What are the Factors that Impact the Outcomes of Arthroscopic Rotator Cuff Repair?

BACKGROUND: The cuff is a complex structure with many factors affecting it. How much it is affected after repair is still being investigated. AIM: The aim of this study was to analyze the functional results of individuals who received arthroscopic rotator cuff repair and assess the various factors that could impact these outcomes. METHODS: The study included 57 patients with a mean age of 58.8 years (range: 39-71) who underwent arthroscopic rotator cuff repair between 2013 and 2020, with a minimum of 6 months after the operation. Functional and clinical outcomes of the patients were evaluated using preoperative and postoperative scores (QDASH, ASES, and VAS). The study also analyzed how demographic factors, type and duration of the tear, comorbidities such as diabetes mellitus (DM) and hypertension (HT), and other pathologies may have affected the patients' scores. RESULTS: The effect of the operation on the scores in rotator cuff tears was highly significant (P < 0.05). Age, gender, tear size, fatty degeneration, anchor configuration, comorbidities, and additional procedures presented variable values on postoperative scores, but were not statistically significant. The effect of DM and HT on VAS scores was statistically significant (P < 0.05). CONCLUSION: The results of rotator cuff repair appear to be influenced by several factors, including the sex of the patient, type and duration of tear, comorbidities, and surgical procedures used. Although these factors had an effect on the scores, they were not statistically significant.

Review of Anterior Submuscular Transposition of Ulnar Nerve for Cubital Tunnel Syndrome.

OBJECTIVE: In this study, we report the results of patients who underwent ulnar nerve submuscular anterior transposition surgery due to cubital tunnel syndrome. METHODS: Data of 46 patients who underwent anterior submuscular transposition surgery due to cubital tunnel syndrome between January 2010 and December 2014 were retrospectively reviewed. Twenty-seven patients with preoperative and postoperative complete medical records available and who had completed at least 24 months follow-up were included in the study. RESULTS: According to preoperative McGovan staging system, 1 patient was classified as stage 1, 8 were stage 2A, 3 were stage 2B, and 15 were stage 3. The mean follow-up time was 61.4 (35-88) months. The mean DASH score of the patients was calculated as 19 (0-81.81). Mayo elbow performance score was excellent in 13 patients, good in 7, fair in 6, and poor in 1. CONCLUSION: Anterior submuscular transposition of ulnar nerve had resolved symptoms 89% of our patients. The technique is a successful method with a low recurrence and complication rate.

Mid-term Results of Two-Stage Tendon Reconstruction of Zone II Flexor Tendon Injuries.

BACKGROUND: Secondary repair of flexor tendon injuries remains a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by a staged approach. Two-stage surgical reconstruction of the flexor tendons by the Hunter technique is the salvage option in case of a severely damaged fibro-osseous canal or neglected flexor tendon injury. AIMS: We report the results of staged flexor tendon reconstruction in 10 patients (10 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. MATERIALS AND METHODS: Between 2012-2016, patients who underwent two-stage tendon reconstruction due to flexor digitorum profundus (FDP) sectioning or tearing in zone II with destruction of flexor pulleys and extensive scarring in the flexor tendon bed were included in the study. RESULTS: Ten patients included to study with a mean follow-up of 34 months (range 12-70 months) and the results were assessed by clinical examination and questionnaire. According to the Strickland score, one (20%) of the results were excellent, five (50%) were good, two (20%) were fair and two (20%) were poor. After the second stage, good to excellent results were achieved in 60% of patients, one patient needed graft tenolysis. These results were similar to the subjective scores given by the patients, four of whom complained of functional problems in daily life at follow-up. There was no complication after the first stage. But after the second stage, there was one bowstringing and one adhesion that require tenolysis. CONCLUSIONS: Hunter technique is still the reference procedure for the reconstruction of flexor tendons. The results of our study showed that two-stage tendon reconstruction which is applied in patients with tendon sheath disruption as a result of acute or delayed tendon injuries which are not possible for primary repair is reliable and satisfactory.

Mid term results of radial metaphyseal core decompression on Kienböck's disease.

OBJECTIVE: Kienböck's disease is a commonly seen posttraumatic avascular necrosis characterized by avascular necrosis of the lunate bone of the wrist which involves the dominant hand. In our study, we aimed to present midterm outcomes of 12 cases treated with radial metaphyseal core decompression. PATIENTS AND METHODS: In our clinic, 12 patients who applied to our outpatient clinic with intractable pain despite at least six weeks of conservative treatment were previously diagnosed and evaluated as Kienböck's disease between the years 2006 and 2014. Patients at early stage received radial metaphyseal core decompression. RESULTS: The patients were evaluated as postoperative grip strength, flexion-extension gap, ulnar-radial deviation gap, VAS, Quick DASH and MAYO wrist scoring and patient satisfaction. CONCLUSIONS: We determined that interventions performed for Kienböck's disease cannot halt radiological progression. We are of the opinion that radial metaphyseal core decompression, aiming at increasing blood perfusion, improve early diagnosis and treatment of Kienböck's disease, increasing the patient satisfaction.

Investigation of cytotoxic and genotoxic effects of Ecballium elaterium juice based on Allium test.

The genus Ecballium only comprises the Ecballium elaterium (EE) (L.) A.Rich species which is a wild medicinal plant found in the Mediterranean region. EE fruit juice is widely used in Turkish folk medicine for the relief of sinusitis and for several illnesses. Up to date, there has been no report on the genotoxicity of EE fruit juice. Thus, the aim of this study was to investigate the potential genotoxic effects of EE fruit juice using the Allium test system. Allium cepa (A. cepa) bulbs were treated with four concentrations (10 ml/L, 20 ml/L, 50 ml/L and undiluted) of EE fruit juice for 72 h and tap water (pH 7.3) was used as a control. The results showed significant dose-dependent (P < 0.05) inhibition of root growth and mitodepressive effects on cell division in A. cepa root tip cells after the EE fruit juice treatments. Also, EE fruit juice significantly increased the dose-dependent frequency of chromosome aberrations (breaks, stickiness and pole deviations) in root tip cells and micronucleus formations. There was no dividing cell in the undiluted EE fruit juice treated group, but there were pyknotic/apoptotic cells with varying frequency.