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Purpose: The purpose of this study was to compare radiographic and clinical outcomes of robotic-assisted and conventional manual techniques in restricted kinematically aligned TKA. Methods: Patients who underwent either manual or robotic-assisted restricted kinematically aligned TKA between 2019 and 2020 were included in this retrospective comparative study. Radiographic outcomes comprised coronal plane measurements performed through standing full-length anteroposterior radiographs. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford score, Visual Analog Scale pain and satisfaction score, and Forgotten Joint Score were used to determine the clinical outcome. The continuous data were compared by Student's t test according to the Kolmogorov‒Smirnov normality test. Results: The manual group consisted of 46 patients (38 females, eight males) with a mean age of 68.1 years, and the robotic group consisted of 70 patients (58 females, 12 males) with a mean age of 65.7 years (n.s.). Preoperatively, no significant difference was observed between groups concerning demographic characteristics, radiographic measurements, and clinical scores except for the symptom and pain domains of the KOOS score, which was significantly worse in the manual group (p = 0.011 and 0.035, respectively). At the postoperative 2-year follow-up, we observed significant differences between groups with respect to the mean HKA angle, mMPTA, and mLDFA (p = 0.034, 0.041, and 0.005, respectively). A comparison of clinical scores at the postoperative 2-year follow-up demonstrated no significant differences between groups. Conclusion: The current study demonstrated that using robotic-assisted technique for restricted kinematically aligned total knee arthroplasty (TKA) resulted in significantly better outcomes compared to the conventional manual technique in achieving normal ranges of lower extremity coronal alignment measurements. While the robotic-assisted group demonstrated better clinical scores, there was no statistically significant difference in clinical outcomes between the robotic-assisted group and the control group at the two-year follow-up. Concerning clinical relevance, the restoration of original anatomy and coronal alignment, a crucial concern in restricted kinematically aligned TKA, may be better achieved by the robotic-assisted technique. Level of evidence: Level III (Retrospective cohort study). [ABSTRACT FROM AUTHOR]

This study aimed to assess the preliminary outcomes of kinematically aligned robot-assisted total knee arthroplasty (TKA) with patient-specific cartilage thickness measurement. Patients who underwent kinematically aligned robot-assisted TKA were included in this study. Robot-assisted total knee arthroplasties were performed by NAVIO Surgical System (Smith & Nephew, Memphis, USA), an image-free handheld robotic system. The kinematic alignment technique was performed according to our intraoperative cartilage thickness measurement technique. Hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), joint-line orientation angle (JLOA), and joint-line convergence angle (JLCA) were measured through standing full-length anteroposterior radiographs. Knee Injury and Osteoarthritis Outcome Score, Oxford score, VAS pain and satisfaction score, and Forgotten Joint Score were used to assess clinical outcomes. A total of 142 knees of 109 patients (92 females and 17 males) were evaluated in this study. There was a significant correction in HKA, JLCA, and mMPTA postoperatively (p ≤0.001, < 0.001, and 0.029, respectively). We observed no significant change in mLDFA and JLOA measurements. All clinical scores significantly increased at the latest follow-up. Our results demonstrated that kinematically aligned robot-assisted TKA with patient-specific cartilage thickness measurement demonstrated no significant change in mLDFA and JLOA, as expected; however, significantly corrected the deformity in HKA, mMPTA, and JLCA measurements. [ABSTRACT FROM AUTHOR]

Purpose: Subacromial volume measurement on magnetic resonance images is relatively new. It has been shown that decreased subacromial volume increases after surgical repair of full-thickness rotator cuff tears. There is no study examining subacromial volume changes after superior capsular reconstruction (SCR). The purpose of this study was to compare subacromial volume changes on magnetic resonance images (MRI) after superior capsular reconstruction performed for primary irreparable rotator cuff tears. Methods: Patients who underwent an SCR procedure between 2017 and 2019 with a minimum 2-year postoperative follow-up were included in this retrospective study. Subacromial volume was measured on MRI using software. The preoperative and postoperative acromiohumeral distance, Constant Scores, graft thickness, and Hamada grades of the patients were evaluated. Results: A total of 18 patients with a mean age of 59.7 years (range: 49–74 years) underwent an SCR for massive irreparable cuff tear. The mean preoperative subacromial volume was 3.54 ± 0.39 cm3 (range 2.88–4.36 cm3), which increased to 4.46 ± 0.39 cm3 (range 3.75–5.32 cm3) postoperatively (p = < 0.001). The increase in subacromial volume and acromiohumeral distance did not correlate with Constant scores and graft thickness. We observed a significantly higher subacromial volume increase among Hamada grade 1 patients, compared to those with Hamada grade 2 (p = 0.011). Conclusions: We observed that subacromial volume significantly increased after superior capsular reconstruction. However, the increase in subacromial volume did not correlate with clinical scores, acromiohumeral distance changes, or graft thickness. Level of evidence: Level III – Retrospective Cohort Study. [ABSTRACT FROM AUTHOR]

