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Barça F, Atilla HA, Demir EB, Çevik K, Ilgın BU, Atlı OY, Yüksel S, Şibar K, Ünlü S, Duman E, Fırat A, Akdoğan M. Comparison of single and double incision leg fasciotomy in disaster settings-Experience from 2023 Türkiye earthquakes. Injury 2024; 55:111582. [PMID: 38640595 DOI: 10.1016/j.injury.2024.111582] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/26/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Although there are studies comparing methods for leg fasciotomy in compartment syndrome after fractures, choice of single or double fasciotomies in disasters was not investigated. The aim of this study was to compare the efficacy of single and double incision leg fasciotomy in the setting of disaster. METHODS Patients that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were retrospectively analyzed. The cases were separated into two groups as single incision and double incision according to the method of the first fasciotomy. The number of debridements after each fasciotomy, muscle group excisions, completion time of treatment, presence of amputation, the method of closure (primary closure or graft/flap) and positive results of wound cultures were analyzed and compared between two groups. RESULTS 62 legs of 52 patients (22 females, 30 males, age 36.9 ± 11.2 years) with compartment syndrome that have undergone fasciotomy after 2023 Kahramanmaraş earthquakes were included in the study. Single-incision group included 27 legs and double incision group included 35 legs. Amputation was needed in 15 patients (%24.2), six in single incision group and nine in double incision group. (p = 0.75). Compartment excision (eight patients in single incision, nine patients in double incision groups, p = 0.81), number of debridements (median 4 in both groups, p = 0.55), wound closure time (median 17 days in single incision, 22 days in double incision groups, p = 0.52), graft or flap requirement (11 patients in single incision, 16 patients in double incision groups, p = 0.53), positive culture results (15 patients in single incision, 16 patients in double incision groups, p = 0.44) were not different statistically between two groups. CONCLUSION Single and double incision fasciotomy methods are equally effective and safe in treatment of compartment syndrome of the leg in disaster situations. To our knowledge, this is the first study comparing outcomes of single and double incision fasciotomy in disaster settings.
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Affiliation(s)
- Fatih Barça
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye.
| | - Halis Atıl Atilla
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Ekin Barış Demir
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Kadir Çevik
- Başakşehir Çam and Sakura City Hospital, Department of Hand Surgery, Istanbul, Türkiye
| | - Bünyamin Uğur Ilgın
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Osman Yağız Atlı
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Sinan Yüksel
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Kemal Şibar
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Serhan Ünlü
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Evrim Duman
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Ahmet Fırat
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
| | - Mutlu Akdoğan
- Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye
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Fırat A, Veizi E, Koutserimpas C, Alkan H, Şahin A, Güven Ş, Erdoğan Y. Extended Interportal Capsulotomy for Hip Arthroscopy, a Single-Center Clinical Experience. Medicina (Kaunas) 2024; 60:738. [PMID: 38792921 DOI: 10.3390/medicina60050738] [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: 03/21/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The number of hip arthroscopy procedures is on the rise worldwide, and awareness regarding proper management of the hip capsule has increased. No capsulotomy shape is agreed upon as a standard approach, with literature supporting both isolated interportal and T-shaped capsulotomies. The aim of this retrospective cohort study is to report the clinical results of a standardized extended interportal capsulotomy (EIPC) during hip arthroscopy. Materials and Methods: Patients operated on between 2017 and 2020 with a hip arthroscopy were eligible. The inclusion criteria were ages 18-60 years, failed non-operative treatment, and at least a 2-year follow-up. Exclusion criteria were bilateral femoroacetabular impingement syndrome (FAS) cases or labral lesions, ipsilateral knee injury, history of ipsilateral hip surgery, and significant spine lesions. Data regarding demographic characteristics such as age, gender, operation date, BMI, but also Beighton score, presence of postoperative pudendal nerve damage, and revision for any reason were gathered from patients' records. All patients were evaluated preoperatively with a visual analog scale (VAS), the Hip Disability and Osteoarthritis Outcome Score (HOOS), and the modified Harris Hip Score (mHHS). Results: Of the 97 patients operated on with a hip arthroscopy between the defined dates, only 90 patients were included. The mean age was 37.9 ± 9.8, and 58.9% of patients were male. The most frequent surgical indication was an isolated FAS lesion (73.3%), followed by FAS associated with a labral tear (12.2%), an isolated labrum tear (10.0%), synovitis (3.3%), and a loose body (1.1%). The mean follow-up for the study cohort was 39.3 months. The majority of the patients had uneventful surgeries (76.7%), while there were three cases of sciatic nerve neuropraxia and 12 cases of pudendal nerve neuropraxia. Two patients underwent revision surgery during the study period. Comparison between preoperative and postoperative clinical scores showed a significant improvement with a final mHHS mean value of 67.7 ± 18.2, an HOOS value of 74.1 ± 13.2, and a low VAS score of 1.3 ± 1.2. Conclusions: A hip arthroscopy procedure with a standardized and unrepaired, extended interportal capsulotomy is a safe procedure with satisfactory mid-term results and high overall patient satisfaction. At a minimum of 2 years and a mean of 39.2 months, patients showed improved clinical scores and a low revision rate.
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Affiliation(s)
- Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
| | - Christos Koutserimpas
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527 Athens, Greece
| | - Hilmi Alkan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
| | - Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
| | - Şahan Güven
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
| | - Yasin Erdoğan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara 06000, Turkey
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Fırat A, Veizi E, Karaman Y, Alkan H, Şahin A, Tolunay T, Kılıçarslan K. Unrepaired Trochanteric Bursae as a Risk Factor for Deep Gluteal Syndrome After Total Hip Arthroplasty: A Prospective Randomized Controlled Trial. J Arthroplasty 2024; 39:1025-1030. [PMID: 37924993 DOI: 10.1016/j.arth.2023.10.049] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The trochanteric bursae are often left unrepaired after total hip arthroplasty (THA) and they retract posteriorly over the muscle belly of the piriformis. Deep gluteal syndrome (DGS) is a multifactorial condition presenting as buttock pain and is attributed to nondiscogenic sciatic nerve irritation or impingement causes. The purpose of this study was to investigate the relationship between bursal repair and incidence of DGS in patients undergoing THA. METHODS This prospective randomized trial included patients treated with a THA between January and December 2022 for a diagnosis of primary osteoarthritis. Patients were randomized into 2 groups: group 1 underwent a routine bursal repair, while group 2 did not, leaving the bursae unrepaired. Follow-up was performed on the 15th, 30th, and 90th day postoperatively with clinical scores, physical examinations, and laboratory tests. In this cohort of 104 patients, mean age was 55 years (range, 26 to 88). Demographic variables as well as range of motion and overall clinical results showed no significant difference between the groups. RESULTS DGS rates were significantly more common in the patients who had an unrepaired bursa (group 2) both on the 30th and 90th postoperative days, while comparison of lateral trochanteric pain on palpation showed similar results between the groups. CONCLUSIONS DGS is common in individuals who have unrepaired trochanteric bursal tissue following a THA. Despite its higher frequency, these symptoms did not have a substantial impact on the overall clinical scores, which remained consistent across the study groups.
