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    Automatic Meniscus Segmentation Using YOLO-Based Deep Learning Models with Ensemble Methods in Knee MRI Images
    (Mdpi, 2025) Simsek, Mehmet Ali; Sertbas, Ahmet; Sasani, Hadi; Dincel, Yasar Mahsut
    The meniscus is a C-shaped connective tissue with a cartilage-like structure in the knee joint. This study proposes an innovative method based on You Only Look Once (YOLO) series models and ensemble methods for meniscus segmentation from knee magnetic resonance imaging (MRI) images to improve segmentation performance and evaluate generalization capability. In this study, five different segmentation models were trained, and masks were created from the YOLO series. These masks are combined with pixel-based voting, weighted multiple voting, and dynamic weighted multiple voting optimized by grid search. Tests were conducted on internal and external sets and various metrics. The dynamic weighted multiple voting method optimized with grid search performed the best on both the test set (DSC: 0.8976 +/- 0.0071, PPV: 0.8561 +/- 0.0121, Sensitivity: 0.9467 +/- 0.0077) and the external set (DSC: 0.9004 +/- 0.0064, PPV: 0.8876 +/- 0.0134, Sensitivity: 0.9200 +/- 0.0119). The proposed ensemble methods offer high accuracy, reliability, and generalization capability for meniscus segmentation.
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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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    Comparison of the prophylactic use of ibandronate and its use in early-stage osteonecrosis in rats with steroid-induced osteonecrosis of the femoral head
    (Turkish Joint Diseases Foundation, 2023) Caglar, Sever; Dasnci, Mustafa Fatih; Acar, Abdurrahman; Caglar, Aysel; Dincel, Yasar Mahsut; Cataltepe, Aziz
    Objectives: The aim of this study was to investigate the effects of ibandronate before and after the onset of osteonecrosis in rats with steroid-induced osteonecrosis of the femoral head.Materials and methods: A total of 24 female Sprague-Dawley rats were used in this study. Three groups were formed with eight rats in each group. The first group was the prophylactic group that received ibandronate treatment before and after the onset of osteonecrosis (Group PT). The second group received ibandronate treatment three weeks after the development of osteonecrosis (Group TAO). The third group was the control group in which osteonecrosis was created, but only normal saline (NS) was given. At the end of the study, all rats were sacrificed, and their right femoral heads were removed, fixed with formalin, and sent for micro-computed tomography. Hematoxylin-eosin (H & E) and immunohistochemical examinations of the right femoral head sections were performed.Results: In the PT group, the trabecular thickness was significantly higher compared to those of the TAO and control groups (p<0.05). The trabecular thickness did not significantly differ between the TAO and control groups. The trabecular bone pattern factor was significantly higher in the PT group compared to the control and TAO groups (p<0.05); however, it showed no significant difference between the TAO and control groups. The incidence of type 2 osteonecrosis in the PT and TAO groups was significantly lower than that in the control group (p<0.05). The incidence of tissue-non-specific alkaline phosphatase (TNAPase) immunoreactivity of osteoblast positivity was significantly higher in the PT and TAO groups compared to the control group (p<0.05), whereas the incidence of TRAPase immunoreactivity of osteoclastic positivity was significantly lower in the PT and TAO groups compared to the control group (p<0.05).Conclusion: Intravenous administration of ibandronate before the onset of the disease was more effective in the treatment of osteonecrosis in rats with steroid-induced osteonecrosis of the femoral head.
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    The Change of Oral Presentations of National Anatomy Congresses Over the Years
    (Pera Yayincilik Hizmetleri, 2023) Ozkan, Mazhar; Dincel, Yasar Mahsut
    Introduction: In this study, it is aimed to examine the characteristics and publication rates of oral presentations presented in national congresses. Methods: The data about the oral presentations in national anatomy congresses (from 2016 to 2021), including the number of contributing institutions, the institutions that contributed the most oral presentations each year, and the publication rates of the oral presentations in the journals scanned in different indexes. In the study, the titles and the keywords were scanned using Google Scholar and Web of Science, and journal index details were noted. Results: Of the national congresses we examined in our study, the most oral presentations (193) were the congress in 2019 and the least oral presentations (47) were the congress in 2017. The publication rate of oral presentations was highest in the papers of the congress in 2016 (42%) and at least in the papers of the congress in 2019 (13%). None of the oral presentations in the last congress held in 2021 were published until the time of our study. Large proportions (34%) of the papers that are accepted as oral presentations and published are radiological studies. 70% of the publications were published in journals indexed in Web of Science. Conclusion: For both new and senior academics, congresses offer a useful and distinctive setting. Congress papers showcase the scientific opportunities and interests of various universities while also providing opportunities for collaboration. Attendance at a conference is significantly influenced by its location, timing, and financial situation.
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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.
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    Three Morphological Risk Factors for Predicting Isolated Meniscal Bucket-handle Tear
    (Springer Heidelberg, 2024) Gultekin, Muhammet Zeki; Keskin, Zeynep; Arslan, Serdar; Dinc, Engin; Dincel, Yasar Mahsut
    Purpose The study aimed to investigate whether morphometric variables of the knee can predict isolated meniscal bucket-handle tears and identify the risk factors. Methods The study included 146 participants with a mean age of 36.547 +/- 12.279 years. They included two groups of 73 patients each: one group with isolated meniscal bucket-handle tears and another with no knee injury (control group). Magnetic resonance imaging findings of the participants were retrospectively assessed. A few morphometric variables associated with distal femur, proximal tibia, and cruciate ligaments were measured. Results Cruciate ligament tensity (CLT), medial femoral condylar height (MFCH), and lateral meniscal bone angle (LMBA) were found to be 12.7 +/- 0.3, 30.1 +/- 2.5 mm, and 21.2 degrees +/- 3.4 degrees, respectively, in patients with meniscal bucket-handle tear, compared with 11.9 +/- 0.2, 28.3 +/- 2.7 mm, and 26.5 degrees +/- 3.7 degrees in the control group, respectively. Based on multivariate Firth's logistic regression analysis, CLT (Odds ratio [OR]: 456.533; 95% confidence interval [CI]: 27.582 to > 999.999), MFCH (OR: 1.603; 95% CI: 1.023-2.513), and LMBA (OR: 0.780; 95% CI: 0.624-0.975) could distinguish between meniscal bucket-handle tears and knees without meniscus tears (p < 0.05). Based on the multicategorical multinominal regression model, CLT (OR: > 999.999; 95% CI: 49.937 to > 999.999) and MFCH (OR: 1.903; 95% CI: 1.005-3.606) were the determinant variables in differentiating medial meniscal bucket-handle tears from knees without meniscus tears (p < 0.05). Conclusion Large CLT, high medial condyle, and small LMBA were revealed as the morphometric risk factors for meniscal bucket-handle tear.