BACKGROUND: To date, only one study assessed the spinal mobility and muscle strength of patients who were treated either with fusion or brace treatment. OBJECTIVE: The aim of this retrospective study was to evaluate the range of motion (ROM) and strength of the cervical and thoracic/lumbar spine in patients who underwent spinal fusion for the treatment of adolescent idiopathic scoliosis (AIS) in comparison to healthy individuals. METHODS: Patients (n= 28) who were treated surgically for AIS were included in the study. An age and gender matched control group (n= 22) was included that consisted of healthy individuals. DAVID® Lumbar/Thoracic Extension, Lumbar/Thoracic Rotation, and Cervical Extension/Lateral Flexion devices were used to measure cervical and lumbar/thoracic ROM as well as muscle strength. RESULTS: Significant differences were observed between groups in all ROM measurements except thoracic/lumbar sagittal flexion ROM measurement (p= 0.198). There were significant differences between groups in terms of muscle strength, except thoracic lumbar left rotation strength (p= 0.081). CONCLUSIONS: The findings of the current study demonstrated that cervical and thoracic/lumbar range of motion, as well as muscle strength, were significantly decreased in surgically treated adolescent idiopathic scoliosis patients compared to healthy counterparts. However, trunk (thoracic/lumbar) flexion range of motion and trunk left rotation muscle strength were not significantly different. [ABSTRACT FROM AUTHOR]

Aim: There are few studies in the literature evaluating the robotic assisted unicondylar knee arthroplasty (rUKA) learning curve. This study aimed to evaluate the learning curve in robotic assisted unicondylar knee arthroplasty in terms of operation time. Materials and Methods: The data of patients who underwent rUKA between October 2016 and December 2019 were retrospectively analyzed. Age, gender, side, and body mass index (BMI) values of the patients were obtained from the patient files. To compare the operation times, the patients were divided into two groups. The first group represented patients who had surgery in the first half of the follow-up period (n=27), while the last group represented patients who had surgery in the second half of the follow-up period (n=28). Results: During the study period, rUKA was performed on 55 patients (42 females, 13 males) with a mean age of 64.1 years. The demographic data of the two groups were similar. The mean operative times of the first (n=27) and the last groups (n=28) were 101.816.1 minutes, and 84.89.9 minutes, respectively (p <0.001). Conclusion: The mean duration of operation was significantly shorter in the last group who underwent rUKA, compared to the first group. Our findings showed that there is a significant learning curve in rUKA surgery in terms of operation time. [ABSTRACT FROM AUTHOR]

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Introduction and hypothesis: In the current study we hypothesized that total knee arthroplasty might improve the overactive bladder symptoms by providing pain relief and improving physical function. Methods: One hundred patients who underwent total knee arthroplasty were preoperatively evaluated for overactive bladder and 47 patients that met inclusion criteria were included in this study. All the patients included in the study were assessed both preoperatively and at the 3rd month postoperatively using the Overactive Bladder-Validated 8 (OAB-V8) questionnaire for overactive bladder symptoms, the Oxford Knee Score (OKS) for pain and physical function, and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity. Results: The mean age of the patients was 65.4 ± 7 (56–83) years. The OAB-V8, OKS and IPAQ-SF scores significantly improved at the 3rd month postoperatively compared with the initial assessment. All the OAB-V8 domains, namely, frequency, urgency, nocturia, and urgency urinary incontinence, significantly improved following total knee arthroplasty. Conclusions: Our results showed that following total knee arthroplasty, overactive bladder questionnaire scores significantly improved at the 3rd month postoperatively. [ABSTRACT FROM AUTHOR]

Objective: Controversies exist in the follow-up and treatment of adolescent idiopathic scoliosis (AIS). Thus, it is important to identify the attitudes of physicians from a national perspective to determine the status and problems associated with AIS treatment. This study aimed to evaluate the preferences of the Turkish Spine Society (TSS) physicians towards AIS treatment by investigating differences in AIS monitoring and treatment through a web questionnaire survey. Materials and Methods: This cross-sectional observational study employed a simple questionnaire focusing on AIS, which was created using Survey Monkey. Twenty questions, which were deemed as the most controversial topics of AIS, were constructed by the authors. A consensus was considered when 70% of the respondents provided the same answer. Results: A consensus was obtained among TSS physicians for using brace as conservative treatment and the brace was used 22 hours daily. Most TSS physicians agreed about the surgical indication of AIS; however, there was a disagreement about the indication of brace treatment. Conclusion: TSS physicians had a consensus on using brace in AIS treatment. However, there was a disagreement towards the indication of the brace treatment. The results demonstrated a consensus about surgical management and surgical experiences. However, a disparity existed about the time by which activities and contact sports are allowed. [ABSTRACT FROM AUTHOR]