Aim of this study is to introduce, evaluate, and propose a basic arthroscopy training course with interactive methods as using bovine knees, joint models but mainly focusing on practices with motor skill-learning devices. This study presents the results of a skill training program which is based on "motor skill training" theory and using "bovine knees" to simulate a specific task as arthroscopy both in education and evaluation. The participants gave feedback regarding their expectations, fulfillment, and self-evaluation on the degree of their improvement levels, after which their skills were evaluated by an expert while they performed the arthroscopic procedure. During this evaluation of the task, a four-dimensional checklist which was prepared previously by the consensus of three experts was used, and a global grading of each rater was added at the end of the checklist. In this 2-day course, small group teaching sessions are integrated with active and experiential learning methods consisting of short presentations by the educators, demonstrations using joint models and audio-visual teaching material, and significant continuous feedback by the teachers during the proceedings. Participants' expectations and post-course feedback results were obtained using a brief questionnaire which involved mostly open-ended questions. The self-rating of "own basic diagnostic arthroscopy skill" on a scale of 0-10 was completed by the participants both previous to and following the course to establish a student-centered learning environment. Overall rating of the course was asked on a 1-5 (poor-excellent) Likert scale. The questioning of the participants who took part in the course during the last five terms involved a 100% feedback. The overall rating of the course was 4.36 ± 0.47 on the 1-5 scale. The majority of the participants (90%) mentioned that the course met their expectations. The most beneficial activities were accepted to be the arthroscopic procedure applications on bovine knee, repetition of the manipulations under the supervision of the trainers, continuous feedback by experienced staff, and chance for immediate correction during the procedures (35/64). Pre- and post-course self-ratings of the participants inquiring about their ability to perform an arthroscopy alone showed significant improvement (4.2 vs. 7.7 P = 0.000, paired samples t test). All participants were found to be competent in the evaluation of their diagnostic arthroscopy skills on bovine knees. To design a skill teaching course based on the needs of the trainees, focusing on basic motor skill training exercises, and using bovine knee as a simulator is a safe, inexpensive, humanistic, and replicable method that proves a foundation for basic arthroscopic skills learning prior to patient encounter.
The effect of osteoporosis on clinical outcomes following surgical treatment of intertrochanteric hip fractures was investigated. A total of 80 patients aged 65-97 years with intertrochanteric hip fractures underwent insertion of a proximal femoral nail. Osteoporosis severity was measured using the Singh index in the unaffected hip. Screw cut-out occurred in four patients, reverse Z-effect in three patients and Z-effect in one patient. Four patients were lost to follow up. Clinical results were evaluated according to the Harris hip scoring system. The mean Harris hip score was 73.58 (range 25-100). When divided according to Singh index grade (I-II versus III-V), there were no significant differences in mean age, type of fracture, American Society of Anesthesiologists classification or frequency of technical failures between the two groups. The mean Harris hip score, however, was significantly lower in patients with grades I-II compared with grades III-V, suggesting that the presence of osteoporosis had a negative effect on clinical outcome after hip fracture.
Retrograde intramedullary nailing of the femur can be performed in patients with supracondylar fractures of the femur due to gunshot wounds, and without skin defects, in the first 7 days after the trauma. Neither osteomyelitis of the femur nor septic arthritis of the knee develops in these patients.
Purpose In this study, we aim to investigate whether the hip with Tönnis type II dysplasia in children older than 18 months can be treated without open reduction. Methods In our study, 47 hips (47 patients) with type II developmental dysplasia of the hip according to the Tönnis classification were treated by a combination of open reduction through an anterolateral approach with iliopsoas tenotomy followed by innominate osteotomy and capsulorrhaphy or iliopsoas tenotomy followed by innominate osteotomy.
A bilateral total knee prosthesis procedure can be performed simultaneously in patients with bilateral gonarthrosis. The purpose of this study was to evaluate the differences in component alignment between the simultaneous bilateral TKA and unilateral TKA. A total of 20 patients out of 40 underwent simultaneous bilateral TKA, whereas 20 patients had unilateral TKA. The component alignments were compared radiographically. There was no statistically significant difference in the component alignment between the simultaneous bilateral TKA group and the unilateral TKA group. In conclusion, component alignment of the patients with simultaneous bilateral TKA is similar to that of unilateral TKA.
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