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Affiliation(s)
- Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Yıldırım Beyazıt University Ankara City Hospital, Ankara, Turkey
| | - Yavuz Karaman
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Hilmi Alkan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Tolga Tolunay
- Department of Orthopedics and Traumatology, Gazi University, Ankara, Turkey
| | - Kasım Kılıçarslan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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Şahin A, Çepni Ş, Veizi E, Erdoğan Y, Fırat A, Kılıçarslan K. Advantages of Simultaneous Cementless Bilateral Unicondylar Knee Arthroplasty Compared to Staged Surgery. Clin Orthop Surg 2023; 15:752-759. [PMID: 37811517 PMCID: PMC10551677 DOI: 10.4055/cios22178] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 10/10/2023] Open
Abstract
Background Unicondylar knee arthroplasty (UKA) is an effective procedure, which reduces pain, increases range of motion, and improves function. UKA could be performed simultaneously or in staged sessions. This study aimed to compare bilateral cementless UKA performed simultaneously and in staged sessions in terms of complications, hemoglobin levels, transfusions, and functional outcomes. Methods Patients undergoing bilateral UKA for symptomatic medial compartment osteoarthritis were retrospectively analyzed. Of the 73 patients who met the inclusion criteria, 40 underwent surgery simultaneously and 33 underwent surgery in separate sessions. Operative time, length of hospital stay, change in hemoglobin, need for blood transfusion, complications, and functional outcomes were assessed. Results There was no statistically significant difference between the two groups in demographic data. Simultaneously operated patients had a significantly shorter hospital stay and shorter operative time. Statistically significant improvements in clinical scores were noted in both groups. The degree of improvement in functional scores did not differ between the groups. There was no difference between the two groups in terms of complication rates, but the number of periprosthetic tibial fractures was higher in the simultaneous group. Conclusions Simultaneous bilateral cementless UKA was more advantageous in terms of cumulative hospital stay and total operation time with similar clinical results when compared to a staged procedure. While the overall complication rate was similar, the rate of periprosthetic fractures was 5% in the simultaneous group.
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Affiliation(s)
- Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Yasin Erdoğan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Kasım Kılıçarslan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
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Akgun E, Emet A, Sibar K, Çatma FM, Kocyigit IA, Şahin A, Imat E, Adiguzel IF, Fırat A. Risk Factors for Surgical Site Infections Following Fasciotomy in Patients With Acute Compartment Syndrome: A Study on the February 2023 Kahramanmaraş Earthquake. Cureus 2023; 15:e46880. [PMID: 37841991 PMCID: PMC10568196 DOI: 10.7759/cureus.46880] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/17/2023] Open
Abstract
INTRODUCTION Surgical site infections (SSIs) developing after fasciotomy are difficult to treat, costly, and an important source of mortality and morbidity. This study aimed to determine the risk factors affecting the development of SSI in patients who underwent fasciotomy with the diagnosis of acute compartment syndrome (ACS) within 72 hours after two consecutive earthquakes of 7.7 and 7.6 magnitude that occurred in Kahramanmaraş on February 6, 2023. METHOD A total of 116 patients were retrospectively analyzed. Patients were divided into two groups: those who developed SSI and those who did not. In this study, variables such as basic demographic characteristics, time of fasciotomy, center performing fasciotomy, type of wound closure, affected extremity, concomitant renal failure, hyperbaric oxygen (HBO) therapy, blood creatine kinase (CK) level were examined. RESULTS Of 116 patients, 58 (50%) had SSI. It was statistically observed that patients who underwent treatment with vacuum-assisted closure (VAC), those who underwent primary closure with the shoelace method, those who went into renal failure, and those whose fasciotomy was performed in an earthquake zone had a higher incidence of SSI (p<0.001). Blood CK level above 17.839 seemed to be a risk factor according to receiver operating characteristic (ROC) analysis (P<0.01). Age (p=0.193), gender (p=0.125), fasciotomy time (p=0.843), lower extremity (p=0.234), upper extremity (p=0.806), and HBO treatment (p=0.56) were not associated with SSI. Infection was found to be a significant risk factor for amputation (p<0.001). CONCLUSION The use of VAC as a wound closure technique for SSI after fasciotomy in patients who developed ACS due to the earthquake, the presence of renal failure in the patients, and performing fasciotomy in the earthquake zone were independent risk factors. A blood CK level above 17.839 was also determined as a risk factor, but the confidence interval was found to be low.
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Affiliation(s)
- Erkan Akgun
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | - Abdulsamet Emet
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | - Kemal Sibar
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | - Faruk M Çatma
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | | | - Ali Şahin
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | - Emrah Imat
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
| | | | - Ahmet Fırat
- Orthopaedics and Traumatology, Ankara Etlik City Hospital, Ankara, TUR
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Alkan H, Erdoğan Y, Veizi E, Sezgin BS, Çepni Ş, Mert HÇ, Fırat A. Better sex after hip arthroscopy; Sexual dysfunction in patients with femoro-acetabular impingement syndrome. Orthop Traumatol Surg Res 2023:103693. [PMID: 37776950 DOI: 10.1016/j.otsr.2023.103693] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/30/2023] [Accepted: 08/30/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Femoro-acetabular impingement syndrome (FAIS) is a common cause of hip pain and functional decline. The quality of life of affected patients has been shown to be significantly diminished, with potential alterations in the ability to perform activities of daily living and recreation, including sexual function. Hip arthroscopy is the surgical technique recognized as the gold standard in FAIS. The aim of this study was to research the relationship between hip arthroscopy due to FAIS and pre- and postoperative sexual function. HYPOTHESIS The hypothesis of the study was that sexual dysfunction would be common during the preoperative period but would significantly improve after surgery. MATERIALS AND METHODS This retrospective study included 96 patients aged 18 to 55 years, who underwent hip arthroscopy for a FAIS diagnosis between 2015 and 2021, with a minimum follow-up of one year. Exclusion criteria were a bilateral symptomatic hip condition, history of ipsilateral hip or knee surgery, history of urological or gynecological conditions, sexual dysfunction, or a history of hip osteonecrosis or osteoarthritis. The Female Sexual Function Scale (FSFI) was used to evaluate sexual dysfunction in females and the International Erectile Function Index (IIEF-5) for males. RESULTS The patients comprised 56.3% males and 43.82% females with a mean age of 35.3±8.3 years. Sexual dysfunction was determined preoperatively in 85.2% of the males and in 57.1% of the females. Overall improvement after surgery was statistically significant. Signs of pudendal nerve damage were seen during the postoperative period in 29 (30.2%) patients. The change in total sexual scores was significantly correlated with nerve symptoms and regression analysis showed that traction time was a significant risk factor for pudendal nerve symptoms. DISCUSSION Sexual dysfunction is a common trait of patients suffering from FAIS and the majority of patients significantly benefit from the procedure. Sexual dysfunction persists in a category of patients during the postoperative period, regardless of the type of lesion, and this phenomenon is associated with transient pudendal nerve symptoms, which are more likely to occur with longer traction times and thus represent a clear risk factor. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Hilmi Alkan
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey
| | - Yasin Erdoğan
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey.
