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Öğe Anthropometric measurements of tibial plateau and correlation with the current tibial implants(SPRINGER, 2016) Erkocak, Omer Faruk; Kucukdurmaz, Fatih; Sayar, Safak; Erdil, Mehmet Emin; Ceylan, Hasan Huseyin; Tuncay, IbrahimThe aim of the study was to make an anthropometric analysis at the resected surfaces of the proximal tibia in the Turkish population and to compare the data with the dimensions of tibial components in current use. We hypothesized that tibial components currently available on the market do not fulfil the requirements of this population and a new tibial component design may be required, especially for female patients with small stature. Anthropometric data from the proximal tibia of 226 knees in 226 Turkish subjects were measured using magnetic resonance imaging. We measured the mediolateral, middle anteroposterior, medial and lateral anteroposterior dimensions and the aspect ratio of the resected proximal tibial surface. All morphological data were compared with the dimensions of five contemporary tibial implants, including asymmetric and symmetric design types. The dimensions of the tibial plateau of Turkish knees demonstrated significant differences according to gender (P < 0.05). Among the different tibial implants reviewed, neither asymmetric nor symmetric designs exhibited a perfect conformity to proximal tibial morphology in size and shape. The vast majority of tibial implants involved in this study tend to overhang anteroposteriorly, and a statistically significant number of women (21 %, P < 0.05) had tibial anteroposterior diameters smaller than the smallest available tibial component. Tibial components designed according to anthropometric measurements of Western populations do not perfectly meet the requirements of Turkish population. These data could provide the basis for designing the optimal and smaller tibial component for this population, especially for women, is required for best fit. II.Öğe Comparison of Arthrodesis, Resurfacing Hemiarthroplasty, and Total Joint Replacement in the Treatment of Advanced Hallux Rigidus(ELSEVIER SCIENCE INC, 2013) Erdil, Mehmet; Elmadag, Nuh Mehmet; Polat, Gokhan; Tuncer, Nejat; Bilsel, Kerem; Ucan, Vandet; Erkocak, Omer FarukThe purpose of the present study was to compare the functional results of arthrodesis, resurfacing hemiarthroplasty, and total joint replacement in hallux rigidus. The data from patients treated from 2006 to 2010 for advanced stage hallux rigidus were retrospectively reviewed. A total of 38 patients who had at least 2 years (range 24 to 66 months, mean 31.1) of follow-up were included in the present study. Of the 38 patients, 12 were included in the total joint replacement group (group A), 14 in the resurfacing hemiarthroplasty group (group B), and 12 in the arthrodesis group (group C). At the last follow-up visit, the functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scale, visual analog scale (VAS), and metatarsophalangeal range of motion. Significant improvements were seen in the AOFAS-HMI score, with a decrease in the VAS score in all 3 groups. According to the AOFAS-HMI score, no significant difference was found between groups A and B. However, in group C, the AOFAS-HMI scores were significantly lower than in the other groups owing to the lack of motion. According to the final VAS scores, no significant difference was found between groups A and B; however, the VAS score had decreased significantly more in group C than in the other groups. No major complications occurred in any of the 3 groups. After 2 years of follow-up, all the groups had good functional outcomes. Although arthrodesis is still the most reliable procedure, implant arthroplasty is also a good alternative for advanced stage hallux rigidus. (C) 2013 by the American College of Foot and Ankle Surgeons. All rights reserved.Öğe A comparison of the effects on postoperative bleeding of the intra-articular application of tranexamic acid and adrenalin in total knee arthroplasty(PAKISTAN MEDICAL ASSOC, 2019) Durgut, Fatih; Erkocak, Omer Faruk; Aydin, Bahattin Kerem; Ozdemir, Ali; Gulec, Ali; Tugrul, Ali IhsanObjective: To compare the efficacies of intra-articular applications of tranexamic acid and adrenaline on postoperative bleeding after total knee arthroplasty. Methods: The single-center, retrospective, controlled study was conducted at Selcuk University, department of orthopedics surgery and comprised data of patients who underwent primary, unilateral, cemented total knee arthroplasty between July 2012 and December 2014. Group 1 had received tranexamic acid 1g after closure of articular capsule. Group 2 had received adrenalin. Group 3, the control group, received no medication intra-articularly after total knee arthroplasty. The amount of blood collected in the drain and postoperative alterations in haemoglobin and haematocrit values were compared. Results: Of the total 90 subjects, there were 30(33.33%) in each of the three groups. The decrease of haemoglobin and haematocrit values in Group 1 was statistically significant compared to both Group 2 and Group 3 (p<0.05). The amount of blood collected in the drains was remarkably lower in Groups I and 2 compared to Group III (p<0.05). No deep venous thrombosis or pulmonary emboli were encountered across the sample. Conclusion: Intra-articular administration of tranexamic acid was found to be beneficial and safe for the achievement of effective haemostasis after total knee arthroplasty.