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    Capsular remnant in the rotator cuff footprint is a novel arthroscopic finding may indicate the etiology of the tear
    (Springer, 2023) Ayanoglu, Tacettin; Ciceklidag, Murat; Kaya, Ibrahim; Ozer, Mustafa; Sarikaya, Baran; Tokgoz, Mehmet Ali; Kanatli, Ulunay
    PurposeThe aim of the study was that the capsule remnant is a common indicator of sub-acromial impingement syndrome and bursal side onset rotator cuff tears.MethodsSixty-three patients with capsule remnants in the rotator cuff footprint (Study group) were detected, while the 53 patients did not have any remnant on the tendon footprint (Control group) between 2015 and 2020 were included. Demographic data of patients, such as age, gender, and operated side information were obtained from the archive files. Acromion type, presence of osteophytes in the acromioclavicular joint, Acromiohumeral Distance (AHD), Acromial Index (AI), Critical Shoulder Angle (CSA), and Coracoacromial Ligament (CAL) degeneration values were evaluated from preoperative MRI, radiographic images, and arthroscopic video recordings.ResultsSevere stages of CAL degeneration were observed in 82.5% of the patients who had capsule remnant (p: 0.001). While type 2 acromion was found in 61.9%, and also acromioclavicular joint osteophyte was found in 58.7% of the patients in the study group. The mean AHD was 8.22 +/- 1.56 mm in the study group and 9.2 +/- 1.3 mm in the control group. The mean CSA was 43.3 +/- 4.9 in the study group and 40.8 +/- 4.2 in the control group. The AI was measured as 0.8 +/- 0.1 in the study group and 0.8 +/- 0.01 in the control group. As a result of these measurements, a statistical difference was found between the two groups in terms of type 2 acromion ratio (p < 0.001), presence of osteophytes in the acromioclavicular joint (p < 0.001), mean acromio-humeral distance (p < 0.001), critical shoulder angle (p = 0.004), and acromial index values (p < 0.001).ConclusionThe findings of sub-acromial impingement syndrome were found to be more prominent in patients with full-thickness degenerative tear and findings of capsular remnant in the footprint. If the presence of the current finding is detected during glenohumeral arthroscopy, sub-acromial impingement syndrome should be examined in more detail to reveal the underlying cause and prevent a recurrence.
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    Radiological Evaluation of Distal Tibiofibular Joint Anatomy Variations in Patients with and Without Syndesmotic Injury
    (Springer Heidelberg, 2023) Ataoglu, Muhammet Baybars; Tokgoz, Mehmet Ali; Ozer, Mustafa; Kokturk, Anil; Yaka, Haluk; Ergisi, Yilmaz
    IntroductionSyndesmosis injuries are a common and debilitating problem affecting the ankle joint, but the precise causes of these injuries remain unclear. In the current retrospective study, it was aimed to investigate the relationship between variations in the distal tibiofibular syndesmosis and surgically proven syndesmosis injuries.Patients and MethodA total of 57 patients with surgically proven syndesmosis injuries and 51 patients without syndesmosis injuries were included as the control group. Computed tomography (CT) scans were used to measure six anatomical features 1 cm proximal to the tibiotalar joint, including the anterior facet length (a), posterior facet length (b), angle between the anterior and posterior facets (c), fibular incisura depth (d), tibia thickness (e), and fibula thickness (f).ResultsComparing the measurements of the patients with and without syndesmosis injury, it was demonstrated that the anterior facet length (a) (p = 0.022) was shorter and the a-b difference (anterior facet length-posterior facet length difference) (p = 0.010) tended toward negative values. Pearson correlation analysis demonstrated that a (r = - 0.211, p < 0.033) and a-b (r = - 0.254, p = 0.010) measurements were strongly negatively correlated with syndesmosis injury.DiscussionOur study findings suggest that the shortness of the anterior facet and the difference in length are related to syndesmosis injuries. To the best of our knowledge, this is the first study to report this relationship with syndesmosis. This study sheds light on the underlying mechanisms of syndesmosis injury, which could help clinicians in the diagnosis, treatment, and prevention of this common ankle injury.Level of evidence: Level 4: case-control study.