| | - Başak Sinem Sezgin
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey
| | | | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey
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Alkan H, Karaman Y, Güven Ş, Biçici V, Subaşı İÖ, Yaşar NE, Fırat A. Are There Any Significant Risk Factors Associated with Lateral Trochanteric Pain in Patients Who Have Undergone Primary Hip Replacement? Cureus 2023; 15:e44863. [PMID: 37809213 PMCID: PMC10560105 DOI: 10.7759/cureus.44863] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Lateral pain around the greater trochanter (LTP) is a common complication after total hip arthroplasty (THA) that can significantly reduce quality of life. The aim of this study was to analyze the relationship between lateral trochanteric bursa repair, subcutaneous fat thickness, and trochanteric pain during the THA procedure. Materials and methods A total of 98 patients who underwent THA for hip arthrosis between 2021 and 2022 were evaluated retrospectively. For all evaluated patients, subcutaneous thickness was measured between the fascia and the skin at the incision site. Bursa repair was performed in 47 patients, while bursa excision was done in 51 patients. The data obtained included demographic information, functional scores, comorbidities, bursa repair and skin thickness values, radiographic evaluations, and other specific markers. These were compared between patients diagnosed with LTP following THA and the controls. Results No difference was observed between the study groups in terms of subcutaneous fat thickness, bursa repair, and other demographic or radiographic evaluations. As expected, there were statistically significant differences between the groups in terms of the visual analog scale (VAS) score (p=0.030) and the Harris hip score (HHS) (p=0.045). When comparing the groups with and without LTP, the VAS score was higher in the group with LTP, while the HHS was found to be lower. Conclusion Trochanteric pain is not associated with bursa repair or subcutaneous thickness. LTP cannot be predicted based on comorbidities such as smoking, BMI, or radiographic measurements.
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Affiliation(s)
- Hilmi Alkan
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Yavuz Karaman
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Şahan Güven
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Vedat Biçici
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - İzzet Özay Subaşı
- Orthopaedics and Traumatology, Erzincan University Faculty of Medicine, Erzincan, TUR
| | - Niyazi Erdem Yaşar
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
| | - Ahmet Fırat
- Orthopaedics and Traumatology, Ankara Bilkent City Hospital, Ankara, TUR
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Subaşı İÖ, Çepni Ş, Tanoğlu O, Veizi E, Alkan H, Yapıcı F, Fırat A. A clinical comparison of two different surgical techniques in the treatment of acute Achilles tendon ruptures: Limited-open approach vs. percutaneous approach. ULUS TRAVMA ACIL CER 2023; 29:935-943. [PMID: 37563893 PMCID: PMC10560806 DOI: 10.14744/tjtes.2023.90839] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/26/2023] [Accepted: 07/08/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Surgical treatment is the commonly preferred method for treating acute Achilles tendon ruptures (AATRs) due to advantages such as less re-rupture rates, better functional results, and an early return to physical activities. The main aim of our study is to compare two common minimally invasive surgical methods, the limited open and the percutaneous approaches, regarding clinical outcomes. METHODS A total of 53 patients (19 females and 34 males) who were treated with limited open (Group 1: 30 patients) and percutaneous (Group 2: 23 patients) approaches for AATRs were retrospectively evaluated between March 2019 and May 2020 in a level 1 trauma center. The evaluation included complications (soft tissue and skin problems, re-rupture, and sural nerve injury rates), the operation time, the duration of return to daily activities, The Achilles Tendon Total Rupture Score (ATRS), and the American Ortho-pedic Foot and Ankle Society (AOFAS) scores of the patients at the first and 6th months of follow-up. Patients' activity levels were compared with the Tegner Activity Scale (TAS). RESULTS The mean age of all patients in this cohort was 45.1±14.1. The mean postoperative follow-up period for group 1 was 36.9±8.81 weeks, whereas, for group 2, it was 35.4±8.73 weeks (P=0.24). The mean age (P=0.47), gender distribution (P=0.41), and body mass index (P=0.29) were similar for both groups. The mean operation time (group 1: 47.1±5.4 vs. group 2: 44.4±6.1, P=0.06) and the duration of return to daily activities (group 1: 49.2±7.4 vs. group 2: 48.5±9.7, P=0.38) were also similar. There was no statistical difference between groups regarding functional results at first (ATRS: group 1: 79.9±3.2 vs. group 2: 79.5±3.9, [P=0.35], and AOFAS: group 1: 80.9±3.1 vs. group 2: 82.1±3.2, [P=0.10]) and 6th months (ATRS: group 1: 85.0±3.8 vs. group 2: 83.7±4.4, [P=0.13], and AO-FAS: group 1: 86.6±3.6 vs. group 2: 86.7±4.2, [P=0.46]). There were no statistically significant differences between groups regarding preoperative and last follow-up TAS scores (P= 0.94 and P=0.46, respectively). We observed no postoperative complications in group 1. There were three complications (13.1%) in group 2. One patient (4.4%) had a re-rupture, and two patients (8.7%) had sural nerve injuries. CONCLUSION Although both groups had similar functional results, the limited open approach yielded better clinical outcomes according to the complication results than the percutaneous approach.
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Affiliation(s)
- İzzet Özay Subaşı
- Department of Orthopedics and Traumatology, Erzincan University, Faculty of Medicine, Erzincan-Türkiye
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Bilkent City Hospital, Ankara-Türkiye
| | - Oğuzhan Tanoğlu
- Department of Orthopedics and Traumatology, Buca Seyfi Demirsoy Training and Research Hospital, İzmir-Türkiye
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Bilkent City Hospital, Ankara-Türkiye
| | - Hilmi Alkan
- Department of Orthopedics and Traumatology, Bilkent City Hospital, Ankara-Türkiye
| | - Furkan Yapıcı
- Department of Orthopedics and Traumatology, Erzincan University, Faculty of Medicine, Erzincan-Türkiye
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Bilkent City Hospital, Ankara-Türkiye
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Veizi E, Erdoğan Y, Sinem Sezgin B, Karaman Y, Kılıçarslan K, Fırat A. The painful joint after COVID-19 treatment: A study on joint osteonecrosis following COVID-19-related corticosteroid use. Jt Dis Relat Surg 2022; 34:75-83. [PMID: 36700267 PMCID: PMC9903115 DOI: 10.52312/jdrs.2023.895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/14/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the incidence of osteonecrosis (ONC), with a special focus on ONC of the femoral head (ONFH), in novel coronavirus disease 2019 (COVID-19) patients two years after the pandemic. PATIENTS AND METHODS This prospective study included COVID-19 patients who were admitted to our center between March 2020 and June 2020. A total of 472 patients (289 males, 183 females; mean age: 42.3±12.0 years; range, 18 to 60 years) were arranged in a list according to their date and time of admission and, then, divided into two groups: those not receiving corticosteroid (CS) treatment (Group 1, n=236) and those receiving CS treatment (Group 2, n=236). The patients were evaluated for joint pain based on X-rays and magnetic resonance imaging scans, and the patients were routinely followed. For each patient in Group 2, additional data regarding CS use were recorded. The possible relationship between ONC and risk factors was analyzed. RESULTS Both groups were similar in terms of age and sex. Group 2 had a significantly longer hospitalization period. A significant increase in the number of painful joints was observed in Group 2. At two years, 5.1% of the patients in Group 1 complained of at least one painful joint compared to 11.9% of patients in Group 2. Eight patients from Group 2 developed ONC. CONCLUSION The incidence of ONC after CS therapy in COVID-19 patients is on the rise. At two years, 5% of patients receiving various doses of CSs may develop ONC. Residual joint pain is common even after recovering from the virus. No relationship is evident between the duration of treatment, cumulative dosage of medication, maximum one-day dosage received, and the presence of ONC.
