods. We also determined the American Orthopedic Foot and Ankle Society (AOFAS), EQ-5D General Life Quality Scale, and Visual Analogue Scale (VAS) scores during the pre- and postoperative periods and compared the scores between groups. Results: Post hoc test results of HVA and IMA angles measured after the operation were significantly higher in Group 2 than in Group 1. In each group, the AOFAS scores during the preoperation period were significantly lower than those during the postoperation period (p < 0.001). According to the post hoc test results, the VAS scores after the operation were significantly higher in Group 2 than in Group 1 (p < 0.001). Conclusions: For the surgical treatment of hallux valgus, operations using self-locked plates compared to a single screw are superior in terms of providing rigid stability and for functional, radiological, and pain scores.

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.

Background and Objectives: This study aimed to determine the relationship between non-simultaneous contralateral hip fractures, urban and rural differences, fracture localization, time between fractures, physiotherapy applications, comorbidity, and the second fracture outcomes. Materials and Methods: We retrospectively analyzed 107 patients aged 65 and older with proximal femur fractures (PFFs) who underwent surgery at Düzce University Medical Faculty between January 2010 and December 2022. High-energy fractures, pathological fractures, and patients with a history of old fractures were excluded. Results: The study included 66 females (61.7%) and 41 males (38.3%), with a mean age of 83.76 years. The mean interval between two fractures was 28.3 months. There was no statistical difference between the localization of the first and second fractures (p = 0.107). However, there was a significant difference in the first PFF localizations of patients living in rural areas (p = 0.023). Patients with heart failure, respiratory failure, osteoporosis, and cognitive impairment had shorter intervals between fractures (p < 0.001). Conclusions: This study shows that age, female gender, place of residence, comorbid diseases, and whether physical therapy is received after the first fracture are significant risk factors for a second hip fracture in patients over 65 years of age.

Objective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate or conventional microsuture technique in a rat peripheral nerve injury model. Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomly divided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventional microsuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No further intervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumatic nylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography (EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conduction velocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolar degeneration, fibrosis, and foreign body reaction histopathologically. Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2 (1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and 3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3 (2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCV was 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant difference between groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathological evaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obvious difference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2, and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reaction score was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743). Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathological results as compared to the conventional microsuture repair. Cite this article as: Atam C, Orhan Z, Toplu G, Serin M, Karaduman ZO, Öztürk A. Comparison of peripheral nerve repair using ethyl-cyanoacrylate and conventional suture technique in a rat sciatic nerve injury model. Acta Orthop Traumatol Turc 2020; 54(3): 330-6. DOI: 10.5152/j.aott.2020.03.156.