Öğe Diagnosis of Hyperostosis of the Medial Calcaneal Tubercle Similar to a Heel Spur(AMER PODIATRIC MED ASSOC, 2013) Altan, Egemen; Senaran, Hakan; Can, Nuray; Aydin, Bahattin Kerem; Erkocak, Omer FarukCalcaneal osteochondromas are rare conditions. To our knowledge, we present the first report of a calcaneal osteochondroma in an adolescent patient that was surprisingly similar to a heel spur, and, in addition, symptoms due to compression of the medial plantar nerve were present.Öğe Effect of Ankaferd blood stopper (R) on tendon healing: an experimental study in a rat model of Achilles tendon injury(TURKISH JOINT DISEASES FOUNDATION, 2015) Aydin, Bahattin Kerem; Altan, Egemen; Acar, Mehmet Ali; Erkocak, Omer Faruk; Ugras, SerdarObjectives: This in vivo study aims to investigate the effects of Ankaferd Blood Stopper (R) (ABS) which is a recently developed topical hemostatic agent on tendon healing using a rat Achilles tendon injury model. Materials and methods: Twelve male Wistar-Albino rats were used in the study. Right legs of the rats were assigned as the study group, and left legs were assigned as the control group. Under anesthesia, bilateral Achilles tendon injuries were created and repaired surgically. To the surgical sites, 1 mL of ABS for the right side and 1 mL of serum physiologic solution for the left side were applied. Animals were euthanized on the 21st postoperative day, and tendon samples were collected from the extremities. Histological analyses were performed according to the semiquantitative tendon scoring system (Bonar Scale). Results: Total tendon healing scores were significantly poorer in the study group compared to the control group. Although there were no significant differences between the groups in terms of tenocyte morphology, degree of ground substance staining, and vascularity, the collagen morphology scores were significantly poorer in the study group. Conclusion: In our study, application of ABS had histologically negative effect on tendon healing in rats. However, further biomechanical and immune histochemical studies are required to support these results.Öğe Evaluation of mobile bearing unicompartmental knee arthroplasty, opening wedge, and dome-type high tibial osteotomies for knee arthritis(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2015) Tuncay, Ibrahim; Bilsel, Kerem; Elmadag, Mehmet; Erkocak, Omer Faruk; Asci, Murat; Sen, CengizObjective: Three methods of surgery used in the treatment of knee osteoarthritis (OA) are mobile bearing unicompartmental knee arthroplasty (Oxford UKA), opening wedge high tibial osteotomy (HTO), and dome-type HTO. This article aimed to retrospectively compare these three methods in terms of outcomes for health status, patient satisfaction, and function. Methods: Between 2003 and 2010, 255 knees of 235 patients underwent operations for medial knee OA. Three types of surgery were performed. Group 1 consisted of 109 knees of 94 patients who underwent Oxford UKA. Group 2 was made up of 36 knees of 36 patients who underwent HTO using circular external fixation, and Group 3 comprised 57 knees of 52 patients on whom opening wedge type HTO using locking plate fixation was performed. SF-36 and HSS knee scores were used to compare the functional outcomes among groups. Results: Statistically significant differences were found between the preoperative and postoperative measures in all 3 of the treatment groups for physical function, physical role, pain, general health, vitality, social function, emotional role, and mental health according to SF-36 and HSS scores. In the 2nd group, the average correction of the mechanical axis deviation (MAD) was 38 mm with 11.7 degrees along the femorotibial axis and 6.2 degrees along the medial proximal tibial angle (MPTA). In the 3rd group, the average correction in the MAD was 28 mm with 9.7 degrees along the femorotibial axis and 5.6 degrees along the MPTA. All 3 of the treatment alternatives were observed to be sufficient. Satisfactory postoperative results were achieved in the UKA group in terms of social function and mental health, and the patients were able to achieve early rehabilitation and return to their previous life activities. Conclusion: UKA is the ideal option for patients who wish for the earliest possible return to social and recreational activities.