Objective: To evaluate the relationship between ultrasonographic femoral cartilage thickness and presence of concomitant osteoporosis in agroup of female patients with knee osteoarthritis (OA).Materials and Methods: This study included 118 women with knee OA who visited our outpatient clinic. Demographic data were collected,radiologic grading using Kellgren Lawrence (K-L) scale, ultrasonographic femoral cartilage thickness (FCT) evaluation, pain intensity evaluation,disability evaluation using OA index [Western Ontario and McMaster Universities Osteoarthritis index (WOMAC)], quality of life measurementusing Short Form-36 (SF-36) and bone density measurement using dual-energy X-ray absorptiometry (DXA) were conducted for each patient.Results: We found that 58 patients (median age: 64.5 years, range: 50-75) had osteoporosis (group 1) and 60 patients (median age: 62 years,range: 51-75) did not have osteporosis (group 2). Group 2 had higher body mass index (BMI) in addition to lower WOMAC, SF-36 physicalfunction, physical role limitation, pain and social function scores. The severity of osteoporosis and K-L staging were negatively correlated. TheDXA femoral neck and total lumbar T-scores were higher in the advanced stages of OA. FCT had no significant correlation with age, WOMACindex and SF-36 scores. Moreover, the left knee FCT was negatively correlated with BMI.Conclusion: Radiologic staging of OA had a negative correlation with osteoporosis but no significant correlation with the quantitativemeasurement of FCT using ultrasonography
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Objective: To investigate the effects of wearing mask and lockdowns during the coronavirus disease-2019 (COVID-19) pandemic on thevitamin D levels in females.Materials and Methods: This retrospective study included female adults aged 18-64 years who underwent vitamin D evaluation at ourhospital in April and May from 2017 to 2020. Vitamin D levels were categorized as follows:<10 ng/mL (severe deficiency); 10 to <20ng/mL(deficiency); 20 to 30ng/mL (insufficiency) and >30ng/mL (normal).Results: A total of 835 (90.8%) out of 920 females had vitamin D deficiency, and among them 463 (50.3%) had vitamin D severe deficiency.In April and May of 2020 (during the national lockdown period), 74 (89.2%) out of 83 subjects had vitamin D deficiency. Vitamin D levelswere found to be higher in 2017 than the other years (p<0.001). There was no significant difference between the lockdown year (2020)and the 2018 and 2019 years regarding vitamin D levels (p>0.05).Conclusion: Our findings indicate that there is a serious and urgent public health problem regarding with vitamin D deficiency (>90%) inour population; and about 50% of them had severe deficiency. This problem was not different during the lockdown period compared withthe previous two years.
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Objective: Osteoporosis is a bone disease that increases the risk of fractures. One out of every two women and one out of every five men are at risk for osteoporosis-related fractures during their lifetime. Bone loss can be prevented by taking precautions in every phase of life. To avoid the serious consequences of osteoporosis, healthy behaviours should be supported using theories of health behaviour as a framework.This study aimed to develop protection against osteoporotic fractures (PROF) scale and to test its validity and reliability.Materials and Methods: This study was conducted among >55-year-old female outpatients who were admitted to the orthopaedic clinics of Zonguldak Atatürk Public Hospital. Test-retest was applied via face-to-face interviews. The sample size was calculated to be 10 times the number of scale items, resulting in a sample of 400 participants. The theory of planned behaviour provided the theoretical framework for the PROF scale development. Four strategies have been selected for PROF: (1) Bone mineral density measurement, (2) adherence to treatment, (3) physical exercise and (4) regulations to prevent falls at home.Results: Factor and matrix correlations of the scale ranged from 0.68 to 0.130. Test-retest reliability of the whole scale was 0.95. Cronbach’s α value was found to be 0.95. A strong and statistically significant positive correlation was noted between attitudes and subjective norms pertaining to PROF (r=0.520; 0.525; p=0.01, respectively). A moderate and statistically significant positive correlation was noted between intention and behaviour control (r=0.462; p=0.01).Conclusion: The PROF scale was found to be highly valid and reliable. It can be a part of the public health model aimed at preventing osteoporotic fractures.
