Papers by Vahit Emre Ozden
Journal of Arthroplasty, Oct 1, 2016
We readwith great interest the article by Dwyer et al [1] entitled “Cartilage Status at Time of A... more We readwith great interest the article by Dwyer et al [1] entitled “Cartilage Status at Time of Arthroscopy Predicts Failure in Patients With Hip Dysplasia” about which localization and level of chondral damage at the time of hip arthroscopy predicted further total hip arthroplasty (THA) in patients with dysplasia. Follow-up comprised 166 patients (201 hips) with borderline or moderate dysplasia without radiological evidence of degenerative arthritis. The primary reason for arthroscopic surgery was to treat symptomatic labral tears. At the time of arthroscopy, the authors observed that 186 hips presented anterior labral tears (92%). They showed that the percentage of labral tears did not differ between THA patients and non-THA patients. However, we were surprised to find that arthroscopic treatment of labral pathologies (excision or repair) was not evaluated or discussed. Developmental hip dysplasia is relatively common among failed hip arthroscopies [2-4]. Failure rates after primary hip arthroscopy were reportedly between 24% and 64% in patients with dysplasia [1]. However, labral debridement (61%) was a common surgical procedure performed during primary hip arthroscopy in patients who underwent revision [2]. Conversely, some case reports showed rapidly progressive osteoarthritis after labral repair in dysplasia patients [5]. At this time, there is not an accurate consensus for repairing or debriding the labrum in dysplasia or femoroacetabular impingement patients [6-8]. All types of labral pathologies were evaluated in a recent multicenter prospective study of dysplasia patients, and 64% of the hips had labral tears. The most common types observed during open anterior arthrotomy and arthroscopy were degenerative (52.3%) and detachment (38.7%), using the Beck classification. Also borderline dysplasia (lateral center-edge angle >20 ) patients were shown to have hypertrophic labrum (40%) [9]. However, Dwyer et al used percent labral tears as a means of comparing the outcomes of failed hip arthroscopies requiring THA. We believe that arthroscopic surgery alone for labral pathology in patients with dysplasia is likely to fail because the labrum maintains joint stability and increases the contact surface area of the acetabulum [10]. Labral debridement may cause instability and increase lateral edge stress on the acetabular rim [11]. Parvizi
Laminar hava akımı (LHA) ile birlikte uzay giysisi kullanımının erken ve geç derin total kalça pr... more Laminar hava akımı (LHA) ile birlikte uzay giysisi kullanımının erken ve geç derin total kalça protezi (TKP) ve total diz protezi (TDP) enfeksiyonu üzerindeki etkilerini araştırmak. Çalışma Planı: Şubat 2009 ve Ocak 2014 tarihleri arasında hastanemize başvuran 367 hastada yapılan 428 primer TKP (29 eş zamanlı bilateral, 32 sıralı bilateral) ve 127 hastada yapılan 211 primer TDP (68 eş zamanlı bilateral, 16 sıralı bilateral) geriye dönük olarak analiz edildi. LHA'ya sahip standart operasyon odası tüm TDP ve TKP olgularda, uzay giysisi ise TDP olgularında %100 ve TKP olgularında %99,06 oranında kullanıldı. Tüm operasyonlar kıdemli cerrah tarafından yapıldı. Vücut kitle indeksinin (BMI) 40 ve üzerinde olması, aktif sigara kullanımı, operasyon öncesi idrar kültüründe üreme ve burun sürüntüsünde taşıyıcılık olması, enfeksiyon riski açısından için enfekte olan ve olmayan hastalar arasında istatistiksel olarak karşılaştırıldı. Bulgular: Hastaların ortalama olarak ilk operasyondan sonrasındaki takip süresi 36 ay (dağılım; 6-59 ay) idi. TKP sonrası geç enfeksiyon oranı %0,46 (n=2) ve erken enfeksiyon oranı %0,23 (n=1) olarak tespit edildi. TDP sonrasında erken enfeksiyon oranı %0,47 (n=1) olarak tespit edildi. TKP sonrasında sırası ile preoperatif burun sürüntüsünde pozitif kolonizasyon (p=0,27), asemptomatik bakteriüri ile idrar kültürü pozitifliği (p=1,0), BMI ≥40 olması (p=1,0), aktif sigara kullanımı (p=0,28) ve farklı yüzey seçeneklerinin kullanıldığı gruplarda (p=0,12) enfeksiyon görülme oranları arasında fark tespit edilemedi. Bilateral eş zamanlı ile sıralı uygulamalar arasında protez çevresi enfeksiyonu gelişme oranları arasında fark yoktu (p>0,05). Çıkarımlar: Kliniğimizde LHA ve uzay giysisinin birlikte kullanılarak yapılan total eklem artroplastisi sonrası takiplerinde, derin enfeksiyon oranları literatür ile uyumlu olarak tespit edilmiş ve erken dönem enfeksiyonda literatürde daha önce belirtilen değerlerden daha düşük oranlar elde edilmiştir. LHA ile birlikte uzay giysisinin erken ve geç dönem periprostetik enfeksiyonu önlemedeki etkisini ortaya koymak için çok merkezli ve prospektif randomize kontrollü uzun takipli çalışmalara ihtiyaç vardır.
