Background and Objectives: Anterior cruciate ligament (ACL) tears are common injuries in the athletic population, and accordingly, ACL reconstruction (ACLR) is among the most common orthopedic surgical procedures performed in sports medicine. This study aims to compare the semitendinosus/gracilis (ST/G) and ACL hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia (MAI) ACLR techniques. We aimed to compare the results of single-leg hop tests (SLHT) applied in different directions and limb symmetry indices (LSI) in athletes with a 6-month post-operative ACLR history. Materials and Methods: A retrospective cohort of 39 athletes from various sports branches who underwent MAI (n = 16) and ST/G (n = 23) ACLR techniques by the same surgeon were evaluated. The knee strength of the participants on the operated and non-operated sides was evaluated with five different SLHTs. The SLHT included the single hop for distance (SH), triple hop for distance (TH), crossover triple hop for distance (CH), medial side triple hop for distance (MSTH), and medial rotation (90°) hop for distance (MRH). Results: There was a significant improvement in the mean Lysholm, Tegner, and IKDC scores in the post-operative leg for both techniques (p < 0.05) compared to the pre-operative levels. When there was a difference between the SH of the operative and the non-operative legs in the ST/G technique (p < 0.05), there was no significant difference in the other hop distance for both ST/G and MAI (p > 0.05). There was no difference between the techniques regarding the LSI scores. Conclusions: The fact that our research revealed similar LSI rates of the SLHTs applied in different directions in the ST/G and MAI techniques assumes that the MAI technique can be an ACLR technique which can be functionally used in athletes.

This study compared the clinical outcomes of patients treated with described “modified all-inside” anterior cruciate ligament reconstruction (ACLR) technique with those of patients treated with suspensory femoral fixation and a bioabsorbable tibial interference screw with the ACLR technique. From 2017 to 2019, 98 patients who underwent ACLR surgery by two surgeons using either of the techniques were included in this study. Patients in group 1 were treated with the “modified all-inside” ACLR technique. In this technique, only the semitendinosus tendon was harvested as a four-strand graft and fixed to the tibia and femur with suspensory buttons. Patients in group 2 were treated with suspensory femoral fixation and a bioabsorbable tibial interference screw ACL reconstruction technique. Patients' functional outcomes were evaluated by the Lysholm score, Tegner activity scale, and International Knee Documentation Committee (IKDC) subjective score. Postoperative knee stability of the patients was evaluated using the Lachman test and the pivot-shift test. The mean ages of the patients were 31.1 (16–55) and 28.7 (18–48) years in groups 1 and 2, respectively. The average follow-up durations were 26 (20–30) and 25.9 (22–30) months for both groups. There was no significant difference between the preoperative and postoperative Lysholm's score, Tegner's activity score, and IKDC subjective score in groups 1 and 2. There were no major complications or reruptures in either group. ACLR incorporating the “modified all-inside” ACLR technique obtained significant clinical outcomes compared to ACLR with a suspensory femoral fixation and a bioabsorbable tibial interference screw.

IntroductionImplants used in orthopedic surgery can be colonized by bacteria that form biofilm layers complicating treatment. We aimed to determine titanium implants' antibacterial and biofilm-degrading properties when coated with sodium borate (NaB) and calcium borate (CaB) minerals. MethodsWe analyzed twenty-four different implants. Three implants were not coated, three were coated with only a carrier polymer (alginate), and eighteen were coated with either CaB or NaB at different concentrations. The implants were incubated with Staphylococcus aureus, and then the bacterial colonies were enumerated. ResultsThe highest microbial load was observed on the implant coated with alginate (1000 colony-forming units [CFU]/mL). The implant without coating contained a microbial load of 420 CFU/mL. The microbial loads of the implants coated with 0.75 mg/mL CaB or 0.25, 0.5, and 0.75 mg/mL NaB (100, 200, 0, and 0 CFU/mL, respectively) were lower than that of the implant without coating. No biofilm formation was observed on implant surfaces coated with 0.5 mg/mL NaB, 0.75 mg/mL NaB, or 0.75 mg/mL CaB; biofilm formation was observed on the implant without coating and alginate-coated implants surfaces. ConclusionAt high concentrations, borate minerals (NaB and CaB) have a potent antibacterial effect on colonization and biofilm formation on the implant surface. These elements may be used in implant coating in the future because of their potential antibacterial effects.