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Affiliation(s)
- Enejd Veizi
- Ankara Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 06800 Çankaya, Ankara, Türkiye.
| | - Yasin Erdoğan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Başak Sinem Sezgin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Yavuz Karaman
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Kasım Kılıçarslan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Türkiye
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Veizi E, Çelik Z, Güneş BE, Beşer CG, Demiryürek D, Fırat A. To wedge or not to wedge; A cadaveric comparison study of two medial malleolar osteotomy modalities. Foot Ankle Surg 2022; 28:1248-1253. [PMID: 35641379 DOI: 10.1016/j.fas.2022.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/22/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To quantify the surface area of the talus accessible with a uniplanar and a biplanar medial malleolus osteotomy. Our secondary purpose study is to quantify the amount of weightbearing area that each osteotomy effects on the tibial articular surface. PATIENTS AND METHODS Eight ankle joint specimens were dissected for this study. The uniplanar osteotomy was performed first. A K-wire marked the limits of access at two different angles: 90° and 30°. The boundaries were marked with a skin marker. Wedges were then created on the tibia plafond, and the osteotomy was converted into a biplanar one. Measurements were repeated again for this osteotomy. The talus, the tibial plafond, and the medial malleolus were then excised. Images were taken and then electronically calibrated for two-dimensional digital measurement of accessible areas. Areas of perpendicular and 30-degree access were recorded for both osteotomies. The articular surface of the tibia was also measured, and an area analysis was performed to calculate the amount of weightbearing cartilage removed by each osteotomy. RESULTS Almost the entire sagittal plane was accessible with both osteotomies. At a 30° angle, bone purchase was achieved for 67.7 % of the talar articular surface with the uniplanar osteotomy and for 74.8 % with the biplanar osteotomy. At a 90° angle, uniplanar osteotomy provided access to 32.7 % of the talar articular area, whereas the biplanar osteotomy achieved an average coverage of 52.8 %. The difference was statistically significant. On average, 25.3 % of the weightbearing area of the tibial plafond is affected when a biplanar osteotomy is performed. CONCLUSION Medial malleolar osteotomy provides varying degrees of access to the talar dome depending on how it is performed. A wedge-shaped biplanar osteotomy provides greater access and is therefore more suitable for defects located deeper on the talar dome. Despite providing wider access, it results in greater disruption of the weightbearing cartilage of the tibial plafond. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Enejd Veizi
- Ankara City Hospital, Department of Orthopedics and Traumatology, 06000 Ankara, Turkey.
| | - Zehra Çelik
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Burcu Erçakmak Güneş
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Ceren Günenç Beşer
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Deniz Demiryürek
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey
| | - Ahmet Fırat
- Ankara City Hospital, Department of Orthopedics and Traumatology, 06000 Ankara, Turkey
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11
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Çepni Ş, Subaşı İÖ, Şahin A, Bozkurt İ, Fırat A, Kılıçarslan K. Tip-neck distance ratio as a novel predictor for failure in cephalomedullary nailing of unstable trochanteric fractures (UTF). Arch Orthop Trauma Surg 2022; 142:2619-2626. [PMID: 34146115 DOI: 10.1007/s00402-021-03999-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/12/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Intertrochanteric femur fractures (ITFF) are frequently fixed with proximal femoral nailing (PFN), and a common cause of fixation failure is cut-out of the lag screws. In the literature, many factors have been defined to determine the failure risk, including the tip-apex distance (TAD), calcar-referenced tip-apex distance (CalTAD), the Cleveland zone and Parker's ratio. In this study, a novel technique is described which favors infero-posterior placement of the lag screw and predicts failure risk for PFN. The purpose of this study was to evaluate the tip-neck distance ratio as a factor for the prediction of cut-out after PFN of ITFF. MATERIALS AND METHODS A retrospective evaluation was made of the data of 125 patients applied with PFN for ITFF between October 2016 and September 2019. The occurrence of mechanical complications was analyzed in relation to age, gender, fracture side, American Society of Anaesthesiologists classification, fracture classification, reduction quality, bone quality, Cleveland zone, Parker's ratio, TAD, CalTAD and the TNDR. RESULTS A total of 125 patients, including 16 with mechanical complications, were suitable for full analysis. In the univariate analysis, reduction quality (p = 0.003), the TAD (p = 0.048) and the TNDR (p = 0.030) were statistically associated with mechanical complications (p < 0.05). In the multivariate analysis, good quality of reduction reduced risk of mechanical failure (p = 0.011) and the TNDR (p < 0.001) indicated that these were two independent factors affecting mechanical complications. CONCLUSION The results of this study provide clinical evidence that the TNDR is a predictor for cut-out risk. Placement of the lag screw posterior and inferior reduces the risk of mechanical complications. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Şahin Çepni
- Department of Orthopaedics, Ankara Bilkent City Hospital, Bilkent Bulvarı No: 1 Bilkent, Ankara, Turkey.
| | - İzzet Özay Subaşı
- Faculty of Medicine, Mengücekgazi Training and Research Hospital, Binali Yıldırım University, Tekin Civas Bulvarı No: 24, Erzincan, Turkey
| | - Ali Şahin
- Department of Orthopaedics, Ankara Bilkent City Hospital, Bilkent Bulvarı No: 1 Bilkent, Ankara, Turkey
| | - İbrahim Bozkurt
- Department of Orthopaedics, Ankara Bilkent City Hospital, Bilkent Bulvarı No: 1 Bilkent, Ankara, Turkey
| | - Ahmet Fırat
- Department of Orthopaedics, Ankara Bilkent City Hospital, Bilkent Bulvarı No: 1 Bilkent, Ankara, Turkey
| | - Kasım Kılıçarslan
- Department of Orthopaedics, Ankara Bilkent City Hospital, Bilkent Bulvarı No: 1 Bilkent, Ankara, Turkey
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12
