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Tasatan E, Kose O, Cakar A, Onder M, Kilicaslan OF, Sindel M. Surface morphology of osteochondral grafts harvested from femoral condyles with free-hand technique: a cadaveric study. Eur J Orthop Surg Traumatol 2024; 34:853-862. [PMID: 37747556 DOI: 10.1007/s00590-023-03731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE The purpose of this cadaver study was to examine the surface morphology of the osteochondral grafts harvested from the femoral condyles using the free-hand graft harvesting technique. MATERIALS AND METHODS One hundred osteochondral grafts were harvested with 6.5 mm chisels at ten different donor sites using the free-hand technique in five paired knee specimens (Mean age: 56.4 years). The cartilage and subchondral bone surface angles were measured through multiplanar reconstruction computerized tomography examination. The cartilage thickness was measured with a MicroScribe G2X digitizer with an accuracy of 0.02 mm. An acceptable congruity could be obtained when these plugs were transferred to a perpendicular socket (articular step-off of less than 1 mm and 0.5 mm) was evaluated. RESULTS Four plugs were damaged or broken during harvesting due to technical difficulties; thus remaining 96 plugs were analyzed. The cartilage thickness varied between 1.36 mm and 3.26 mm across the donor sites. The cartilage was the thinnest in the medial intercondylar notch and thickest in the lateral supracondylar notch. Twenty of ninety-six plugs (20.8%) had unacceptable cartilage surface inclination according to the > 0.5 mm protrusion criteria. Of these plugs, 14 were harvested from the lateral intercondylar notch, whereas five of 96 plugs (5.2%) had unacceptable cartilage surface inclination according to the > 1 mm protrusion criteria. Of these plugs, all were harvested from the lateral intercondylar notch. CONCLUSIONS High rates of unacceptable plugs (up to 100%) might be harvested from the lateral intercondylar notch. In large chondral lesions that require multiple plugs, lateral and medial supracondylar ridges were the best donor sites for perpendicular plug harvesting, whereas lateral intercondylar notch should be avoided.
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Affiliation(s)
- Ersin Tasatan
- Department of Orthopedics and Traumatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ozkan Kose
- Department of Orthopedics and Traumatology, Antalya Training and Research Hospital, Varlık Mah., Kazım Karabekir Cd., 07100, Muratpasa, Antalya, Turkey.
- Medical Faculty, Department of Anatomy, Akdeniz University, Antalya, Turkey.
| | - Albert Cakar
- Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Merve Onder
- Medical Faculty, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - Omer Faruk Kilicaslan
- Department of Orthopedics and Traumatology, Antalya Training and Research Hospital, Varlık Mah., Kazım Karabekir Cd., 07100, Muratpasa, Antalya, Turkey
| | - Muzaffer Sindel
- Medical Faculty, Department of Anatomy, Akdeniz University, Antalya, Turkey
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Baymurat AC, Yapar A, Kilicaslan OF, Tokgoz MA, Selcuk H, Yas S, Senkoylu A. Intermittent pedicle screw application provides better kyphosis restoration in adolescent idiopathic scoliosis for Lenke type 1 and type 2 curves. Eur Spine J 2023:10.1007/s00586-023-07669-6. [PMID: 37010609 DOI: 10.1007/s00586-023-07669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/04/2023] [Accepted: 03/17/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE There is still no consensus on the optimum pedicle screw density required for the desired thoracic kyphosis restoration in adolescent idiopathic surgery (AIS). The aim of this study to evaluate the effect of pedicle screw density on thoracic kyphosis restoration in AIS surgery. METHODS The data of 106 patients from two centers that operated for Lenke type 1 and 2 AIS were retrospectively reviewed. Two groups were constituted according to the pedicle screw density: intermittent pedicle screw constructs (IPSC) (n = 52 patients) and consecutive pedicle screw construct (CPSC) (n = 54 patients) groups. The preoperative and at least 24-month follow-up radiographs and SRS-22 scores were evaluated. The Cobb angle of the main and concomitant curves in the coronal plane and the sagittal plane were measured and compared. RESULTS The mean follow-up period for the IPSC and CPSC groups was 72.3 ± 37.2 and 62.9 ± 28.8 months, respectively. In the SRS-22 questionnaire, there was no significant difference between the two groups in terms of self-image/appearance domain scores (p = 0.466), but better results were obtained in the IPSC group in terms of treatment satisfaction domain scores (p = 0.010) and better thoracic kyphosis restoration was achieved in IPSC group radiologically for Lenke type 1 curves with - 81.4 ± 81.4% in the IPSC group and 6.8 ± 83.8% in the CPSC group (p < 0.001). CONCLUSION It was considered that better thoracic kyphosis restoration could be achieved with the less lordotic effect of IPSC in Lenke type 1 curves. Although the current situation had a significant impact on radiological outcomes, its effect on SRS-22 scores was limited.
