Emre Ergen

Functional outcomes of arthroscopic treatment of lateral epicondylitis.

OBJECTIVE The aim of this study is to evaluate the functional results of arthroscopic lateral epicondylitis (LE) treatment in patients in whom conservative treatment proved insufficient. METHODS Between 2011-2014, 29 patients with LE (15 women, 14 men; mean age: 46 years; range: 33-79) who received at least 6 months of conservative treatment methods and did not achieve full recovery and thus underwent arthroscopic surgery were included in this study. RESULTS One patient was excluded from the functional assessment. Mean follow-up was 20.5 months (range: 7-42). Mean preoperative and postoperative Disabilities of the Arm, Shoulder and Hand (DASH) scores were 81.1±17.5 and 34.7±26.8 (p<0.0001), respectively, and Mayo Elbow Performance Scores (MEPS) were 48.5±11.5 and 101.2±22.9 (p<0.0001), respectively. Twenty-one patients (75%) were satisfied with the functional outcome. CONCLUSION As a result, LE treated with the arthroscopic method, with its low complication rate, successful degenerated tendon debridement, and decortication of the lateral epicondyle, is a useful method for intervention in pathologies such as annular plica, loose body, synovial hypertrophy, and radiocapitellar chondropathy.

Extensor carpi radialis longus tendon ball interposition arthroplasty for treatment of late-stage Kienböck’s disease: Short-term results of a novel technique

Purpose: The aim of this study was to evaluate short-term clinical and radiological results of extensor carpi radialis longus (ECRL) tendon ball arthroplasty for treatment of late-stage Kienböck’s disease. Methods: We retrospectively reviewed data of 19 patients suffering from Kienböck’s treated with ECRL tendon ball arthroplasty between December 2014 and December 2016. Patients’ clinical functions were assessed using grip strength, range of motion (ROM) of the wrist, QuickDASH, Mayo wrist score, and visual analog scale score. Radiological examination was performed to assess carpal height ratio and progression of arthritis. Results: The median follow-up was 30 months (range, 12–36 months). At final follow-up, ROM of operated wrist was 71% of the nonoperated side. Thirteen (86.6%) patients were pain free. Carpal height ratio was statistically significantly reduced compared with preoperative values. All patients declared their satisfaction with the results due to their preoperative status. Conclusions: ECRL tendon ball arthroplasty is a new and good option for treatment of late-stage Kienböck’s disease with low complication rate.

Clinical results of anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft: a prospective study

Aim: In this study, we aimed to present prospective follow-up results of patients who were reconstructed with bone-patellar tendon-bone autograft for ACL rupture. Material and Methods: Twenty-seven patients were operated for ACL rupture with bone-patellar tendon-bone(B-PT-B) autograft ACL reconstruction. Patients were followed for at least 2 years. Patients were evaluated preoperatively and postoperatively with Lysholm knee function score, IKDC objective score and Tegner activity level scale. Results: All of operated patients were male. The mean age of the patients was 25.4 (range 19-35 years). The mean follow-up time was 27.9 (range 24-30 months). There was a statistically significant increase in postoperative knee scores. Hematoma, requiring surgical drainage, developed in two patients. Six patients had anterior knee pain while kneeling. Conclusion: Patients with ACL rupture showed increase in knee stability and functional scores after reconstruction. Anterior cruciate ligament reconstruction with B-PT-B autograft incorporates and heals faster with low rerupture and complication rate.

Endoscopic assisted retrograde release of posterior interosseous nerve: Preliminary results of a new technique

PURPOSE Open surgical release of posterior interosseous nerve (PIN) has been well defined in literature with different surgical approaches. In this retrospective study, we aimed to present outcomes of endoscopic assisted retrograde release of posterior interosseous nerve. METHODS From 2015 to 2017, 10 patients with radial tunnel syndrome and concomitant lateral epicondylitis treated endoscopic assisted retrograde posterior interosseous nerve release. RESULTS Mean follow-up time was 24,6 months. Eighty percent of the patients had excellent and good results in final follow-up using the Roles and Maudsley criteria. All of patients but one were satisfied from the surgery in terms of the symptom relief and improved functional state. CONCLUSION Our study showed that our endoscopic assisted technique could be a good alternative to open techniques. Complication rate of this new technique was similar to open techniques.

