Background: The aim of the current study is to determine the relationship between osteoporosis findings in plain X-ray and dual-energy X-ray absorptiometry (DXA) measurement results and to create an alternative diagnostic method for osteoporosis without DXA measurement when necessary. Methods: DXA values and hip radiographs of 156 patients were retrospectively analyzed. Singh index (SI), Dorr index (DI), cortical thickness index (CTI), and canal-to-calcar ratio (CCR) measurements from both plain hip radiographs were determined by two observers. The correlation of the DXA parameters (hip total T-score, femoral neck T-score, hip total Z-score, hip total bone mineral density [BMD], and femoral neck BMD) and osteoporosis markers on plain hip radiography (SI, DI, CTI, and CCR) was calculated. In addition, patients were evaluated by dividing them into three groups according to the level of their T-scores (normal, osteopenia, and osteoporosis). In addition, cut-off values were calculated for CTI and CCR. Results: The mean age was 68.27 ± 8.27 (50–85) years. There was a strong correlation between hip total T-score values and SI, DI, and CTI (r = 0.683, −0.667, and 0.632, respectively), and a moderate correlation (r = −0.495) with CCR. When both hips were compared, there were strong correlations between radiographic parameters (r = 0.942 for SI, 0.858 for DI, 0.957 for CTI, and 0.938 for CCR, all with p < 0.001). When patients divided into three groups according to the T-score level were compared in terms of SI, DI, CTI, and CCR, it was found to be directly related to osteoporosis level (all p < 0.001). In the differentiation of osteopenia and osteoporosis, the cut-off values were 50.4 degrees for CTI and 60.3 degrees for CCR. Conclusion: Good correlations between hip total T-score values and SI, DI, CTI, and CCR (r = 0.683, −0.667, 0.632, and −0.495, respectively) indicate that the presence of osteoporosis can be detected by hip radiography findings without DXA.
Background:This study from a single center in Turkey aimed to evaluate preoperative magnetic resonance imaging (MRI) parameters with arthroscopic validation of subscapularis (SS) tendon abnormalities in 187 patients. Material/Methods:Preoperative MRI scans of 187 patients who had undergone arthroscopic shoulder surgery by the senior author (all in lateral decubitus position) were evaluated by 3 researchers. Patients with arthroscopically proven SS tendon rupture (n=69) and without rupture (n=118) were divided into 2 groups and compared with various distances and angles. The following parameters were measured: coracohumeral distance (CHD), coracoid morphology, coraco-glenoid angle (CGA), coracoid angle (CA), coraco-humeral angle (CHA), coracoid overlap (CO), coracoid body-glenoid angle (CBGA), coracoid tip-glenoid angle (CTGA), coracoid tip-body angle (CTBA), coraco-scapular angle (CSA), lesser tuberosity angle (LTA), and lesser tuberosity height (LTH). Results:CHD, CHA, CA, and LTA values decreased in the SS tendon rupture group; coracoid type grade and CO increased (all P<0.001, excluding LTA [P=0.022]). The cut-off values of these measurements were CHD=7.25 mm, CHA=107.25°, CA=111.5°, LTA=31.7°, and CO=16.5 mm. The differences in CGA and CBGA values were not statistically significant (P=0.11, 0.441, respectively). CTGA, CTBA, LTH, and CSA measurements were not included in the intergroup comparisons due to insufficient inter-observer reliability (k=0.478, 0.239, 0.496, 0.309, respectively). Power (1-b) in post hoc analysis was calculated as 0.941. Conclusions:SS tendon rupture was associated with a reduction in the parameters of CHD, CHA, CA, and LTA and an increase in CO on MRI.
