Clinical trials

Intra-articular platelet-rich plasma (PRP) injection is a widely used treatment for knee osteoarthritis, but patients respond to it very differently and there is currently no simple, inexpensive way to predict who will benefit. The neutrophil-to-lymphocyte ratio (NLR) and related indices derived from a routine complete blood count reflect a person's baseline inflammatory state. This prospective single-arm observational cohort study investigates whether the baseline NLR, together with the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII), and the monocyte-to-lymphocyte ratio (MLR), predicts the clinical response to intra-articular PRP in patients with Kellgren-Lawrence grade 2 to 3 knee osteoarthritis. The investigators will enroll 120 patients aged 40 to 60 years, each of whom receives a standardized course of three leukocyte-poor PRP injections one week apart. Patients are followed for 6 months, and the primary clinical outcome is the change in the WOMAC osteoarthritis index at 6 months. Outcome assessors are blinded to patients' blood-count values. If a baseline blood ratio predicts response, it could become a low-cost tool to guide patient selection for PRP.

Patients increasingly consult artificial intelligence (AI) chatbots such as ChatGPT for health information before clinical visits, yet the impact of an actual orthopedic consultation on patient trust in AI-derived information remains unknown. This prospective longitudinal observational study quantifies how a single orthopedic outpatient consultation modifies patient trust in AI chatbots, the concordance between AI-derived and physician-delivered information, and patient anxiety, using a paired pre-post survey design supplemented by a matched physician-side assessment. Adult patients (18 years and older) presenting to two orthopedic outpatient clinics in Cyprus complete a brief pre-consultation questionnaire (T0) capturing demographics, AI use patterns, prior AI consultation regarding the current complaint, baseline trust, expectations, and anxiety. Immediately after their consultation they complete a second questionnaire (T1) assessing concordance with physician advice, trust change, consultation facilitation, post-consultation anxiety, and future intention. The consulting physician completes a brief 30-second post-visit form capturing whether AI was discussed, the medical accuracy of AI-derived information conveyed by the patient, and the effect of the AI discussion on consultation duration. The primary outcomes are the paired within-patient change in AI trust between T0 and T1 and physician-patient concordance on AI versus physician advice. Target enrollment is 180 to obtain 150 paired completed assessments.

Ankle fractures are common injuries that can affect a patient's mobility, mood, sleep, and everyday life for months. The Ankle Fracture Outcome of Rehabilitation Measure (A-FORM) is an English-language patient-reported outcome measure developed in Australia to capture this broader rehabilitation experience. No validated Turkish version of A-FORM currently exists. This prospective multi-centre observational study aims to translate the A-FORM into Turkish (A-FORM-TR), culturally adapt it for use in Turkish-speaking patients, and evaluate its psychometric properties. The investigators will recruit 150 adults with a unilateral ankle fracture, treated either surgically or conservatively, from three orthopedic centres in Turkiye and the Turkish Republic of Northern Cyprus. Participants complete the A-FORM-TR together with two established comparator questionnaires (AOFAS Ankle-Hindfoot Score and the Turkish Olerud-Molander Ankle Score). A subset of approximately 50 participants is re-administered the A-FORM-TR after 7 to 14 days to assess test-retest reliability, with a Global Rating of Change item identifying clinically stable patients. Analyses include classical test theory, confirmatory factor analysis, and Rasch measurement analysis.