No abstract

In this retrospective study we evaluated the method of acute shortening and distraction osteogenesis for the treatment of tibial nonunion with bone loss in 17 patients with a mean age of 36 years (10 to 58). The mean bone loss was 5.6 cm (3 to 10). In infected cases, we performed the treatment in two stages. The mean follow-up time was 43.5 months (24 to 96). The mean time in external fixation was 8.0 months (4 to 13) and the mean external fixator index was 1.4 months/cm (1.1 to 1.8). There was no recurrence of infection. The bone evaluation results were excellent in 16 patients and good in one, while functional results were excellent in 15 and good in two. The complication rate was 1.2 per patient. We conclude that acute shortening and distraction osteogenesis is a safe, reliable and successful method for the treatment of tibial nonunion with bone loss, with a shorter period of treatment and lower rate of complication.

Treatment of knee osteoarthritis with intra-articular hyaluronic acid injections or mud-pack therapy yielded similar results in the short-term in terms of functional improvement and pain relief. Mud-pack therapy is a noninvasive, complication-free, and cost-effective alternative modality for the conservative treatment of knee osteoarthritis.

In this experimental animal study the effects of calcitonin and alendronate on distraction osteogenesis are investigated. Forty-five mature female New Zealand type rabbits were used.

Alteration of tibial slope is one of the important anatomical changes of the proximal tibia after high tibial osteotomy. Increased or decreased tibial slope can effect further total knee prosthesis procedure. In this retrospective study, 18 knees of 17 patients (17 female, mean age 51 range 43-61, mean BMI is 33.6 +/- 4.6 kg/m2) who were applied high tibial osteotomy using circular external fixator due to medial compartment arthrosis of the knee were evaluated in terms of tibial slope changes. While mean correction about 12.3 degrees in mechanical femoro-tibial angle was obtained in frontal plan (P = 0.0001), significant change in tibial slope was not determined in sagittal plan (P = 0.127). The mean posterior proximal femoral angle values were measured as 79.5 +/- 2.1 degrees preoperatively and as 80.3 +/- 2.7 degrees postoperatively and found to fall into the normal range (80.4 +/- 1.6 degrees). As there is no significant alteration in tibial slope after high tibial osteotomy performed with the Ilizarov system, complications due to alteration in tibial slope will not be experienced in follow-up or in further total knee prosthesis procedure.

Viper is a new device for arthroscopically all-inside meniscal repairing. In previous studies about Viper device, procedures were not applied arthroscopically despite this device has been designed for arthroscopic application. In this study, we evaluated primary fixation strength of arthroscopically applied meniscal repair using Viper device to obtain better clinical relevance. Two centimeter in length meniscal tear 2-3 mm far from periferic edge of medial meniscus of 50 calves were created arthroscopically. The menisci were divided into five groups including 10 menisci in each. In group 1, tears were repaired by outside-in vertical loop suture technique with No: 0 PDS. Tears were fixed by all-inside vertical suture by using Viper device with No: 0 PDS in group 2. In meniscal implant groups, RapidLoc, H-Fix, and Clearfix were applied in groups 3,4, and 5, respectively. Primary fixation strength of repairing techniques were evaluated with bio-mechanical testing machine. Fixation strengths determined in groups 1 and 2 were detected as 145 +/- 13 and 136 +/- 33 N, respectively. There was no difference in pull-out strength between groups 1 and 2. Fixation strengths in these two groups were significantly higher compared to groups 3, 4, and 5. There was no significant difference between group 3 (33 +/- 6 N) and 5 (28 +/- 6 N) in terms of fixation strengths whereas fixation strengths of these two groups were significantly higher compared to group 4 (20 +/- 3 N) (P = 0.005, P = 0.018, respectively). All-inside vertical suture technique using Viper device revealed comparable primary fixation strength with outside-in vertical suture technique for meniscal repair. We suggest that the Viper device is safe and reliable for meniscal repair.

Osteoid osteoma is a benign, osteoblastic and painful tumoral lesion. Apart from en-bloc resection, intralesional resection and percutaneous excision or destruction of the nidus, arthroscopic removal of the lesion in intraarticular locations have been reported. We present a patient with osteoid osteoma at distal femur which is accessible through knee joint, treated by arthroscopic complete excision.

We report a case of a subperiosteal osteoid osteoma on the talar neck that was removed arthroscopically. Intralesional excision, en bloc resection, and percutaneous ablation techniques have all been used for the treatment of osteoid osteoma. For intra-articular osteoid osteomas, arthroscopy-assisted removal of the tumor has been described in a few case reports. Obtaining a nidus fragment for pathologic evaluation is important during arthroscopic removal of intra-articular osteoid osteomas. Sometimes it is not possible to obtain a specimen for pathologic examination. In the present case, the osteoid osteoma on the talar neck was easily located, the nidus was completely removed, and the tumor was extirpated.