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Affiliation(s)
- Alim Can Baymurat
- Department of Orthopaedics and Traumatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Aliekber Yapar
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Omer Faruk Kilicaslan
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Mehmet Ali Tokgoz
- Department of Orthopaedics and Traumatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Huseyin Selcuk
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Semih Yas
- Department of Orthopaedics and Traumatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Alpaslan Senkoylu
- Department of Orthopaedics and Traumatology, Gazi University Medical Faculty, Ankara, Turkey.
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Kilicaslan OF, Onder M, Kose O, Aldemir C. Circumferential Graft Technique for Treatment of chronic multidirectional ligamentous Instability of the interphalangeal Joint of the Thumb. HANDCHIR MIKROCHIR P 2023; 55:81-83. [PMID: 35263777 DOI: 10.1055/a-1759-2996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | | | - Ozkan Kose
- Antalya Research and Education Hospital, Orthopaedics and Traumatology Department
| | - Cengiz Aldemir
- Antalya Research and Education Hospital, Orthopaedics and Traumatology Department
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Kilicaslan OF, Tokgoz MA, Butun Ş, Nabi V, Akalin S. Accuracy of Freehand Versus Modified Funnel Technique for Pedicle Screw Insertion in the Thoracic Spine. Turk Neurosurg 2021; 31:795-802. [PMID: 34374984 DOI: 10.5137/1019-5149.jtn.34716-21.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM To describe a new pedicle screw insertion technique, a modification of the funnel technique, and to compare this technique with conventional freehand screw insertion regarding their accuracy and complications in the thoracic spine. MATERIAL AND METHODS Three hundred forty-three patients who underwent a posterior spinal fusion with different etiologies were retrospectively analyzed. In 84 patients, pedicle screws were placed using the freehand technique, and in 259 patients, the modified funnel technique was used. Screw malposition was evaluated in the immediate and final follow-up in anteroposterior and lateral spinal radiographs by two independent observers. The rates of incorrect pedicle screws and complications, surgical duration, and estimated blood loss were compared between the groups. RESULTS A total of 6141 pedicle screws (1468 in the freehand group, 4673 in the modified funnel group) were evaluated. The rate of incorrect pedicle screws was higher in the freehand group (12.0% vs. 4.6%, p=0.001). The surgical time was shorter in the modified funnel group (190.9±57.0 vs. 174.1±47.6 min; p=0.017). The estimated blood loss was similar between the groups (1391.50±570.01 vs. 1264.13±602.29 mL; p=0.053). There were 82 intraoperative pedicle fractures but no neurologic complications in either group. CONCLUSION The modified funnel technique provides more accurate pedicle screw insertion in the thoracic spine in the presence of dysplastic pedicles in conjunction with axial rotation compared with the freehand technique. Furthermore, surgical time may be reduced without increasing blood loss.
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Affiliation(s)
- Omer Faruk Kilicaslan
- Antalya Education and Research Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey
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Ünal M, Demirayak E, Ertan MB, Kilicaslan OF, Kose O. Bioabsorbable magnesium screw fixation for tibial tubercle osteotomy; a preliminary study. Acta Biomed 2021; 92:e2021263. [PMID: 35075077 PMCID: PMC8823573 DOI: 10.23750/abm.v92i6.11716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Metallic screws are commonly used to fix tibial tubercle osteotomies (TTO). However, hardware removal late after osteotomy union is one of the most common causes of reoperation following TTOs. The use of bioabsorbable screws may eliminate secondary surgeries, but there is no study on their use in this indication. The purpose of this retrospective study was to evaluate the safety and efficacy of bioabsorbable magnesium (Alloy: MgYREZr) screws in tibial tubercle osteotomy (TTO) fixation. METHODS Ten patients with objective patellar instability who underwent distal realignment procedure using Fulkerson TTO were retrospectively reviewed. The osteotomy was secured with two parallel 4.8 mm magnesium screws in all patients. Kujala score and Lysholm knee score were used to assess the functional outcomes before and after the operation. Union of the osteotomy, displacement, and other imaging findings were evaluated with serial knee radiographs during the follow-up. RESULTS There were five male and five female patients with a mean age of 23.4±9.2 years (range, 15-45). The mean follow-up duration was 11.5±3.2 months (range,6-17 months). The osteotomy united in all cases at an average of 3 months. No infection or wound healing problems were seen. A significant increase in Kujala (p:.005) and Lysholm knee scores (p:.005) were recorded in all patients. CONCLUSION The findings support that bioabsorbable magnesium screws can be safely used as an alternative fixation technique in TTO. Furthermore, it provides the advantage to eliminate the need for implant removal.