Mid-Term Outcomes of Arthroscopic Treatment in Patients with a Stiff Elbow

Introduction Loss of function and pain are the main complaints at the time of hospital admission for patients with a stiff elbow. In this study, we present mid-term radiological and functional results for the use of the arthroscopic release technique in patients admitted to the outpatient clinic with a stiff elbow. Methods A total of 22 patients (six females, 16 males; mean age: 36 years, range: 18 to 56 years) who underwent an arthroscopic intervention for traumatic or non-traumatic stiff elbow and arthrosis between January 2005 and November 2015 were included in the study. All patients started elbow movement after the first day following surgery. Pre- and postoperative radiological evaluations of patients were carried out, in addition to functional evaluation to measure the range of motion of the elbow joint and the Disabilities of the Arm, Shoulder and Hand (DASH) scores before and after surgery. Results The mean follow-up was 28.4 (range: 21 to 118) months. The mean preoperative flexion-extension arc of the patients was 89° (range: 0° to 115°), and the mean flexion-extension arc increased to 103.5° (range: 52° to 128°) at the final follow-up visit (p < 0.05). The mean preoperative DASH score was 42.17 (range: 33 to 81), decreasing to 30.35 (range: 9.7 to 41.3) postoperatively (p<0.05). In the final visit, none of the patients were found to require additional surgical interventions for the elbow. Conclusions Arthroscopic release can be considered a safe and effective option to obtain range of motion in joints in post-traumatic stiff elbow cases.

Clinical outcomes of scaphoid nonunions treated with 1,2 intercompartmental supraretinacular artery pedicled vascularized bone graft and headless compression screw

Scaphoid fractures are the most common fracture of the carpal bones and account for 60% carpal injuries. Nonunion may occur in 5-12% of scafoid fractures. Aim of this study is to present result of scaphoid nonuinon treated with 1-2 intercompartmental pedicled artery bone graft and canullated screw in our clinic. Between 2009-2012, 19 scaphoid nonunions (18 males, 1 female) were treated with 1-2 intercompartmental pedicled artery bone graft and canullated screw. The average age of patients were 31,2 (range 12-47 years). The average time from initial injury to operation was 40.8 months (range 8 months -20 years). All scaphoid nonunions healed with union at an average of 9,4 weeks( range 6-12 weeks) after surgery. The average Mayo score of patients were 76,6 (range-25100). We determined that treatment with 1-2 intercompartmental pedicled artery bone graft and canullated screw is good option in scaphoid nonunions regardless of avascular necrosis.

Bilateral Achilles Tendon Xanthomas in a Patient with Cerebrotendinous Xanthomatosis

Cerebrotendinous xanthomatosis is a rare, autosomal recessive, lipid storage disease with accumulation of cholestanol in most tissues, particularly in the Achilles tendons. We described a 23-year-old female patient who had progressive painfull swelling of both Achilles tendons due to cerebrotendinous xanthomatosis. We performed surgery on both-side Achilles tendon tumors. Wide degenerative areas of the tendons were resected, and the flexor hallucis longus tendon was harvested and transferred to reconstruct motion function.

Isolated Tuberculosis of Capitate and Triquetrum

Musculoskeletal system is involved in about 20% of the patients diagnosed with tuberculosis. Although musculoskeletal tuberculosis generally affects spine and large joints (hip and knee), hand involvement of the tuberculosis is seen in 10% of the patients with musculoskeletal involvement and also isolated tuberculosis of hand or wrist is much rarer. In the following report, we discuss the case of a 23-year-old male patient who was diagnosed with isolated tuberculosis of the capitate and triquetrum bone. The patient presented with a nonhealing sinus on the left wrist joint. Imaging revealed lytic lesions of the capitate and triquetrum. The diagnosis of tuberculosis was confirmed by histopathological examination on the bone specimen obtained from the debridement and curettage. Antituberculosis therapy was started postoperatively and 1 month later, healing of the sinus was observed. There was no sign of reactivation seen at follow-up 22 months after treatment.