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Background: Plantar fasciitis (PF) is the most common cause of heel pain. Previous work has shown promising results regarding platelet-rich plasma (PRP) injections for the treatment of PF. The aim of this study is to prospectively compare the efficacy of PRP and autologous blood injections in a randomized anonymized patient group to treat PF. Methods: PF patients who failed at least 6 weeks of noninvasive conservative treatment aged between 40 and 65 years were recruited to be in the study. Patients were randomly assigned into group A (PRP) or group B (autologous blood). Injections were performed under ultrasonographic guidance in a double-anonymized manner. The groups were compared according to preinjection and postinjection health-related quality of life (HRQoL) scores measured with Foot and Ankle Disability Index (FADI) and visual analog scale (VAS). Intragroup comparative analysis was also performed at different time points. Independent t tests and repeated measures analyses of variance were used for statistical analysis, with P <.05 set for statistical significance. Results: Group A (PRP) included 30 (19 female, 11 male) patients with mean age 52.2 ±6.3; group B (ABI) included 30 (20 female, 10 male) patients with mean age 52.7 ± 6.5. Both groups had similar body mass index ( P = .719). No injection-related complications were recorded. After treatment, both groups had improved FADI and VAS scores compared to the baseline. Although the mean HRQoL scores were higher in the PRP group, there was no significant difference between the 2 groups ( PVAS = .589; PFADI = .742). Conclusion: Participants with plantar fasciitis improved statistically significantly after either PRP or ABI injections compared with baseline HRQoL scores, with no significant differences seen between the groups. Level of Evidence: Level I, prospective randomized double-anonymized clinical comparative study.

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Study DesignRetrospective analysis of adolescent idiopathic scoliosis.PurposeThis study aimed to investigate the influence of distinct distal fusion levels on spinopelvic parameters in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior instrumentation and fusion surgery.Overview of LiteratureThe distal fusion level selection in treatment of AIS is the one of milestone to effect on surgical outcome. Most of the paper focused on the coronal deformity correction and balance. The literature have lack of knowledge about spinopelvic changing after surgical treatment and the relation with distal fusion level. We evaluate the spinopelvic and pelvic parameter alteration after fusion surgery in treatment of AIS.MethodsA total of 100 patients with AIS (88 females and 12 males) were retrospectively reviewed. Patients were assigned into the following three groups according to the distal fusion level: lumbar 2 (L2), lumbar 3 (L3), and lumbar 4 (L4). Using a lateral plane radiograph of the whole spine, spinopelvic angular parameters such as thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS), and pelvic tilt (PT) were radiologically assessed.ResultsThe mean age was 15±2.4 years, and the mean follow-up period was 24.27±11.69 months. Regarding the lowest instrumented vertebra, patients were categorized as follows: 30 patients in L2 (group 1), 40 patients in L3 (group 2), and 30 patients in L4 (group 3). TK decreased from 36.60±13.30 degrees preoperatively to 26.00±7.3 degrees postoperatively in each group (p=0.001). LL decreased from 52.8±9.4 degrees preoperatively to 44.30±7.50 degrees postoperatively (p=0.001). Although PI showed no difference preoperatively among the groups, it was statistically higher postoperatively in group 3 than in the other groups (p<0.05). In addition, in group 2, PI decreased from 50.60±8.74 degrees preoperatively to 48.00±6.84 degrees postoperatively (p=0.027). SS decreased from 35.20±6.40 degrees preoperatively to 33.40±5.80 degrees postoperatively (p=0.08, p>0.05). However, mean SS was significantly higher in group 3 (p=0.042, p<0.05). PT decreased from 15.50±7.90 degrees preoperatively to 15.2±7.10 degrees postoperatively. The positive relationship (28.5%) between LL and PI measurements was statistically significant (r=0.285; p=0.004, p<0.01). Furthermore, the positive relationship (36.5%) between LL and SS measurements was statistically significant (r=0.365; p=0.001, p<0.01).ConclusionsWhen the distal instrumentation level in AIS surgery is below L3, a significant change in PT and SS (pelvic parameters) is anticipated.

The management of nonunion and limb length discrepancy has remained a constant challenge in hemophilic patients. In this study, we aimed to present the treatment of femur infected nonunion and limb length discrepancy in a twenty-seven-year-old patient with hemophilia type A. A 27-year-old male patient with hemophilia type A referred to our institution for the treatment of right femur infected nonunion and 10 cm shortness of the femur. Resection of the nonunion site and bone-to-bone fixation with autologous bone grafting were performed. Compression to the pseudoarthrosis site and distraction from new osteotomy site were applied with the unilateral external fixator. Union was achieved, and 6 cm lengthening was obtained according to the initial length. Patient was followed up for 7 years. After this treatment, the patient is able to walk with full weight bearing on the affected extremity with 4 cm shortening which is compensated by the heel lift. The results of this case indicate that limb lengthening and treatment of nonunion with the external fixation could be reliable and effective method for hemophilic patients.