Femoroacetabular impingement (FAI) syndrome is one of the significant reasons for hip pain, loss of ROM at hip joint and developing early osteoarthritis at young active adults. FAI is not a new term and it is treated successfully with open surgical techniques. Some disadvantages of open surgical tecniques has lead orthopedists to develop arthroscopic tecniques.

At this study, we aimed to assess the effectiveness of arthroscopy at the treatment of FAI. We included 25 patients (19 male, 6 female) and evaluated retrospectively which has gone under arthroscopic surgery for the treatment of FAÄ° at Gulhane Military Medicine Academy, Department of Orthopedics and Traumatology and Ankara Koru Hospital, Department of Orthopedics and Traumatology between January 2009 and May 2012.

We have evaluated modified Harris Hip Score and Visual Analogue Score (VAS) preoperatively and postoperatively at all of our patients. Also we have evaluated, hip internal rotation and flexion range of motions clinically. Mean preoperative Harris Hip Score was 68,52 (range 55–76), mean postoperative score was 88,84 (range 72–98). Mean preoperative flexion ROM was 87, 6 (range 80–95) and 108,2 (range 90–120) postoperatively. Also 4,4 (range 0–5) degrees of mean preoperative internal rotation ROM increased to 19,80 range (10–30) degrees postoperatively. Mean preoperative alpha angle was 76,76 (range 60–90) and it was decreased to 41,76 (range 34–48) postoperatively. Mean preoperative visual analog score were decreased from 8, 63 to 2,8 postoperatively.

We had to perform o second look arthroscopy to a patient because of inadequate resection. Also femoral neck stres fracture occured at a patient probably due to early weight bearing. Transient sciatic nevre neuropraxy occured at a 3 patients and, transient ankle pain (approximately 6 weeks) had occured at 2 patients due to traction. Loss of sensation has occured at a patient due to lateral femoral cutaneus nevre injury during portal placement.

With these results, we assessed that arthroscopic treatment of the FAI syndrome is succesfull with minor complications comperable to open procedures.

Arthroplasty is a successfulsurgical procedure which provides returning daily activities by relieving pain, correcting deformity, and regaining the loss of ROM which is caused by many diseases such as degenerative arthritis when conservative and other surgical techniques fail to achieve. Successful outcomes depend on many variables at arthroplasty. Proper indication, careful selection of patient, adequate surgical technique and postoperative rehabilitation plays a major role.

Despite successful outcomes achieved at arthroplasty, undesired complications can be frustrating for the patient and the surgeon. These complications can be minimized by careful preoperative planning, meticulous surgical procedure and rigorius postoperative care.

Infection is the most frequent and most effective complication on outcomes after arthroplasty. Because of that, risk factors for infection must be researched carefully and minimized preoperatively. Antibiotic prophylaxis is routinely suggested before the surgery. Using routine irrigation as well as the standard surgical technique is effective for decreasing postoperative infection rates. Antibiotic impregenated cement is used especially at revision arthroplasties and should be used at primary surgery at high risk groups.

In this study we evaluated 19 patients which admitted to Gulhane Military Academy of Medicine, Department of Orthopedics and Traumatology betwen 2007 and 2012. 5 patients had total hip arthroplasty (26.32%), 11 patients had total knee arthroplasty (57.89%) and 3 patients had hip hemiarthroplasty after femoral neck fractures. 14 of the patiens were female (73.68%) and 5 were (26,32%). Mean age was 69.74 (53–83). Primary surgery was held at our institution at 14 of the patients and 5 patients were referred from other instutitions because of their complaints.6 of the knees were right-sided and 5 of them was left-sided. 3 of the totap hips were left-sided and 2 of them was right-sided. 1 of the hip hemiarthroplasties were left-sided and 2 of them was right-sided. 42.11%of the patients were treated medically and 47.37%were treated with two staged surgery. 42.11%of the surgically treated group were healed completely and 5.26%of the patients passed away due to other comorbidities. Wound debridement was applied 10.53%of the patients which were admitted at early phase and resection arthroplasty was applied 5.26%of these patients because of the lack of response to medical and surgical debridement.

With these results, patients with infected prosthesis can present with many different symptoms and infection risk must always be considered. It must be remembered that the onset time of infection is very important during diagnosis and treatment. Follow ups and treatment protocols must be standardized by clinics as algorithms. During the treatment the surgeon must be in close contact with infectious diseases and microbiology departments. Especially by new developing techniques during the recent years, spesific agents of the infection can be determined and spesific antibiotics can be used for the treatment.

Developmental hip displasia (DHD) still presents as an important problem in our country. Latency in diagnosis and inaccurate treatment causes seconder osteoarthritis in young adults and elder patients. Variable reconstructive surgical procedures as proximal femoral and acetabular osteotomies can be performed, but the most satisfactory functional results are achieved by total hip arthroplasty (THA). In this study, we analyzed the results of the cementless total hip arthroplasties performed in coxarthrosis secondary to developmental hip displasia. Between January 2006 and October 2009, 53 patients diagnosed with hip osteoarthritis secondary to DHD, whom performed 59 total hip arthroplasties in GATA Orthopaedics and Traumatology Clinic were included in the study. 10 of the patients were male (%19), and 43 of them were female (%81). Age of the patients varied between 29 and 78 years and the mean age was 48,7. In 23 patients (%44), THA procedure was performed at the right hip and in 24 patients (%45) at the left hip. 6 patients operadted bilaterally. All patients were followed up 8–38 months (mean 20, 6 months) with clinical and radiological evaluation. The hospitalization period varied between 7–14 days, mean 8,3 days. Posterolateral incision was used at all of the patients. Totally 10 (%17) complications were observed. 5 (%8,5) of them was intraoperative and 5(%8,5) was postoperative. Patients evaluated preoperatively and postoperatively with modified Harris Hip Score. While preoperative mean Harris score was 39,1, the postoperative mean score measured as 90,3. The results were excellent in 52 cases (%88,1), and very good in 7 cases (%11,9). Appropriate implementation of cementless total hip prosthesis in patients with hip osteoarthritis secondary to DHD, who have good bone quality and surgical indicaton; clinical and radiological short term results were satisfactory.

An anterior skin flap taken from the instep can be used to cover the bone ends in disarticulation of the ankle when ulceration or necrosis of the heel prevents the use of the heel flap for a conventional Syme’s amputation. From 1995 to 2003 December, we performed ankle disarticulation by using anterior flap after primary radical debridement in 42 cases with traumatic foot amputation injured by antipersonnel land mines. In all our cases, we observed wound healing in 2 weeks without any problems. The patients were advised to use a cylindrical bootee for indoor walking in third week. After 1–1.5 month, we put plastazote pad on stump end for prosthesis fitting, and for ourdoor walking the patients used prosthesis which would combine partial end-bearing and partial weight bearing on the patellar tendon. Ground contacting and standing without a prosthesis were also acceptable. We observed the advantages of prosthesis fitting. For instance, there is no need to open a window on the prosthesis socket for fitting and it is easier to fit the slender stump into the prosthesis. In early fitting we did not come across any problems about the slipping of the flap from stump as seen in conventional Syme’s amputation. In short and long term follow-ups, we found that the patients did not complain much about their prosthesis. For all these reasons, we think that ankle disarticulation with anterior flap rather than transtibial amputation should be preferred in patients with traumatic foot amputation since conventional Syme’s amputation can not be performed in heel injuries.