Treating symptomatic flexible flatfoot deformities. a novel technique: comparison of uc berkeley laboratory foot orthosis with and without kinesio taping in juvenil athletes.

PURPOSE: Symptomatic flexible pes planus (SFPP) can cause pain and discomfort when walking or engaging in sportive activities in children and adolescents. SFPP can be treated conservatively with foot orthoses, such as the University of California Berkeley Laboratory (UCBL) foot orthosis, which can improve foot function and reduce pain. Kinesio Tape (KT) has also been used as an adjunct to foot orthoses in the treatment of pes planus. This study aims to compare the effectiveness of the UCBL foot orthosis with and without KT in the treatment of SFPP among amateur juvenile and adolescent athletes. METHODS: Fifty patients with SFPP were included in the study. In 27 patients UCBL foot orthosis with KT (group 1) was used whereas in 23 UCBL (group 2) was preferred only. The patients were evaluated with AOFAS and radiological measurements. RESULTS: The mean follow-up period was 28.6 ± 4.3(26) months. At the final follow-up AOFAS of group 1 was significantly higher than group 2. In group 2, 12 patients (%52,17) had pressure sores that caused superficial dermabrasion. Lateral TFMAs and talocalcaneal angle in group 1 was significantly better than group 2. CONCLUSIONS: This study attempted to determine if using KT with the UCBL foot orthosis was beneficial to the treatment of SFPP compared to simply wearing the orthosis. Our results suggest that KT is effective in reducing pronation and improving the AOFAS score. The use of UCBL with KT seems to be preferable in children and adolescents with SFPP since it is associated with a lower rate of complication, a higher degree of patient compliance and faster improvement in the radiological and clinical findings, compared to the use of the UCBL orthosis alone.

How Efficient Is ChatGPT in Accessing Accurate and Quality Health-Related Information?

Background and objective The field of artificial intelligence (AI) is advancing at a rapid pace, impacting all aspects of human life. Chat Generative Pre-trained Transformer (ChatGPT), which represents one of AI's most recent and remarkable achievements, has garnered significant attention and popularity in the academic community. ChatGPT, a language model-based chatbot developed by OpenAI, responds quickly and provides answers to the questions put to it. This chatbot has the ability to gather content from a variety of sources on the internet. However, its success in providing correct information has not yet been comprehensively analyzed. In light of this, this study aimed to engage in a comparative content analysis of health-related information provided by ChatGPT and a few selected websites. Methods We performed a qualitative analysis of data obtained from various information sources by using the DISCERN score and the Journal of the American Medical Association (JAMA) benchmark criteria. In addition, readability levels of the content were measured by using the Flesch-Kincaid grade level, Gunning Fog Index, and Simple Measure of Gobbledygook (SMOG) index. Results Based on our findings, there was no statistically significant difference between the websites and ChatGPT in DISCERN scores. However, the JAMA score was statistically significantly higher for websites. With regard to the Flesch-Kincaid grade level, Gunning Fog Index, and SMOG index values, the data obtained from the websites had higher readability. Conclusion Although AI is starting to play a significant role in our everyday lives, it has yet to surpass traditional methods of accessing information in terms of readability and reliability.

Efficacy of autologous stem cell therapy in femoral head avascular necrosis: a comparative study.

OBJECTIVE: Avascular necrosis of the femoral head is a disease usually seen in middle-aged individuals. Although many aetiological factors have been blamed, there are still aetiological factors that have not been fully elucidated. Although treatment options show a wide range, early and appropriate treatment is of great importance to preserve the hip joint. In our study, we compared the results of core decompression and core decompression combined with bone marrow mesenchymal stem cell implantation in patients with avascular necrosis of the femoral head. MATERIAL METHOD: In this retrospective study, Steinberg stage 1-2 patients operated on for avascular necrosis of the femoral head between 2018 and 2023 were analysed. Separate groups were formed from patients who underwent isolated core decompression and core decompression + bone marrow mesenchymal stem cell implantation. Age, gender, Steinberg staging, aetiology of the disease, follow-up period, progression to hip arthroplasty, Vas scores, Harris hip scores (HHS), and complications were evaluated. Harris hip scores at preoperative and 2-year follow-up periods; VAS scores at preoperative, 3-month, 6-month, 1-year, and 2-year follow-up periods were analysed. RESULTS: In the study, 44 patients were analysed. While 25 patients underwent core decompression only (group 1), 19 patients underwent core decompression and bone marrow mesenchymal stem cell implantation (group 2). The mean age of the patients in group 1 was 39.3 ± 6.5 years, and the mean age of the patients in group 2 was 38.4 ± 6.7 years. The mean follow-up was 31.85 ± 4.4 months in group 1 and 32.2 ± 4.1 months in group 2. Total hip arthroplasty was performed in 2 of the patients in group 1 (one of the patients underwent total hip arthroplasty at month 28 and the other at month 33). CONCLUSION: The treatment of avascular necrosis of the femoral head varies according to various staging methods. Early diagnosis of the disease and correct treatment are very important for the patient's quality of life in the future. In our research, we found that patients who received both core decompression and stem cell implantation for early-stage avascular necrosis of the femoral head exhibited decreased pain at the 6-month, 1-year, and 2-year follow-up examinations. Additionally, their hip function improved at the 24-month mark according to the HHS evaluation.

