[Purpose] The aim of this study was to determine the functional differences between total knee arthroplasty (TKA) patients who were treated with supervised physiotherapy or a standardized home program and perform a cost analysis. [Subjects and Methods] Patients who received total knee arthroplasty between January 2009 and June 2011 were enrolled in this study; those with mean ages of 64.25±3.86 (60-68) years (n=18) and 68.08±6.25 (61-79) years (n=16) were placed in the supervised physiotherapy and standardized home program groups, respectively. All patients were evaluated by the same researcher before and after surgery, and the therapy programs were applied by another physiotherapist. All patients were evaluated for joint range of motion (ROM), pain, functional status (WOMAC), overall quality of life (SF-36), and depressive symptoms (BECK Depression Scale). [Results] A significant clinical improvement was observed in postoperative assessments. A statistically significant difference could not be found between ROM and functional levels of the patients in both groups. [Conclusion] No difference was found between the patients performing supervised or standardized home program with respect to the effects on functional status. A home exercise program can be used in the rehabilitation of patients with TKA, and implementation of home exercise programs can also reduce health-care spending.

BACKGROUND: Impaired postural balance due to somatosensory data loss with mechanical instability has been shown in patients with ACL deficiency. Impaired postural balance due to somatosensory data loss with mechanical instability has been shown in pa

The current study aimed to determine the changes in pre-and post-operative Pittsburg sleep quality index (PSQI) and Tampa scale of kinesiophobia (TSK) values ​​according to the Hamada classification in patients who underwent reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy (RCTA). One hundred and eight patients who underwent RSA for RCTA were reviewed retrospectively. The patients were divided into two groups with low grade (stages 1-2-3) (n = 49) and high grade (stages 4a-4b-5) (n = 59) according to the Hamada classification, which is the radiographic evaluation of RCTA. PSQI and TSK values ​​were calculated preoperatively, and post-operatively at the 6th week, 6th month, and 1st year. The change in PSQI and TSK values ​​between the evaluations and the effect of staging according to the Hamada classification on this change was examined. When compared in preoperative evaluations, PSQI and TSK scores were found to be lower in low-grade group 1 (7.39 ± 1.56, 51.88 ± 4.62, respectively) than in high-grade group 2 (10.47 ± 2.39, 57.05 ± 3.25, respectively) according to Hamada classification (both p < 0.001). In the postoperative evaluations, PSQI and TSK results decreased gradually compared to the preoperative evaluations, and there was a severe decrease in both parameters between the 6th-week and 6th-month evaluations (both p < 0.001). Preoperatively, 102 (95%) patients had sleep disturbance (PSQI ≥ 6), and 108 (100%) patients had high kinesiophobia (TSK > 37). In the 1st year follow-ups, sleep disturbance was observed in 5 (5%) patients and kinesiophobia in 1 (1%) patient. When the Hamada stages were compared, it was seen that there was a significant difference before the operation (both p < 0.001), but the statistically significant difference disappeared in the PSQI value in the 1st year (p = 0.092) and in the TSK value in the 6th month (p = 0.164) post-operatively. It was observed that Hamada staging caused significant differences in PSQI and TSK values ​​in the preoperative period but did not affect the clinical results after treatment. RSA performed based on RCTA improves sleep quality and reduces kinesiophobia. RCTA stage negatively affects PSQI and TSK before the operation but does not show any effect after the treatment.