Journal of Clinical Monitoring and Computing, Nov 10, 2018
The aim of this study was to evaluate the anterior root muscle (ARM) response monitorability duri... more The aim of this study was to evaluate the anterior root muscle (ARM) response monitorability during total hip arthroplasty (THA) under spinal anesthesia. A total of 20 adults (64.6 ± 13.87 years old) were monitored using ARM response and free-run electromyography during THA. To elicit the ARM response from muscles, percutaneous stimulation of the lumbosacral roots was performed by self-adhesive electrodes placed over the skin of the projection of the first and third lumbar interspinous space (anode) and over the abdominal skin of the umbilicus (cathode). Latency and amplitude values of the ARM response were recorded from both sides (non-operated and operated) and from five muscles as follows: rectus femoris (RF), vastus lateralis (VL), biceps femoris long-head (BF), Tibialis Anterior (TA) and gastrocnemius. The most recorded ARM response in a muscle was the TA (n = 38); the least recorded AMR response in a muscle was the BF (n = 33). The mean stimulus intensities for the non-operated and the operated sides were 462.5 ± 112.8 V and 520.0 ± 172.3 V (p = 0.834), respectively. The mean latencies and amplitude values of the ARM response from muscles were as follows: 8.
Acta orthopaedica et traumatologica turcica, 2022
OBJECTIVE The aim of the study was to evaluate the single bundle (SB) and double bundle (DB) ante... more OBJECTIVE The aim of the study was to evaluate the single bundle (SB) and double bundle (DB) anterior cruciate ligament (ACL) reconstruction in terms of graft survival, complications, and patient reported functional outcomes in adolescent athletes. METHODS In this retrospective study, 89 elite adolescent athletes who underwent either SB or DB ACL reconstruction were included. All patients were then divided into two groups: group 1 including 51 patients with SB ACL reconstruction (31 male, 20 female; mean age = 15.4 ± 1.03 years) and group 2 including 38 patients with DB ACL (30 male, 8 female; mean age = 15.7 ± 1.3 years). Clinical data were obtained, comprising skeletal maturity, sports type, ACL reconstruction technique, Lachman scores, KT-1000™ arthrometer measurement, additional meniscal procedures as well as International Knee Documentation Committee (IKDC) score, Cincinnati score, and graft size. RESULTS The mean follow-up period was 53.1 ± 8.6 months in group 1 and 46.4± 9.1 ...
