ARTHROSCOPIC MANAGEMENT OF MENISCAL INJURIES IN ADOLESCENTS: OUTSIDE-IN SUTURING VERSUS MENISCAL DART TECHNIQUE.

The aim of this study was to evaluate clinical and subjective outcomes of the meniscal dart technique in patients having undergone arthroscopic meniscal repair by comparing it with the outside-in suturing technique. From January 2006 until June 2017, case records of 37 patients having undergone arthroscopic meniscal repair were retrospectively reviewed. The patients were divided into two groups based on the technique used for meniscal repair, as follows: 18 patients in suture technique group and 19 patients in meniscal dart group. Each patient was analyzed for the following parameters: age, gender, mechanism of injury, side of injury and injured meniscus, injury localization regarding anatomic position, injury type and associated injuries. The patients that underwent meniscal repair were analyzed for type of repair technique, operating results and results of follow-up (Lysholm and International Knee Documentation Committee (IKDC) score). There were no statistically significant differences between the groups according to clinical outcomes except for anatomic injury localization (p=0.035). Median of operation time was 62.5 min in suture technique group and 70 min in meniscal dart group (p=0.184); median of hospital stay was 2 days for both groups (p=0.951); median of Lysholm score was 86.5 and 84.5 (p=0.651); and median of IKDC score was 81.05 and 81.6, respectively (p=0.986). Understanding the harmful impact of meniscectomy, arthroscopic meniscal repair should be attempted whenever possible. Our data support arthroscopic repair of meniscal tears, since both the suture technique and the meniscal dart technique are safe and successful in meniscal repair in children, with good long-term results and without important complications.

Protective effect of urapidil on testicular torsion-detorsion injury in rats.

PURPOSE: The aim of this study was to investigate the effect of urapidil and low-molecular weight heparin (LMWH) on testicular torsion-detorsion injury in rats. METHODS: Thirty-two male Sprague-Dawley rats were used. In the torsion-detorsion (T/D) group, the left testis was twisted at 720° for 3 h. After 3 h of reperfusion, the testis was removed. Urapidil or LMWH was administered intraperitoneally 30 min before detorsion in the treatment groups. RESULTS: Unilateral testicular torsion-detorsion caused significant increases in the malondialdehyde level and apoptosis and significant decreases in the superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in ipsilateral testes (p < 0.001). The rats treated with urapidil had a significant decrease in the malondialdehyde level and apoptosis and significant increases in the SOD and GPx activities in ipsilateral testes compared to the T/D group (p < 0.001). Animals treated with LMWH showed non-significant reductions in malondialdehyde levels and apoptosis compared to the T/D group. In addition, no significant difference in the SOD activities (p = 0.52) between the groups was found. The increase in the GPx activities was significant in the LMWH group compared to the T/D group (p < 0.001). CONCLUSION: The administration of urapidil before detorsion prevents ischemia/reperfusion cellular damage in testicular tissue. LMWH was not found to have a beneficial effect on testicular T/D injury in rats.

Beneficial effect of nifedipine on testicular torsion-detorsion injury in rats.

OBJECTIVE: To investigate the effect of nifedipine on testicular torsion-detorsion injury. MATERIALS AND METHODS: Twenty-four adult male Sprague-Dawley rats were randomly divided into 3 groups, each containing 8 rats. Rats in the control group underwent a sham operation of the left testis. In the torsion-detorsion (T/D) group, the left testis was twisted at 720° for 3 hours. After 3 hours of reperfusion, at the end of the experiment, the testes were removed. Rats in the treatment group received the same surgical procedure as the T/D group, but nifedipine was administered intraperitoneally (100 µg/kg) 30 minutes before the time of detorsion. RESULTS: Unilateral testicular torsion-detorsion caused a significant increase in the malondialdehyde level and apoptosis and caused significant decreases in superoxide dismutase and glutathione peroxidase activities in ipsilateral testes. The rats treated with nifedipine had a significant decrease in malondialdehyde level and apoptosis and had significant increases in superoxide dismutase and glutathione peroxidase activities in ipsilateral testes compared with those of the T/D group. CONCLUSION: These results suggest that biochemical and histological torsion-detorsion injury occurs in the ipsilateral testes after a 3-hour torsion and 3-hour detorsion and that administration of nifedipine before detorsion prevents ischemia/reperfusion cellular damage in the testicular tissue.

Influence of open testicular biopsy in prepubertal rats on rats' adulthood fertility with correlation to serum levels of inhibin B and follicle stimulating hormone.

OBJECTIVE: Open testicular biopsy (OTB) is one of the options to accurately assess fertility potential of the undescended testis. The aim of the study was to investigate consequences of OTB in prepubertal rats on their adulthood fertility. METHODS: Thirty-eight prepubertal male rats were divided into three groups depending on day 20 procedure. The first group was the control group, the second sham operated and the third has left OTB. Bilateral orchiectomy was performed on day 70 to all groups, with determination of serum inhibin B and follicle stimulating hormone (FSH). Removed testes were compared according to the weight, volume, spermatogenesis, histological and apoptotic changes in both testes with differences in serum levels of inhibin B and FSH. RESULTS: Ipsilateral testicular weight, volume, and spermatogenesis reduction with a reduction of tubular number, diameter and germinative epithelium was found in OTB group. Significant increase in apoptotic index was found in biopsied testis without compensatory hypertrophy of contralateral testis. Differences of inhibin B and FSH were not statistically significant among three groups. CONCLUSION: OTB in prepubertal rats has detrimental effects on fertility in adulthood. It does not cause compensatory hypertrophy of the contralateral testis nor does it disturb serum levels of inhibin B and FSH.

Differentiation of inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests: prospective study.

OBJECTIVE: The differential diagnosis of an acute scrotum is of great importance in clinical practice and may be difficult in some cases. The aim of this study was to differentiate inflammatory from non-inflammatory causes of acute scrotum using relatively simple laboratory tests which can be performed quickly and easily outside a hospital setting. PATIENTS AND METHODS: From 2007 to 2010, 85 boys with acute scrotum were included in this prospective study. There were 28 boys with inflammatory and 57 with non-inflammatory causes. We investigated the role of erythrocyte sedimentation rate, C-reactive protein, leukocyte, white blood cell differential count, alkaline phosphatase, creatine kinase and child's age in differential diagnosis of the acute scrotum, differentiating inflammatory from non-inflammatory causes of the disease. We used receiver operating characteristics (ROC) analysis and logistic regression analysis. RESULTS: Statistically significant parameters in accurate differentiation between inflammatory and non-inflammatory causes of the acute scrotum were C-reactive protein (p = 0.001) and child's age (p < 0.001). These two parameters yielded the probability of an inflammatory outcome in the etiology of acute scrotum with sensitivity of 75% and specificity of 69.1%. CONCLUSION: C-reactive protein and child's age are helpful in differentiating inflammatory from non-inflammatory causes of the acute scrotum.