Cumhur Cevdet Kesemenli

Bone marrow edema seen in MRI of osteoarthritic knees is a microfracture.

We hypothesize that the bone marrow edema seen in MRI images of osteoarthritic joints are a result of microfractures. These microfractures caused intermittent pain of the osteoarthritis knees. Varus malalignment of the knee with osteoporosis leads loading on the medial compartment, and high pressure on the lateral compartment for valgus malalignment.

A Minimally Invasive Technique for the Reduction of Calcaneal Fractures Using the Endobutton

Calcaneal fractures are very common injuries, and closed reduction-percutaneous pinning, open reduction-internal fixation, and primary arthrodesis are the procedures used in the surgical treatment of these injuries. The aim of surgical treatment is to restore the normal biomechanics of the Achilles tendon and rearfoot by anatomic reduction of the articular surfaces. Minimization of the soft tissue complications commonly associated with the open treatment of calcaneal fractures can be achieved using indirect closed reduction and Kirschner wire or screw-assisted minimally invasive percutaneous osteosynthesis methods. In the present report, we describe a technique for the treatment of calcaneal fractures associated with soft tissues that are at risk of complications and present the cases of 3 patients treated with indirect, minimally invasive reduction of comminuted calcaneal fractures with the Endobutton(®) fixation device. From our experience with this method, we believe it will be useful in cases of acute calcaneal fracture with pronounced soft tissue injury localized to the hindfoot.

Arthroscopic fixation with intra-articular button for tibial intercondylar eminence fractures in skeletally immature patients.

The aim of this study was to describe our experiences with arthroscopy-guided intra-articular button fixation in the treatment of displaced tibial eminence fractures in skeletally immature children. Eleven adolescent patients with an average age of 12.2 years were treated arthroscopically between January 2005 and February 2007. At follow-up evaluation at 69 months, we did not find any instability. Only minimal differences were found in the functional outcomes (Lysholm and International Knee Documentation Committee scores: 95.7 and 94.3, respectively). None of the patients had a leg-length discrepancy defined at the time of the final follow-up. The advantages of this technique are as follows: (a) it is a simple and reliable arthroscopic technique with a direct view, (b) the fixation is stable, (c) there is no need to remove the implant, (d) minimal physeal interruption in a pediatric skeletally immature population, and (e) no additional arthroscopic portal.

Skeletal Muscle Patch Engineering on Synthetic and Acellular Human Skeletal Muscle Originated Scaffolds

The reconstruction of skeletal muscle tissue is currently performed by transplanting a muscle tissue graft from local or distant sites of the patients body, but this practice leads to donor site morbidity in case of large defects. With the aim of providing an alternative treatment approach, skeletal muscle tissue formation potential of human myoblasts and human menstrual blood derived mesenchymal stem cells (hMB-MSCs) on synthetic [poly(l-lactide-co-caprolactone), 70:30] scaffolds with oriented microfibers, human muscle extracellular matrix (ECM), and their hybrids was investigated in this study. The reactive muscle ECM pieces were chemically crosslinked to the synthetic scaffolds to produce the hybrids. Cell proliferation assay WST-1, scanning electron microscopy (SEM), and immunostaining were carried out after culturing the cells on the scaffolds. The ECM and the synthetic scaffolds were effective in promoting spontaneous myotube formation from human myoblasts. Anisotropic muscle patch formation was more successful when human myoblasts were grown on the synthetic scaffolds. Nonetheless, spontaneous differentiation could not be induced in hMB-MSCs on any type of the scaffolds. Human myoblast-synthetic scaffold combination is promising as a skeletal muscle patch, and can be improved further to serve as a fast integrating functional patch by introducing vascular and neuronal networks to the structure.

Isolated avulsion fracture of lesser tuberosity of the humerus: Review of the literature and report of two cases.

Two cases of acute isolated avulsion fracture of the lesser tuberosity of the humerus and their short-term outcome are presented with a review of previously reported cases. Open reduction and internal fixation was performed. Outcomes were excellent, and the patients regained their normal pain-free shoulder function 3 months after the operation. This was a Level IV study.

Differentiation between septic and nonseptic arthritis.

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