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body shape index (ABSI), a new anthropometric measurement parameter.Materials and Methods: In this cross-sectional study, a total of 130 KTRs were included. Laboratory and demographic findings, aetiology of kidney failure, time on dialysis, donor type, time after transplantation, additional diseases, menopausal status for women and medications were recorded from patients’ files. Height, weight and waist and hip circumferences were also recorded from the files. ABSI was calculated using a specific formula. Bone mineral density (BMD) was measured using dual X-ray absorptiometry. Patients were divided into the following three groups based on the T-score: Normal, osteopenia and osteoporosis groups, according to the World Health Organization recommendations.Results: According to the BMD values, 24 patients (18.5%) had normal BMD, 82 patients (63.1%) were osteopenic and 24 patients (18.5%) were osteoporotic. Patients with osteoporosis have significantly higher parathormone hormone and ABSI and lower body mass index (BMI) than patients without osteoporosis (p<0.05). A positive correlation of BMI was found in the lumbar (r=0.294, p=0.002) and femoral T-scores (r=0.216, p=0.024). A negative correlation was found between ABSI and lumbar T-score (r=-0.237, p=0.014). Receiver operating characteristic curves showed that ABSI had the optimal power to discriminate patients with/without osteoporosis in both sexes.Conclusion: ABSI is found to be a more useful tool than anthropometric measurements in predicting osteoporosis in KTRs.
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Rana TERLEMEZ , Selda ÇİFTÇİ, Merve GÜNERLİ, Beril DOĞU, Figen YILMAZ, Banu KURAN
Rana TERLEMEZ ,
Selda ÇİFTÇİ, Merve GÜNERLİ, Beril DOĞU, Figen YILMAZ, Banu KURAN
Amaç: İnsan bağışıklık yetmezlik virüsü (HIV) pozitif hastalarda osteopeni ve osteoporoz sık karşılaşılan bir komorbiditedir. Biz bu çalışmamızda HIV pozitif erkek hastalarda düşük kemik mineral yoğunluğu prevelansını saptamayı ve CD4+ T hücre düzeyini kullanarak, kemik mineral yoğunluğu ile hastalık aktivitesi arasındaki ilişkiyi araştırmayı amaçladık.Gereç ve Yöntem: Polikliniğimize 2016-2019 yılları arasında başvurmuş olan 18-50 yaş arası 50 HIV pozitif erkek hasta çalışmaya dahil edildi. Hastaların dual enerji X-ışını absorpsiyometri ölçümlerindeki kemik mineral yoğunlukları ve CD4+ T hücre sayıları retrospektif olarak tarandı.Bulgular: Hastaların 19’unda (%38) osteoporoz ve 16’sında (%32) osteopeni olmak üzere toplam 35’inde (%70) kemik mineral yoğunluğunda azalma tespit edilmiştir. Hastaların CD4+ T hücre sayısı ile kemik mineral yoğunluk değerleri arasındaki korelasyon incelenmiş, anlamlı korelasyon saptanmamıştır (p>0,05).Sonuç: HIV pozitif erkek hastalarda, kemik mineral yoğunluğundaki azalma prevelansı oldukça sık bir problem olmakla beraber, etiyolojisini sadece hastalığın kendisine veya viral yüke bağlamak mümkün görünmemektedir. Antiretroviral tedavilere naif daha fazla sayıda hasta ile yapılacak çalışmalara ihtiyaç duyulmaktadır.
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Objective: Hip fracture treatment in elderly patients remains challenging. This study aimed to evaluate short-term clinical results of long-stem cementless arthroplasty in elderly patients with femoral neck and intertrochanteric fractures.Materials and Methods: We collected data of patients we treated with long-stem cementless arthroplasty between January 2011 and December 2019 due to hip fractures. This study included 48 patients (≥65 years of age) with femoral neck and intertrochanteric fractures. The patients underwent either bipolar or total hip arthroplasty. A 2-year follow-up was conducted in all the patients. Outcomes were evaluated with the Harris hip score (HHS), Koval categories, complications and hip and mid-thigh pain. We compared clinical results of patients with femoral neck fractures and those with intertrochanteric fractures.Results: The mean follow-up period was 57 (34-92) months. Sixteen patients had femoral neck fractures and 32 had intertrochanteric fractures. No difference in demographic characteristics and comorbidities was noted between groups. The mean preoperative Barthel index of activities of daily living score was 79. At the last follow-up, the mean HHS of the control group was 77 and the mean Koval categories score was 3. Revision surgeries were conducted in two patients due to dislocation. Infection was observed in one patient and was treated by debridement and anti-biotherapy. Implant loosening and periprosthetic fractures were not noted.Conclusion: With fair outcomes, long-stem cementless arthroplasty is a potential treatment for hip fractures in elderly patients. A longer follow-up to evaluate the efficacy of these prostheses is warranted.
