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Öğe A New Anatomical Plate for Extra-Articular Distal Humeral Fractures: Biomechanical Study(Atha Comunicacao & Editora, 2022) Mutlu, Harun; Polat, Abdulkadir; Çetin, Mehmet Ümit; Mutlu, Serhat; Demir, Teyfik; Parmaksizoglu, Atilla SancarIntroduction: We compared the mechanical properties of two fixation techniques for the treatment of extra-articular distal third humeral fractures. Materials and Methods: Two groups were created from twenty-four humeri. Group 1 was instrumented using a new, precontoured, 8-hole (3.5-mm-diameter) locking compression plate (LCP) placed anterolaterally. Group 2 was instrumented using an 8-hole (3.5-mm-diameter) precontoured posterolateral LCP plate placed on the distal humerus. Four-point bending tests and torsion tests were performed until the specimens broke. Results: The four-point bending stiffness test showed that the stiffness of anterolaterally fixed humeri was significantly higher than that of posterolaterally fixed humeri (p<0.05). Torsion testing revealed that posterolateral fixation was associated with better yield strength (p<0.05), but the torsional stiffness did not differ significantly between the two plates (p>0.05). Conclusions: The anterolateral plate exhibited higher bending stiffness and torsional yield strength than the posterolateral plate. Anterolateral plate fixation can thus be used to manage extra-articular distal humeral fractures. Multiaxial locking screws ensure rigid fixation, allow early elbow motion without olecranon fossa impingement, and prevent iatrogenic injury of the triceps muscle. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment.Öğe A new method for diagnosis of anterior cruciate ligament tear: MRI with maximum flexion of knee in the prone position: A case control study(Elsevier Ltd, 2019) Günaydın, Burak; Şahin, Gülcan Güçer; Sarı, Abdulkadir; Kara, A.; Dinçel, Yaşar Mahsut; Çetin, Mehmet Ümit; Kabukçuoğlu, Yavuz Selim; Tekin, ÇağatayBackground: The diagnosis of anterior cruciate ligament tear can be made by physical examination and magnetic resonance imaging (MRI) in the supine position. In cases where the tear is partially evaluated on MRI, the choice of treatment may vary. The purpose of the study was to investigate the efficiency of MRI at maximum knee flexion in the prone position and to compare the images with findings of the ACL detected during surgery. Materials and methods: Sixty-one patients with partial ACL tears with meniscal and cartilage lesions requiring arthroscopic knee surgery were included in the study between 2017 and 2019. MRI of these patients was prescribed at maximum knee flexion in the prone position. Then, an arthroscopic operation was performed on 61 patients and the findings (intact, partial or total tear of ACL) were recorded. The ACL was evaluated as being intact and partial or total tear. The statistical significance of the efficacy of MRI in the supine position with the knee at maximum flexion in the prone position was compared. Results: It was found that, of 61 patients with suspected partial ACL tears, 25 patients had intact ACLs, 22 patients had partial tears and 14 patients had total ACL tears, through the interpretation of MRIs of the prone position by the radiologist. In the arthroscopic surgery of 61 patients, 20 patients had intact ACLs, 27 patients had a partial tear and 14 patients had a total tear. The MRI results with maximum knee flexion in the prone position were more compatible with the findings of the arthroscopic surgery. Conclusions: It could be considered that MRI with maximum knee flexion in the prone position may also be guiding in the diagnosis and treatment of patients with partial anterior cruciate ligament rupture. © 2019Öğe Analysis of the coracoid morphology with multiplanar 2D CT and its effects on the graft size in the Latarjet procedure(Sage Publications Ltd, 2020) Sarı, Abdulkadir; Sasani, Hadi; Çetin, Mehmet Ümit; Günaydın, Burak; Kılınç, Seyran; Yıldırım, İlker; Dinçel, Yaşar MahsutPurpose: In this study, we aimed to reveal the individual differences regarding the size of the coracoid and their effects on the classical and modified Latarjet procedures. Methods: Computed tomography images of 120 patients (mean age: 41.18 +/- 12.01 years) without shoulder complaints or shoulder instability were evaluated retrospectively. The glenoid width, the surgical graft length, and the coracoid total length, width, and thickness were measured using the multiplanar reconstruction method on the Sectra Picture Archiving and Communications System (PACS) system. Age, gender, side, the dominant hand, and the height of