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Aydın M, Veizi E, Çepni Ş, Şahin A, Fırat A. Transosseous repair with a cortical implant for greater tubercle cyst-related rotator cuff tear results in good clinical outcomes, but significant implant migration. Knee Surg Sports Traumatol Arthrosc 2022; 30:3499-3507. [PMID: 35366077 DOI: 10.1007/s00167-022-06958-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate whether an arthroscopic transosseous technique (ATO) with cortical implants is effective for rotator cuff tear (RCT) repair in patients with cysts of the greater tuberosity (GTC). METHODS Patients treated with the ATO technique between January 2013 and October 2017 were evaluated. Inclusion criteria were patients treated for both cyst-related and non-cyst-related RCTs and patients with a moderate-sized tear (1-3 cm) according to the DeOrio and Cofield classification. A total of 39 patients were separated into two groups: Group 1 (n = 16) patients with cyst-associated RCT, and Group 2 (n = 23) patients with no cyst. Implant pull-out and migration were evaluated radiologically on standard antero-posterior shoulder radiographs and rotator cuff re-tear was assessed on magnetic resonance images at the final follow-up examination. Group 1 patients were separated into two subgroups according to cyst size (cyst < 5 mm and cyst ≥ 5 mm) and subgroup analysis was performed. Clinical assessment was performed using a visual analog scale, the Constant score and Oxford shoulder score. RESULTS The mean follow-up time was 33.7 ± 11.7 months. The mean cyst size was 5.4 ± 1.5 mm. There was no significant difference in re-tear rates between the cystic and non-cystic groups. The mean implant migration distance was 3.0 ± 2.2 mm in patients with a RCT -related cyst and 0.7 ± 0.8 mm in those without a cyst. A statistically significant difference was found between the groups (p = 0.002). There was no statistically significant difference between the groups in respect of clinical scores. No implant failure was observed. CONCLUSION The ATO method performed with a cortical implant in RCTs resulted in satisfactory recovery and clinical outcomes in the short to medium term with low failure rates. While no implant failures were observed, implant migration was associated with cyst presence. Therefore, judicious use is advocated in the choice of transosseous fixation for cyst-related RCTs and patients should be informed of the possibility of implant migration. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Mustafa Aydın
- Department of Orthopedics and Traumatology, Gülhane Training and Research Hospital, 06000, Ankara, Turkey
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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13
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Veizi E, Alkan H, Çay N, Şahin A, Çepni Ş, Tecimel O, Fırat A. Clinical and radiological comparison of bioactive glass and poly-L-lactic acid/hydroxyapatite bioabsorbable interference screws for tibial graft fixation in anterior cruciate ligament reconstruction. Orthop Traumatol Surg Res 2022; 108:103247. [PMID: 35167963 DOI: 10.1016/j.otsr.2022.103247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/27/2021] [Accepted: 12/03/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ligament reconstruction is still the main treatment modality for patients with a complete ligament rupture. The semitendinosus tendon, alone quadrupled or double folded and combined with the gracilis tendon, is still the most frequently used autologous graft for a reconstructive procedure. Absorbable interference screw usage has gained popularity in the past decade because they create less artifacts during MR imaging and tend to osteointegrate over the years, arguably leading to a more anatomic fixation. The purpose of this study was to compare the 5-year radiological and clinical results of two different tibial graft fixation screws. HYPOTHESIS We hypothesized that bioabsorbable interference screws made of bioactive glass would lead to higher rates of osteointegration, better overall clinical results, less foreign body reaction rates and less tibial tunnel widening when compared to the poly-L-lactic acid/hydroxyapatite (PLLA-HA) screws. PATIENTS AND METHODS Fifty-one patients treated with an anatomic single bundle ACL reconstruction between June 2015 and July 2016 at our institution were included in the study. The tibial graft was fixed with a bioactive glass screw in 24, and with a PLLA-HA in 27 patients. Tibial tunnel widening, foreign body reaction, osteointegration and resorption rates were evaluated and compared on a magnetic resonance scan at a minimum of 5 year postoperatively. Overall clinical results and side-to-side difference on KT-1000 were also analyzed in-between groups. RESULTS Tibial tunnel widening was similar for both groups. Foreign body reaction, while not statistically significant, was less aggressive when bioactive glass screws were used. Osteointegration and resorption rates of the bioactive glass screws were significantly higher than the PLLA-HA group (p=0.000). While all patients showed an overall improvement on postoperative scores (p=0.000), patients with a bioactive glass interference screw had statistically higher translational stability with KT-1000, compared to the poly-L-lactic acid/hydroxyapatite group (p=0.001). DISCUSSION At a minimum of 5 years, compared to conventional PLLA-HA interference screws, 45S5 bioactive glass screw provide higher resorption rates, are more highly biodegradable and provide overall good clinical results. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.
| | - Hilmi Alkan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Nurdan Çay
- Department of Radiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey
| | - Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Osman Tecimel
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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14
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Çepni Ş, Veizi E, Erdoğan Y, Şahin A, Fırat A, Kılıçarslan K. Closure of the femoral medullary canal after retrograde nailing using an in-situ osteochondral autograft-Technical trick and a case series. Injury 2022; 53:798-801. [PMID: 34742571 DOI: 10.1016/j.injury.2021.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 02/02/2023]
Abstract
Retrograde intramedullary nailing (RIMN) is the favored over antegrade intramedullary nailing in fractures of the distal femur. It provides a longer working length and allows for multiple distal screw insertion and therefore a more stable construct. Concerns remain regarding the violation of the knee cartilage and the effect this has on knee function. Many studies have shown high incidence of knee pain with reports varying from 20 to 86%. We describe a novel technical trick aiming at partially restoring the knee cartilage of the operated side and decreasing the hemorrhage stemming from the medullary canal. Our experience of the technique and the case series shows that closing the entrance point of the medullary canal after a RIMN procedure leads to better function and less knee pain in the postoperative period.
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Affiliation(s)
- Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey.
| | - Yasin Erdoğan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ali Şahin
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Kasım Kılıçarslan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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15
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Gündoğan K, Akbudak İH, Hancı P, Halaçlı B, Temel Ş, Güllü Z, İnci K, Bilir Y, Bozkurt FT, Yıldırım F, Şimşek M, Yüksel RC, Eren E, Altıntaş ND, Talan L, Elay G, Güven G, Kara İ, Aydın E, Yılmaz S, Mengi T, Sarı S, Akbaş T, Acar Cinleti B, Ateş Ayhan N, Aral Özbek D, Şahin TK, Açıkgöz A, Esbah AÜ, Fırat A, Aydemir F, Gürkök MÇ, Zerman A, Gümüş A, Türkoğlu M, Aydoğdu M, Ulu R, Çelik JB, Balcı C, Kıraklı C, Karakoç E, Özyılmaz E, Ortaç Ersoy E, Öcal S, Akın Şen İ, Tor İH, Cömert B, Ergan B, Saraçoğlu KT, Ergil J, Yüksel ÜG, Tutar N, Sungur M, Topeli A. Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units. Balkan Med J 2021; 38:296-303. [PMID: 34558415 PMCID: PMC8880837 DOI: 10.5152/balkanmedj.2021.21188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.
