Is medial or lateral localization of osteochondral lesions of talus related to foot angles?

OBJECTIVES: This study aims to examine the relationship between foot angles and the presence and localization of osteochondral lesions of the talus (OLTs). PATIENTS AND METHODS: Between January 2014 and January 2019, a total of 152 patients with a diagnosis of medial OTLs (95 males, 57 females; mean age: 28.8±6.4 years; range, 18 to 40 years), 51 patients with a diagnosis of lateral OTLs (36 males, 15 females; mean age: 27.1±6.2 years; range, 18 to 39 years), and 114 patients without known foot-ankle trauma as the control group (56 males, 58 females; mean age: 29.0±6.1 years; range, 18 to 40 years) were included. Magnetic resonance imaging and radiographs of each group were analyzed retrospectively. Lateral talocalcaneal angle (LTCA), calcaneal inclination angle (CIA), Böhler angle (BA), and Gissane angle (GA) were measured on the images and the values were compared among the groups. RESULTS: The CIA had a significant relationship with the localization (p<0.001). It was higher in patients with OLTs and had an effect on localization. The mean CIA was 26.6º±3.9º in the medial OLTs group, 23.0º±3.5º in the lateral OLTs group, and 18.5º±3.6º in the control group. There was a significant difference in the LTCA between the control and OLTs groups (p<0.001). The LTCA was higher in patients with OLTs, but had no effect on localization. The mean LTCA was 41.1º±4.2º for medial OLTs, 41.3º±4.2º for lateral OLTs, and 35.7º±6.8º for the controls. No significant relationship was found for BA and GA among the three groups. CONCLUSION: Factors affecting the localization of OLTs are still not fully understood. However, foot morphology seems to play a role in determining medial or lateral localization. The LTCA is not related to the localization of OLTs; however, an increased LTCA may be related to the occurrence of OLTS. Increased CIA may be related to both OLTS localization and OLTs occurrence.

Evaluation of the effect of vitamin D level on greater tuberosity primary bone marrow edema.

INTRODUCTION: The anabolic effects of vitamin D on bone tissue have been demonstrated in experimental studies. The aim of this study was to evaluate the relationship between greater tuberosity primary bone marrow edema (GTPBMO) and vitamin D levels. MATERIALS AND METHODS: Thirty-nine patients (22 females and 17 males; mean age 49.02 ± 13.08 years) with isolated GTPBMO between March 2016 and March 2018 were included in the study. Sixty patients (34 females and 26 males; mean age 43.45 ± 12.61 years) who did not have any shoulder complaints and fulfilled the study criteria were selected as the control group. Both groups were compared in terms of vitamin D levels. RESULTS: The mean vitamin D level was 13.43 ± 9.02 ng/mL in the GTPBMO group. In contrast, mean vitamin D level was 21.54 ± 8.03 ng/mL in the control group (p < 0.001). In the GTPBMO group, vitamin D deficiency was detected in 31 (79.5%) patients, vitamin D insufficiency was detected in 5 (12.8%) patients, and vitamin D levels were normal in 3 (7.7%) patients. In the control group, vitamin D deficiency was detected in 29 (48.3%) patients, vitamin D insufficiency was detected in 16 (26.7%) patients, and vitamin D levels were normal in 15 (25%) patients. CONCLUSION: The etiology of GTPBMO has not yet been fully understood, but the results obtained in this study show that vitamin D levels were significantly lower in patients with GTPBMO. The findings suggest that low vitamin D levels may be one of the contributing factors in the etiology of GTPBMO.

Evaluation of the relationship between lateral epicondylitis and vitamin D.

OBJECTIVES: This study aims to examine the relationship between low vitamin D levels and lateral epicondylitis (LE). PATIENTS AND METHODS: Between January 2016 and January 2018, a total of 40 patients (17 males, 23 females; mean age: 38.6±10.7 years; range, 18 to 59 years) diagnosed with LE were included as the study group, while 66 patients (33 males, 33 females; mean age: 33.6±12.5 years; range, 18 to 58 years) who did not have any elbow complaints and met the study criteria were included as the control group. Both groups were compared in terms of vitamin D levels, of which levels of >30 ng/mL were considered normal, levels between 20-30 ng/mL were accepted as vitamin D insufficiency, and levels <20 ng/mL were categorized as vitamin D deficiency. RESULTS: Vitamin D levels of the LE group were significantly lower than the control group (p<0.001). The mean vitamin D level was 16.47±8.22 (range, 8.32 to 39.55) ng/mL in the LE group, and 23.64±8.4 (range, 11.6 to 49) ng/mL in the control group. While 31 of the patients (77.5%) diagnosed with LE had vitamin D deficiency, four (10%) had vitamin D insufficiency, and five (12.5%) had normal vitamin D levels. In the control group, 29 (43.9%) patients had vitamin D deficiency, 20 (30.3%) had vitamin D insufficiency, and 17 (25.8%) had normal vitamin D levels. CONCLUSION: Although the etiology of LE has not been fully understood yet, vitamin D levels were significantly lower in LE patients in our study. This finding supports that low vitamin D may be one of the factors in the etiology of LE.