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Purpose Risk factors for meniscal tears play a decisive role in deciding on treatment and rehabilitation. The purpose of this study was to investigate the efect of tibial rotation on medial meniscus posterior horn tears (MMPHTs). Methods This study is a retrospective case-control study. Fifty patients with meniscal tears and 57 knees with intact meniscus were compared. Tibial rotation, femoral version, tibial slope and knee varus were measured in each participant. Knee osteoarthritis was classiied according to the Kellgren-Lawrence classiication. Demographic characteristics were noted. Results There were signiicant diferences in the mean tibial torsion angles and mean mechanical axes between the groups. The mean tibial rotation and mean mechanical axis were 26.3° ± 6.7 and 3.7° ± 2.7 in the MMPHT group and 30.3° ± 8.4 and 2.05° ± 2.7 in the control group, respectively (p = 0.008, p = 0.002). ConclusionThe current retrospective study has shown that tibial rotation is markedly reduced in patients with MMPHTs. Although the actual mechanism is not clear, the internal torsion of the tibia causes a decrease in the foot progression angle and increases the knee adduction moment, which in turn increases the medial tibial contact pressure. Internal torsion of the tibia, such as knee varus, may play a role in the aetiology of MMPHTs by this way. Whilst there was a signiicant diference in the mean varus and tibial torsion between the groups, there was no signiicant diference in the mean femoral version or tibial slope. Level of evidence III.

Almost a half of the hip fractures are extracapsular and are subclassified as intertrochanteric and subtrochanteric. [1] Fracture stability or fracture classification systems are used for the recommendation of treatment in intertrochanteric fractures. Such classifications are also used to recommend proper implant or surgical techniques. The ideal classification system allows interaction between physicians, guides the planning, predicts the treatment outcome, and is applicable for clinical practice and research. Examination of the fracture evaluation by the same physician and different physicians should yield the same result each time (intraobserver and interobserver reliability).Objectives: This study aims to evaluate the effect of surgical experience on reliability for Boyd-Griffin, Evans/Jensen, Evans, Orthopaedic Trauma Association (main and subgroups), and Tronzo classification systems.Patients and methods: Between January 2013 and December 2014, radiological images of a total of 60 patients (13 males, 47 females; mean age: 78.9±21.9 years; range, 61 to 96 years) with the diagnosis of intertrochanteric femur fracture were analyzed. Radiographs were evaluated and classified by five residents and five orthopedics and traumatology surgeons according to the Evans, Boyd-Griffin, Evans/Jensen, OTA, and Tronzo classification systems. Intraand interobserver reliability were calculated using the kappa statistics. Results:The worst intraobserver compatibility among the residents was the classification system with OTA subgroups (k=0.516), while the classification system with the best intraobserver fit was found to be OTA main groups (k=0.744). The worst agreement among surgeons was in the Evans classification system (k=0.456). However, the best intraobserver agreement was in the OTA main groups (k=0.741). The best interobserver agreement was observed regarding the OTA main groups (k=0.699). Conclusion:The classification that has the best harmony both among residents and surgeons, and between residents and surgeons is the OTA main group classification.

Objective: The objective of this study was to compare the outcomes of individuals who had acute mallet fracture treatment early versus those who underwent delayed surgical treatment. Methods: This was a retrospective cohort study in which all patients were skeletally mature and underwent closed extension pinning surgery for Doyle Type 4B mallet fractures. Crawford criteria were used to evaluate extension lag, loss of DIP joint flexion, and pain outcomes following surgery. All patients were evaluated clinically and radiographically. Results: There were 16 females and 32 males with total of 48 patients in this study. The mean age at the time of surgery was 31.50 ± 9.75 years (range, 19-60 years). A total of 30 patients with early surgical treatment of mallet fractures and 18 patients with delayed surgical therapy were included in the study. There was no significant difference in the active flexion of the DIPJ, Crawford criteria (p=0.085, p=0.907, respectively), except for complication rates (p=0.045). Conclusions: When compared to the early closed extension-block pinning technique, the delayed closed extension-block pinning technique yielded a satisfactory functional outcome in the treatment of mallet fractures.