1. | Cover Page I |
2. | Editorial Board Pages II - IV |
3. | Contents Page V |
4. | Editorial Page VI |
5. | Manuscript Preparation Pages VII - IX |
REVIEW ARTICLE | |
6. | Rehabilitation for Femoro-acetabular Impingement Syndrome Kadir Songür, Banu Dilek doi: 10.5505/TJHS.2021.79188 Pages 67 - 77 Femoroacetabular impingement syndrome (FAIS) is a precursor pathology of hip osteoarthritis that causes pain and functional impairment due to mechanical incompatibility between the two components of the hip joint, the acetabulum, and the proximal femur. Young adult athletes are especially an important risk group for FAIS. The diagnosis of FAIS is made by evaluating symptoms, signs, and related radiological evaluations. Although radiographs of the lateral hip and anteroposterior pelvis are often significant guides for the diagnosis, possible lesions related to the labrum and cartilage should be examined with MRI. The treatment protocols of the FAIS are activity restriction, pain relief therapies, physical therapy and rehabilitation, manual therapy, guided intra-articular injections, and surgical interventions. The rehabilitation program, which is seen as an important treatment option before surgery, consists of soft tissue mobilization techniques, physical therapy modalities for pain relief, joint range of motion, strengthening of the muscles around the hips, and proprioception exercises. In recent years, studies suggested that ultrasound or fluoroscopy-guided intra-articular injections may be beneficial. Surgical methods should be recommended to patients whose conservative treatment methods are inadequate and osseous findings are detected in their radiological imaging. Arthroscopic methods have become popular for treating these pathologies depending on type of impingement. Although an international consensus has not yet been achieved in terms of surgery-related rehabilitation protocols, it is reported that preoperative and postoperative rehabilitation methods increase the success of the surgery. |
ORIGINAL RESEARCH | |
7. | Post-Surgical Mortality Increases in Patients with Covid-19 Positive Hip Fractures Sabit Numan Kuyubaşı, Nihat Demirhan Demirkiran, Süleyman Kozlu, Süleyman Kaan Öner doi: 10.5505/TJHS.2021.88597 Pages 78 - 83 Aim: This study aims to evaluate the mortality and complication rates of patients surgically treated for geriatric hip fractures, and compare the results between groups with and without accompanying Covid-19 diagnosis. Method: 40 patients (22 males and 18 females), including 20 Covid-19 positive patients who underwent bipolar endoprosthesis due to hip fracture in our clinic between April 2020 and July 2021, and 20 Covid-19 negative patients who were matched paired in terms of age, gender, and American Society of Anesthesiologists (ASA) scores as the control group were included in the study. Demographic data of the patients, time to surgery, operative time, length of hospital stay, mobilization status, postoperative wound problems, 90-day mortality, hemoglobin, and albumin parameters were evaluated. Results: Ninety-day mortality, operative time, and hospital stay were significantly higher in the Covid-19 positive group compared to the matched Covid-19 negative control group in terms of age, gender, and comorbidity data (p=0.025, p=0.012, p<0.001, respectively). Conclusion: Patients diagnosed with geriatric hip fractures and accompanying Covid-19, face comorbidities related to both fracture and systemic Covid-19 infection. An early orthogeriatric examination, thorough planning, and prompt surgical intervention are mandatory to achieve favorable outcomes. |
8. | Functional Outcomes of Soft Tissue Release Surgery in Advanced Legg-Calve-Perthes Disease Vadym Zhamilov, Can Doruk Basa, İsmail Eralp Kaçmaz, Ali Reisoğlu, Haluk Agus doi: 10.5505/TJHS.2021.66375 Pages 84 - 89 Objectives: This study aimed to investigate the functional and radiological outcomes in Legg–Calvé–Perthes Disease (LCPD) patients undergoing soft tissue release surgery. Materials and methods: Ten children (11 hips) diagnosed with LCPD who had previously been conservatively treated with movement limitation were included in the study. Patients in the late fragmentation period of the disease were evaluated with arthrography in hip-neutral, abduction, abduction/internal rotation, and adduction positions using radioscopy. Dynamic examination using arthrography was performed to determine whether the patient had any bone pathologies (hinging). For patients with no bone