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    Aperture fixation instead of transverse tunnels at the patella for medial patellofemoral ligament reconstruction
    (Springer, 2012) Hapa, Onur; Aksahin, Ertugrul; Ozden, Raif; Pepe, Murad; Yanat, Ahmet Nedim; Dogramaci, Yunus; Bozdag, Ergun
    Medial patellofemoral ligament (MPFL) reconstruction is an effective option for the treatment of recurrent patellar instability. Most techniques utilize the passage of a tendon graft through tunnels at the patella with the risk of patellar fracture. The purpose of this study was to investigate the strength of the recent MPFL reconstruction techniques (transverse tunnel, interference screw, anchor, and docking technique). Thirty-six saw bones were divided into four groups (transverse tunnel, interference screw, anchor fixation, and docking technique) with nine patellae in each. Patella-tendon constructs were pre-loaded to 10 N and cyclically loaded for 20 cycles from 2 to 30 N under load control at a rate of 5 N/sec. The construct was then tested to failure at a constant displacement rate of 6 mm/sec. Ultimate load (N), stiffness (N/mm), and failure mode were recorded for each specimen. The docking group had lower ultimate load [106 (SD 41) N] and stiffness [14 (SD 2) N/mm] values than the other groups tested (P = 0.007). The anchor group had lower stiffness [21 (SD 6) N/mm] values than the tunnel group [28 (SD 3) N/mm (P = 0.01)] and the interference screw group [31 (SD 6) N/mm, (P = 0.004)]. There was no significant difference in the ultimate load between anchor [299 (SD 116) N], tunnel [304 (SD 140) N], and interference screw groups [241 (SD 103) N] (n.s.). Aperture fixation techniques, especially interference screw fixation, were as strong as the technique utilizing tunnels in the patella for MPFL reconstruction.
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    Axial plane coverage and torsion measurements in primary osteoarthritis of the hip with good frontal plane coverage and spherical femoral head
    (Springer, 2010) Hapa, Onur; Yuksel, Halil Yalcin; Muratli, Hasan Hilmi; Aksahin, Ertugrul; Gulcek, Serap; Celebi, Levent; Bicimoglu, Ali
    Introduction Mechanical factors play a role in pathogenesis of primary osteoarthritis of the hip. Torsion measures were made to detect whether there is a causal relationship between increase or decrease of femoral anteversion, acetabular anteversion, and osteoarthritis. There are no studies in the literature indicating a relationship between axial plane coverage and osteoarthritis of the hip. Deficient axial plane coverage of femoral head may also play a role in pathogenesis of osteoarthritis. Materials and methods Thirty patients with primary osteoarthritis of the hip and 29 control cases were included in the study. We used the method of Anda et al. (Acta Radio! Diagn 27:443-447, 1986; Comput Assist Tomogr 15:115-120, 1991) to measure axial plane anterior, posterior coverages in patients with primary osteoarthritis of the hip. The computerized tomography sections and pelvic radiographs indicated good frontal plane coverage and spherical femoral head. In addition to anterior acetabular sector angle, posterior acetabular sector angle, horizontal acetabular sector angles for axial plane coverage detection, femoral anteversion, acetabular anteversion, and McKibbin instability index were also measured. Results Posterior coverage was lower at osteoarthritic hips than the control group's hips (96.0 +/- 16.7, 104.2 +/- 10.6) (p < 0.05). Conclusion The results may indicate that in addition to other mechanical factors, axial plane coverage, especially the posterior coverage deficiency, may play a role in the pathogenesis of hip osteoarthritis.
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    The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis
    (Springer, 2012) Aksahin, Ertugrul; Dogruyol, Daghan; Yuksel, Halil Yalcm; Hapa, Onur; Dogan, Ozgur; Celebi, Levent; Bicimoglu, Ali
    In this study, the results of local injection of platelet-rich plasma (PRP) and corticosteroids in the treatment of plantar fasciitis were compared. Sixty patients who were diagnosed as plantar fasciitis and treated conservatively for at least 3 months and had no response to conservative treatment modalities were involved in this study. The first 30 consecutive patients were treated by local injection of 2 mL of 40 mg Methylprednisolone with 2 mL of 2% prilocaine (metilprednizalone) and the second 30 patients were treated by injecting 3 mL PRP after 2 mL of 2% prilocaine injection. Patients were evaluated according to the modified criteria of the Roles and Maudsley scores and visual analog scale before injection and 3 weeks and 6 months following injection. The mean VAS heel pain scores measured 6 months after treatment were 3.4 in steroid group and 3.93 in PRP group, and the scores in both groups were significantly lower when compared with pretreatment levels (6.2 in steroid group and 7.33 in PRP group). There was no significant difference between steroid and PRP groups in visual analog scale scores and modified criteria of the Roles and Maudsley scores measured at 3 weeks and 6 months ( > 0.05). Our results revealed that both methods were effective and successful in treating plantar fasciitis. When the potential complication of corticosteroid treatment was taken into consideration, PRP injection seems to be safer and at least having same effectivity in the treatment of plantar fasciitis.