Öğe THE IMPORTANCE OF SONICATION IN THE DIAGNOSIS OF PROSTHETIC JOINT INFECTIONS(NOBEL ILAC, 2017) Sumer, Sua; Erkocak, Omer Faruk; Arslan, Ugur; Findik, Duygu; Dagi, Hatice Turk; Aydin, Bahattin Kerem; Demir, Nazlim AktugObjective: The objective of this study is to investigate the efficacy of sonication method used to determine the cause in the diagnosis of prosthetic joint infections (PJI). Material and Method: This study included 30 patients who were operated due to prosthesis infection and as a control group 10 patients whose prostheses were removed due to mechanical reasons and who had no sign of infection. Cultures were prepared from these tissue samples through gram staining and conventional methods. The prostheses removed from the patients were put into the sonication device in sterile water with ringer lactate. After sonication, Gram staining, cultures and polymerase chain reaction (PCR) were made. Results: During the Gram staining done prior to the sonication, microorganisms were found in six patients (20%); after the sonication, microorganisms were seen in nine patients (30%), but this difference was not statistically significant (p>0.05). While agents were found in the cultures of 11 patients (36.7%) that were prepared using the conventional method, agents were found in 20 patients (66.7%) with the sonication method. The rate of detecting the agent in the culture prepared after sonication was statistical significantly higher than in the culture prepared with conventional methods (p=0.004). The sensitivity of PCR was found 63.3%. Conclusion: The sonication method of PJI is basically a procedure performed to increase the detectability of microorganisms. We found in the present study that the sonication method was obviously more precise than conventional methods in the microbiological diagnosis of PJI.Öğe Nitric oxide inhibits autophagy via suppression of JNK in meniscal cells(OXFORD UNIV PRESS, 2014) Shen, Chao; Yan, Jun; Erkocak, Omer Faruk; Zheng, Xin-Feng; Chen, Xiao-DongObjective. Autophagy is a potential protective mechanism that is involved in several degenerative diseases. Nitric oxide (NO) is associated with programmed cellular death in meniscal cells, but whether it can induce autophagy is still undetermined. This study aims to investigate the interaction between autophagy and NO in normal human meniscal cells. Methods. Normal meniscal cells were harvested from female patients. NO donors and NO synthase inhibitors were used to regulate the level of NO. Changes in the incidence of autophagy and apoptosis were examined using flow cytometry, western blot and immunofluorescence methods. The effects of NO-mediated autophagy regulation of the expression of MMPs and aggrecanases (ADAMTS-4 and -5) were analysed by real-time PCR. Results. NO donors inhibited autophagy as well as augmented apoptosis in human meniscal cells with serum deprivation. Conversely, treatment with NOS inhibitors resulted in up-regulation of the autophagy level while repressing apoptosis. NOS inhibitor treatment also resulted in down-regulation of MMPs and aggrecanase mRNA expression. This effect of NOS inhibitor was also blocked by autophagy inhibitors. Our results also showed that NOS inhibitor enhanced Jun-N-terminal kinase (JNK) activation. Furthermore, SP600125, a selective JNK inhibitor, blocked up-regulation of autophagy by NOS inhibitor. Conclusion. Our results demonstrated that NO augmented serum deprivation-induced apoptosis of meniscal cells via inhibition of autophagy through inactivation of JNK. Up-regulation of autophagy may be a potential approach in the treatment of meniscal tissue degeneration.Öğe Other benefits of intra-articular injection of tranexamic acid in primary total knee arthroplasty apart from reducing blood transfusion rates(TURKISH JOINT DISEASES FOUNDATION, 2017) Aydin, Bahattin Kerem; Durgut, Fatih; Erkocak, Omer Faruk; Acar, Mehmet AliObjectives: This study aims to evaluate the effect of intraarticular tranexamic acid (TA) administration on the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and the total cost in total knee arthroplasty (TKA) patients. Patients and methods: The study included a total of 118 patients (24 males, 94 females; mean age 67.0 years, range 52 to 81 years) who underwent primary unilateral TKA surgery. Patients were divided into two groups as 58 patients who were performed intra-articular injection of 2 g TA after closure of articular capsule (TA group; 10 males, 48 females, mean age 65.6 years; range 55 to 80 years) and 60 patients who were not performed any intra-articular injection (non-TA group; 14 males, 46 females; mean age 68.3 years; range 