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BACKGROUND: It has not yet been fully established that there is coronavirus disease 2019 (COVID-19) involvement in the synovial fluid and it remains a topic of debate. OBJECTIVE: The aim of this study was to evaluate the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in knee joint synovial fluid of patients with COVID-19. METHODS: This retrospective study was conducted with an initial screening of patients who were admitted to a tertiary pandemic hospital due to COVID-19 symptoms, and underwent treatment for COVID-19 between March and June 2020. RESULTS: A total of 2476 patients were hospitalized or received treatment for a possible diagnosis of COVID-19. While the RT-PCR test was positive in 318 patients (12.8%), 2158 (87.2%) were computed tomography positive but reverse transcription-polymerase chain reaction (RT-PCR) negative. Twelve patients were consulted due to acute joint effusion. Of five patients with knee joint effusion and a positive RT-PCR test, the synovial tissue RT-PCR test was positive in only one patient. CONCLUSION: This paper is the first to show the presence of SARS-CoV-2 in synovial fluid. This can be considered of importance for the determination and elimination of the route of transmission, thereby preventing further development and spread of the disease. [ABSTRACT FROM AUTHOR]

Objective: Vertebroplasty (VP) is a commonly used technique for the treatment of osteoporotic vertebral fractures (OVF). The aim of the study is to compare general anesthesia (GA) and local anesthesia (LA) applications for VP. Materials and Methods: Patients who underwent VP for a single-level OVF were included in to the study. Visual analog scale (VAS), demographic characteristics, operative time, mean arterial pressure (MAP), heart rate, length of stay in intensive care and hospital, complications, side effects, kyphotic angle (KA) and anterior vertebral height (AVH) of the vertebral body were compared between groups. Results: Eighty patients (52 female, 28 male) were included and divided into two groups: As GA, group 1, and as LA, group 2. There was statistical significant differences between preoperative VAS scores, KA, AVH compared to postoperative period in both groups (p<0.05). There was no difference between the groups in terms of recovery rates of these variables, complications and side effects (p>0.05). Heart rate and MAP was lower in group 1 (p<0.05). Conclusion: VP is a minimally invasive method that provides pain relief and restoration of the fractured vertebrae. Our study showed there is no difference in the success, complication and side effect rates of VP surgeries performed with both anesthesia methods. LA may be an alternative method to GA as the primary anesthetic option for VP operations. VP can be performed under local anesthesia to avoid complications of GA and shorten the length of stay in the hospital especially in high-risk patients. [ABSTRACT FROM AUTHOR]

Background: The treatment of Intertrochanteric fractures in the elderly osteoporotic patient is still controversial. The aim of this study was to compare the outcomes of proximal femoral nailing (PFN) and a distally-fixed non-modular monoblock fluted long-stem hemiarthroplasty (HA) in elderly patients with an osteoporotic intertrochanteric fracture. Methods: This retrospective study included patients who had undergone surgery for an unstable intertrochanteric fracture. The patients were separated into PFN and HA groups. The demographic features of the 2 groups were compared. All patients were evaluated using the Singh index, ASA score, AO/OTA classification, Harris Hip Score (HHS), and Parker and Palmer mobility score. Results: The most common complications were nonunion (12.0%) and cut-out of the screw (10.7%) in the PFN group, and dislocation of the prosthesis (6.7%) and wound infection (5.7%) in the HA group. Overall, the 2-year mortality rate was 29.3%. Mortality, particularly within the first 3 months, was 2.4 times higher in the PFN Group than in the HA group (40% vs. 19.75%). Although the HHS was significantly higher in the first year for the HA group, no significant difference was seen between the 2 groups at 24 months. Conclusions: Although PFN and HA have similar good outcomes at 2 years, HA allows earlier mobilisation and has fewer complications and a lower mortality rate. [ABSTRACT FROM AUTHOR]

Objective: The purpose of our study was to evaluate aortic stiffness and distensibility changes and the presence of aortic and mitral valve calcifications in patients with primary knee osteoarthritis (OA), using 2-dimensional and Doppler transthoracic echocardiography., Methods: This case-control study included 115 participants with OA and a control group between May 2019 and November 2019. The Kellgren-Lawrence classification was used for the diagnosis and classification of knee OA, based on radiological images. We compared the demographic data, 2-dimensional and Doppler transthoracic echocardiography results, and laboratory findings between the OA patient group and the control group., Results: There was a significant difference between aortic strain, aortic distensibility, aortic stiffness, and C-reactive protein values between the OA patient group and the control group (p < 0.001 for all). Post hoc analyses revealed that aortic strain and aortic distensibility values were significantly lower, and aortic stiffness values were significantly higher in the grade 4 OA group than those of other groups (p < 0.05 for all). In addition, the C-reactive protein values of the grades 3 and 4 patients were significantly higher than those of other groups (p < 0.05 for all). No significant difference was observed between the groups in terms of aortic and mitral valve calcifications (p > 0.05 for all)., Conclusion: Aortic strain and distensibility values were lower in the advanced grades of primary knee OA, whereas aortic stiffness values and the frequency of valve calcifications were higher., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The aim of this study was to conduct a sonographic assessment of sciatic nerve thickness and stiffness following total hip arthroplasty (THA) and to determine the relationship between sonographic characteristics of the sciatic nerve and clinical outcomes., Methods: This prospective study included patients undergoing primary cementless THA due to hip osteoarthritis between January 2018 and January 2019 in a tertiary-level hospital. The thickness, strain elastography, strain ratio (SR), and shear wave elastography (SWE) of the sciatic nerve were measured. The clinical outcome measures included leg lengthening (LL), leg length discrepancy (LLD), Oxford Hip Score (OHS), Visual Analog Scale (VAS) at rest, VAS during activity, and the Leeds Neuropathic Symptoms and Signs Evaluation (LANSS) scale. The data of the patient group were assessed preoperatively and at 3, 6, and 12 months postoperatively., Results: The sciatic thickness and SR values of the operated side were significantly lower than those of the non-operated side (P < 0.05 for all). The sciatic SWE was significantly greater on the operated side compared with the non-operated side (P < 0.001 for all). Sciatic nerve thickness and SR were negatively correlated, and sciatic nerve SWE was positively correlated with OHS, VAS at rest, VAS during activity, and LANSS values. Sciatic nerve thickness and SR values were significantly lower, and SWE was significantly higher in the group with a change in LL > 20 mm. Clinical scores decreased during the following period in mild and moderate lengthening group (< 20 mm). In the severe lengthening group (≥ 20 mm), the clinical score increased over time. The VAS activity score was higher in the mild and moderate LL group (< 20 mm) than the VAS rest score (P < 0.001). However, the VAS rest score was significantly higher in the severe LL group (≥ 20 mm) than the VAS activity score (P < 0.001)., Conclusion: The results of this study have shown a significant relationship between thickness and stiffness of the sciatic nerve and LL after THA. The ultrasound parameters were significantly associated with functional outcomes., Level of Evidence: Level IV, Therapeutic Study.