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    Comparison of the results of ultrasonographic evaluation and arthroscopy in patients scheduled for surgery of the supraspinatus tendon rupture
    (K Faisal Spec Hosp Res Centre, 2014) Gormeli, Cemille; Gormeli, Gokay; Yucesoy, Cuneyt; Ataoglu, Baybars; Kanatli, Ulunay
    BACKGROUND and OBJECTIVES: This study aims to compare the findings of the shoulder ultrasonography (US) of patients with a supraspinatus (SS) tendon rupture with those of the shoulder arthroscopy, to determine the reliability and diagnostic performance of the shoulder US in the algorithm of the SS tendon pathologic lesions and their secondary ultrasonographic findings. DESIGN and SETTINGS: A prospective study conducted with patients scheduled for arthroscopy of the shoulder due to an SS tendon rupture in Yildirim Beyazit Education and Research Center and Gazi University, Ankara, Turkey. MATERIALS and METHODS: Fifty patients scheduled for an arthroscopy of the shoulder due to an SS tendon rupture were evaluated by shoulder US 1 week before the surgery. SS tendon pathologic lesions (tendinosis, partial tears, and full-thickness tears) and humeral degeneration were recorded, and the results of shoulder US were compared with those of arthroscopy. RESULTS: With reference to the arthroscopic data, the sensitivity of the ultrasonographic evaluation for the diagnosis of a full-thickness SS tendon rupture was 91%, with a specificity of 88%; the sensitivity for the diagnosis of a partial-thickness rupture was 86%, with a specificity of 82%; and the sensitivity for the diagnosis of a tendinosis was 98%, with a specificity of 71%. With reference to the arthroscopic data, the sensitivity of US for the diagnosis of humeral degeneration was 93%, with a specificity of 91%. CONCLUSION: The high sensitivity and specificity rates of US in detecting SS tendon rupture and its secondary imaging findings make it an efficient and reliable diagnostic modality, which should be preferred to other more expensive and more invasive methods in the algorithm.
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    Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial
    (Springer, 2017) Gormeli, Gokay; Gormeli, Cemile Ayse; Ataoglu, Baybars; Colak, Cemil; Aslanturk, Okan; Ertem, Kadir
    To compare the effectiveness of intraarticular (IA) multiple and single platelet-rich plasma (PRP) injections as well as hyaluronic acid (HA) injections in different stages of osteoarthritis (OA) of the knee. A total of 162 patients with different stages of knee OA were randomly divided into four groups receiving 3 IA doses of PRP, one dose of PRP, one dose of HA or a saline injection (control). Then, each group was subdivided into two groups: early OA (Kellgren-Lawrence grade 0 with cartilage degeneration or grade I-III) and advanced OA (Kellgren-Lawrence grade IV). The patients were evaluated before the injection and at the 6-month follow-ups using the EuroQol visual analogue scale (EQ-VAS) and International Knee Documentation Committee (IKDC) subjective scores. Adverse events and patient satisfaction were recorded. There was a statistically significant improvement in the IKDC and EQ-VAS scores in all the treatment groups compared with the control group. The knee scores of patients treated with three PRP injections were significantly better than those patients of the other groups. There was no significant difference in the scores of patients injected with one dose of PRP or HA. In the early OA subgroups, significantly better clinical results were achieved in the patients treated with three PRP injections, but there was no significant difference in the clinical results of patients with advanced OA among the treatment groups. The clinical results of this study suggest IA PRP and HA treatment for all stages of knee OA. For patients with early OA, multiple (3) PRP injections are useful in achieving better clinical results. For patients with advanced OA, multiple injections do not significantly improve the results of patients in any group. I.