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Affiliation(s)
- Kürşat Gündoğan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - İsmail Hakkı Akbudak
- Division of Intensive Care Medicine, Department of Internal Medicine, Pamukkale University School of Medicine, Denizli, Turkey
| | - Pervin Hancı
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - Burçin Halaçlı
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Şahin Temel
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Zuhal Güllü
- Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Kamil İnci
- Intensive Care Unit, Ministry of Health, Ankara Yenimahalle Training and Research Hospital, Ankara, Turkey
| | - Yeliz Bilir
- Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Firdevs Tuğba Bozkurt
- Intensive Care Unit, Ministry of Health, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | - Fatma Yıldırım
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Meltem Şimşek
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Recep Civan Yüksel
- Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
| | - Esma Eren
- Intensive Care Unit, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey
| | - Neriman Defne Altıntaş
- Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Leyla Talan
- Division of Intensive Care Medicine, Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Gülseren Elay
- Division of Intensive Care Medicine, Department of Internal Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Göksel Güven
- Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey
| | - İskender Kara
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Emre Aydın
- Division of Intensive Care Medicine, Department of Internal Medicine, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Seda Yılmaz
- Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey
| | - Tuğçe Mengi
- Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Sema Sarı
- Intensive Care Unit, Ministry of Health, Nigde Omer Halisdemir University, Nigde, Turkey
| | - Türkay Akbaş
- Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey
| | - Burcu Acar Cinleti
- Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey
| | - Nazire Ateş Ayhan
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Deniz Aral Özbek
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Taha Koray Şahin
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aslı Açıkgöz
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Ali Ümit Esbah
- Division of Intensive Care Medicine, Department of Internal Medicine, Düzce University School of Medicine, Düzce, Turkey
| | - Ahmet Fırat
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Ferhan Aydemir
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mehmet Çağatay Gürkök
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Avşar Zerman
- Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Ayça Gümüş
- Intensive Care Unit, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Melda Türkoğlu
- Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Müge Aydoğdu
- Division of Intensive Care Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Ramazan Ulu
- Division of Intensive Care Medicine, Department of Internal Medicine, Fırat University School of Medicine, Elazığ, Turkey
| | - Jale Bengi Çelik
- Department of Anesthesiology, Intensive Care Unit, Selçuk University School of Medicine, Konya, Turkey
| | - Canan Balcı
- Anesthesiology Intensive Care Unit, Kütahya Health Science University, Kütahya, Turkey
| | - Cenk Kıraklı
- Intensive Care Unit, Ministry of Health, İzmir Suat Seren Training and Research Hospital, İzmir, Turkey
| | - Emre Karakoç
- Division of Intensive Care Medicine, Department of Internal Medicine, Çukurova University School of Medicine, Adana, Turkey
| | - Ezgi Özyılmaz
- Division of Intensive Care Medicine, Department of Chest Diseases, Çukurova University School of Medicine, Adana, Turkey
| | - Ebru Ortaç Ersoy
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Serpil Öcal
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - İrem Akın Şen
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - İbrahim Hakkı Tor
- Division of Intensive Care Medicine, Department of Chest Diseases, Ministry of Health, Intensive Care Unit, Erzurum Training and Research Hospital, Erzurum, Turkey and Trakya University School of Medicine, Edirne, Turkey
| | - Bilgin Cömert
- Division of Intensive Care Medicine, Department of Internal Medicine, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Begüm Ergan
- Division of Intensive Care Medicine, Department of Chest Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Kemal Tolga Saraçoğlu
- Intensive Unit, Ministry of Health, İstanbul Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Jülide Ergil
- Intensive Care Unit, Ministry of Health, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Ümmü Gülsüm Yüksel
- Division of Intensive Care Medicine, Department of Internal Medicine, Ministry of Health, Intensive Care Unit, Tokat State Hospital, Tokat and Hacettepe University School of Medicine, Ankara, Turkey
| | - Nuri Tutar
- Division of Intensive Care Medicine, Department of Chest Diseases, Erciyes University School of Medicine, Kayseri, Turkey
| | - Murat Sungur
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey
| | - Arzu Topeli
- Division of Intensive Care Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Veizi E, Çay N, Güven Ş, Şahin A, Fırat A, Kılıçarslan K. Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans. Cureus 2021; 13:e16902. [PMID: 34513475 PMCID: PMC8418210 DOI: 10.7759/cureus.16902] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/05/2022] Open
Abstract
Background and objective Unicondylar knee replacement (UKR) is one of the most frequently performed arthroplastic operations worldwide. Migration and subsidence regarding the tibial component of UKR is a well-known phenomenon. In this study, we aimed to analyze whether plain radiographs are a reliable means to measure the true coronal and sagittal alignment of the UKR’s tibial component. Methods Patients undergoing a UKR procedure at our center between December 2020 and March 2011 were eligible for this study. Inclusion criteria were as follows: the presence of well-aligned standard and reproducible anteroposterior and lateral X-rays taken one week before or after a low-radiation artifact-reduced CT scan. Sixty-six knees were included in the study. Coronal and sagittal alignment of the tibial component was measured in a standard manner by two observers on both X-rays and CT scans. A correlation analysis was performed, and the margin of error was established. Results Intra-observer reliability was high among the two observers whether for X-ray or CT scan measurements [intraclass correlation coefficient (ICC): >0.900]. On the other hand, coronal plane measurements had lower inter-observer ICC values on both X-rays and CT scans while reliability on the sagittal plane was higher. There was a high correlation between radiographic measurements on X-rays and CT scans on both planes. Conclusion Even though the measurements on plain radiographs were slightly different from the ones obtained from CT scans, the correlation between them was very strong. Caution should be exercised when measuring the coronal alignment of the tibial implant on X-rays since it is more frequently affected by rotational misalignment.
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Affiliation(s)
- Enejd Veizi
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Nurdan Çay
- Radiology, Ankara City Hospital, Ankara, TUR
| | - Şahan Güven
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Ali Şahin
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Ahmet Fırat
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
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Pehlivanlar Küçük M, Küçük AO, Kömürcü Ö, Dikmen Y, Kadıoğlu M, Uzan ÇA, Ergin Özcan P, Orhun G, Ünal Akdemir N, Eroğlu A, İlyas Y, Zeyneloğlu P, Şahintürk H, Dai Özcengiz D, Fırat A, Aydın D, Özlü T, Pehlivanlar A, Kıraklı C, Acar Çinleti B, Gök F, Yosunkaya A, Aktaş M, Öztürk ÇE, Ülger F. Effects of personality traits on severity of sepsis. Tuberk Toraks 2021; 69:349-359. [PMID: 34581156 DOI: 10.5578/tt.20219707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The aim of this study was to reveal the effect of the individual's lifestyle and personality traits on the disease process in patients with sepsis and to have clinical predictions about these patients. MATERIALS AND METHODS The study was planned as a multi-center, prospective, observational study after obtaining the approval of the local ethics committee. Patients were hospitalized in different intensive care units. Besides demographics and personal characteristics of patients, laboratory data, length of hospital and ICU stay, and mortality was recorded. Two hundred and fifty-nine patients were followed up in 11 different intensive care units. Mortality rates, morbidities, blood analyses, and personality traits were evaluated as primary outcomes. RESULT Of the 259 patients followed up, mortality rates were significantly higher in men than in women (p= 0.008). No significant difference was found between the patients' daily activity, tea and coffee consumption, reading habits, smoking habits, blood groups, atopy histories and mortality rates. Examining the personal traits, it was seen that 90 people had A-type personality structure and 51 (56.7%) of them died with higher mortality rate compared to type B (p= 0.038). There was no difference between personalities, in concomitant ARDS occurrence, need for sedation and renal replacement therapies. CONCLUSIONS Among individuals diagnosed with sepsis/septic shock, mortality increased significantly in patients with A-type personality trait compared to other personality traits. These results showed that personal traits may be useful in predicting the severity of disease and mortality in patients with sepsis/septic shock.
