Level IV.

III.

No abstract

Background and purposePatients with slipped capital femoral epiphysis (SCFE) are phenotypically overweight or obese and may therefore require clinical follow-up of obesity-related disorders. We evaluated obesity-related disorders such as dyslipidemia, type 2 diabetes mellitus (DM), and vitamin-D deficiency during the postoperative period in patients with SCFE.Patients and methods51 patients who were operated and followed-up for SCFE and 62 healthy adolescents without SCFE (control group) were included in this retrospective study. Patients’ BMI, serum lipid profile (total cholesterol, LDL-C, HDL-C, triglyceride), fasting blood glucose, HbA1c, and serum vitamin D levels were evaluated.ResultsAt the time of surgery, 45 patients in the SCFE group were overweight or obese (BMI >25). At the latest follow-up, 42 patients in the SCFE group and 53 patients in the control group were overweight/obese. Abnormal serum lipid profile and ratio of total dyslipidemia were similar between the groups. 8 patients had abnormal HbA1c levels in the SCFE group and mean HbA1c levels were significantly higher in the SCFE group (p = 0.03). All patients and controls had low levels of vitamin D.InterpretationAlthough serum lipid profile and vitamin D levels were detected as similar in SCFE and control groups, the potential risk of type 2 DM identified via abnormal HbA1c levels was significantly higher in patients with SCFE. We recommend that patients diagnosed with SCFE should be considered as potential candidates for type 2 DM; thus follow-up after surgical treatment should include not only orthopedic outcomes but also evaluation of future risk for DM.

Objective:To compare the effect of two different corticosteroid types in bilateral and symmetrical knee osteoarthritis (OA). Methods:One hundred and twenty-six patients received injections of methylprednisolone acetate (MP) in one knee and triamcinolone hexacetonide (TH) in the contralateral knee. Patients were evaluated before injection and 2, 4, 8, 12, and 24 weeks after. Results:Mean patient age was 68.5±9 years. Mean BMI was 26.3±2.6 kg/m2. At first admission, mean VAS score was 7.7±1.3 for the right side and 7.5±1.5 for the left side, and mean WOMAC score was 67.6±14.4. After bilateral intra-articular injection, VAS scores for both knees and WOMAC scores decreased significantly when initial scores were compared with 2, 4, 8, 12, and 24 weeks after injection (p<0.05). A statistically significant change was seen over time when VAS and WOMAC scores for 2, 4, 8, 12, and 24 weeks post-injection were compared to each other (p<0.05). No significant difference was seen between knee sides (p>0.05). Conclusion:MP and TH have similar efficacy in relieving pain and improving function. The efficacy of intra-articular corticosteroid injection peaks 2 weeks after injection and the effect continues until the 24th week. Level of Evidence II, Comparative Prospective Study.

BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study.

Purpose: This study aimed to compare functional recovery and change in morbidity status from the preoperative levels among patients who underwent two different surgical treatments for unstable intertrochanteric fracture. Methods: This retrospective comparative study enrolled 140 patients (aged >80 years) who were referred to two hospitals. Of these, 64 were treated using proximal femoral nail (PFN) and 76 were treated using hemiarthroplasty (HA). To evaluate functional recovery, primary outcome measures were cumulative illness rating scale (CIRS) score to evaluate changes in morbidity status, activity of daily living (ADL) index, and mobility scores. Results: The proportion of patients who experienced increased CIRS scores in the HA group was higher at the 3-month follow-up (p ¼ 0.02) but similar at the 6-month followup (p ¼ 0.2) in comparison to the PFN group. Treatment with HA, American Society of Anesthesiologists scores of 3-4, and lower, preoperative ADL indexes were the major predictors of increased postoperative CIRS score. Impaired ambulatory ability and the need for walking aids were significantly higher in the PFN group at the 3-month follow-up (p ¼ 0.01 and p ¼ 0.02, respectively) but similar at the 6-month follow-up with respect to the HA group. PFN treatment and high patient body mass index were the major predictors of decreased ambulatory ability at postoperative 3 months. Conclusion: HA has several advantages, including early mobilization and decreased dependency. However, it is associated with greater blood loss, a higher need for blood transfusion, and longer surgical duration than PFN, all of which are predisposing factors for significantly higher risk of reduced CIRS scores.

According to our results, IA MP injection prior to PRP injection resulted in significantly better clinical outcomes compared to PRP and MP injections alone in patients who had mild to moderate knee OA.