TOTBID Dergisi, 2020
Türk Ortopedi ve Travmatoloji Birliği Derneği enfeksiyon bulgularının ortaya çıkmasına kadar geçe... more Türk Ortopedi ve Travmatoloji Birliği Derneği enfeksiyon bulgularının ortaya çıkmasına kadar geçen süreye göre, erken-akut, gecikmiş-kronik, geç akut hematojen ve geç-kronik PEE olarak sınıflandırılmıştır (Tablo 1). PEE tedavi yönetimi farklı cerrahi teknikler ve hedefe uygun antimikrobiyal tedaviler içerir (Şekil 1). [5-7] P rotez çevresi eklem enfeksiyonu (PEE) total eklem artroplastisi (TEA) sonrası primer artroplasti uygulamalarında %2 ve revizyon olguları sonrası %10'a varan oranlarda karşılaşılan ve belirgin morbiditeye yol açan en ciddi komplikasyonlardan biridir. [1-4] Güncel kılavuzlarda, implantasyondan Enfekte implant revizyonu: DAİR (Debridman, Antibiyotik ve İmplant Retansiyonu)-tek aşamalı revizyon artroplastisi Revision of infected implant: DAIR (Debridement, Antibiotics and Implant Retention)-one stage revision arthroplasty
Bezmialem Science, 2019
The aim of this study was to evaluate the factors that led to re-revision surgeries in patients w... more The aim of this study was to evaluate the factors that led to re-revision surgeries in patients who underwent revision total hip arthroplasties (THA). Methods: A total of 352 revision THAs in 274 hips of 252 patients (January 2001-December 2012) were retrospectively analyzed. Patients with a history of a major component revision surgery, replacement of the modular components, debridement and irrigation with liner exchange in the presence of infection and a two-stage revision surgery were included in the study. The mean follow-up period after the revision surgery was 7.5 (range: 2 to 15) years. Results: A re-revision surgery was required in 17.6% of the index THA revision patients (62 THA re-revisions/352 THA revisions). The mean time between the index revision and re-revision surgeries was 60.4 (range: 0.5 to 348) months. The most common reason for the second revision surgery was aseptic loosening (38 THA revisions; 61.2%), followed by instability (8 THA revisions; 12.9%) and infection (6 THA revisions; 9.1%). When the re-revision surgery was taken as end point for assessing the survival rate after the index revision surgery, the cumulative survival rate 10 years after the first revision surgery was found 70.8%. No significant relationship was established between age, gender and the type of fixation and the rate of repeat revisions. However, re-revision rates were significantly higher in acetabular-only component revision cases in comparison to other or both component revisions. Conclusion: In our revision series, the major factor that necessitated a re-revision following index revision surgery was aseptic loosening, followed by instability.
Orthopaedics & Traumatology: Surgery & Research, 2017
Tapered stems one-third proximally coated have higher complication rates than cylindrical two-thi... more Tapered stems one-third proximally coated have higher complication rates than cylindrical two-third coated stems in patients with high hip dislocation undergoing total hip arthroplasty with step-cut shortening osteotomy
TOTBİD Dergisi
Kemik iliği stimülasyon teknikleri izole kıkırdak lezyonlarında kısa dönemde iyi sonuçlar vermesi... more Kemik iliği stimülasyon teknikleri izole kıkırdak lezyonlarında kısa dönemde iyi sonuçlar vermesiyle hâlen popülerliğini korumaktadır. Uzun dönemde sonuçların kötüye gitmesi ve fonksiyonel sonuçlardaki gerileme, tedavinin temel olarak uygulandığı alan olan subkondral kemik mikromimarisinin değiştirilmesi veya potansiyel kötüleşmesi neticesinde osteoartritin ilerlemesiyle açıklanabilir. Endikasyonları yazarlar arasında hâlen farklılıklar göstermektedir. Ek rejeneratif tedavi yöntemleri (hyalüronik asit, trombositten zengin plazma, kemik iliği aspiratı konsantresi ve adipoz doku kaynaklı mezenkimal kök hücre uygulaması) ve yeniden doğuş olarak isimlendirilen nanokırık tekniği için hâlen yeterli sayıda prospektif karşılaştırmalı çalışmanın olmaması literatürde kanıt düzeylerinin düşük seviyede kalmasına sebep olmaktadır.
