In this study we aimed to identify infection rates in arhroplasty patients which were operated bilaterally with single anesthesia and to discuss the reasons of infections in these patients. We evaluated 163 knees of 82 patients (Follow up: 12 to 60 months). Mean age was 66.8. Right knees were operated first followed by left knees. 16 of the patients had diabetes mellitus, 4 of them had rheumatoid arthritis, and 1 of them had systemic lupus erithmatosus. All patients were evaluated according to operation time, wound healing, laboratory findings, clinical presentation and X rays. We had 7 infections (6 deep, 1 superficial infection). When we evaluate operation times, no statistically significant difference was obtained between the infected knees and non infected knees (p=0,275). Two of the infected knees had urinary track infection and dental abscess after the opertaion. Five of seven infected knees were left sided. Six of the infected knees were treated with debridement irrigation and antibiotics successfully. But one had two staged revision. Bilaterally operated knee arthroplasty increases operation time significantly. This increase of operation time decreases the sterility of surgical field, and may increase infection rates. The increased infection rates in left sided knees may explain this. Postoperative dental and urinary tract infections may also increase infection rates. There is no correlation between infection and other systemic diseases like diabetes mellitus, systemic lupus erithematosus or rheumatoid arthritis
Degenerative lumbar spinal stenosis is one of the most frequent surgical indications of spinal surgery in the elderly patient group. Because of the progression of the disease and neurologic deficiencies, patients’ quality of life is affected. We aimed to evaluate the postoperative quality of life of the surgically treated spinal stenotic patients. Between 1998 and 2009, 38 patients, who were surgically decompressed and enstrumentated in our clinic were included to the study. The patients were preoperatively and postoperatively evaluated with Visual Analogue (Scale (VAS) and Japanese Orthopaedics Association (JOA) criterias. The same patient group were re-evaluated on the postoperative 6th month with Hamilton anxiety and depression scale, on the 12th month with short form-36 and Oswestry pain scoring scales to measure the quality of life. Mean age of 38 patients (31 female, 7 male) was 59.6 (range 44 to 82). Mean preoperative VAS was 7.97 and postoperative VAS was 2.28. The pain decreased 56.9%. According to JOA criterias, in 3 patients (7.89%) no recovery, in 13 patients (34.2%) less than 50% recovery and in 22 patients (57.8%) more than 50% recovery was obtained. On the 6th month, according to Hamilton anxiety and depression scale, in 12 patients anxiety and in 3 of these patients depression which needs treatment was observed. The pain of all the patients with anxiety recovered meaningfully (42.3%) but according to JOA, less than 50% recovery could be obtained. Surgically treated spinal stenosis patients improved clinically and radiologically and this affected the patients’ quality of life positively
We aimed to evaluate the relationship of forearm rotation with the magnitude of radial bowing and the localization of maximal radial bowing in children. The purpose of the study was to estimate the future forearm rotation limitation related the with the radial bowing. Forearm fractured 26 children (younger than 15 years, 20 male, 6 female) were evaluated in 2 groups. Operatively treated (n=14) and nonoperatively treated (n=12) groups included diaphysis fracture of both forearm bones. In the early postreductive X-rays, maximal radial bowing (MRB) and the localization of maximal radial bowing (LMRB) were measured. Both groups were re-evaluated after a mean follow up of 25.5 months (range 4–62) clinically by the technique of Price et al. and radiologically by the method of Schemitsch and Richards. The relation of the MRB and LMRB with the forearm rotational movements were evaluated statistically. No meaningful difference could be observed between the MRB and LMRB values of the injured and normal sides statistically (p>
0.05). Operatively treated patient group had closer degrees of MRB when compared with the normal side but there was not any meaningful statistical analysis. The number of patients having forearm rotation was so low that limits of forearm rotation could not be determined by the statistical methods. In the forearm pronation limited cases, it was observed that, when MRB decreases, the ability of pronation decreses and when LMRB increases, the ability of pro-nation also decreases. If radial bowing degrees close to the normal side can be obtained, forearm rotation limitations due to differences of radial bowing can be prevented. The mean values of radial bowing and localization of radial bowing must be measured after forearm fractures of both bones.