Histopathological examination revealed that both LMWH and rivaroxaban have positive effects on tendon healing. However, the same positive effects were not detected in biomechanical examination.

ObjectiveThe aim of the present study was to evaluate histopathological and biomechanical effects of isotretinoin on Achilles tendon.Materials & methodsSixteen rats were divided into two groups including the control group (n = 8) and isotretinoin group (n = 8). The control group received 1.42 ml/kg soy oil per day whereas the isotretinoin group received 15 mg/kg/day (gavage dose 1.42 ml/kg) isotretinoin dissolved in soy oil through gavage method for 6 weeks. Achilles tendons were excised at the end of week 6. The tendon samples were evaluated by hematoxylin-eosin under a light microscope. Quantitative evaluation was performed via Movin and Bonar scoring. A computer-monitored tensile testing machine was utilised for biomechanical testing. Biomechanical characteristics of the tendon samples (elastic modulus, yield force, ultimate tensile force) were measured.ResultsHistopathological evaluation revealed a significantly higher Movin and Bonar scores in histopathological evaluation. Movin score in isotretinoin group was 4.1 ± 2.5 and it was 2.3 ± 1.0 in control group (p = 0.032). Bonar score in isotretinoin group was 2.9 ± 1.4 and it was 1.6 ± 0.7 in control group (p = 0.022). In line with histopathological evaluation, biomechanical measurements in isotretinoin group (elastic modulus, yield force, ultimate tensile force) were significantly lower than the control group. Elastic modulus in isotretinoin group was 227 ± 27.7 N/mm2 and in control group it was 281.7 ± 38.7 N/mm2 (p = 0.006). In isotretinoin group; yield force was 33.7 ± 4.3 Pa and in control group it was 40.8 ± 5.9 Pa (p = 0.021). Ultimate tensile force in isotretinoin group was 35.7 ± 4.2 Pa and in control group it was 44 ± 7 Pa (p = 0.009).ConclusionThe present study detected histopathological and biomechanical negative effect of isotretinoin on Achilles tendon. Therefore, isotretinoin should be questioned in medical history of patients with tendinopathy.

ÖZAmaç: Bu çalışmada talon tibial intramedüller (İM) çivilemenin sonuçları ile konvansiyonel distal kilitli tibial İM çivilemenin sonuçları karşılaştırıldı. Hastalar ve yöntemler: Çalışmaya Ocak 2013 -Ocak 2016 tarihleri arasında tek taraflı, kapalı veya açık (Gustilo-Anderson tip 1) tibia diyafiz kırığı (Ortopedik Travma Birliği 42) tanısı ile tibial İM çivileme yapılan 60 hasta (37 erkek, 23 kadın; ort. yaş 42.2 yıl; dağılım 18-92 yıl) dahil edildi. Hastalar talon tibial İM çivileme grubu (grup 1, n=30) ve distal kilitli tibial İM çivileme grubu (grup 2, n=30) olmak üzere iki gruba ayrıldı. Tüm hastaların ameliyat ve toplam radyasyona maruz kalma süreleri kaydedildi. Son kontrolde, Amerikan Ortopedik Ayak ve Ayak Bileği Derneği ve Tegner Lysholm skorları klinik sonuçlar açısından değerlendirildi. Tüm komplikasyonlar kaydedildi. Bulgular: Ortalama ameliyat süresi grup 1'de 43.8 dakika, grup 2'de 50.2 dakika idi. Grup 1'de ortalama radyasyona maruz kalma süresi 5.4 dakika idi ve bu süre 17.5 dakika olan grup 2'nin süresinden üç kat daha kısa idi. Kaynamaya kadar geçen ortalama süre, grup 1'de 16.9 hafta ve grup 2'de 12.2 hafta idi. Ameliyat, radyasyona maruz kalma ve kaynama sürelerinde iki grup arasında istatistiksel olarak anlamlı farklılıklar vardı (sırasıyla p= 0.009, p= 0.001, p= 0.001). Amerikan Ortopedik Ayak ve Ayak Bileği Derneği ve Tegner Lysholm skorları karşılaştırıldığında, istatistiksel olarak anlamlı farklılık yoktu (p= 0.951 ve p= 0.896). Sonuç: Talon tibial İM çivileme, daha kısa ameliyat ve radyasyona maruz kalma süreleri ile konvansiyonel distal kilitli tibial İM çivilemenin daha kolay ve güvenilir bir alternatifidir. Bununla birlikte, radyografik kaynamaya kadar geçen sürenin konvansiyonel tibial İM çivilemeye kıyasla daha uzun olabileceği akılda tutulmalıdır.