the patients were recorded and the correlations between them were investigated. On the created hypothetical model, the current size of the coracoid was evaluated to determine what size of glenoid defects it could repair by employing the classical and the modified Latarjet techniques. Results: There was no significant difference between the right-hand-dominant group and the left-hand-dominant group in terms of coracoid measurement results (p > 0.05). Again, there was no statistically significant difference between the right and the left side regarding the coracoid size (p > 0.05). A positive correlation could be detected only between age and the coracoid width and thickness (p < 0.05). A positive correlation was also found between the glenoid width and the coracoid width and thickness in both shoulders (p < 0.001). Coracoid thickness could fill in the defects that amounted to 40% of the glenoid width, while the coracoid width could fill in for the defects that were 50% of the glenoid width in both genders. Conclusion: Our study showed that hand dominance and side were not effective on the coracoid dimensions. In addition, it has been shown that the coracoid dimensions did not have a significant effect in the choice of Latarjet technique in terms of defect repair and that repair rates of up to 40% could be achieved in glenoid defects with both techniques.Öğe Assessment of the Glenoid Morphology Based on Demographic Data in the Turkish Population(Hindawi Ltd, 2020) Sarı, Abdulkadir; Dinçel, Yaşar Mahsut; Günaydın, Burak; Çetin, Mehmet Ümit; Özçağlayan, Ömer; Bilsel, KeremPurpose. In this study, our aim was to evaluate the glenoid version, height, and width measurements based on gender, side, age, height, and hand dominance in the Turkish population using computed tomography (CT) images. Methods. In our study, CT images of 140 patients (62 females and 78 males; mean age: 39.6 years) who had no shoulder complaints were evaluated retrospectively. Glenoid version (GV), AP diameter (width), and SI diameter (height) on both shoulders were measured on the CT images. Correlations between patient gender, side, age, height, and hand dominance and the GV and size were evaluated. Results. The right shoulder had a mean GV of -0.93 +/- 7.80 degrees and the left shoulder had a GV of -0.88 +/- 6.63 degrees (p>0.05). The mean AP diameter of the glenoid was 26.57 +/- 3.02 mm in the right shoulder and 26.33 +/- 3.01 mm in the left shoulder (p>0.05). The mean SI diameter of the glenoid was 31.8 +/- 3.6 mm in the right and 31.7 +/- 3.3 mm in the left shoulder (p>0.05). When men and women were evaluated in two separate groups, the GV, AP, and SI values did not exhibit a statistically significant difference between the two shoulders in both genders (p>0.05). There was a positive correlation between the ages and heights of the patients and the glenoid size (p<0.05). The mean AP diameter was approximately 28 mm and the SI diameter was 34 mm in males, whereas the mean AP diameter was 24 mm and the SI diameter was 30 mm in females (p<0.05). The GV values of the dominant shoulders were significantly more retroverted (p<0.05). There was a positive correlation between the ages and heights of the patients and the glenoid size (p<0.05). Conclusion. Hand dominance had an effect on the glenoid version, while patient gender, age, and height had an effect on the glenoid size. The glenoid width in the Turkish population was similar to that of the European and American populations, and the glenoid height was similar to that of the Asian population. Our GV values were similar to those of the Asian population and more anteverted compared to the Western population. We believe that our findings will be useful in preoperative planning and in the production of implants for our population.Öğe Behaviour and knowledge skill levels of orthopedic surgeons about radiation safety and fluoroscopy use: A survey analysis(Turkish Association of Orthopaedics and Traumatology, 2019) Fidan, F.; Çetin, Mehmet Ümit; Kazdal, C.; Kılıç, F.; Özkaya, U.Objective: The aim of this study was to evaluate the behaviour and knowledge skill levels of Turkish orthopedic surgeons about fluoroscopy usage and radiation safety. Methods: The questionnaire, consisting of nineteen questions, was sent to orthopaedic surgeons and requested by a total of 323 surgeons online. The questions were about personal information, training and behaviours related to radiation and fluoroscopy usage, and the use of protective equipment. Results: A total of 277 individuals completed the questionnaire. The answers of 180 surgeons whose working duration was more than 1 year and also who participated in at least one fluoroscopy requiring operation per week, were analysed. 