Coblation is supposed to enhance healing due to increasing vascularity in the degenerated tendon. In the present study the effect of coblation treatment on tendon degeneration was investigated. A total of 32 New Zealand rabbit were enrolled in the current study. Experimental degeneration was performed by injecting prostaglandin E1 (PGE1) to bilateral achilles tendons of rabbits. Four rabbits were excluded by different reasons. Coblation and control groups were composed of 12 rabbits in each. Coblation device only touched to tendon in the control group whereas in the coblation group coblation treatment was performed through 2 cm segment to form grids with 0.5 mm apart with level four energy lasted for 500 ms. 6 rabbits in control and coblation groups were sacrificed in 6th and 12th weeks. Achilles tendons were evaluated histopathologically by modified Movin scale and immunohistopathologic examination was performed using vascular endothelial growth factor (VEGF) and type 4 collagen. After injection of PGE1, findings similiar to chronic tendinosis were revealed. Coblation group revealed significant increment in vascularity with histopathological and immunohistochemical examination. However difference regarding healing of tendon degeneration was not significant between control and coblation group. Coblation treatment increases vascularity in degenerated tendon, but doesn’t increase healing process.
The aim of this study was to evaluate the early results of a high flexion total knee prosthesis design and patient factors affecting the final range of motion (ROM) on a consecutive series of primary total knee arthroplasty (TKA) patients. 61 knees of 42 patients of a single surgeon series were prospectively evaluated. The mean follow up was 18 (13–30) months. The results were evaluated pre–and postoperatively using the Knee Society Score, the knee flexion and the difference between the preoperative and postoperative knee flexion angles (Δ flexion). Two tailed Student t test was used to compare preoperative and postoperative variables. Knee and function scores increased significantly from 33 (range 11–54) points and 41 (range 10–70) points to 94 (range 77–100) [p<
0,0001] and 89 (range 65–100) [p<
0,0001] respectively. ROM increased significantly [p<
0,0001] from 106 (range 20–140) to 124 (range 90–160) degrees. There was a strong correlation between the preoperative and postoperative flexion [r=0,5984 p=0,0002; (95% CI: r= 0,3210 to 0,7812)]. ROC (receiver-operating characteristic) curve analysis showed that to reach ≥ 130 degrees of final flexion using a high flexion knee system, the patient has to have minimum 100 degrees of flexion preoperatively. The use of high flexion knee system by itself should not be interpreted to bring flexion ≥ 130 degrees to every TKA patient, rather a design not to compromise ROM in selected patients.