Effect of Glenohumeral Joint Bone Morphology on Anterior Shoulder Instability: A Case-Control Study.

PURPOSE: Glenohumeral joint compatibility and bone morphology are among the most critical factors in shoulder stabilization. Our study investigated the effect of the bone morphological structure of the shoulder joint on anterior shoulder dislocation. METHODS: In our study, people with a history of shoulder dislocation were selected as the patient group. In the control group, patients with shoulder MRIs for any reason and no history of shoulder dislocation were included. Those who have a fracture around the shoulder, a congenital deformity in the shoulder region, arthrosis of the shoulder, those whose MRI images cannot be measured, those with Hill-Sachs lesion, connective tissue diseases (such as Ehler Danlos), who are unsure of their diagnosis, or who have incomplete and incorrect suspicious information in their patient file have been excluded. In our retrospective case-control study, glenoid width, glenoid height, glenoid's height-to-width ratio, glenoid's depth, glenoid's version, glenoid's inclination, humerus radius of curvature, glenoid radius of curvature, and bony shoulder stability ratio were measured on MRI images of the patients. The sample size for each group was determined using a power analysis method. The intra-class coefficient (ICC) assessed interobserver and intraobserver reliability. RESULTS: A total of 80 patients, 40 each in the control and patient groups, were included in the study. Glenoid width was measured as 24.27 ± 1.58 in the patient group, 25.61 ± 1.72 in the control group; glenoid height was as measured 36.49 ± 2.26 in the patient group, 36.74 ± 1.99 in the control group; height-to-width ratio was measured as 1.5 ± 0.08 in the patient group, 1.43 ± 0.05 in the control group; glenoid version was as measured -0.53 ± 1.17 in the patient group, -1.44 ± 1.1 in the control group; glenoid inclination was measured as 1.44 ± 3.93 patient group, 2.64 ± 3.81 in the control group; glenoid depth was measured as 1.69 ± 0.41 in the patient group, 2.12 ± 0.53 in the control group; humerus radius of curvature was measured as 29.70 ± 6.76 in the patient group, 24.98 ± 3.22 in the control group; glenoid axial radius of curvature was measured as 61.8 ± 13.52 in the patient group, 52.53 ± 15.69 in the control group; glenoid coronal radius of curvature was measured as 43.01 ± 7.47 in the patient group, 37.74 ± 6.89 in the control group; the bony shoulder stability ratio was measured as 0.35 ± 0.06 in the patient group and 0.44 ± 0.06 in the control group. In the statistical evaluation, the glenoid width (p < 0.001), the glenoid height/width ratio (p < 0.001), the glenoid version (p < 0.001), the depth of the glenoid cavity (p < 0.001), and the radius of curvature measurements of the humeral head (p < 0.001) and the glenoid (axial, p < 0.007; coronal, p < 0.001) were found to be significantly different. Glenoid height and inclination were similar in both groups. CONCLUSIONS: The detection of bone morphological features that constitute risk factors for shoulder dislocations plays an important role in preventing shoulder dislocations. In this way, it provides essential data on personalized rehabilitation programs and treatment selection for recurrent dislocations.

Lumbosacral fusion increases the risk of hip osteoarthritis.

OBJECTIVE: There may be biomechanical changes in the adjacent hip joint after lumbosacral fusion. The literature has limited information on how these biomechanical changes may result in hip joint space. MATERIAL: METHOD: Our retrospective study examined hip joint space narrowing in patients who underwent lumbosacral fusion between 2020 and 2022. In addition, spinopelvic parameters such as sacral slope, the sagittal vertical axis, pelvic incidence, lumbar lordosis, and pelvic tilt were compared in patients who underwent short-segment (up to three levels, S group) and long-segment (4 and higher levels, L group) fusions. RESULTS: Our study found no significant relationship between spinopelvic parameters and joint space narrowing in the S and L groups. In addition, it was determined that there was more narrowing in the hip joint space in the long-segment group, and there was a positive correlation between the segment length and the narrowing in the hip joint space. CONCLUSION: After lumbosacral fusion, narrowing of the hip joint space was observed. Particularly patients with long-segment lumbosacral fusion should be followed closely regarding hip osteoarthritis risk.

How high is the quality of the videos about children's elbow fractures on Youtube?