22 (12%) participants answered that they were trained on fluoroscopy usage. Sixty people (33.3%) reported that they did not use any protective equipment regularly. The most commonly used protection methods were lead aprons 123 (68.3%). Thyroid protectors were used by 92 participants (52.1%). There was no significant difference between the groups when comparing the use of protective equipment according to the academic title. Only 19 (10.6%) of the surgeons noted that they used dosimeter regularly, and 15 (83.3%) of them reported that they controlled their dosimeters. Conclusion: In this study, Orthopedic surgeons were found not to be adequately trained about use and risks of fluoroscopy and also not to be equipped about methods for preventing radiation damage. © 2019 Turkish Association of Orthopaedics and TraumatologyÖğe Can fracture healing be accelerated by serum transfer in head trauma cases? An experimental head trauma model in rats(Turkish Joint Diseases Foundation, 2021) Sarı, Abdulkadir; Dinçel, Yaşar Mahsut; Çetin, Mehmet Ümit; İnan, SevdaObjectives: In this study, we aimed to investigate whether the positive union effect caused by head trauma could be transferred between individuals.& nbsp; Materials and methods: Seventy-two male rats with an average weight of 375 g were used in this study and divided into four groups including 18 in each group. Group 1 consisted of serum donor rats that were exposed to head trauma, while Group 2 consisted of study rats with long bone fractures that were given the serum obtained from the rats in Group 1, Group 3 included control rats with isolated long bone fractures, and Group 4 included control rats with both head trauma and long bone fractures. For radiological evaluation, the ratio of the width of the callus to the width of the neighboring diaphysis was considered as the callus-todiaphyseal ratio in the study and control groups. Histopathological and radiological evaluations was made on Days 10, 20, and 30.& nbsp; Results: In evaluation of the radiological data regarding the callusto-diaphyseal ratio, Group 3 was found to have significantly lower radiological values than Group 4 on Day 10 (p=0.006). Group 2 had significantly higher values than Group 3 (p=0.02). On Day 20, Group 2 exhibited significantly higher radiological values than Group 3 (p=0.004), but lower than Group 4 (p=0.032). As for Day 30, Group 2 exhibited significantly higher radiological values than Group 3, but lower than Group 4 (p=0.001). In the evaluation of the Huo scores obtained for histopathological evaluation, there was no significant difference among the groups on Days 10, 20, and 30 (p=0.295, p=0.569, and p=0.729, respectively).& nbsp; Conclusion: Our study results suggest that the osteoinductive effect after head trauma can be transmitted between individuals by means of serum transfer.Öğe Changes in Bone Mineral Density After Total Knee Arthroplasty(Atha Comunicacao & Editora, 2020) Dinçel, Yaşar Mahsut; Sarı, Abdulkadir; Tekin, Çağatay; Günaydın, Burak; Çetin, Mehmet Ümit; Arslan, Yunus ZiyaObjective: We aimed to investigate the change in bone mineral density (BMD) in the first postoperative year in patients that underwent total knee arthroplasty (TKA) due to primary osteoarthritis of the knee. Methods: Preoperative and first postoperative year dual-energy X-ray absorptiometry measurements of 76 patients with knee osteoarthritis, who undergone surgery between 2016 and 2018 due to the recommendation for TKA, were statistically evaluated in the study. Results: Of the 19 patients with a normal BMD in the preoperative period, 73.7% (n = 14) continued to have a normal BMD in the postoperative period. Of the 34 patients with a low BMD (osteopenia) in the preoperative period, 91.2% (n = 31) did not show any change, whereas osteoporosis was observed in two patients (5.9%) in the postoperative period. Of the 23 patients with osteoporosis in the preoperative period, 95.7% (n = 22) did not show any change, whereas osteopenia was observed in one patient (4.3%) in the postoperative period. Both the T and Z scores of the spine (L1-L4) and proximal femur showed a slightly positive trend, however, with an insignificant statistical difference (p >= 0.05). Conclusion: Patients that underwent TKA experienced a statistically insignificant bone gain at the spine and proximal femur twelve months after the surgery.