Objective The aim of the study was to compare the outcomes of the transtibial and anatomical femoral single tunnel surgical techniques in ACL reconstruction. Methods A total of 30 patients, with 16 patients (15 males and 1 female; mean age: 27.2 ± 7.04) with anatomical femoral single-tunnel technique (AFT) and 14 (12 males and 2 females; mean age: 29.4 ± 8.82) with transtibial technique (TT) were included into the study. All patients were evaluated with isokinetic tests at an angular velocity of 60°/s and 180°/s and the IKDC and Lysholm tests were performed preoperatively and in third, sixth, and 12th months postoperatively. The results were compared between the groups. The mean follow-up time was 17.1 ± 6.48 months. Results Postoperative third month changes in extension parameters of peak torque (AFT: −93.286, TT: −61.500), peak work (AFT: −77.071, TT: −47.500), peak torque ext/kg (AFT: −1.182, TT: −0.773), peak work ext/kg (AFT: −0.982, TT: −0.604), peak work (AFT: −55.143 TT: −33.063) at an angular velocity of 60°/s and postoperative third month change in extension parameter of peak power (AFT: −86.786 TT: −54.875) at an angular velocity of 180°/s were found to be better in the transtibial group ( p < 0.05) and postoperative sixth month peak torque (AFT: 1.429, TT: −5.688) value at an angular velocity of 60°/s was found to be less in the anatomical femoral single-tunnel group ( p < 0.05). The IKDC (AFT: 94.671, TT: 90.025) ( p < 0.05) and Lysholm (AFT: 96.714, TT: 92.375) ( p < 0.05) scores of the anatomical femoral single-tunnel group were better than the transtibial group regarding to the postoperative final follow-up. There are positive intermediate correlations between preoperative IKDC and Lysholm scores with preoperative and postoperative some isokinetic test ratio (r = 0.539; p = 0.031), and preoperative peak power extension (r = 0.541; p = 0.030) at the both angular velocity of 60°/s and 180°/s in the transtibial group. There was no significant difference between the two groups with regards to the Lachman, anterior drawer and pivot shift tests ( p < 0.05). Conclusion There were differences in terms of isokinetic parameters in early outcomes but there was no statistical difference between isokinetic parameters at the end of 1st year between two groups. There were some correlations between IKDC and Lysholm scores with some isokinetic parameters. Level of Evidence Level III, Therapeutic Study.
The aim of this study is to examine the distribution properties of pelvic bone metastases according to primary cancers and to reveal the properties of additional bone metastases that may accompany pelvic bone metastasis.Methods and Materials: 151 patients with pelvic bone metastases and without visceral metastases were included in the study. Clinical data, pathological diagnostic reports and PET-CT results of 151 patients were evaluated. The patients were evaluated in terms of age, gender, number of pelvic bone metastases (single focus, multiple foci) and localization of pelvic bone metastasis (sacroiliac joint, sacrum, ilium, ischium, pubis, acetabulum).Results: Multiple pelvic metastasis frequency was significantly higher in the females (80.00%) than in the males (61.46%) (p=0.030). The most common location of the metastasis was the ilium for both genders. The most common location of the metastasis was ilium for the breast (61.76%), prostate (44.44%) and gynecologic (66.67%) cancers. The most common locations of respiratory system cancer metastases were sacrum (54.29%) and ilium (54.29%). The acetabulum was the most common metastatic location for gastrointestinal (72.73%) and urinary (58.33%) tract cancers. Conclusion:As the result of this study, the ilium is the most common metastatic bone region of the pelvis. Primary cancers often tend to cause multiple metastases to the pelvic bone. Evaluating the metastases of the pelvic ring with a larger number of cases may provide clues in finding the tumors of unknown primary origins.
The purpose of this study was to define posterior border distance (PBD), which represents an ultrasonographic diagnosing method of carpal tunnel syndrome (CTS), and to determine the reliability of PBD in comparison with electromyography (EMG) results. Methods Thirty-three patients (mean age: 51.8 ± 9.5 years; 27 females and six males) with CTS were included in this study. Ultrasonography (US) and EMG were performed under blinded conditions. PBD was evaluated by measuring the length of the perpendicular line between the posterior border of the median nerve and the line between the hook of the hamate and trapezoid tubercle. The cross-sectional area, anteroposterior (AP), and transverse diameter of the median nerve were measured. Control US was performed in 20 patients who were available at the first year postoperative follow-up and the results compared with preoperative US values. Correlation analyzes were performed to determine the relationship between electrodiagnostic results and ultrasonographic measurements. Results According to the results of preoperative and postoperative first-year US, there were statistically significant differences in the results of PBD (preoperative: 3.309±1.7472 mm, postoperative: 2.290±0.7867 mm p: 0.013) and AP diameter of the median nerve (preoperative: 3.012±0.7865 mm, postoperative: 2.680±0,5578 mm p: 0.017). There was no statistically significant difference in transverse diameter (preoperative: 6.585±1.9505 mm, postoperative: 6.955±2.2128 mm) and cross-sectional area (preoperative: 14.33±6.513 mm 2 , postoperative: 11.20±5.830 mm 2) results (p>0.05). The cutoff value of PBD was ≥3.6 mm, it yielded 81.48% specificity and 83.33% sensitivity in the diagnosis of CTS. PBD was correlated with motor and sensory latency, anteromedial, and transverse diameter of the median nerve (p<0.05). There was no correlation between EMG values and the results of the cross-sectional area, transverse diameter, and AP diameter of the median nerve (p>0.05). Conclusion PBD is suggested as a reliable ultrasonographic measurement method for the diagnosis of CTS.
Backround: The present study aimed to determine the frequency of spinal metastases, to evaluate the features of spinal metastases, and to reveal clues to shed light on the origin of spinal metastases with unknown primary. Methods: The data of patients who were followed up with the diagnosis of cancer in Istanbul Oncology Hospital between 2017 and 2019 were analyzed retrospectively. A total of 156 patients with spinal metastases and without visceral metastases were included in the study by applying inclusion and exclusion criteria. Clinical data, pathological diagnostic reports, and positron emission tomography-computed tomography results of 156 patients were evaluated. The groups were evaluated in terms of age, gender, number of spinal metastases (single focus, multiple focus), and localization of spinal metastasis. The spinal localization evaluation included both the main anatomical localizations and a detailed evaluation of each spine. Results: The most common metastasis region was the thoracic spine in respiratory system cancers (28.38%), the thoracic þ lumbar spine in breast (42.42%), prostate (50.00%), and gynecologic (40.00%) cancers, and the lumbar spine in gastrointestinal (37.50%) and urinary (30.00%) tract cancers (P ¼ .313). C5 spinal metastasis percentages were significantly higher in breast and gastrointestinal tract cancers than the others (P ¼ .042). T5 spinal metastasis percentage was significantly higher in gynecologic tumors than in the other cancers (P ¼ .002). T10 spinal metastasis percentages were significantly higher in prostate and gynecologic tumors than the others (P ¼ .016). L1 spinal metastasis percentage was significantly higher in breast tumors (P ¼ .009). L2 spinal metastasis percentages were significantly higher in breast, prostate, and gynecologic tumors (P ¼ .011). L4 spinal metastasis percentages were significantly higher in breast and prostate tumors (P ¼ .041). L5 spinal metastasis percentage was significantly higher in prostate tumors (P ¼ .029) than the other cancers. Conclusions: It was observed that primary cancers were often prone to metastasis to nearby spine. The results obtained by detailed examination of spinal metastases may provide a clinical benefit by providing clues in investigation of primary unknown cancers. Level of Evidence: 3.
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