Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

We hypothesised that the anterior and posterior walls of the body of the first sacral vertebra could be visualised with two different angles of inlet view, owing to the conical shape of the sacrum. Six dry male cadavers with complete pelvic rings and eight dry sacrums with K-wires were used to study the effect of canting (angling the C-arm) the fluoroscope towards the head in 5° increments from 10° to 55°. Fluoroscopic images were taken in each position. Anterior and posterior angles of inclination were measured between the upper sacrum and the vertical line on the lateral view. Three authors separately selected the clearest image for overlapping anterior cortices and the upper sacral canal in the cadaveric models. The dry bone and K-wire models were scored by the authors, being sure to check whether the K-wire was in or out. In the dry bone models the mean score of the relevant inlet position of the anterior or posterior inclination was 8.875 (standard deviation (sd) 0.35), compared with the inlet position of the opposite inclination of -5.75 (sd 4.59). We found that two different inlet views should be used separately to evaluate the borders of the body of the sacrum using anterior and posterior inclination angles of the sacrum, during placement of iliosacral screws.

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Background/aim: The aim of this study is to compare the stability and implant stresses of suprapectineal plate with infrapectineal plate in three subconfigurations of the screw types. Materials and methods:The stabilities of different fixation methods were compared by finite element analysis on six models. Three infrapectineal and three suprapectineal models each with locked, unlocked, or combined screws were employed. Three-dimensional finite element stress analysis was performed by using isotropic materials with a load of 2.3 kN applied at standing positions. Motion at the fracture line was measured on four different points located on the pubic and iliac sides of the fracture line.Results: Infrapectineal plate fixation with unlocked screws was found to be the most stable fixation method with 0.006 mm displacement of fragments in all axes at standing positions. The suprapectineal unlocked method was found to be the most unstable in standing positions with maximum displacement values of 0.46 mm vertical shear movement in the x-axis, -0.14 mm displacement in the y-axis, and -0.33 mm lateral shear in the z-axis. Conclusion:The infrapectineal unlocked plate supplies the most stable fixation with the least implant stress, contrary to the suprapectineal unlocked plate, which has the lowest stability and highest implant stresses.

Objectives:This study aims to investigate the reliability of the Lichtman classification among residents, orthopedic surgeons, and hand surgeons. Materials and methods:This study was carried out with 30 male observers (mean age 37.8 years; range, 26 to 62 years) who agreed to participate in the study. All observers were orthopedic surgeons. The observers were separated into three groups that consist of 10 residents, 10 orthopedic surgeons, and 10 hand surgeons. The anteroposterior and lateral wrist radiographs of 20 patients (12 males, 8 females; mean age 49 years; range, 38 to 74 years) diagnosed as Kienböck's disease were sent to observers via e-mail as a survey. All 40 radiographs were asked to be kept classified. Results:The classification of Kienböck's disease was analyzed by 30 observers on 40 digital radiographs. The overall agreement with the Lichtman classification was fair within all of the observers (kappa=0.203). When groups were evaluated within themselves, the agreement level was found poor in group 1 (kappa=0.162) and fair in group 2 (kappa=0.210) and group 3 (kappa=0.252).Conclusion: A useful classification system in orthopedics and traumatology should classify the type of musculoskeletal disorder reliably, facilitate communication in clinical practice, guide preoperative planning, and enable comparison of results between studies. The Lichtman classification alone is insufficient and should be supported by other imaging and measurement techniques. ABSTRACT Citation: Aydemir AN, Yücens M, Cansu CE, Demirkan AF. Are plain radiographs reliable in Lichtman classification?. Jt Dis Relat Surg 2020;31(1):34-38.