Öğe Combined suprascapular nerve block and axillary nerve block approach vs. peri-articular infiltration analgesia for postoperative pain management following arthroscopic shoulder surgery: a randomized clinical trial(Verduci Publisher, 2022) Şahin, Ayhan; Baran, Onur; Çetin, Mehmet Ümit; Gültekin, Ahmet; Arar, Makbule Cavidan- OBJECTIVE: Postoperative pain following shoulder surgery is a devastating sit-uation. Several approaches, including region-al nerve blocks such as combined supras-capular nerve block and axillary nerve block (SSNB+ANB) and peri-articular infiltration (PÖğe COMPARISON OF CHANGES IN THE ANKLE AFTER UNICONDYLAR KNEE ARTHROPLASTY AND HIGH TIBIAL OSTEOTOMY(Atha Comunicacao & Editora, 2022) Sarı, Abdulkadir; Dinçel, Yaşar Mahsut; Çetin, Mehmet Ümit; Kılınç, Seyran; Günaydın, Burak; Özdemir, MikailObjectives: We aimed to compare the changes in the coronal alignment of the ankle joints and their clinical effects after high tibial osteotomy (HTO) and unicondylar knee arthroplasty (UKA). Methods: 50 HTO and 54 UKA patients who were operated on for medial knee osteoarthritis between 2013 and 2018 were retrospectively evaluated. The hip-knee-ankle angle (HKA), the medial proximal tibial angle (MPTA), the tibial plafond inclination (TPI) and the talar inclination (TI) angles were measured before and after operation. Visual analog scale (VAS), short form 36 (SF-36), and ankle-hindfoot scale (AHS) scores of both groups were evaluated and recorded. Results: Angular changes in the HKA, MPTA, TPI and TI values showed significantly greater values in the HTO group (p<0.001). When asymptomatic and symptomatic cases were compared, it was found that changes in the HKA, TPI and TI values were significantly greater in symptomatic cases in the HTO group (p<0.05). A significant decline was observed in the VAS, SF-36 and AHS scores in the HTO group in the postoperative period (p<0.05). In intergroup evaluations, a significant decline was detected in pain and functional scores of the HTO group when compared to the UKA group (p<0.05). Conclusion: Unicondylar knee arthroplasty can be a good alternative to HTO in selected cases for postoperative ankle complaints.Level of Evidence III; Therapeutic Studies Investigating the Results of Treatment.Öğe Correction of more hallux valgus pathologic disorders with a single distal osteotomy a new surgical technique(American Podiatric Medical Association, 2021) Çetin, Mehmet Ümit; Parmaksızoğlu, A.S.; Fidan, F.; Kılıç, M.; Aybar, A.; Dinçel, Y.M.Background: Hallux valgus, one of the most common deformities of the great toe, may cause pain, dysfunction, and impaired gait pattern. In this retrospective study we report the results of a new type of distal metatarsal osteotomy combined with distal soft-tissue release in patients with mild-to-moderate hallux valgus deformity. Methods: This new technique was used in the management of 32 feet of 31 patients (eight men and 23 women) with mild-to-moderate hallux valgus. Hallux valgus angle, i ntermetatarsal angl e, and distal metatarsal articular angl e were measured on preoperative, earl y postoperative (6–8 weeks), and l ate (1 year) postoperative radiographs. American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal score was calculated. Sesamoid position, by considering medial sesamoid position, and metatarsal shortness were also measured. Results: Statistically significant differences were detected between the preoperative and late postoperative measurements of the hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position parameters in patients operated on with this technique. Improvement was 14° for the hallux valgus angle, 4° for the distal metatarsal articular angle, and 4° for the intermetatarsal angle. Sesamoid position was also improved, and the mean American Orthopaedic Foot and Ankle Society score was significantly improved. Metatarsal shortness greater than 2 mm was observed in two patients without resulting in any clinical discomfort. Conclusions: This new technique was easy, safe, and promising in patients diagnosed as having mild-to-moderate hallux valgus deformity. © 2021, American Podiatric Medical Association. All rights reserved.