52 to 81 years). The maximum difference between pre-and postoperative hemoglobin levels, the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and cost of each patient were recorded. Results: The mean difference between pre-and postoperative hemoglobin levels were higher in the non-TA group (1.7 g/dL vs 2.6 g/dL, p<0.05). The mean amounts of blood in drains (327.5 mL vs 800.0 mL, p<0.05), the amounts of blood transfusions (0 units vs 10 units, p<0.05), the mean lengths of hospital stay (4.03 days vs 4.53 days, p<0.05), and the hospital costs (1,935.26 United States dollars vs 1,959.64 United States dollars, p<0.05) were lower in TA group. Conclusion: Administration of intra-articular TA during primary TKA may reduce blood loss and the need for blood transfusion while significantly shortening the postoperative length of hospital stay and reducing the total hospital costs. rthroplasty;Öğe Percutaneous double-button fixation method for treatment of acute type III acromioclavicular joint dislocation(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2015) Acar, Mehmet Ali; Gulec, Ali; Erkocak, Omer Faruk; Yilmaz, Guney; Durgut, Fatih; Elmadag, MehmetObjective: The aim of this study was to evaluate the functional and radiological results of patients treated with the percutaneous double-button technique for acute acromioclavicular (AC) joint dislocation. Methods: A retrospective evaluation was performed of 13 patients surgically treated for acute Type III AC joint dislocation with the percutaneous double-button fixation method. The coracoclavicular (CC) distance of the affected side was compared with that of the healthy side on anterior-posterior radiographs obtained at the final follow-up. In the functional evaluation, Disabilities of the Arm, Shoulder and Hand (DASH), Constant, and visual analog scale (VAS) scores were used. Results: The 13 patients in the study included 12 males and 1 female with a mean age of 43.4 years (range: 22-60 years). The mean follow-up period was 13.61 months (range: 9-24 months). The mean CC distance on the operated side was 9.23 mm (range: 8-15 mm), and when compared with the healthy side, no statistically significant difference was observed. Preoperative Constant scores of a mean of 30.3 (range: 18-42) increased to 84.4 (range: 70-90) at the final follow-up. Preoperative DASH scores had a mean of 14.1 (range: 11-28) and decreased to 0.4 (range: 0-3) at the final follow-up (p<0.001). Mean preoperative VAS score was 6.0 (range: 5-8), which decreased to 0.6 (range: 0-3) at the final follow-up (p<0.001). Conclusion: The percutaneous double-button fixation technique is a safe, practical, and effective fixation method that can be used as an alternative to arthroscopic and open methods for acute Type III AC joint dislocations.Öğe Post-spinal hyperacute subdural hematoma(ELSEVIER SCIENCE INC, 2017) Onal, Ozkan; Aslanlar, Emine; Apiliogullari, Seza; Erkocak, Omer Faruk; Celik, Jale Bengi[Abstract not Available]Öğe Primary hydatid disease of brachialis and biceps brachii muscles: a case report(SAGE PUBLICATIONS INC, 2014) Aydin, Bahattin Kerem; Acar, Mehmet Ali; Sumer, Sua; Demir, Nazlim Aktug; Erkocak, Omer Faruk; Ural, OnurPrimary hydatid cyst of the skeletal muscle is very rare and accounts for less than 1% of all cases. It is often asymptomatic and can pose diagnostic problems. Accurate diagnosis should be made using ultrasonography and magnetic resonance imaging. Proper treatment should be a wide surgical resection of the localized muscle with the aid of antihelmintic chemotherapy pre- and postoperatively. We report a case of primary hydatic cyst located simultaneously in both the biceps brachii and brachialis muscles, treated with wide resection surgery and pre- and postoperative anthelmintic chemotherapy.Öğe Reconstruction of Foot and Ankle Defects with a Free Anterolateral Thigh Flap in Pediatric Patients(THIEME MEDICAL PUBL INC, 2015) Acar, Mehmet Ali; Gulec, Ali; Aydin, Bahattin Kerem; Erkocak, Omer Faruk; Yilmaz, Guney; Senaran, HakanBackground There are a limited number of published studies describing reconstruction with an anterolateral thigh (ALT) flap following lower extremity injury in pediatric patients. The aim of this study was to present our experiences with the application of a free ALT flap not only in the reconstruction of soft tissue defects around the pediatric foot arid ankle but also in patients with bone, tendon, and ligament injuries that require repair. Materials and Methods Reconstruction with a free ALT flap was performed in 11 pediatric patients (mean age, 8.9 years; range, 3-15 years) between November 2010 and February 2013. The modes of injury were as follows: six traffic accidents, three firearm accidents, one agricultural machinery accident, and one bicycle chain accident. A retrospective evaluation of the applied