Acıbadem üniversitesi sağlık bilimleri dergisi, Dec 1, 2017
Laminar hava akımı (LHA) ile birlikte uzay giysisi kullanımının erken ve geç derin total kalça pr... more Laminar hava akımı (LHA) ile birlikte uzay giysisi kullanımının erken ve geç derin total kalça protezi (TKP) ve total diz protezi (TDP) enfeksiyonu üzerindeki etkilerini araştırmak. Çalışma Planı: Şubat 2009 ve Ocak 2014 tarihleri arasında hastanemize başvuran 367 hastada yapılan 428 primer TKP (29 eş zamanlı bilateral, 32 sıralı bilateral) ve 127 hastada yapılan 211 primer TDP (68 eş zamanlı bilateral, 16 sıralı bilateral) geriye dönük olarak analiz edildi. LHA'ya sahip standart operasyon odası tüm TDP ve TKP olgularda, uzay giysisi ise TDP olgularında %100 ve TKP olgularında %99,06 oranında kullanıldı. Tüm operasyonlar kıdemli cerrah tarafından yapıldı. Vücut kitle indeksinin (BMI) 40 ve üzerinde olması, aktif sigara kullanımı, operasyon öncesi idrar kültüründe üreme ve burun sürüntüsünde taşıyıcılık olması, enfeksiyon riski açısından için enfekte olan ve olmayan hastalar arasında istatistiksel olarak karşılaştırıldı. Bulgular: Hastaların ortalama olarak ilk operasyondan sonrasındaki takip süresi 36 ay (dağılım; 6-59 ay) idi. TKP sonrası geç enfeksiyon oranı %0,46 (n=2) ve erken enfeksiyon oranı %0,23 (n=1) olarak tespit edildi. TDP sonrasında erken enfeksiyon oranı %0,47 (n=1) olarak tespit edildi. TKP sonrasında sırası ile preoperatif burun sürüntüsünde pozitif kolonizasyon (p=0,27), asemptomatik bakteriüri ile idrar kültürü pozitifliği (p=1,0), BMI ≥40 olması (p=1,0), aktif sigara kullanımı (p=0,28) ve farklı yüzey seçeneklerinin kullanıldığı gruplarda (p=0,12) enfeksiyon görülme oranları arasında fark tespit edilemedi. Bilateral eş zamanlı ile sıralı uygulamalar arasında protez çevresi enfeksiyonu gelişme oranları arasında fark yoktu (p>0,05). Çıkarımlar: Kliniğimizde LHA ve uzay giysisinin birlikte kullanılarak yapılan total eklem artroplastisi sonrası takiplerinde, derin enfeksiyon oranları literatür ile uyumlu olarak tespit edilmiş ve erken dönem enfeksiyonda literatürde daha önce belirtilen değerlerden daha düşük oranlar elde edilmiştir. LHA ile birlikte uzay giysisinin erken ve geç dönem periprostetik enfeksiyonu önlemedeki etkisini ortaya koymak için çok merkezli ve prospektif randomize kontrollü uzun takipli çalışmalara ihtiyaç vardır.
International Orthopaedics, 2020
Background Bone defect around the femur related to revisions or periprosthetic fractures (PFF) is... more Background Bone defect around the femur related to revisions or periprosthetic fractures (PFF) is an issue. We present a bone defect reconstruction technique in femoral revisions and/or PFF using fibula autograft and compared our radiological and clinical results to that of allograft. Methods A total of 53 patients who underwent revision hip arthroplasty and/or PFF fixation with the use of cortical fibula autograft (FG group) or cortical allograft (CG group) were evaluated. After exclusions, 20 patients who had minimum two years of follow-up were investigated for each group, for their radiological and clinical outcomes. Results In FG and CG groups, the median ages were 69.5(44-90) and 62(38-88) years, follow-ups were 59(28-72) and 120(48-216) months, defect lengths were seven (1-10) and ten (1-17) cm, and grafts lengths were 16.5(10-30) and 20(12-37) cm, respectively. The rate of graft incorporation was 90% in each group and median time to incorporations were seven (4-12) and 12(6-24) months (p < 0.001), and graft resorption (moderate and severe) rates were 10% and 25% (p = 0.41), respectively. Median Harris Hip (77.6 vs 78.0), WOMAC (23.2 vs 22), SF-12 physical (50.0 vs 46.1), and SF-12 mental (53.8 vs 52.5) scores were similar between the groups, respectively. Kaplan-Meier survivorship analyses revealed an estimated mean survival of 100% at six years in FG group and 90% at 14 years in CG group. Conclusion In the reconstruction of periprosthetic bone defects after femoral revision or PPF, onlay cortical fibula autografts provide comparable clinical and radiological outcomes to allografts. Its incorporation is faster, it is cost-effective and easy to obtain without apparent morbidity.
