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    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 Ziya
    Objective: 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.
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    Comparison of Lower Limb Joint Reaction Forces in Patients with Cerebral Palsy and Typically Developing Individuals
    (Mdpi, 2025) Dincel, Yasar Mahsut; Kidwai, Alina Nawab; Atmaca, Kerim; Sozener, Nese Aral; Arslan, Yunus Ziya
    Background and Objectives: Kinematic and kinetic data from gait analysis are commonly used for clinical decision making in cerebral palsy (CP). However, these data may not fully capture the underlying causes of movement pathologies or effectively monitor post-treatment changes. Joint reaction forces (JRFs), estimated through simulation-based methods, provide valuable insights into the functional state of musculoskeletal components. Despite their importance, comprehensive evaluations of lower limb JRFs in CP are limited, and comparisons with typically developing (TD) individuals remain underexplored. This study aimed to provide a detailed comparison of lower limb JRFs between children with CP exhibiting mild crouch gait and age-matched TD children during self-selected walking speeds. Materials and Methods: Open-access gait datasets from eight children with CP and eight TD children were analyzed. A full-body musculoskeletal model was scaled to individual anthropometric data in OpenSim. Joint angles and moments were obtained using inverse kinematics and inverse dynamics, respectively. Ankle, knee, and hip JRFs were calculated using OpenSim's Joint Reaction tool. Root-mean-square differences and Pearson correlation coefficients quantified the differences between CP and TD JRFs. Results: The anterior-posterior and vertical components of the hip JRFs in CP were lower than in TD children. CP knee JRFs exceeded TD values across all anatomical axes. For the ankle, the anterior-posterior JRF was lower in CP, whereas the vertical component was higher compared to TD. Conclusions: Children with CP experience distinct lower limb JRF patterns compared to TD children. While some findings align with previous studies, discrepancies in other components highlight the influence of model and patient-specific characteristics. These results emphasize the need for standardization in reporting patient data and systematic evaluations to improve the interpretation and applicability of JRF analyses in CP research and treatment planning.
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    The effect of papaverine on tendon healing and adhesion in rats following Achilles tendon repair
    (2024) Can, Erdem; Dincel, Yasar Mahsut; Karabulut, Derya; Karabağ, Sevil; Arslan, Yunus Ziya
    Objectives: The study aimed to examine the histopathological and biomechanical effects of papaverine administered intraperitoneally and locally on Achilles tendon healing in a rat model. Materials and methods: Forty-eight adult male Sprague- Dawley rats (range, 300 to 400 g) were used in this study conducted between October and November 2022. The rats were divided into three groups, with each group further subdivided into two for sacrifice on either the 15th (early period) or 30th (late period) day after surgery. The first (control) group received no treatment following Achilles tendon repair, while papaverine was intraperitoneally administered every other day for 10 days in the second group and locally in the third group after surgery. On the 15th and 30th days, the rats were sacrificed, and their Achilles tendons were subjected to biomechanical testing and histopathological evaluation. Results: Histopathologically, there were no significant differences among the groups on the 15th day. However, on the 30th day, the locally applied papaverine group exhibited superior histopathological outcomes compared to the control group (p<0.05). Concerning the highest tensile strength values before rupture, the biomechanical assessment showed that the group receiving local papaverine treatment in the early period and both the group with systemic papaverine treatment and the one with local papaverine treatment in the late period displayed a statistically significant advantage compared to the control group (p<0.05). Conclusion: Locally administered papaverine has positive biomechanical effects in the early period and exhibits a positive correlation both histopathologically and biomechanically in the late period. Novel therapeutic options may be provided for patients through these findings.
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    The effect of papaverine on tendon healing and adhesion in rats following Achilles tendon repair
    (Turkish Joint Diseases Foundation, 2024) Can, Erdem; Dincel, Yasar Mahsut; Karabulut, Derya; Karabag, Sevil; Arslan, Yunus Ziya
    Objectives: The study aimed to examine the histopathological and biomechanical effects of papaverine administered intraperitoneally and locally on Achilles tendon healing in a rat model. Materials and methods: Forty-eight adult male SpragueDawley rats (range, 300 to 400 g) were used in this study conducted between October and November 2022. The rats were divided into three groups, with each group further subdivided into two for sacrifice on either the 15(th) (early period) or 30(th) (late period) day after surgery. The first (control) group received no treatment following Achilles tendon repair, while papaverine was intraperitoneally administered every other day for 10 days in the second group and locally in the third group after surgery. On the 15(th) and 30(th) days, the rats were sacrificed, and their Achilles tendons were subjected to biomechanical testing and histopathological evaluation. Results: Histopathologically, there were no significant differences among the groups on the 15 th day. However, on the 30 th day, the locally applied papaverine group exhibited superior histopathological outcomes compared to the control group (p<0.05). Concerning the highest tensile strength values before rupture, the biomechanical assessment showed that the group receiving local papaverine treatment in the early period and both the group with systemic papaverine treatment and the one with local papaverine treatment in the late period displayed a statistically significant advantage compared to the control group (p<0.05). Conclusion: Locally administered papaverine has positive biomechanical effects in the early period and exhibits a positive correlation both histopathologically and biomechanically in the late period. Novel therapeutic options may be provided for patients through these findings.