Objective: The aim of this study was to compare the therapeutic effect of sacroiliac (SI) blockade in patients with and without lumbosacral fusion.\r\nMethods: This study included 72 patients diagnosed with SI pain and who received blockade injection (methylprednisolone and lidocaine). Patients were divided into 2 groups; 22 patients in the fusion group who underwent previous lumbosacral fusion and 50 patients in the non-fusion group. Average follow-up was 17.7 (range: 6 to 30) months. All patients were evaluated before and after intervention using the Visual Analog Scale (VAS), Oswestry Disability Index, Rivermead Mobility Index and SF-36. Results were statistically analyzed.\r\nResults: Activity pain (a component of VAS) was significantly better in the non-fusion group than the fusion group (p=0.042). No other statistically significant differences were observed between groups (p>0.05).\r\nConclusion: Sacroiliac blockade has a similar therapeutic effect on patients who underwent lumbosacral fusion surgery as on non-operated patients in the middle-term. Therefore, alternative treatment options are not necessary in patients with fusion. Özet Amaç: Bu çalışmanın amacı lumbosakral füzyonlu hastalar ile füzyonu olmayan hastalarda sakroiliak (SI) blokaj uygulamasının terapötik etkilerini karşılaştırmaktı.\r\nÇalışma planı: Blokaj enjeksiyonu (metilprednizolon ve lidokain) ile SI ağrı tanısı almış 72 hasta çalışmaya alındı. Daha önce lumbosakral füzyon öyküsü olan 22 hasta ilk gruba alınırken, füzyonu olmayan 50 hasta ikinci grubu oluşturdu. Hastalar ortalama 17.7 (dağılım: 6-30) ay takip edildiler. Hastalar enjeksiyon öncesinde ve sonrasında Görsel Analog Skala (GAS), Oswestry Özür Anketi, Rivermead Mobilite İndeksi ve SF-36 ile değerlendirildiler. Sonuçların istatistiksel karşılaştırması yapıldı.\r\nBulgular: Sonuçlarda sadece GAS’ın ‘aktivite ağrısı’ bileşeni füzyonsuz grubun lehine anlamlı bir fark gösterdi (p=0.042). Diğer parametreler arasında anlamlı bir fark bulunamadı (p>0.05).\r\nÇıkarımlar: Sakroiliak blokaj tedavisinin, orta vadede, lumbosakral füzyonlu hastalarda ameliyat geçirmemiş hastalardakine benzer bir terapötik etkisi olduğunu söyleyebiliriz. Bu nedenle, füzyonlu hasta grubunda farklı bir tedavi alternatifi düşünülmesine gerek yoktur.

Background: The study aimed to determine the grade of retraction and atrophy according to the time elapsed in traumatic isolated full-thickness supraspinatus (SS) tears in young patients. Methods: One thousand twenty-six patients, who underwent arthroscopic shoulder surgery, were retrospectively reviewed. Pre-operative magnetic resonance imaging (MRI) of 69 patients aged 18 to 40 years with isolated traumatic full-thickness SS lesions remaining after exclusion criteria were evaluated for tendon retraction and atrophy grades. SS retraction was determined from a T2-weighted oblique coronal MRI slice, and the atrophy grade was determined from the T1-weighted oblique sagittal MRI slice. The patients were divided into four groups 0–1 month, 1–3 months, 3–6 months, and 6–12 months according to the time between trauma and MRI. The relationship of tendon retraction and muscle atrophy with elapsed time was evaluated, in addition, comparisons between groups were made. Results: Thirty-one (45%) of the patients were female and their mean age was 30 ± 7.3 (18–40) years. The mean age of men was 30.5 ± 6.9 (18–39) years (p = 0.880). The time between rupture and MRI was moderately correlated with retraction and strongly correlated with atrophy grades (r = 0.599, 0.751, respectively). It was observed that there was a statistically significant difference between the 1st (0–1 month) and 2nd (1–3 months) groups (p = 0.003, 0.001, respectively), and between the 2nd and 3rd (3–6 months) groups (p = 0.032, 0.002, respectively), but there was no significant difference between the 3rd and 4th (6–12 months) groups (p = 0.118, 0.057, respectively). In addition, there was a moderate correlation between tendon retraction and atrophy grades (r = 0.668). Power (1- b) in post hoc analysis was calculated as 0.826. Conclusions: The current study, supported by arthroscopy, showed that there is a moderate and strong positive correlation between the time elapsed after trauma and the level of retraction and degree of atrophy in traumatic full-thickness SS tears, and demonstrated the importance of early surgical intervention in young patients.