Öğe Corrigendum to "A new method for diagnosis of anterior cruciate ligament tear: MRI with maximum flexion of knee in the prone position: A case control study" (International Journal of Surgery (2019) 68 (142-147), (S1743919119301451), (10.1016/j.ijsu.2019.06.017))(Elsevier Ltd, 2020) Günaydın, Burak; Şahin, Gülcan Güçer; Sarı, Abdulkadir; Kara, A.; Dinçel, Yaşar Mahsut; Çetin, Mehmet Ümit; Kabukçuoğlu, Yavuz Selim; Tekin, ÇağatayThe authors regret that the figure captions in this article appeared incorrectly and should have been displayed as follows: Fig. 3. First patient's suspected partial tear in the sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 4. The first patient's total tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image) Fig. 5. The second patient's suspected partial tear in a sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 6. The second patient's total tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image) Fig. 7. The third patient's suspected partial tear in a sagittal section in the supine position with the knee in extension (knee MRI image) Fig. 8. The third patient's partial tear image in a sagittal section in the prone position with the knee in maximum flexion (knee MRI image)The authors would like to apologise for any inconvenience caused. © 2019Öğe Does anterolateral ligament injury change the treatment option in patients with partial ACL tears?(ARSMB-KVBMG, 2021) Günaydın, Burak; Kurtoğlu Özçağlayan, Tuğba İlkem; Çetin, Mehmet Ümit; Sarı, Abdulkadir; Dinçel, Y.M.; Tekin, ÇağatayPatients with ACL tears with ALL injury have more clinical complaints (instability, feeling of the pop on the knee or knee sliding). patients have ALL injury with partial ACL tears, It is unclear whether the choice of treatment will be conservative or surgical. This study aimed to determine the effect of anterolateral ligament (ALL) status, whether intact or ruptured, on the choice of conservative or surgical treatment in patients with partial anterior cruciate ligament (ACL) tears. Between 2015 and 2019, patients with suspected partial ACL tears were identified on both physical examination and MR imaging. 122 patients who had partial ACL tears and also status of patient’s ALL could be evaluated by radiologist were included in the study, retrospectively. Sixty-two patients who underwent ACL reconstruction were determined as group 1, and 60 patients who did not undergo ACL reconstruction were defined as group 2. In patients with partial ACL rupture with or without ACL reconstruction, it was evaluated whether a ruptured or non-ruptured ALL was effective in this decision of conservative or surgically. The MRIs of patients with partial ACL tears were evaluated by a radiologist and it was concluded that the ALLs of 50 patients were ruptured, and 72 were intact. The ALLs of 36 patients in group 1 were ruptured, and 26 patients were intact. Fourteen patients in group 2 had ruptured ALLs, 46 patient’s ALLs were intact. Seventy-two percent of the patients with partial ACL tears who had ruptured ALLs in MRI underwent ACL reconstruction. It was found that ACL reconstruction was performed more frequently in patients with partial ACL tears with ALL rupture. Therefore, we believe that preoperative evaluations of ALLs using MRI in patients with partial ACL tears are essential for surgical planning. © 2021, Acta Orthopædica Belgica.Öğe Does radiological evaluation of endobutton positioning in the sagittal plane affect clinical functional results in single-bundle anterior cruciate ligament reconstruction?(Springer, 2021) Günaydın, Burak; Sever, Cem; Çetin, Mehmet Ümit; Sarı, Abdülkadir; Dinçel, Yaşar Mahsut; Şener, Burak; Heybeli, NurettinIntroduction Sports injuries are increasing today due to the increased interest in sports. The most common injured knee ligament is the anterior cruciate ligament (ACL) in sport injuries. Accordingly, surgical treatment of the ACL is performed frequently. In this study, it was aimed to retrospectively evaluate whether the location of an endobutton on lateral knee radiography was effective on knee functional scores in patients who underwent ACL reconstruction. Materials and methods One hundred thirty patients who underwent ACL reconstruction between January 2015 and February 2019 were identified. The patients were divided into three groups according to the location of the endobutton on lateral radiographs taken in the postoperative period. Group 1 patients were classified as anterior, group 2 as middle, and group 3 as posterior according to the location of the endobutton. Functional scoring, physical examination tests, comparative thigh diameter measurements, and single-leg hop tests were compared between the groups. It was evaluated as to whether there was a statistically significant difference between the groups. Results There were 38 patients in group 1, 63 patients in group 2, and 29 patients in group 3. The mean age was 29.1 in group 1, 29.1 in group 2, and 29.7 in group 3. The mean follow-up period of the patients was 18.4 months in group 1, 19.1 months in group 2, and 21.4 months in group 3. The average Lysholm score was 92.9 in group 1, 93.3 in group 2, and 91.7 in group 3. The mean modified Cincinnati scores were 27.0, 27.1, and 26.6, respectively, in the groups. The mean IKDC score of the subjective