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Affiliation(s)
- Melih Ünal
- Antalya Research and Education Hospital, Orthopedics and Traumatology Department.
| | - Engin Demirayak
- Antalya Research and Education Hospital, Orthopedics and Traumatology Department.
| | - Mehmet Baris Ertan
- Antalya Research and Education Hospital, Orthopedics and Traumatology Department.
| | | | - Ozkan Kose
- Antalya Research and Education Hospital, Orthopedics and Traumatology Department.
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Turan A, Kilicaslan OF, Kose O. Os subtibiale and secondary ossification center of medial malleolus are two different entities. Am J Emerg Med 2017; 35:929. [PMID: 28131604 DOI: 10.1016/j.ajem.2017.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/20/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Adil Turan
- Antalya Education and Research Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey
| | - Omer Faruk Kilicaslan
- Antalya Education and Research Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey
| | - Ozkan Kose
- Antalya Education and Research Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey.
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Egerci OF, Kose O, Turan A, Kilicaslan OF, Sekerci R, Keles-Celik N. Prevalence and distribution of the fabella: a radiographic study in Turkish subjects. Folia Morphol (Warsz) 2016; 76:478-483. [PMID: 28026849 DOI: 10.5603/fm.a2016.0080] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/14/2016] [Accepted: 10/19/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study is to examine the plain knee radiographs in Turkish subjects in order to determine the prevalence of the fabella and analyse the differences between age, gender, laterality and its symmetry pattern. MATERIALS AND METHODS Bilateral antero-posterior and lateral knee radiographs of 500 patients (250 male and 250 female subjects, 1000 knee radiographs) were randomly selected from the clinical database and retrospectively evaluated. Data on patient age, gender, and knee laterality (right-left) were evaluated from hospital records. The differences between the sesamoid bones at a particular location and the side, sex and age groups were analysed. RESULTS The overall prevalence of the fabella (unilateral or bilateral) was 22.8% (114 subjects). The fabella was present unilaterally in 38 (7.6%) subjects, while it was present bilaterally in 76 (15.2%) subjects. The prevalence of the fabella was similar between the body sides. The prevalence of the fabella was also similar between genders (unilateral or bilateral cases) and age groups. CONCLUSIONS We examined the prevalence, symmetry pattern, age and gender differences in Turkish population. It is the first study performed on Turkish population with the largest sample in current literature. Prevalence of fabella is found to be 22.8% which is quite similar with other Caucasian ethnic populations.
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Affiliation(s)
| | | | | | | | | | - N Keles-Celik
- Anatomy Department, Akdeniz University Medical Faculty, Antalya, Turkey, Turkey.
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Abstract
UNLABELLED Plantar fasciitis is a common cause of plantar heel pain; however, a broad spectrum of disorders may also present with plantar heel pain. A detailed history, physical examination, laboratory testing, and imaging studies may be necessary to reach an accurate diagnosis. Herein, the clinical presentation of a 33-year-old woman with calcaneal insufficiency fracture secondary to celiac disease-induced osteomalacia is presented, and its diagnosis and treatment are discussed. Calcaneal insufficiency fractures should be kept in mind in a patient with celiac disease that presents with heel pain. LEVEL OF EVIDENCE Therapeutic, Level IV: Case study.