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Synovial osteochondromatosis (SOC) is an uncommon benign condition characterized by the proliferation of the synovium with cartilaginous metaplasia. It can develop in any joint where synovium exists but is most prevalent in the knee. It generally occurs in the knee’s anterior compartment, but it can also be seen in the posterior fossa. In this article, we report a 58-year-old woman with knee pain and swelling secondary to SOC. The detection of calcific nodules in both plain radiography and magnetic resonance imaging of the knee determined the diagnosis. SOC needs attention due to its high morbidity rates and possibility of malignant transformation.
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Lateral epikondilit, çoğunlukla tekrarlayan kavrama veya el bilek ekstansiyonundan kaynaklanan, el bilek ekstansör kas ve tendonlarınınyapışma yeri olan humerus lateral epikondilinin ağrılı tendinozudur. Lateral epikondilit dirsek yan ağrısının erişkinlerde en sık nedenlerininbaşında gelmektedir. Hastaların çoğu konservatif tedaviye cevap verirken bazı hastalarda cerrahi tedavi yöntemleri kullanılmaktadır. Bu olgubazlı derlemede kliniğe dirsek ağrısı ile başvuran 68 yaşındaki bir erkek hasta üzerinden konu irdelenecektir. Çeşitli konservatif tedavilerdenfayda görmeyen lateral epikondilit tanılı hastaya tedavi olarak sol dirsek lateral epikondil tendon yapışma bölgesine 0,5 cc prilokain hidroklorürve 1 cc triamsinolon hekzasetonid enjekte edildi. Enjeksiyondan sonra hastanın 2., 3. ve 4. parmaklarında düşme meydana geldi. Hastadaradiyal sinir felci düşünüldü ve eli uygun şekilde atele alındı. Yetmiş iki saat sonra hastanın kas güçlerini tekrar değerlendirmek için yapılankontrolde hastanın enjeksiyon sonrası oluşan şikayetlerinin düzeldiği gözlendi. Bu derlemede çok yaygın bir enjeksiyon tipinden sonraortaya çıkan geçici radiyal sinir felçli bir olgu bağlamında lateral epikondilit tedavi yöntemleri ve enjeksiyon sonrası görülen komplikasyonlarvurgulanmıştır.
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Postural musculature functioning emphasises the importance of dynamic actions in multiple motion stresses and the mechanical deficienciesof movement modelling. Human posture is a result of the distortion of space in different increments in static and dynamic conditions.Postural dysfunctions are caused by muscle tightness related to myofascicular stiffness. Herein, this traditional review explains the heat- andpain-induced syndromes, general mechanical deficiencies in muscle performance, and hypertrophy. Postural analysis shows the connection ofmotion system to biomechanics and kinesiology. Mechanical syndromes are caused by complex crossovers in the postural skeleton. Complexpostural muscles confirm isometric modelling for limb fixation according to the location of compartment. However, different movementpatterns in individualised exercises are inadequate and require further comparisons. Therefore, kinematic data regarding mechanicalsyndromes are limited. Moreover, this study shows how muscular performance should be involved in postural exercises. Postural musclestrength is the conditioning of the muscles in different working principles. Postural muscle dysfunctions should be analysed to compareatrophic characteristics. Current approaches present that postural analyses should be individualised to examine atrophic shortening andelongation because individuals have varied resistance and motion performance. This study aimed to explain development of mechanicalsyndromes to evaluate the indexes before postural exercises. These mechanical syndromes are presented in view of the longitudinal bodykinesiology involved in comprehensive exercises.
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Objective: This study aimed to investigate the presence of neuropathic pain (NP) in female patients after total knee arthroplasty (TKA) alongwith NP-associated factors.Materials and Methods: In total, 85 female patients who underwent TKA due to knee osteoarthritis were included in this study. Sociodemographic factors along with medical and psychological comorbidities were investigated. Pain levels were assessed using the visualanalogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scales. The functional status wasassessed using the WOMAC physical function scales. Importantly, the presence of NP was assessed using the PainDETECT questionnaire. Theemotional status of the patients was assessed using the hospital anxiety depression scale.Results: In total, 9 (10.6%) patients were classified as having likely NP and 14 (16.5%) as having possible NP. The PainDETECT scoreswere significantly correlated with the preoperative VAS scores (p=0.004), WOMAC pain (p=0.000) and physical function scores (p=0.007)and presence of depression (p=0.021) Furthermore, the PainDETECT scores were significantly negatively correlated with the period afterarthroplasty (p=0.033). No correlation was found between NP and socio-demographic factors and medical comorbidities.Conclusion: Patients with NP had a shorter period after arthroplasty, depression, an increased severity of pain and a decreased physicalfunction. The presence of NP in the patients who underwent TKA should be considered and associated factors should be evaluated.
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