Objectives: This study aims to assess whether platelet rich plasma (PRP) is an effective treatment for knee osteoarthritis (OA), and compare its efficiency with corticosteroid treatment in terms of pain control, physical function, and quality of life. Patients and methods: The study included 50 patients (4 males, 46 females; mean age 61.6±6.9 years; range 50 to 75 years) who were diagnosed as grade 3 knee OA. Patients were randomized into three groups as corticosteroid group (receiving one corticosteroid injection), single PRP group (receiving one PRP injection), and three PRP group (receiving three PRP injections with one week interval). All patients were given a home exercise program. Patients were evaluated with Visual Numeric Scale (VNS), Western Ontario and McMaster Universities Arthritis Osteoarthritis Index (WOMAC), Lequesne index and the Hospital Anxiety and Depression Scale before treatment, and at second and sixth months following the implementation of injections. Results: In single and three PRP groups; VNS, WOMAC and Lequesne scores decreased significantly at second month follow-up; also, sixth month scores showed a slight increase but remained significantly lower than baseline. In corticosteroid group, all VNS, WOMAC, and Lequesne scores decreased at second month follow-up; however, at sixth month, rest, night VNS and WOMAC stiffness scores were increased while no significant difference was found with baseline. At sixth month; VNS movement, WOMAC pain, function, and the total and Lequesne scores were worse, but remained significantly lower than baseline. When groups were compared, three PRP group's second month VNS movement scores were significantly lower than the corticosteroid group. Sixth month VNS movement and WOMAC pain scores were significantly lower in single and three PRP groups compared to the corticosteroid group, with no significant difference between the PRP groups. Conclusion: Our findings revealed that PRP is a safe treatment option and efficient in OA symptom control up to six months after application. Treatment response obtained with corticosteroid injection has a shorter duration than PRP treatment.

Objective:The study aimed to investigate whether there is any association of anterior knee pain and knee function with chondromalacia stage and patellofemoral alignment in patients with anterior knee pain for over a month and with chondromalacia patellae (CMP) detected by magnetic resonance imaging (MRI). Materials and Methods: We reviewed the medical records of 38 patients who underwent a knee MRI examination and were diagnosed with chondromalacia based on the MRI. Knee MRI images were evaluated by a radiologist for chondromalacia staging. Patients were divided into two groups as early stage (stage 1-2) and advanced stage (stage 3-4) chondromalacia. Patients' demographical data (age, sex, and occupation), clinical features, physical examination findings and patellofemoral pain severity scale, kujala patellofemoral scoring system, and functional index questionnaire scores were obtained from their medical records. Trochlear sulcus angle, sulcus depth, lateral patellofemoral angle, patellar translation, and Insall-Salvati index were measured using the MRI images. Results: The mean patient age was higher in the advanced stage CMP group compared to the early stage CMP group (p=0.038). There was no statistically significant difference regarding other demographical data (p>0.05). MRI measurement parameters did not show difference between the groups (p>0.05). Patients in the advanced stage CMP group had higher patellofemoral pain severity score, lower kujala patellofemoral score, and lower functional index questionnaire score compared to the early stage CMP group. The differences were statistically significant (p=0.008, p=0.012, and p=0.026, respectively). Conclusion: As chondromalacia stage advances, the symptom severity worsens and knee functions decline; however, MRI measurements do not show difference between early and advanced stage CMP patients.

Introduction:Anti-tumor necrosis factor (anti-TNF) treatments are effective in controlling disease activity in many immune-mediated diseases such as psoriasis and ankylosing spondylitis (AS). Although side effects such as infection and skin reactions are predictable in anti-TNF treatment; susceptibility to psoriasis is considered as a paradoxical side effect.Case report:We report a case of forty-year-old male patient with 7 years of AS was taking anti-TNF therapy. He admitted our clinic with widespread guttate sized round, crusty rashes at feet, legs and elbows. In pathological examination of lesions; focal parakeratosis, mild acanthosis, capillary proliferation in the papillary dermis and focal extravasated erythrocytes were observed. He was diagnosed as anti-TNF induced guttate psoriasis. Although there is no definite treatment option, topical treatments, interrupting drug treatment or adding a disease-modifying agent for psoriasis are recommended. In this case report, we aimed to share our clinical approach to the paradoxical psoriasis manifestation which developed after two different anti-TNF treatments in a patient with AS.

Background Although cardiac implantable electronic device ( CIED ) implantation is considered to be minor surgery, almost 60% of the patients suffer from shoulder‐related problems a short time after the procedure. The purpose of this study was to determine the possible effects of the preference of the dominant side for CIED implantation on the ipsilateral superior extremity functions. Methods The study included a total of 107 patients who had been living with a CIED for >6 months. Patients were separated into two groups according to the dominant hand and side of the CIED . The ipsilateral dominant‐hand group comprised those with a CIED on the same side as the dominant hand and the contralateral dominant‐hand group included patients with the CIED placed on the contralateral side to the dominant hand. Visual analogue scale ( VAS ) pain score, quick disability of the arm shoulder and hand questionnaire (Quick DASH ) and maximum isometric grip strength tests were used to evaluate the upper extremity disabilities. Results No significant difference was determined between the groups in respect of VAS pain scores ( P = 0.10), Quick DASH scores ( P = 0.21), and limitations of the shoulder joint range of motion ( P = 0.192). The maximum isometric grip strength was significantly different in the right hands between two groups (34 [16‐95]‐40 [24‐85]) ( P = 0.02). Conclusion The present study shows that the joint range of motion limitation, pain, and disability of the upper extremity were no different in the affected arm compared to the healthy contralateral side with respect to the placement of the CIED on the dominant or non‐dominant side.

Background/aim: Clinicians associate the changes in cervical lordosis with neck pain, but there is no clear consensus on this. We aimed to investigate the relationships of cervical angles, neck pain, disability, and the psychological status of the patients with acute and chronic neck pain.Materials and methods: A total of 110 patients with neck pain were included in this study. Demographic and clinical characteristics of the patients were recorded. The lordosis angle was determined by the posterior tangent method. A visual analog scale (VAS), the Neck Disability Index (NDI), and the Hospital Anxiety and Depression (HAD) scale were administered to all patients. Results:The mean cervical lordosis angle was 23.10 ± 8.07 degrees. A statistically negative correlation was detected between cervical angle and duration of disease (P < 0.05). The cervical angle of the acute neck pain group was higher than that of the chronic pain group (P < 0.05). There was no difference between the acute and chronic neck pain groups with respect to VAS, NDI, and HAD scores (P > 0.05). Conclusion:We found that the cervical angle was significantly lower in chronic neck pain patients when compared to acute patients, and patients with higher pain scores had more severe disability and that disability increased with the duration of disease.