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Introduction: Total hip replacement (THR) in the neck of femur fracture in the elderly is associated with a higher risk of dislocation compared to hemiarthroplasty of hip or total hip replacement in the native hip. There is uncertainty regarding combining surgical approach, femoral head size, and the usage of single bearing or dual mobility to reduce the risk of dislocation. This study looks into the bearing of the prosthesis for posterior or lateral surgical hip approach as well as their head size to give a stable hip to these vulnerable groups of patients.Methods: Initial data were collected retrospectively from February 2017 till May 2019 from the electronic records database and clinical notes. Patients included in the study had a femoral neck fracture (age >60 years) who underwent a total hip replacement. Subsequent data were collected prospectively from June 2019 to July 2020.Results: High rate of dislocation was found with posterior approach and single bearing prosthesis. However, if dual mobility prosthesis was used while using the posterior approach the dislocation rate was very low. Also, with lateral approach and single bearing prosthesis using large femoral head size, the dislocation rate was negligible. Conclusions: We recommend a dual mobility prosthesis for posterior approach THR and lateral approach with single-bearing hip replacement with large size femoral head. The dislocation rate is low using this principle irrespective of the surgical approach.

Background: Pigmented villonodular synovitis, particularly of the hip joint, has been historically treated via open synovectomy. However, an arthroscopic approach to management has been trailed successfully in recent years and has demonstrated encouraging outcomes. Case Presentation: We report the case of a 17-year-old man with pigmented villonodular synovitis of the right hip who underwent arthroscopic treatment. He remains well 5 years later with no signs of recurrence. We discuss the advantages and disadvantages of arthroscopically managed pigmented villonodular synovitis as well as the recent literature surrounding this topic. We also explain a technical tip during hip arthroscopy to access these difficult lesions. Conclusion: Arthroscopy can be used for hip pigmented villonodular synovitis treatment. These lesions may also be accessed by extending the hip to 10 degrees and releasing the traction. There is evidence to suggest that arthroscopically managed pigmented villonodular synovitis carries better outcomes and lower morbidity rates compared to an open approach in suitable cases.

Orcid :Levent Bayam: https://orcid.org/0000-0001-5149-0829 Justine Theaker: https://orcid.org/0000-0001-5223-2944 Sanat V Shah: https://orcid.org/ AbstractObjective This epidemiological study was conducted in the joint haematology-orthopaedics clinic of a university hospital. The aim was to analyze the data in terms of age and radiology of patients with moderate or severe haemophilia A and knee involvement. ( Sakarya Med J 2019, 9(3):506-512 ). Materials and MethodsThis was a cross sectional and descriptive retrospective study of 49 patients with knee problems out of 130 haemophilia A and musculoskeletal problems. Kellgren-Lawrence (KL) classification was used for radiological assessments of osteoarthritis degree.Results KL degree was 3 or 4 for most patients (27/41, 65.85%) in the group. There was statistically a meaningful correlation between KL degree and patients' age (Spearman's: rs = 0.512, p = 0.001). There were 7 patients with KL degree 4 at the age of 50 or younger (14.29%). 25 patients in 49 (51.02%) had total knee arthroplasty (TKA) and 10 (40%) of those was bilateral. Mean age for bilateral TKA (56.35) was higher than unilateral (49.87).There was a statistically meaningful correlation between patient age and the patients with TKA (Spearman's: rs = 0.338, p = 0.017). There were 2 revision surgeries out of 35 TKA (5.71%). Most of the patients had prophylactic factor treatment (43, 87.75%).Conclusion Our study signifies the high ratio of bilateral knee replacements in hemophilia A patients and how early age they progressed to KL stage 4 comparing to normal population. These results show the importance of patient care in this group of patients, close follow-up and prophylactic treatment. They should be managed in experienced unites by an experience team to decrease the risks and complications. ÖzAmaç Hemofili hastalarında epidemiyolojik olarak yapılan çalışmamızda, bir üniversite hastanesinin hematoloji-ortopedi ortak kayıtları kullanıldı. Bu çalışmanın amacı, orta ve ileri derecede hemofili A 'sı olan hastalarda, diz problemlerini, cerrahi tedavi sıklığını yaş ve radyolojik açısından degerlendirmekti. ( Sakarya Tıp Dergisi 2019, 9(3):506-512 ) Gereç ve Yöntemler Tanımlayıcı-kesitsel bir retrospektif çalışma olup, iskelet-kas sistemi problemleri olan 130 hemofili A hastasından diz problemli 49'u bu çalısmaya dahil edildi. Kellgren-Lawrence (KL) sınıflaması, osteoartritlerin radyolojik değerlendirmesinde kullanıldı. Elektronik datalardan elden edilen bilgiler, sonuçları analiz etmek ve istatistiksel değerlendirmeler için kullanıldı. Bulgular Düz diz grafisi çekilmiş hastaların çoğunluğunda (27/41, %65,85), KL derecesi 3 veya 4 idi. KL derecesi ile hastaların yaşları arasında istatistiksel olarak anlamlı bir korelasyon mevcut idi (Spearman's : rs = 0,512, p (2-tailed) = 0,001). Ayrıca, KL derecesi 4 olan 50 yas ve altında 7 hasta (%14,29) vardı. 49 diz problemi olan hastanın 25'inde (%51.02) total diz artroplasti (TDA) yapıldı ve bunların da 10 tanesi (%40) bilateral idi. Bilateral TDA icin ortalama yas (56...