knee assessments was 92.5, 92.8, and 91, respectively, according to the groups. The average thigh atrophy value was 1 cm, 1 cm, and 1.2 cm, respectively, in the groups. In the single-leg hop test, 34 patients in group 1 jump to over 85% of the distance compared with the intact side, while 58 patients in group 2, and 23 patients in group 3 were successfully able to jump this distance. The effect of the placement of the endobutton in the anterior, middle or posterior was not statistically significant on functional scores and physical examination results. In patients with endobuttons in the middle, functional scores were found better than in those with anterior or posterior placement. Conclusions No statistically significant differences were found in clinical functional results when comparing patients' endobutton location on femur. For this reason, surgical time should not be extended using unnecessary extra effort to change the orientation of the exit hole during surgery.Öğe Gözden Kaçan Perilunat Karpal Dislokasyonda Dorsal Yaklaşım ve Geçici Tespit Prosedürünün Orta-Uzun Dönem Sonuçları(2021) Sarı, Abdülkadir; Çetin, Mehmet Ümit; Özçelik, İsmail Bülent; Polat, Abdulkadir; Fidan, FıratAmaç: Çalışmadaki amacımız, perilunat çıkıklı olgularda dorsal yaklaşımla açık redüksiyon, K-teli uygulaması ve skafolunat ligaman tamiri sonrasıorta-uzun dönem fonksiyonel ve radyolojik sonuçlarımızı sunmaktır.Gereç ve Yöntem: 2014-2018 yılları arasında perilunat çıkık nedeniyle başvuran, en az 18 aylık takibi olan 11 hasta çalışmamıza dahil edildi. Buolgularda, skafolunat açı, skafolunat gap, artroz ve avasküler nekroz varlığı değerlendirildi. Hastaların el bileği fleksiyon-ekstansiyon ve pronasyon-supinasyon hareket açıklığı gonyometre ile ölçüldü. Jamar dinamometresi ile el bileği kavrama gücü değerlendirildi. Olgular fonksiyonel olarak Kol,Omuz ve El Sorunları Anketi (DASH) skorlaması ve Herzberg klinik skorlama sistemine göre değerlendirildi.Bulgular: Ortalama yaş 41,1 (28-64), ortalama takip süresi 3,8 (1,5-6) yıldı. Ortalama skafolunat açı 49,1±8,7 (37,3-70,4) derece, skafolunat interval2,0±0,5 (1,2-2,8) mm, fleksiyon-ekstansiyon arkı 131±17,5 (90-155) derece, pronasyon-supinasyon arkı 155,4±6,1 (140-160) derece olarak ölçüldü.DASH skoru ortalama 5,6±3,2 (0-10,9), Herzberg klinik skoru ortalama 89,1±9,4 (70-100) olarak bulundu.Sonuç: Perilunat çıkıklarda tedavinin erken dönemde ve uygun şekilde yapılması prognozdaki ana belirleyicidir. Bu yaralanmaların olasıkomplikasyonlar açısından minimum 18 aylık yakın takibi son derece önemlidir.Öğe Histopathological and immunohistochemical investigation of the local and systemic effects of tranexamic acid on the healing of the Achilles tendon in rats(Turkish Joint Diseases Foundation, 2021) Sarı, Abdulkadir; Dinçel, Yaşar Mahsut; Karabağ, Sevil; Çetin, Mehmet ÜmitObjectives: This study aims to compare the effects of systemic and local applications of tranexamic acid (TXA) on tendon healing using a rat Achilles tendon injury model. Patients and methods: Thirty-six adult male albino Wistar rats (aging 3-4 months; weighing 350 to 400 g) were used in this study conducted between December 2019 and January 2020. The Achilles tendon was performed bilateral tenotomy and surgically repaired. Postoperatively, 1 mL of TXA was administered to each leg locally in the local group, whereas 2 mL of TXA was intraperitoneally administered in the systemic group. The control group was left untreated. Half of the rats were sacrificed on Day 15 and the other half on Day 30. Tendon healing was evaluated with the Bonar and the Movin scoring systems and immunohistochemical methods. Results: The systemic group had the highest Bonar and Movin scores on Day 15. All groups exhibited tendon healing on Day 30, with no significant differences among the groups. The tenocyte morphology was found to be more impaired in both TXA groups on Day 30 (p=0.013). Ground substance scores were lower in the systemic group on Day 30 (p=0.028). The fiber structure and arrangement scores were higher in the systemic group on Day 15 (p=0.007 and p=0.032). Immunohistochemical analyses showed that galectin-3 values exhibited a significant difference in all groups on Day 30 (p=0.020). In all groups, it was determined that type I collagen values showed an increasing trend on Day 30, compared to the values on Day 15, whereas type III collagen values showed a decreasing trend. Conclusion: Our results demonstrated that local and systemic use of TXA does not impair tendon healing. Although advanced studies are needed, our study suggests that TXA application reduces the development of fibrosis.