Amaç: Bu çalışmada omuzun adezif kapsülit hastalığı tedavisinde, fizyoterapinin izole uygulanması ile anestezi altında manipülasyon sonrasında uygulanması karşılaştırılmıştır. Gereç ve Yöntem: Primer adezif kapsülit olup, dışlanma kriterlerine sahip olmayan 32 hasta, izole fizyoterapi (İF) alan ve anestezi altında manipülasyon (AAM) sonrası erken dönem fizyoterapi alanlar olmak üzere 2 gruba ayrılarak ağrı ve fonksiyon skorları retrospektif karşılaştırmalı olarak değerlendirildi. Bulgular: İF grubuna kıyasla, fizyoterapinin AAM sonrası uygulanması, erken dönemde istatistiksel olarak daha etkin bir modalite olarak görülmüştür. İstatistiksel analizde Mann-Whitney-U testinin kullanıldığı çalışmamızda tedaviler öncesi, tedaviler sonrası 1. hafta, 6. hafta ve 6. ayda Vizüel Analog Skala (VAS) ve Constant Murley Skoru (CMS) değerlendirilmeleri yapılmıştır. Tedaviler öncesi değerlendirmelerde; istatistiksel anlamlı fark yokken (sırasıyla; p=0.322, p=0.663), tedaviler sonrası 1. haftada (sırasıyla; p
Background The study aimed to determine the level of retraction and atrophy according to the time elapsed in traumatic isolated full-thickness supraspinatus (SS) tears in young patients. Methods One thousand twenty-six patients, who underwent arthroscopic shoulder surgery, were retrospectively reviewed. Pre-operative magnetic resonance imaging (MRI) of 69 patients aged 18 to 40 years with isolated traumatic full-thickness SS lesions remaining after exclusion criteria were evaluated for tendon retraction and atrophy levels. SS retraction was determined from a T2-weighted oblique coronal MRI section, and the atrophy level was determined from the T1-weighted oblique sagittal MRI section. The patients were divided into four groups 0–1 month, 1–3 months, 3–6 months, and 6–12 months according to the time between trauma and MRI. The relationship of tendon retraction and muscle atrophy with elapsed time was evaluated, in addition, comparisons between groups were made. Results Thirty-one (45%) of the patients were female and their mean age was 30 ± 7.3 (18–40) years. The mean age of men was 30.5 ± 6.9 (18–39) years (p = 0.880). The time between rupture and MRI was moderately correlated with retraction and strongly correlated with atrophy levels (r = 0.599, .751, respectively). It was observed that there was a statistically significant difference between the 1st (0–1 month) and 2nd (1–3 months) groups (p = 0.003, .001, respectively), and between the 2nd and 3rd (3–6 months) groups (p = 0.032, .002, respectively), but there was no significant difference between the 3rd and 4th (6–12 months) groups (p = 0.118, .057, respectively). In addition, there was a moderate correlation between tendon retraction and atrophy levels (r = 0.668). Power (1- b) in post hoc analysis was calculated as 0.826. Conclusions In traumatic full-thickness SS tears, the moderate positive correlation between the time elapsed after trauma with the level of retraction, and a strong correlation with the level of atrophy showed the importance of early surgical repair in young patients.
Background The aim of the current study was to determine the changes in pre-and postoperative Pittsburg sleep quality index (PSQI) and Tampa scale of kinesiophobia (TSK) values according to the Hamada classification in patients who underwent reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy (RCTA). Methods One hundred and eight patients who underwent RSA for RCTA were reviewed retrospectively. The patients were divided into two groups with low grade (stages 1-2-3) (n = 49) and high grade (stages 4a-4b-5) (n = 59) according to the Hamada classification, which is the radiographic evaluation of RCTA. PSQI and TSK values were calculated preoperatively, and post-operatively at the 6th week, 6th month, and 1st year. The change in PSQI and TSK values between the evaluations and the effect of staging according to the Hamada classification on this change was examined. Results When compared in preoperative evaluations, PSQI and TSK scores were found to be lower in low-grade group 1 (7.39 ± 1.56, 51.88 ± 4.62, respectively) than in high-grade group 2 (10.47 ± 2.39, 57.05 ± 3.25, respectively) according to Hamada classification (both p < 0.001). In the postoperative evaluations, PSQI and TSK results decreased gradually compared to the preoperative evaluations, and there was a dramatic decrease in both parameters between the 6th-week and 6th-month evaluations (both p < 0.001). Preoperatively, 102 (95%) patients had sleep disturbance (PSQI ≥ 6), and 108 (100%) patients had high kinesiophobia (TSK > 37). In the 1st year follow-ups, sleep disturbance was observed in 5 (5%) patients and kinesiophobia in 1 (1%) patient. When the Hamada stages were compared, it was seen that there was a significant difference before the operation (both p < 0.001), but the statistically significant difference disappeared in the PSQI value in the 1st year (p = 0.092) and in the TSK value in the 6th month (p = 0.164) post-operatively. It was observed that Hamada staging caused significant differences in PSQI and TSK values in the preoperative period but did not affect the clinical results after treatment. Conclusions RSA performed based on RCTA improves sleep quality and reduces kinesiophobia. RCTA stage negatively affects PSQI and TSK before the operation but does not show any effect after the treatment.
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