OBJECTIVE: Pediatric elbow fractures are children's most common fractures. People use the internet to get information about their illnesses and also to search for treatment options. Videos uploaded to Youtube do not go through the review process. The aim of our study is to determine the quality of videos related to child elbow fractures on Youtube. MATERIAL METHOD: The study was carried out with the data obtained from the video-sharing site www.youtube.com on 01.12.2022. Pediatric elbow fractures are written in the search engine section. Information about the number of views of the videos, upload date, view rate (number of views per day), number of comments, number of likes and dislikes, duration, whether they contain animation and the publishing source were evaluated. The videos are divided into 5 groups according to their sources: medical society/non-profit organization, physician, healthrelated website, university/academic, and patient/independent user/other. The quality of the videos was evaluated using the Global Quality Scale (GQS). All videos have been evaluated by 2 researchers. RESULTS: In the study, 50 videos were included. In the statistical evaluation, no significant correlation was found between the modified discern score and GQS found by both researchers, and the number of views, the rate of views, comments, likes and dislikes, video duration and VPI. In addition, when the GQS and modified discern scores were compared according to the source of the video, it was found that the patient/independent user/other group scores were lower numerically, but there was no statistically significant difference in comparison. CONCLUSION: Most of the videos about child elbow fractures have been uploaded by healthcare professionals. Therefore, we concluded that the videos are quite informative in terms of accurate information and quality content.

Comparison of the Clinical Results of Platelet-Rich Plasma, Steroid and Autologous Blood Injections in the Treatment of Chronic Lateral Epicondylitis.

BACKGROUND: The aim of our study is to compare the efficacy of PRP, steroids, and autologous blood injection in patients with chronic lateral epicondylitis. METHOD: A total of 120 patients comprised our study. Three groups of 40 patients each received only one of the following: PRP, steroids, or autologous blood injections. Thereafter, VAS (visual analog scale), DASH (Disabilities of the Arm, Shoulder, and Hand), and Nirschl scores of those treated were evaluated in the second week, the fourth week, the third month, and the sixth month. RESULTS: The baseline evaluation revealed no significant change in VAS, DASH, and Nirschl scores among the three groups (p > 0.050). At the second week evaluation, patients treated with steroids showed significant improvement compared to patients treated with PRP and autologous blood (p < 0.001). The fourth-week evaluation revealed the VAS, DASH, and Nirschl scores of the patients treated with steroids to have improved more significantly than those of patients treated with PRP and autologous blood (p < 0.001). The third month, when the results of all three groups were compared, revealed similar results (p > 0.050). The sixth-month evaluation, when the results of all three groups were compared, revealed the autologous blood and PRP applications provided significantly better results than the group treated with steroids (p < 0.001). CONCLUSION: We concluded that steroid administration is effective in the short term, while PRP and autologous blood applications are more effective than steroid administration in the long term.

Peritendinous injection of platelet-rich plasma to treat tendinopathy: A retrospective review.

OBJECTIVE: The aim of this study was to determine factors associated with the likelihood of a better clinical outcome after the peritendinous injection of PRP for the treatment of chronic tendinopathy and identify whether PRP represents an effective treatment option for chronic tendinopathies. METHODS: The study included 214 patients (86 males and 128 females; mean age: 39.3 (18-75) years) who received PRP injections for tendinopathy refractory to conventional treatments. The mean duration of symptoms at the moment of the PRP treatment was 8.3 months. Primary outcome measurement was perceived improvement in symptoms for each anatomic compartment for upper and lower limbs at 6 months after treatment. Also, a visual analog scale (VAS) score (pain intensity on a 0-10 scale) was used for pain scoring questionnaire before treatment, 6 weeks and 6 months following the PRP injection(s). To identify factors associated with the likelihood of a better clinical outcome, patients were categorized on the basis of their perceived improvement in symptoms 6 months after the PRP injection(s)-that is, as lower (less than 50% global improvement) or higher (more than 50% global improvement). RESULTS: A visual analogue scale score and perceived improvement in symptoms were significantly lower after peritendinous injection in 6-week and 6-month follow-ups compared with the baseline (P < 0.001) except for peroneal and Achilles tendons. Overall, 83% of patients indicated moderate to complete improvement in symptoms. The most common injection sites were the lateral epicondyle, Achilles, and patellar tendons. Furthermore, 30% of patients received only 1 injection, 30% received 2 injections, and 40% received 3 or more injections. A total of 85% of patients were satisfied (more than 50% global improvement) with the procedure. In addition, upper limb tendons, increase in the age, and female gender were associated with a higher likelihood of perceived improvement in symptoms. CONCLUSIONS: In the present retrospective study assessing PRP injections in the treatment of chronic tendinopathy, a moderate improvement (>50%) in pain symptoms was observed in most of the patients. Our research found that results were most promising with patellar and lateral epicondylar tendinopathy in the short to medium term. Female patients, patients with upper extremity tendinopathy and older patients appeared to benefit more from PRP injection. LEVEL OF EVIDENCE: Level IV, Therapeutic study.