Öğe HOW USEFUL IS ELASTOGRAPHY IN THE FOLLOW-UP OF ACHILLES TENDON REPAIR?(Sociedade Brasileira de Ortopedia e Traumatologia, 2022) Çetin, Mehmet Ümit; Sökmen, Bedriye Koyuncu; Fidan, Fırat; Mutlu, Harun; Sarı, Abdülkadir; Dinçel, Yaşar Mahsut; Kazdal, C.Introduction: In addition to conservative modalities in the treatment of Achilles tendon injuries, open, percutaneous and minimally invasive semi-open techniques, as well as biological open surgical repair methods are used as surgical options. Compression elastography is one of the methods used for the follow-up of treatment in Achilles tendon injuries. Methods: 23 patients were included in our study between July 2013 and June 2014, as long as they had at least 4 years of follow-up. In the final control, the intact side and the operated side were both examined and compared. The variables were the American Orthopedic Foot and Ankle Score (AOFAS) which is measured as a functional score considering plantar flexion and dorsiflexion; calf circumference; Achilles tendon anteroposterior (AP) diameter; and elastographic examination. Results: The strain ratio value and AP diameter of the patients was significantly higher on the operated side than on the non-operated side (p <0.001). There was no significant difference between the plantar flexion and dorsiflexion degrees on the operated side of the patients (p> 0.05). No correlation was observed between strain ratio and AOFAS (p: 0,995). Conclusion: Elastography is not a useful technique to evaluate functional results on long-term tendon healing. Level of Evidence III; Retrospective comparative study. © 2022. Acta Ortopedica Brasileira. All Rights Reserved.Öğe Is arthroscopic intervention-assisted fragment-specific fixation technique superior to volar plating in distal radius fractures involving the middle column?(Cukurova Univ, Fac Medicine, 2022) Çetin, Mehmet Ümit; Polat, Abdulkadir; Fidan, FıratPurpose: In this study, the clinical and radiological results of volar plating and arthroscopic intervention-assisted fragment-specific fixation techniques used in patients operated for AO Type B-C distal radius fracture in which the medial colon is affected were compared. Materials and Methods: X-ray and clinical records of 98 patients who underwent surgical treatment for radius distal end (DER) fracture between April 2011 and January 2017. The patient groups treated with arthroscopy-assisted fragment-oriented fixation (Group A) and plate screw fixation with a volar approach without arthroscopic intervention (Group B) were compared in terms of joint range of motion, grip strength, and clinical scores. Flexion and extension, ulnar deviation, radial deviation, pronation, and supination angles measured with a standard goniometer were recorded in the joint range of motion measurement. Grip strength was measured with a Jamar dynamometer for power measurement. DASH score was used in clinical evaluation. Results: When the operated wrists of both patient groups were compared, there was no significant difference between the DASH score, grip strength, palmar flexion, and pronation angles of motion. A statistically significant difference was observed between the mean dorsiflexion angles of 55 degrees in group A and 44 degrees in group B, mean radial deviation angles of 25 and 19 degrees, and the mean supination angles of 87 and 80 degrees, respectively. Conclusion: Although arthroscopic-assisted fragmentspecific fixation is technically a laborious procedure that requires a learning curve in patients with intra-articular distal radius fractures, it may be beneficial to provide better postoperative results, especially in young patients with high range of motion expectations.Öğe Is Cyclic Exercise Performed before Tibial Fixation Effective on Grafts during Anterior Cruciate Ligament Reconstruction?(2020) Günaydın, Burak; Dinçel, Yaşar Mahsut; Sarı, Abdülkadir; Çetin, Mehmet Ümit; Sever, Cem; Tekin, Çağatay; Kabukçuoğlu, Yavuz SelimObjectives: The necessity of cyclic exercise to pre-stretch the autograft before tibial fixation during ACL reconstruction is unknown. In this study, we evaluated whether there was a statistically significant difference between the results of patients whounderwent cyclic exercise by way of physical examinations, knee joint stability tests, and functional evaluation tests, comparedwith the patients who underwent ACL reconstructions with or without cyclic exercise.Methods: Between March 2016 and May 2018, 59 patients with at least eight months’ follow-up of an ACL reconstruction wereidentified. Thirty patients (Group 1) who underwent cyclic exercise before tibial fixation and 29 patients (Group 2) who did notundergo cyclic