pathology, adductor longus and iliopsoas tenotomy and inferior capsulotomy were performed. Sitting was allowed immediately following surgery, and mobilization with support was allowed after the wound had healed. Patients were followed up at regular intervals. Functional assessments of patients were made using the Harris hip scoring system. Evaluation of radiological imaging was carried out according to the Stulberg classification. Results: The mean age of patients was 10.9 (6–15) years. According to the Herring lateral pillar classification, one patient was type B, three were type B/C, and seven were Type C. At the 12-month follow-up, the active range of motion was increased, and hip pain decreased. At the final follow-up (patients followed for 1–5 years; mean: 3 years), one patient was evaluated as type II, seven as type IV, and three as type V according to the Stulberg classification. The mean Harris hip score was 92.3. Conclusion: Soft tissue release surgery performed as tenotomy in LCPD patients had no effect in terms of radiological characterization, but had positive functional impacts. |
9. | The Effect of Ifosfamide and Mifamurtide Loaded Cement on The Viability of Osteosarcoma Cells Ömer Bekçioğlu, Safiye Aktas, Melek Aydın, Nur Olgun doi: 10.5505/TJHS.2021.76486 Pages 90 - 95 urpose: Despite the good results of neoadjuvant chemotherapy used in the treatment of osteosarcoma, post-operative recurrences continue to be a common problem. It is important to seek new approaches to prevent recurrence in post-operative patients and to eliminate the disadvantages of systemic chemotherapy. The study aims to examine the effects of chemotherapeutic (ifosfamide) and immunotherapeutic (mifamurtide) agents, which are adsorbed into cementum in vitro, on the viability of the osteosarcoma cell line K7M2. Methods: After the K7M2 osteosarcoma cell line was cultured, the cells were adhered to and became 70% confluent, and the supernatants were removed, taking care not to lose the cells. Different doses of ifosfamide (10 ug/ml, 20 ug/ml, 40 ug/ml) alone and with cement; Different doses of mifamurtide (0.25 µg/ml, 0.5 µg/ml, 1 µg/ml) were given by co-culture with mononuclear cells alone and with cement. Cement was used as the control group. Cell viability was determined by WST after the plate was placed in a 37°C 5% CO2 incubator for 24 hours and 48 hours. Results: It was determined that ifosfamide and mifamurtide in cementum were released into the environment compared to the agent alone, causing more cytotoxic effects in osteosarcoma cells at 24 hours. While an increased effect at 48 hours was observed in mifamurtide, it was not detected in the ifosfamide plus cement group compared to the ifosfamide group alone. Conclusion: Our findings support that local application of ifosfamide and mifamurtide in bone cement may be effective in preventing local recurrence of osteosarcoma after surgery; while filling bone defects resulting from excision surgeries. Among post-operative biomaterials, local therapy may be an additive treatment option in preventing recurrence in osteosarcoma by interacting directly and with the microenvironment. |
10. | Proximal Femur Osteoid Osteoma Treatment: CT Guided Drilling or Excision? Selahaddin Aydemir, Cihangir Türemiş, Hasan Havitcioglu, Onur Hapa doi: 10.5505/TJHS.2021.57966 Pages 96 - 99 Objective: This study aims to report the results of 16 patients having proximal femur osteoid osteoma who were treated with CT guided mini-open excision, drilling, or x-ray guided excision Method: 16 patients receiving surgical treatment (7 CT guided mini-open excision, 6 CT guided percutaneous drilling, 3 Scopy guided mini-open excision) who were followed for at least one year were evaluated. Preoperative and latest follow-up VAS pain scoring and degree (0-10 point) or level (1 ‘high to 4 ‘worse’) of patient satisfaction were analyzed. Results: Mean postoperative VAS pain score (0.7±1.1) was lower compared to pre-operative values (8±1) (p: 0.0004). The mean level and point of satisfaction were 1.3±0.6 and 8±2 points. There was no difference between CT-guided mini-open excision or Ct-guided percutaneous drilling for any parameter. There was not any recurrence or major complication during follow-up. Conclusion: Although histological verification of the lesion was more obvious in the CT-guided excision group, both groups resulted in similar relief of pain and high satisfaction at all patients with no recurrence of symptoms or major complications. |