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Affiliation(s)
- Mehtap Pehlivanlar Küçük
- Department of Chest Diseases, Division of Intensive Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ahmet Oğuzhan Küçük
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Özgür Kömürcü
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Yalım Dikmen
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Istanbul University Cerrahpaşa-Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Mustafa Kadıoğlu
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Istanbul University Cerrahpaşa-Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Çağdaş Alp Uzan
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Istanbul University Cerrahpaşa-Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Perihan Ergin Özcan
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Istanbul University Istanbul Faculty of Medicine, İstanbul, Turkey
| | - Günseli Orhun
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Istanbul University Istanbul Faculty of Medicine, İstanbul, Turkey
| | - Neslihan Ünal Akdemir
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Ahmet Eroğlu
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Yasir İlyas
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Pınar Zeyneloğlu
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Helin Şahintürk
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Dilek Dai Özcengiz
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Ahmet Fırat
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Davut Aydın
- Clinic of Intensive Care, Kanuni Research and Training Hospital, University of Health Sciences, Trabzon, Turkey
| | - Tevfik Özlü
- Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Ayşegül Pehlivanlar
- Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Cenk Kıraklı
- Clinic of Intensive Care, İzmir Suat Seren Chest Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Burcu Acar Çinleti
- Clinic of Intensive Care, İzmir Suat Seren Chest Diseases and Surgery Training and Research Hospital, University of Health Sciences, İzmir, Turkey
| | - Funda Gök
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Alper Yosunkaya
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Murat Aktaş
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Çağatay Erman Öztürk
- Department of Anesthesiology and Reanimation, University of Sciences, Samsun Research and Training Hospital, Samsun, Turkey
| | - Fatma Ülger
- Department of Anesthesiology and Reanimation, Division of Intensive Care Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
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Çepni Ş, Yaman F, Veizi E, Fırat A, Çay N, Tecimel O. Does Malrotation After Minimally Invasive Plate Osteosynthesis Treatment of Distal Tibia Metaphyseal Fractures Effect the Functional Results of the Ankle and Knee Joints? J Orthop Trauma 2021; 35:492-498. [PMID: 33395180 DOI: 10.1097/bot.0000000000002053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate whether rotational malalignment of tibia, after fracture management with minimally invasive plate osteosynthesis technique (MIPO), leads to impaired results in knee and ankle joint functional scores. DESIGN Prospectively collected data were retrospectively analyzed for this study. SETTING Level III academic trauma center. PATIENTS/PARTICIPANTS Sixty-five consecutive patients who applied between October 2010 and January 2014 with a unilateral distal tibia fracture and had full bone union at their last visit were analyzed. Patients were excluded if they had a pathologic fracture, Gustilo-Anderson type II or III open fracture, additional ligamentous trauma, were pregnant, or had any deformity. A total of 27 patients were accepted into the study. INTERVENTION All patients were treated with a MIPO technique after a mean of 2.8 days. The fibular fracture, when present, was fixed first. MAIN OUTCOME MEASUREMENTS The main outcome of this study was the relation between tibial malrotation after a MIPO procedure, and Lower Extremity Functional Scale, American Orthopedic Foot and Ankle Society, KOOS scores, and range of motions of adjacent joints. RESULTS Fourteen patients (51.8%) had a rotation higher than 10 degrees. The mean malrotation angle was 14.6 degrees. Concomitant fibular fractures were present in 13 patients, which did not seem to have a significant influence on malrotation. There was no significant difference between groups regarding functional scores and range of motions of the knee and ankle joints. CONCLUSIONS Despite high rates of malrotation after tibial metaphyseal-diaphyseal fractures treated with MIPO technique, this finding does not seem to have a significantly negative effect on knee and ankle joint functions. Meticulous intraoperative evaluation, through a range of different techniques, should be performed to avoid malrotation. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Şahin Çepni
- Departments of Orthopedics and Traumatology, and
| | - Fırat Yaman
- Departments of Orthopedics and Traumatology, and
| | - Enejd Veizi
- Departments of Orthopedics and Traumatology, and
| | - Ahmet Fırat
- Departments of Orthopedics and Traumatology, and
| | - Nurdan Çay
- Radiology, Ankara City Hospital, Ankara, Turkey
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Veizi E, Fırat A, Tecimel O, Çepni Ş, Subaşı İÖ, Kılıçarslan K. The Change in Posterior Tibial Slope After Cementless Unicondylar Knee Arthroplasty. J Arthroplasty 2021; 36:1784-1791. [PMID: 33478893 DOI: 10.1016/j.arth.2020.12.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The posterior tibial slope (PTS) is an important factor in patients undergoing unicondylar knee arthroplasty. It is an area subjected to high shear and compressive forces. Our objective is to investigate the changes taking place on the tibial slope of cementless unicondylar knee arthroplasties and define its relationship with functional scores. METHODS Patients undergoing a cementless unicondylar knee arthroplasty between January 2011 and July 2019 were selected. Exclusion criteria were lack of at least 1 year of follow up, loss to follow-up for any reason, and revision of a metallic component. Overall, 161 cases were included. Patients were analyzed using standard radiographs for changes in PTS, coronal positioning of the implant, and overhanging. Function was analyzed using Oxford Knee Score, Tegner Activity Scale, and Knee Society Score. Changes of the PTS were analyzed for statistical significance and for correlations with all the other variables. RESULTS All postoperative functional scores showed significant improvement (P < .05). Compared to the early postoperative values, increases of ≤5° were detected in 79% of all patients. The greater amount of slope change occurred during the first 6 months postoperatively. Statistical analysis revealed no significant relationship with functional scores of the knee, age, body mass index, overhanging, and coronal alignment of the tibial component. CONCLUSION This study showed that, with time, minimal changes take place in the PTS of cementless unicondylar knee arthroplasty. The change mostly takes place during the first 6 months. These changes do not affect functional scores.
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Affiliation(s)
- Enejd Veizi
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Osman Tecimel
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Şahin Çepni
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - İzzet Özay Subaşı
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Kasım Kılıçarslan
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
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20
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Sürmelioğlu N, Nenni M, Fırat A, Demirkan K, Özcengiz D. Evaluation of regular insulin adsorption to polypropylene bag and polyvinyl chloride infusion set. Int J Clin Pract 2021; 75:e13895. [PMID: 33277818 DOI: 10.1111/ijcp.13895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/01/2020] [Indexed: 01/08/2023] Open
Abstract
AIM Clinical application of insulin infusion therapy is usually accomplished with regular human insulin. It is known that the regular insulin adsorbed to the hydrophobic surfaces and different approaches were implemented into the clinical practices. It was aimed to evaluate the rate of adsorption of insulin to polypropylene (PP) bags and polyvinyl chloride (PVC) infusion sets and stability of insulin during the infusion. METHODS A 100 IU insulin was added to PP bags containing 100 mL of 0.9% NaCl solution (n = 6). The infusion was started at a rate of 2 mL/h using infusion sets in the PVC structure. Insulin quantification was performed in the samples taken both from the bag and from the end tip of the infusion set during infusion. The stability of insulin solutions stored at room (+25°C) and refrigerator (+4°C) temperatures were compared. Samples were analysed using reverse-phase high-performance liquid chromatography. RESULTS No statistically significant difference was found between the concentrations of the samples taken from the bags stored at room and refrigerator temperatures at the 4th, 12th, and 24th hours (P > .05). It was seen that the adsorption rate of insulin to PVC set was 57% and PP bags is at most 5% at the 24th hour. CONCLUSION When PP bags are used for insulin infusion, it is predicted that 24-hour change can be made instead of frequent change. In addition, losses caused by the high rate of insulin adsorption to PVC infusion sets should be considered and PP infusion sets would be the better option to use if available.
