The present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

Background: Tear completion followed by repair (TCR) and in situ repair (ISR) have been widely used for bursal-side partial-thickness rotator cuff tears (PTRCTs). Both techniques have shown favorable results; however, controversy continues in terms of the best management. Purpose: To compare the histological and biomechanical outcomes of these 2 techniques for 50% partial-thickness bursal-side rotator cuff tear repair in a rabbit model. Study Design: Controlled laboratory study. Methods: A total of 27 rabbits were used in this experimental study. Seven rabbits were sacrificed at the beginning of the study to form an intact tendon control group. A chronic 50% partial-thickness bursal-side tear model was created in 20 rabbits, and 5 rabbits were sacrificed for biomechanical testing of chronic partial-thickness tears (control group) without repair. In 15 rabbits, partial-thickness tears were repaired after 8 weeks. Partial-thickness tears in the right shoulders were completed to full thickness and repaired; in contrast, left shoulders were repaired in situ. All rabbits were euthanized 8 weeks after the repair. The tendons were tested biomechanically for ultimate failure, linear stiffness, and displacement. Histological evaluations of tendon-to-bone healing were performed via the modified Watkins score. Results: Macroscopically, all repaired tendons were attached to the greater tuberosity. The TCR group had a higher failure load than the ISR group, with mean values of 140.4 ± 13.8 N and 108.1 ± 16.6 N, respectively ( P = .001). The modified Watkins score was significantly higher in the TCR group (23.5; range, 22-27) than in the ISR group (19.5; range, 16-22) ( P = .009). Conclusion: Both repair techniques are effective for 50% partial-thickness bursal-side rotator cuff tears; however, TCR yields significantly superior biomechanical and histological characteristics compared with ISR. Clinical Relevance: Tear completion and repair technique may increase tendon-to-bone healing and thereby reduce re-rupture rate in the partial thickness bursal side rotator cuff tears.

No abstract

No abstract

No abstract

Introduction The literature is scarce regarding the management of combined tears of scapholunate (SL) and lunotriquetral (LT) ligaments. This study aimed to evaluate our preliminary results with the arthroscopic dorsal ligamentocapsulodesis in managing such cases. Materials and Methods Forty-two patients (13 females, 29 males; mean age = 31; age range = 18–51 years) who underwent arthroscopic dorsal ligamentocapsulodesis due to the combined tears of SL and LT ligaments were retrospectively reviewed. The mean follow-up was 38 (range = 24–55) months. The Modified Mayo Wrist Score, the visual analogue scale (VAS), and grip strength were assessed preoperatively and at the final follow-up examination. Results The mean Modified Mayo Wrist Score significantly improved from 49 (range = 25–70) preoperatively to 82 (range = 60–100) at the final follow-up (p = 0.000). The mean VAS significantly decreased from 6.33 to 1.6 (p = 0.000). The mean hand grip strength significantly improved from 31 (range = 19–41) kg to 44 (range = 25–60) kg at the final follow-up examination (p < 0.001). No major complications were encountered. Conclusion Arthroscopic dorsal ligamentocapsulodesis seems to be a safe and effective surgical technique in the management of this rare combined injury pattern. Level of Evidence This is a Level IV, retrospective case series study.

Background: The literature is scarce regarding isolated tears of lunotriquetral interosseous ligament (LTIL). The purpose of this study was to present mid-term clinical and functional results of arthroscopic dorsal ligamentocapsulodesis in the treatment of isolated LTIL tears. Methods: Twenty-two patients (8 females, 14 males; mean age: 31 years; age range: 18–42) with isolated LTIL tears verified by wrist arthroscopy were retrospectively reviewed and included in the study. The mean follow-up was 55 months (range: 24–84). The modified Mayo wrist score, visual analog scale (VAS), flexion and extension deficits of passive wrist range of motion (ROM), pain-free ROM with forced wrist extension and grip strength were measured in all patients preoperatively and at final follow-up. Results: The mean modified Mayo wrist score significantly improved from 50 ± 10.29 preoperatively (range: 30–65) to 86 ± 11.61 (range: 60–100) at the final follow-up (p < 0.001). The mean VAS score significantly improved from 7.1 ± 0.83 (range: 6–8) preoperatively to 2.2 ± 1.35 (range: 0–6; p < 0.001) at the final follow-up. At the final follow-up examination, the forced wrist extension was painless in all but three patients who developed pain at 70º, 75º and 80º of extension, respectively. The mean strength of hand grip significantly increased from 38.6 ± 9.68 (range: 24–54) kg to 49.5 ± 12.36 (range: 33–66) kg at the final assessment (p < 0.001). No major complications were observed during or after the procedure. Conclusions: With the encouraging mid-term outcomes and a lower complication rate, arthroscopic LTIL dorsal ligamentocapsulodesis seems to be a safe and effective surgical technique in improving functional outcomes and reducing pain in patients with isolated LTIL tears. Level of Evidence: Level IV (Therapeutic)

The changes of copper, zinc, iron, magnesium, manganese, and triiodothyronine as a result of short- and long-term isothermal exposure to light were determined in the plasma of mirror carp (Cyprinus carpio). Two groups of fish were subject to a 3-mo treatment that consisted of (1) 8 h of light followed by 16 h of darkness and (2) 16 h of light followed by 8 h of darkness at 25 degrees C. No significant changes were recorded between the two groups at the beginning of the study. After 3 mo, the triiodothyronine and elements levels as well as the growth rates of fish in the long-time exposure period were significantly higher than those in the short-time exposure (p<0.05).