surgical procedures was performed: flap size, perforator type and number, placement area, site of anastomosis, closure of the donor site, complications, and flap survival. Results The mean size of the skin flap was 83.2 mm(2) (range, 48-117 mm(2)). Except for two patients, there were two perforators in the obtained flaps, which were 75% musculocutaneous and 25% septocutaneous. To strengthen the Achilles tendon in one patient, the ALT, together with the fascia lata, was raised as a composite flap. This flap was used as a "sensate flap" in three patients with defects in the heel area and as a "perforator flap" in seven patients. Anastomosis was performed in the anterior tibial artery in five patients and in the posterior tibial artery in six patients. Primary closure was performed for the donor site in all patients. Due to venous thrombus after 24 hours in one patient, reexploration was performed, and blood flow was regained with a vein graft. In the same patient, partial necrosis developed on the lateral edge of the flap; after debridement of the necrotic areas, closure was performed with a split thickness skin graft. After the ALT flap procedure, the primary flap survival rate was 90.9%. Conclusion The free ALT flap could be a safe, reliable, and aesthetically appealing option for foot/ankle resurfacing in children after traumatic soft tissue loss. The ALT flap can cover a far greater area and provide the versatility needed to optimize soft-tissue coverage.Öğe Short-Term Functional Outcomes of First Metatarsophalangeal Total Joint Replacement for Hallux Rigidus(SAGE PUBLICATIONS INC, 2013) Erkocak, Omer Faruk; Senaran, Hakan; Altan, Egemen; Aydin, Bahattin Kerem; Acar, Mehmet AliBackground: Although metatarsophalangeal (MTP) arthrodesis has been advocated by many authors, implant arthroplasty appears to be successful option in advanced hallux rigidus (HR). The aim of our study was to evaluate the early results of the ToeFit-Plus prosthesis for the treatment of HR. Methods: Between December 2007 and January 2011, a total of 26 toes of 24 patients with MTP arthritis of the great toe were treated with ToeFit-Plus implant. The average follow-up time was 29.9 (range: 25 to 62) months. All patients were evaluated clinically and radiographically. Postoperative satisfaction and function were scored according to the American Orthopaedic Foot and Ankle Society (AOFAS) score. Pain was assessed with the use of a visual analogue scale. Results: Mean preoperative AOFAS score improved from 42.7 (range: 36 to 59) to 88.5 (range: 59 to 98) at the final follow-up (P < .01). Preoperative average visual analogue scale pain scores improved from 7.4 preoperatively to 1.9 at the final follow-up (P < .01). The average MTP joint range of motion improved from 25.9 degrees preoperatively to 53.8 degrees at the final follow-up. No radiologic loosening was found, but radiolucency was observed in 2 patients with this implant. No revision was required for any of the patients during the follow-up period. Conclusions: This total first MTP joint prosthesis yielded good functional outcome and high patient satisfaction level with low early complication rate. Preservation of joint movement and good pain relief with early mobilization were the advantages of this procedure. Salvage arthrodesis remains an option if future revisions are indicated.Öğe Treatment of Clubfoot With Ponseti Method Using Semirigid Synthetic Softcast(LIPPINCOTT WILLIAMS & WILKINS, 2015) Aydin, Bahattin Kerem; Sofu, Hakan; Senaran, Hakan; Erkocak, Omer Faruk; Acar, Mehmet Ali; Kirac, YunusRandomized controlled clinical trial.The main purpose of the present study was to comparatively analyze the effectiveness, advantages, and the complications of using semirigid synthetic softcast with respect to plaster of Paris (POP) during the treatment of clubfoot deformity.The study group consisted of 196 babies (249 feet). A total of 133 feet treated by an orthopedic referral center using semirigid synthetic softcast were included in group A whereas the other 116 feet treated by another orthopedic clinic using POP cast were included in group B. The Pirani scores, number of cast applications, time period until Achilles tenotomy, any skin problems due to the cast itself, and/or cast removal were recorded. A final parent satisfaction score was also obtained.The mean Pirani sores were significantly improved from the first administration to the time before Achilles tenotomy in both groups. There was no significant difference according to the number of casts applied until tenotomy. The slippage of the cast and skin lesions was significantly more common in group B. Higher parent satisfaction levels were detected in group A.Semirigid softcast has been found as superior to POP in the aspects of parent satisfaction and cast-related complication rates.