ObjectiveThe aim of this study to evaluate the effects of autologous conditioned serum (ACS) on the healing of transected rat Achilles tendons via the assessment of biomechanical and histological parameters.MethodsThe study was conducted on 45 male Sprague–Dawley rats. Five rats were used as donors for ACS preparation. Animals were randomly assigned to the experimental or control group. In both groups, the Achilles tendon was cut transversally and then sutured. In the placebo control and ACS-treated groups, saline or ACS, respectively, was injected into the repair zone three times after surgery. Ten rats from each group (ACS group, n = 20; control group, n = 20) were euthanized at days 15 and 30 after surgery for histopathological (n = 5) and biomechanical (n = 5) testing. The histopathological findings were interpreted using the Bonar and Movin scales. Tendon remodelling was evaluated via the immunohistochemical staining of collagen type 3. Biomechanical effects were assessed by tensile testing.ResultsThe Bonar and Movin scale scores were significantly better in the ACS-treated group on both day 15 (p = 0.003 and p = 0.003, respectively) and day 30 (p = 0.005 and p = 0.004, respectively). The immunohistochemical density of collagen type 3 was significantly lower in the ACS-treated group on day 30 (p = 0.018). The type 1/3 collagen ratios of the groups were similar on days 15 and 30, as determined by Sirius Red staining (p = 0.910 and p = 0.133, respectively). In the biomechanical assessment results, the ACS-treated group's maximum load to failure values were significantly higher on day 15 (p = 0.049).ConclusionInjection of ACS had a positive effect on the histopathological healing of rat Achilles tendons on days 15 and 30 and on biomechanical healing on day 15. ACS treatment contributed to lowering the collagen type 3 density by day 30. According to our study, ACS may be favourable for the treatment of human Achilles tendon injuries and tendinopathies.

Treatment of radiation myelopathy remains a challenge. Supportive and rehabilitative therapy is the mainstay of treatment. This article describes a case of central nervous system (CNS) toxicity of radiation with a progressive improvement in the clinicoradiological picture following high dose steroid treatment. A female patient was admitted to the neurology department of our hospital 7 months after a course of radiotherapy in another centre for lingual epidermoid cancer. Neurological examination revealed a heavy spastic quadriplegia syndrome. On MRI examination, T2 weighted hyperintensities were observed in cerebral and cerebellar peduncles, periventricular regions and medulla spinalis at Th1-Th2 levels. The patient was treated with high dose methylprednisolone, 1 g day(-1) for 5 days (pulse therapy) followed by oral methylprednisolone 80 mg day(-1) for a week, tapered over 3 weeks. Within the first week of pulse therapy, she regained muscle strength of upper limbs against gravity. At the 2 year follow-up, MRI demonstrated obvious regression of the lesions in the medulla and cerebellum with disappearance of contrast enhancement. This case report is notable with the complete disappearance of MRI lesions at the 2 year follow-up after the treatment with high dose steroid.

Relationship between the tilt angle of bipolar radial head prostheses and radiological radiocapitellar instability

The aim of the study is to evaluate the quality and reliability of videos about Achilles tendon ruptures on YouTube. Material and Methods: The first 50 videos were included in the study by typing the keyword 'achilles tendon rupture' in the YouTube search tab. The videos were analyzed by two orthopedic surgeons. All videos were analyzed by length, number of views, number of likes, dislikes and source of the video. Global Quality score (score range: 1-5), Journal of the American Medical Association (0-4) and DISCERN (15-75) scoring systems were used to evaluate the quality of the videos. The data obtained were analyzed statistically according to these scoring systems. The Video Power Index (VPI) was used to evaluate the popularity of videos. Results: In this study, 50 videos were evaluated. According to the DISCERN score, five (10%) videos were excellent, ten (20%) videos were good, eight (16%) videos were medium, ten (20%) videos were poor and seventeen (34%) videos were observed to be very poor.

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