Evaluation of the short-term outcomes of anatomic ACL reconstruction with hamstring autograft in patients with generalized joint laxity: A retrospective case-control study.

PURPOSE: The outcomes of anterior cruciate ligament reconstruction (ACLR) in patients with generalized joint laxity (GJL) are not clearly understood. In this study, we compared the outcomes of ACLR with quadruple hamstring autograft between GJL and non-GJL patients. METHODS: In a retrospective case-control study, 36 patients with GJL, according to the Beighton and Horan Joint Mobility Index, who underwent ACLR surgery, were included. Forty-four group-matched non-GJL patients were included in the control group. The mean follow-up of the patients was 20.65 ± 6.93 months. The outcomes of ACLR were evaluated by the Lachman test, pivot shift test, anterior tibial translation and KT-1000 side-to-side difference, and International Knee Documentation Committee (IKDC) scale. RESULTS: The results of the Lachman and pivot shift test were not significantly different between the GJL and non-GJL patients (P = 0.67 and P = 0.27, respectively). The mean anterior tibial translation was 7.06 ± 1.41 mm in the GJL group and 6.11 ± 1.53 mm in the non-GJL group (P = 0.006). The mean KT-1000 side-to-side difference was 2.25 ± 1.31 mm in the case and 2.5 ± 1.44 mm in the control group (P = 0.42). The mean IKDC score of the patients was not significantly different between the GJL and non-GJL groups (66.1 ± 20.6 vs. 69.9 ± 16.1, P = 0.35). ACLR failure occurred in 2 (5.5%) patients of the GJL group and no patients of the control group (P = 0.21). CONCLUSION: The present findings suggest ACLR with quadruple hamstring autograft as an adequate treatment for GJL patients, at least in short-term follow-up.

The Impact of Depression, Personality, and Mental Health on Outcomes of Total Knee Arthroplasty.

BACKGROUND: Precise assessment of preoperative mental health and psychological determinants may be useful in identifying patients at risk for poor postoperative outcomes of total knee arthroplasty (TKA). The aim of this study was to investigate the influence of psychological status and physical and mental health on the outcome of patients undergoing TKA. METHODS: Fifty-two patients undergoing unilateral TKA were assessed preoperatively with Oxford Happiness Inventory, Eysenck Personality Inventory, 12-item short form health survey (SF-12), and Knee Injury and Osteoarthritis Outcome Score (KOOS) for evaluating depression, personality traits, physical and mental health, and function, respectively. At 1 year after surgery, health-related quality of life (HRQL) and function were assessed using the SF-12 and KOOS. RESULTS: HRQL and function of all personality traits increased significantly after TKA, without significant difference among them. Extroversion and neuroticism did not have significant correlation with subjective well-being, HRQL, and function before and after surgery. Subjective well-being and the baseline physical and mental health scores were correlated strongly and directly with postoperative physical component summary, mental component summary, and KOOS scores and their improvement. Among many factors that significantly affected the outcomes of TKA, the only independent predictor of physical, mental, and functional outcome was depression. CONCLUSIONS: Outcomes of surgery were not significantly different among diverse personality traits. Patients with less depressive symptoms and higher baseline mental and physical scores had significantly greater improvement in HRQL after surgery. The only independent factor affecting the physical, mental, and functional outcome was depression.

Sensorineural hearing loss in patients with chronic suppurative otitis media: Is there a significant correlation?

INTRODUCTION: Hearing loss as a sequel of chronic suppurative otitis media (CSOM) is often conductive, but recent studies have found an additional sensorineural component in these patients, thus demonstrating inner ear damage. The aim of the study was to determine the association between CSOM and sensorineural hearing loss (SNHL) and to assess the influence of patient's age, duration of disease, and presence of cholesteatoma and ossicular erosion on the degree of SNHL. METHODS: In a retrospective study, the medical records of 119 patients who underwent surgery was reviewed. Seventy patients met the inclusion criteria of unilateral otorrhea, normal contralateral ear on otoscopy, and age between 10-65 years with no history of head trauma or ear surgery or familial hearing loss. Bone conduction (BC) thresholds for affected and contralateral ear were measured at frequencies of 500, 1000, 2000, and 4000 Hz. Data analysis was performed using SPSS 13 with independent-samples t-test, Pearson correlation test, and two-tailed analysis. A p ≤ 0.05 was considered statistically significant. RESULTS: Significant higher BC thresholds were found in the affected ear than in the normal ear for each frequency (p < 0.001), which increased with increasing frequency (7.00 dB at the 500 Hz and 9.71 dB at the 4000 Hz). There was a significant correlation between age and degree of SNHL (r = 0.422, p < 0.001) but no significant correlation was in duration of the disease (r = 0.119, p > 0.05). There was no relationship between presence of cholesteatoma and ossicular erosion with SNHL (p > 0.05). CONCLUSION: These findings demonstrate that CSOM is associated with some degree of SNHL and cochlear damage, and higher frequencies are more affected. Aging can act as a precipitating factor in this pathological process.