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    Histopathological Evaluation of the Anterior Cruciate Ligament in Patients With Advanced Gonarthrosis
    (Wiley, 2025) Polat, Elif; Gunaydin, Burak; Karabag, Sevil; Heybeli, Nurettin
    Introduction: Knee osteoarthritis is a degenerative disease of the knee joint that leads to progressive loss of articular cartilage. There is only limited information in the literature on the degeneration of the anterior cruciate ligament (ACL) in patients with gonarthrosis. In this study, ACL samples excised during the surgery of patients undergoing total knee replacement (TKR) in 2019-2020 were evaluated histopathologically. The present study aims to investigate the relationship between the degeneration of the ACL and the stage of gonarthrosis. Methods: Direct X-rays of 47 patients undergoing knee arthroplasty were evaluated and stratified into two groups: Stage 3 (Group 1) and Stage 4 (Group 2). ACL samples were examined histopathologically. Staining was performed with hematoxylin-eosin (H&E), Alcian blue, and Masson's trichrome. The degree of degeneration was determined according to the Movin score and Bonar score. Based on these scores, the statistical significance of the relationship between the stage of gonarthrosis and histopathological examination results was evaluated. Results: When Group 1 patients were graded according to total Movin scores, the result was mild degeneration in 72.7% of the patients, while the corresponding rates were 76% in Group 2. None of the patients had a score reflecting severe degeneration. The total Bonar scores showed mild degeneration in 68.2% of Group 1 patients. In Group 2, the scores showed mild degeneration in 52% of the patients. No statistically significant difference was found between the groups in either scoring. Conclusion: It was determined that comparable degeneration occurred in the ACL with the progression of the stage of gonarthrosis.
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    HOOK ASSISTED REDUCTION IN CEPHALOMEDULLARY NAILING WITHOUT TRACTION TABLE
    (Atha Comunicacao & Editora, 2024) Tekin, Cagatay; Gunaydin, Burak; Kariksiz, Mesut
    Introduction: Proximal femoral nailing for intertrochanteric femur fracture is sometimes a challenging procedure without a traction table, especially if complicated fracture pattern. We aimed to overcome this difficulty with the hook. Materials and Methods: A retrospective study of 60 patients. 28 of the patients reduction was necessitated with a hook (group 1). The other patients did not need to use this technique (group 2, n=32). The collo-diaphyseal angle, lag screw placement, and tip -apex distance were measured using radiographs. Results: There were statistically significant differences between the two groups regarding the Garden Alignment Index, postoperative collo-diaphyseal angle measurements, and tip -apex distance. The Garden Alignment Index was found as 163.92 degrees (dg.) In the frontal plane in group 1, and 154.78 dg in group 2, respectively. In group 1, the tip -apex distance was 16.05 cm, whereas it was 25.32 cm in group 2. The collo-diaphyseal angle was 133.1 degrees in group 1, and 128.65 degrees in group 2. Conclusions: The hook -assisted reduction is beneficial when operating without a traction table; however, it can also be a part of the surgeons' equipment even when operating on a traction table. When difficulties in obtaining an ideal anatomical reduction in displaced intertrochanteric femoral fractures, we suggest using the hook -assisted reduction technique. Level of Evidence III; Case -control Study.
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    How Many Bundles Does the Anterior Cruciate Ligament Consist of? A Case Report
    (Kare Publ, 2023) Gunaydin, Burak; Ozcaglayan, Tugba Ilkem Kurtoglu; Sever, Cem; Oznur, Meltem; Cetin, Mehmet Umit; Can, Erdem; Eren, Osman Tugrul
    In some cases with anterior cruciate ligament (ACL) injury, physical examination and magnetic resolution imaging cannot clearly identify whether the ACL is intact or partially or completely ruptured. A 40-year-old female patient was admitted to our clinic with complaints of knee pain. After the requested examinations, we could not clearly identify whether the ACL was intact or partially or completely ruptured. Arthroscopic knee surgery was planned for the patient. In diagnostic arthroscopy, it was also determined that there was a multibundle ACL that was not surrounded by the synovium and was tight in the figure 4 position. The surgery was completed by repairing the meniscal tear. It was seen in the current case report that the ACL was a multibundle structure without overlying synovium around. In such cases, it is difficult to evaluate the ACL, and it should be kept in mind that there may also be variations of the ACL.