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Affiliation(s)
- Nursel Sürmelioğlu
- Department of Clinical Pharmacy, Faculty of Pharmacy, Çukurova University, Adana, Turkey
| | - Merve Nenni
- Department of Analytical Chemistry, Faculty of Pharmacy, Çukurova University, Adana, Turkey
| | - Ahmet Fırat
- Department of Intensive Care, Faculty of Medicine, Çukurova University, Adana, Turkey
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Dilek Özcengiz
- Department of Intensive Care, Faculty of Medicine, Çukurova University, Adana, Turkey
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21
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Veizi E, Fırat A, Çepni Ş, İnan HM, Kılıçarslan K. Segmental Defect-Bridging Intramedullary Knee Arthrodesis for Osseous Hydatidosis of the Distal Femur: A Case Report. Cureus 2021; 13:e13273. [PMID: 33728208 PMCID: PMC7955198 DOI: 10.7759/cureus.13273] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hydatid cyst is a condition endemic to many parts of the world and is mainly caused by Echinococcus granulosus (E. granulosus). It rarely affects the bone tissue, with the most commonly impacted sites being the vertebrae and the pelvis. Preoperative diagnosis is challenging and very rarely possible because of its similarities with other pathologies. In this report, we present the case of a 64-year-old patient with osseous hydatidosis of a pathological distal femur fracture. The fracture pattern was not recognized on the initial operation and multiple serial debridements were required to control the disease, leading to a large bone defect and a weakened extensor mechanism. A knee arthrodesis with a segmental defect-bridging intramedullary system was eventually performed, which led to satisfying outcomes. Osseous hydatidosis very often presents itself as a pathological fracture and is difficult to diagnose preoperatively with plain radiographs. Orthopedic surgeons are advised to maintain a high index of suspicion and to test for this disease when cystic bone lesions are detected at fracture sites, especially in patients from endemic regions.
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Affiliation(s)
- Enejd Veizi
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Ahmet Fırat
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Şahin Çepni
- Orthopedics and Traumatology, Ankara City Hospital, Ankara, TUR
| | - Hacı M İnan
- Pathology, Ankara City Hospital, Ankara, TUR
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Çepni Ş, Veizi E, Şahin A, Fırat A, Kılıçarslan K, Tahta M. Mason II-III radial head and neck fractures treated with locking plate fixation. Hand Microsurg 2021. [DOI: 10.5455/handmicrosurg.41382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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23
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Pişkin İ, Akcan G, Fırat A, Tufan AÇ. A single-nucleotide polymorphism (rs8176070) of lncRNA PART1 may reflect the risk for knee osteoarthritis. Eur J Rheumatol 2020; 7:88-89. [PMID: 32644930 DOI: 10.5152/eurjrheum.2020.19210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/13/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- İlkay Pişkin
- Department of Histology and Embryology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Gülben Akcan
- Department of Histology and Embryology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Ahmet Fırat
- Clinic of Orthopaedics, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Çevik Tufan
- Department of Histology and Embryology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Fırat A, Aydın M, Tecimel O, Öçgüder A, Sanisoğlu Y, Uğurlu M. Comparison of the clinical and radiological outcomes of arthroscopic transosseous and transosseous-equivalent double-row rotator cuff repair techniques. Acta Orthop Traumatol Turc 2020; 54:178-185. [PMID: 32254034 DOI: 10.5152/j.aott.2020.02.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study compared the clinical and radiological results of the arthroscopic transosseous (ATO) and transosseous-equivalent (TOE) double-row rotator cuff repair techniques. METHODS Prospective data collected from patients treated with ATO (32 women and 7 men, mean age: 57.03±6.39 years) and TOE (36 women and 8 men; mean age: 57.86±7.81 years) techniques were retrospectively evaluated. The visual analog scale score, Constant score, and Oxford shoulder score were used to assess the clinical results. Anchor pullout on standard anteroposterior shoulder radiographs and rotator cuff re-tear on magnetic resonance images were examined at the final follow-up to evaluate the radiological results. Rotator cuff re-tears were graded as per the classification system described by Sugaya et al. Results: The mean follow-up duration was 33.3±11.8 months. No difference was observed in the demographic data of the two groups. Significant improvement was observed in the postoperative shoulder scores of the groups; however, no difference was observed between the groups. Re-tear was detected in 10 patients of the TOE group and 9 patients of the ATO group. Age, tear size, and retraction level could cause re-tear. CONCLUSION In the treatment of rotator cuff tears, the ATO and TOE techniques may achieve considerable improvements in shoulder functions in the short term. LEVEL OF EVIDENCE Level III, Therapeutic study.
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Affiliation(s)
- Ahmet Fırat
- Department of Orthopedics, Ankara City Hospital, Ankara, Turkey
| | - Mustafa Aydın
- Department of Orthopedics, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Osman Tecimel
- Department of Orthopedics, Ankara City Hospital, Ankara, Turkey
| | - Ali Öçgüder
- Department of Orthopedics, Ankara City Hospital, Ankara, Turkey
| | - Yavuz Sanisoğlu
- Department of Biostatistics, Yıldırım Beyazıt University, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Mahmut Uğurlu
- Department of Orthopedics, Ankara City Hospital, Ankara, Turkey
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Abstract
OBJECTIVE To determine the outcomes after combined inside-out and all-inside repair technique of bucket-handle meniscus tears. METHODS A retrospective review was made of patients with bucket-handle meniscus tears repaired with combined techniques, using the all-inside technique in posterior meniscal tears and the inside-out technique in the middle part of the meniscal tears. Meniscal healing was assessed clinically using Barrett's criteria and MRI. RESULTS The study comprised 52 patients with a mean age of 28.4 years old (range, 19-52 years old). The mean follow-up period was 31.3 months (range, 24-59 months). Two patients had ACL re-rupture, and complete meniscal healing was achieved in all but one patient. Although improved from preoperative status, Tegner and Lysholm scores were lower in the ACL reconstructed patients than in the intact ACL patients. CONCLUSION Combined inside-out and all-inside meniscal repair technique is a successful and cost-effective treatment method in bucket-handle meniscus tears. Level of Evidence IV, Therapeutic Study.
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Affiliation(s)
- Serdar Yılmaz
- Ankara Numune Training and Research Hospital, Turkey
| | - Deniz Cankaya
- Ankara Numune Training and Research Hospital, Turkey
| | - Ahmet Fırat
- Ankara Ataturk Training and Research Hospital, Turkey
| | - Alper Devecı
- Ankara Numune Training and Research Hospital, Turkey
| | - Bulent Ozkurt
- Ankara Numune Training and Research Hospital, Turkey
| | - Murat Bozkurt
- Ankara Ataturk Training and Research Hospital, Turkey
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Deveci A, Fırat A, Bozkurt M, Hücümenoğlu S. A case of osteoid osteoma in the distal radius epiphysis with atypical onset. Acta Orthop Traumatol Turc 2014; 48:98-101. [PMID: 24643108 DOI: 10.3944/aott.2014.2502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We present a 16-year-old male patient, with a history of wrist trauma 3 months prior to admission, presented with widespread swelling, limitation of motion and pain that was unresponsive to anti-inflammatory drugs in the left wrist. A lesion compatible with osteoid osteoma in the distal epiphysis of the left radius was detected radiologically. Diagnosis of osteoid osteoma was confirmed with pathological examination of the lesion. Differential diagnosis is important as the atypical lesion occurred after trauma, making it difficult to distinguish from synovitis and infection in consideration of its location.
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Affiliation(s)
- Alper Deveci
- Department of Orthopedics and Traumatology, Etlik İhtisas Training and Research Hospital, Ankara, Turkey.
| | - Ahmet Fırat
- Department of Orthopedics and Traumatology, Etlik İhtisas Training and Research Hospital, Ankara, Turkey
| | - Murat Bozkurt
- Department of Orthopedics and Traumatology, Etlik İhtisas Training and Research Hospital, Ankara, Turkey
| | - Sema Hücümenoğlu
- Department of Pathology, Etlik İhtisas Training and Research Hospital, Ankara, Turkey
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