exercise were evaluated and compared.Results: The mean age of the patients in Group 1 and Group 2 was 25.9 (range, 18-36) years and 25.2 (range, 18-35) years, respectively. The mean follow-up period in Group 1 was 14.6 (range, 8-22) months and 13.5 months in Group 2 (range, 8-21 months).The mean Lysholm scores of Group 1 and 2 were 95.1 (range, 83-100) and 87.1 (range, 78-100), respectively. The modified Cincinnati scores of Groups 1 and 2 were 28.7 (range, 24-30) and 26.2 (range, 21-30). The mean IKDC subjective knee evaluation scoresin Groups 1 and 2 were 91.9 (range, 83-100) and 86.7 (range, 75-100). The mean thigh atrophy was 1.5 cm in Group 1 and 2.5 cm inGroup 2. In Group 1, 23 patients jumped 85% of the distance compared with the intact side in the single-legged hop test, and 12patients in Group 2 were able to hop this distance successfully.Group 1 had statistically significantly better results in Lysholm activity scores, modified Cincinnati scores, IKDC subjective kneeassessment scores, two-time IKDC activity scale results, comparison of thigh diameters, and single-legged hop tests (p<0.05). Nosignificant difference was found in other examinations and tests.Conclusion: Cyclic exercise during the operation had a positive effect on functional scores. We believe that cyclic exercise shouldbe added to the operative procedureÖğe Macromineral intake and effect on hospitalization of patients in the orthopedic and traumatology ward(2022) Nizam, Beydanur; Demırok, Nazan Tokatlı; Sarı, Abdülkadir; Günaydın, Burak; Çetin, Mehmet ÜmitThis study was carried out with the aim of investigating the correlation between nutrition and macromineral intake levels with hospitalization duration and complications among patients with orthopedic diagnoses. The sample for the study comprised 85 patients admitted to Tekirdağ Namık Kemal University Health Practices and Research Hospital Orthopedic and Traumatology ward with diagnosis of orthopedic disorders. Among patients, 17.7% had femur fracture, 12.9% had tibia/fibula fracture, 12.9% had foot/ankle fracture, 14.1% had arm fractures, 23.5% had arthroscopic surgery, 10.6% had knee prosthesis and 8.3% had hip prosthesis. Among patients, 47.1% had complications observed after hospitalization, while the reduction in loss of appetite and diarrhea complications as potassium intake increased was found to be statistically significant (p<0.05). Of patients, 94.12% had NRS 2002 score below 3, while 5.88% had NRS 2002 score of 3 and above and were at risk. It was identified that patients at risk for nutritional status had statistically significantly longer hospitalization (p<0.05). Male patients had statistically significantly more Ca, P, K and Fe consumption compared to women (p<0.001). Based on the results, nutritional programs planned by dietitians will contribute to shortening hospitalization duration and preventing malnutrition.Öğe The Effect of Tranexamic Acid and Tourniquet Use on Tibial Cement Penetration in Primary Total Knee Arthroplasties(Elsevier Inc, 2020) Dinçel, Yaşar Mahsut; Sarı, Abdulkadir; Çetin, Mehmet Ümit; Günaydın, Burak; Ağca, E.; Doğan, A.H.; Varol, R.Background: In this study, our aim was to compare the effects of tourniquet and tranexamic acid (TXA) use on tibial cement penetration in primary total knee arthroplasty (TKA) using radiograph images. In addition, we also aimed at investigating the effects of age, gender, body mass index (BMI), and bone mineral density on cement penetration. Methods: One hundred seventy patients who underwent TKA for primary osteoarthritis were retrospectively evaluated. TXA was administered to patients in group 1 (n = 96), and tourniquet application was used in patients in group 2 (n = 74). Tibial cement penetration was evaluated radiologically on a total of 4 zones: 2 anteroposterior and 2 lateral zones. In addition, age, gender, BMI, and bone mineral density were recorded in each group. Results: The mean cement penetration in the total study population was 2.34 ± 0.24 mm, with a mean of 2.33 ± 0.25 mm in the TXA group and a mean of 2.35 ± 0.24 mm in the tourniquet group (P = .453). A negative correlation was detected between BMI and anteroposterior 1 values in the total and TXA groups (P = .022 and P = .029). In the evaluation of the differences between genders, significantly higher penetration values were observed only in the females in the tourniquet group (P = .024). Conclusions: The use of TXA instead of a tourniquet does not reduce the depth of cement penetration in TKA. The clinical implications of individual-induced penetration differences may be significant for future implant survival. © 2020 The Authors
