Objective The aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in detecting biceps lesions in patients with rotator cuff tears. Material and Methods A total of 168 patients operated on between January 2012 and February 2020 were included in the study. All the patients underwent arthroscopic surgery with the diagnosis of rotator cuff tears. All patients were operated on under general anesthesia and in the beach chair position. Demographic data and preoperative MRI findings were recorded. Arthroscopic findings were accepted as the standard reference and correlated with preoperative MRI records. Results In preoperative images, full-thickness rotator cuff tears were identified in 118 (70.2%) cases and partialthickness tears in 50 (29.8%) cases. Labrum/SLAP lesions were detected in 18 (10.7%) cases. Biceps disorders were reported in 51 (30.4%) cases. During the surgeries, we observed additional pathologies in 41 (24.4%) cases besides the preoperatively detected lesions. Rotator cuff and labrum/SLAP repairs were performed in the same surgical sessions. The majority of newly detected lesions were biceps lesions, being identified in 26 (15.5%) cases. In 41 (24.2%) cases tenodesis, tenolysis, or tenotomy were performed for biceps lesions. LHBT surgery was performed in 26 cases with negative MRI. Biceps lesions were confirmed in 77 (45.8%) cases intraoperatively; therefore, the accuracy of MRI in detecting these lesions was 66.2%. Conclusion Biceps lesions are among the common pathologies of the shoulder. Preoperative MRI is important in evaluation of the shoulder, but the efficacy of MRI may be limited in detecting biceps disorders. Arthroscopic surgery is crucial in diagnosis and treatment of LHBT lesions.
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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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Objective: The aims of this study were (1) to investigate the effects of different demographic and perioperative modalities on
mortality rates and (2) to compare mortality rates between different implants in elderly patients operated on for hip fractures.
Methods: In this retrospective study, a total of 314 patients who were operated on for hip fractures were included study. Patients
were then divided into four groups based in their implant types: long-stem cementless bipolar hemiarthroplasty (n = 124; 102
female, 22 male; mean age = 84.2 ± 6.4 years), standard-stem cementless bipolar hemiarthroplasty (n = 74; 48 female, 26 male;
mean age = 83.5 ± 6.9 years), antegrade intertrochanteric nail (n = 61; 35 female, 26 male; mean age = 78.5 ± 6.8 years), and total
hip arthroplasty (n = 55; 34 female, 21 male; mean age = 72.5 ± 4.3 years). Data including gender, age, duration from injury to
surgery, American Society of Anesthesiologists (ASA) score, comorbidities, use of antiplatelet agents, Barthel Index of Activities
of Daily Living, type of anesthesia, operation time, preoperative hemoglobin values, blood transfusions given, duration of
hospital stay, complications, and type of fracture were recorded.
Results: Overall, the mean follow-up was 36.5 (range = 0 – 107) months. The overall mortality rate was 53.2%. The median
survival duration was 44.2 ± 5 months (range = 34.3 – 54). Survival rates were found significantly different among the groups (P =
0.001). In the first three years postoperatively, the mortality rate was higher in the standard-stem bipolar hemiarthroplasty group,
but in the long-term follow-up, the long-stem bipolar hemiarthroplasty group exhibited the higher mortality rates. It was observed
that some parameters had statistically significant effects on the mortality rates. Male gender, higher age, lower hemoglobin
values, increased number of blood transfusions, ASA scores ≥3, the existence of ≥ 3 comorbidities were found as main predictors
of increased mortality rates.
Conclusion: The results of this study have shown that age, gender, preoperative hemoglobin levels, ASA scores, and
comorbidities are significant factors affecting mortality in elderly patients operated on for hip fractures. Long-stem cementless
bipolar hemiarthroplasty appears to show similar rates of mortality with standard-stem cementless bipolar hemiarthroplasty.
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Bu çalışmanın amacı COVID-19 pandemisi sürecinde farklı maske tiplerinin ve bunların kullanım güçlüklerinin incelenmesidir. Çalışma etik kurul onayı sonrası düzenlendi. İzmir Ekonomi Üniversitesi Medical Park Hastanesi’nde çalışan, sekreter, hemşire ve doktorlardan oluşan, yaş ortalaması 29,5 olan 78 kadın, 34 erkek toplam 112 gönüllü çalışmaya dâhil edildi. Gönüllüler cerrahi tıbbi maske ve FFP2 maske kullananlar olarak iki gruba ayrıldı. 1. gruba cerrahi tıbbi maske kullanan 81 gönüllü, 2. gruba FFP2 maske kullanan 31 gönüllü dahil edildi. Gönüllülerin, maske kullanımı esnasında 60. dakika ve 180. dakikada nefes darlığı, görme sıkıntısı, kulak ağrısı, baş ağrısı, yüzde rahatsızlık hissi, anksiyete şikâyetlerinin gelişip gelişmediği sorgulandı. Ayrıca 60. ve 180. dakikalarda pulse oksimetre cihazı ile gönüllülerin oksijen satürasyonları ve kalp atım sayılarındaki değişiklik ölçüldü ve başlangıç değerleriyle kıyaslandı. Şikâyetlerin; alerji, sigara kullanımı ve gözlük kullanımı ile değişkenlik gösterip göstermediği değerlendirildi. Verilerin analizinde SPSS 17 paket program kullanıldı. Mevcut verilerin dağılımı Kruskal Wallis ve Shapiro Wilk testleri ile incelendi. Verilerin normal dağılım paterninde olduğu saptandı ve ortalama±standart sapma olarak, gruplar arasında başlangıç, 60 ve 180. dakika satürasyon ve nabız değerleri açısından fark olup olmadığı Student-t testi ile karşılaştırıldı. p<0.05 istatistiksel olarak anlamlı kabul edildi. Nefes darlığı, anksiyete, yüzde rahatsızlık hissi, baş ağrısı, kulakta ağrı ve görme sıkıntısı açısından grupların kendi içinde ve gruplar arasında fark olup olmadığı Ki-Kare testi ile değerlendirildi. Her iki grupta da başlangıç ile 60. Dakika(p<0.001) ve 180 dakika (p<0.001), oksijen satürasyonları açısından istatistiksel anlamlı fark bulunmuştur. Yine başlangıç nabız değerleri ile 60.dakika (p<0.001) ve 180. dakika nabız değerleri açısından (p<0.001) istatistiksel anlamlı fark bulunmuştur. 180. dakika satürasyon değeri arasındaki fark ile maske türü, alerji varlığı, gözlük kullanımı, sigara kullanımı, yaş ve cinsiyet arasında istatistiksel anlamlı ilişki saptanmamıştır. FFP2 tipi maskenin cerrahi maske kullanımıyla kıyaslandığında, daha fazla şikâyete yol açtığı saptanmıştır. Sonuç olarak FFP2 tipi maskenin kullanımda tolerasyonunun daha zor olduğu görülmüştür. Her iki maske tipinde de 180 dakika kullanım sonunda oksijen satürasyonu ve kalp atım hızında düşüş görülmesine rağmen, bu değerler fizyolojik sınırlarda kalmıştır. COVID-19 pandemisi sürecinde, sağlık çalışanları ve toplumdaki kişilerin kendilerinin korunması için önemli bir bariyer olan maske kullanımının sağlık üzerine olumsuz etkisi saptanmamıştır.
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