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Affiliation(s)
- Ozkan Kose
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey (OK, OFK, AI)Assoc. Prof., the Department of Orthopaedics and Traumatology, Aksaz Military Hospital, Marmaris, Mugla, Turkey (SO)
| | - Omer Faruk Kilicaslan
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey (OK, OFK, AI)Assoc. Prof., the Department of Orthopaedics and Traumatology, Aksaz Military Hospital, Marmaris, Mugla, Turkey (SO)
| | - Selahattin Ozyurek
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey (OK, OFK, AI)Assoc. Prof., the Department of Orthopaedics and Traumatology, Aksaz Military Hospital, Marmaris, Mugla, Turkey (SO)
| | - Ahmet Ince
- Department of Orthopaedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey (OK, OFK, AI)Assoc. Prof., the Department of Orthopaedics and Traumatology, Aksaz Military Hospital, Marmaris, Mugla, Turkey (SO)
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Kose O, Kilicaslan OF, Guler F, Acar B, Yuksel HY. Functional outcomes and complications after surgical repair of triceps tendon rupture. Eur J Orthop Surg Traumatol 2015; 25:1131-9. [PMID: 26164405 DOI: 10.1007/s00590-015-1669-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/03/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The purpose of this study was to present the functional outcomes and complications after primary repair of triceps tendon ruptures (TTR). PATIENTS AND METHODS A retrospective review was performed on eight patients (six males, two females) who underwent transosseous suture repair for TTR. Mayo elbow score, range of motion, muscle strength and patient satisfaction were evaluated after at least 1-year follow-up. RESULTS The mean age of the patients was 25.1 years (range 16-42). The mechanism of injury was a sports injury in three patients, simple fall (fall on outstretched hand) in four and motorcycle accident in one patient. Two patients had associated radial head fracture, and one had a radial head fracture and trochlear fracture, and one patient had a medial epicondyle fracture. In two patients the diagnosis was missed at the initial admission to ED (delay, 20 and 75 days). Only one patient, who was a bodybuilder, had a history of anabolic steroid use, and the rest had no underlying disease or a predisposing factor for TTR. One of the patients with radial head fracture (displaced three parts) underwent simultaneous fixation using two headless screws. Patients were followed up for a mean of 18.8 months (range 12-26). At the final follow-up, all patients were satisfied with the treatment and the Mayo elbow score was excellent in six patients and good in two patients. There was 5° extension loss in two patients. Triceps muscle strength was 5/5 in all patients. Ulnar nerve entrapment occurred in one patient, so ulnar nerve release and anterior transposition were performed 3 months after surgery. Posterior interosseous nerve palsy occurred in one patient who underwent simultaneous radial head fracture fixation, but eventually returned back to normal 3 months postoperatively. All patients returned to their previous level of activity and occupation. CONCLUSION Transosseous suture technique is a safe and effective treatment method for acute TTR with a low rate of complications and excellent functional outcomes. LEVEL OF EVIDENCE Retrospective case series, Level IV.
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Affiliation(s)
- Ozkan Kose
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey.
| | - Omer Faruk Kilicaslan
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey
| | - Ferhat Guler
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey
| | - Baver Acar
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey
| | - Halil Yalçın Yuksel
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Uncalı mahallesi Toroslar caddesi, Samut Comfort Palace E Blok No: 2, Konyaaltı, Antalya, Turkey
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Kose O, Kilicaslan OF, Guler F, Aktan C. Intraarticular Entrapment of Os Subfibulare Following a Severe Inversion Injury of the Ankle: A Case Report. Arch Trauma Res 2015; 4:e27046. [PMID: 26101763 PMCID: PMC4475342 DOI: 10.5812/atr.4(2)2015.27046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 02/16/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Anterior Talofibular Ligament (ATFL) rupture is the most commonly injured anatomic structure in lateral ankle sprain. In some cases, ATFL avulsion fracture from the lateral malleolus may occur instead of purely ligamentous injuries. The ATFL avulsion fracture is detected as a small ossicle at the tip of lateral malleolus on direct radiographs, which is called os subfibulare in chronic cases. CASE PRESENTATION Severe displacement of this ossicle to the tibiotalar joint space is an extremely rare injury. Herein, a case of intra-articular entrapment of os subfibulare following a severe inversion injury of the ankle, which caused a diagnostic challenge was presented. CONCLUSIONS To the best of our knowledge, this is the first case of entrapment of os subfibulare in the talotibial joint space. Fixation of the os subfibulare to lateral malleolus resulted in union and excellent functional results.
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Affiliation(s)
- Ozkan Kose
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey
- Corresponding author: Ozkan Kose, Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey. Tel: +90-5326422612, Fax: +90-2422494400, E-mail:
| | - Omer Faruk Kilicaslan
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ferhat Guler
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Cemil Aktan
- Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Antalya, Turkey
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