HIP International, 2018
Introduction: The purpose of this study was to summarise the performance of dual-mobility cup sys... more Introduction: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. Methods: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips. All of the patients had abductor insufficiency. We evaluated the clinical Harris Hip scores (HHS) and radiographs for migration, loosening, and osteolysis. The survival of the components was calculated according to Kaplan-Meier survivorship analysis, and failure was defined as any dislocation, acetabular component or total hip revision for any reason. Results: The mean duration of follow-up was 38.1 months (range 24-98 months). There were 2 (12.5%) revisions for cemented cup migration after 11 months and 1...
Revue de Chirurgie Orthopédique et Traumatologique, 2017
Ankara Medical Journal, 2014
Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutm... more Amac: Osteoporotik kiriklarin onlenmesi icin osteoporozun tanisi ve tedavisi onemli bir yer tutmaktadir. Bu tani icin en sik kullanilan yontem BMD olmakla beraber, davranis, kas fonsiyonlari ve kalsiyum dengesi; dolayli olarak da kemik yapisinin dongusunu saglayan vitamin D’ nin osteoporotik kiriklarin olusmasinda etkilidir; ama bu etkinin kalca kiriginin tipinin olusmasindaki etkisini degerlendirmeye calistik. Gerec-Yontem: Dusuk enerjili travma sonrasi meydana gelen 20 intertrokanterik ve 20 kollum femoris kirik tanisi ile servise yatirilan tum hastalarin BMD ve 25-OH vitamin D3 degerleri olculdu. Bulgular: Intertrokanterik femur kirigi olan hastalarda 25-OH vitamin D degeri ortalama 10,42; kollum femoris kirigi olan hastalarda 24,84 olarak bulundu. Sonuc: Osteoporotik, yasli hastalarda vitamin D eksikliginin tani ve tedavisi yapildigi takdirde, intertrokanterik kalca kiriklarinin, kollum femoris kiriklarina gore daha az gorulebilecegi kanaatindeyiz.
Muscle & Nerve, 2013
Introduction: We describe a simple and quickly applied electrodiagnostic method for confirming th... more Introduction: We describe a simple and quickly applied electrodiagnostic method for confirming the diagnosis of interdigital neuropathy caused by Morton neuroma (MN). Methods: Interdigital nerves II-III and III-IV were stimulated with surface electrodes simultaneously touching the lateral side of 1 toe and the medial side of the other. Recording was also made with surface electrodes. The results of 20 normal controls and 14 patients with MN were evaluated. Results: The amplitude and peak latency values elicited in the patients as well as the interside differences revealed an acceptable abnormality rate between 57.1% and 71.4%. Conclusions: Although the most popular and effective method of MN diagnosis is clinical evaluation supported by imaging, electrophysiological studies can, in selected patients, provide valuable information.
Joint Diseases and Related Surgery, 2020
Objectives This study aims to evaluate the long-term results of osteochondral autograft transfer ... more Objectives This study aims to evaluate the long-term results of osteochondral autograft transfer (OAT) of talar lesions performed using a modified osteotomy technique. Patients and methods This retrospective study included 20 consecutive patients (11 males, 9 females; mean age 33.5±11 years; range, 15 to 56 years) (21 ankles) with osteochondral lesions of the talus (OLT) treated with the OAT system between August 2002 and October 2008. We performed a modified sulcus groove osteotomy, which provides better exposure of medial and central lesions. After a minimum duration of 10 years following surgery, patients’ clinical functions were evaluated according to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle- hindfoot scale and visual analog scale (VAS). The Tegner-Lysholm scoring system was used to determine the levels of knee activity. Results The mean follow-up period was 143.5 (range, 120 to 186) months. The mean AOFAS scores significantly improved from 60.4±7.4 (range, ...
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Papers by Vahit Emre Ozden