The aim of this study was to investigate the indicators of adapting to an artificial joint in ter... more The aim of this study was to investigate the indicators of adapting to an artificial joint in terms of age, period after surgery, fear of falling, quality of life and physical function following Total Hip Arthroplasty (THA). Material and Methods: This cross-sectional design included 52 patients with OA who underwent THA, aged between 46-74 years, and with a mean period of 1.96±0.76 years after surgery (1-3). Fear of falling, joint-specific functional outcome measurements and health-related quality of life questionnaires were assessed with the supervision of physiotherapists. Fear of falling was assessed with 0-10 cm Visual Analogue Scale (VAS). Health related quality of life and joint-specific function were assessed with EuroQol 5-Dimension 3-Level (EQ-5D-3L) VAS scale and Hip disability and Osteoarthritis Outcome Score (HOOS)-Physical Function Short form (HOOS-PS), respectively. The Forgotten Joint Score (FJS-12) was used to assess patient's adaptation in daily life to their artificial joint. Results: The FJS-12 scores were inversely related with fear of falling in patients with THA (r=-0.418; p=0.002). FJS-12 scores were strongly correlated with EQ-5D-3L VAS (r=0.536); and HOOS-PS scores (r=-0.519) (p<0.001). In linear regression analysis, strongest significant indicators of the dependent variable (FJS-12) were fear of falling, EQ-5D-3L VAS and HOOS-PS (R2=0.48; p<0.05). Conclusion: Detailed assessment about fear of falling, physical function and quality of life can explain adaptability to artificial joint in patients with THA. Therefore, rehabilitation programmes that are individualised according to patients' fear of falling, physical function and health-related quality of life should also be considered to decrease fear leading to activity limitation and participation in daily life following THA.
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, Dec 1, 2012
Bu çal›flman›n amac› femur k›r›¤› nedeniyle cerrahiye al›nan hastalara uygulanan anestezi teknikl... more Bu çal›flman›n amac› femur k›r›¤› nedeniyle cerrahiye al›nan hastalara uygulanan anestezi tekniklerinin postoperatif morbidite ve mortaliteye etkisinin incelenmesidir. Gereç ve Yöntem: Hacettepe Üniversitesi Anesteziyoloji ve Reanimasyon Anabilim Dal›'nda 2000-2009 y›llar› aras›nda femur k›r›¤› nedeniyle opere olan hastalarda retrospektif dosya incelemesi yap›ld›. Bulgular: Çal›flmaya 83 (%67.5) kad›n ve 36 (%29.3) erkek toplam 119 hasta dahil edildi, ortalama yafl 79.5±8.2 idi. Genel anestezi 48(%39) hastaya, rejyonel anestezi ise 71(%61) hastaya uygulanm›flt›r. Rejyonel ve genel anestezi alan hastalar aras›nda intraoperatif, yo¤un bak›m ya-t›fl› s›ras›nda, birinci, üçüncü, alt›nc› ve onikinci ay mortaliteleri aç›s›ndan fark bulunamam›flt›r. Ay-n› zamanda, yo¤un bak›ma yat›fl oranlar› ve yat›fl süreleri benzerdi. Genel anestezi alan hastalarda rejyonel anestezi uygulananlara göre kan kayb› (p=0.038) anlaml› flekilde yüksektir. Hastalar›n %21'inde intraoperatif hipotansiyon geliflmifl ve genel anestezi alan hastalarda daha s›k görülmüfltür (p=0.012). Postoperatif serebrovasküler olay rejyonel anestezi uygulanan hastalarda daha yüksek bulunmufltur (p=0.049). Tüm hastalar›n 12 ayl›k mortalite h›z› %20.3'tür. Sonuç: Sonuç olarak femur k›r›¤› nedeniyle opere olan hastalarda genel anestezi uygulanma-s› rejyonel anestezi ile karfl›laflt›r›ld›¤›nda kan kayb› ve hipotansiyon daha fazla olmaktad›r fakat genel ve rejyonel anestezinin mortalite oranlar› benzerdir.
Türk Ortopedi ve Travmatoloji Birliği Derneği dergisi, 2019
Türk Ortopedi ve Travmatoloji Birliği Derneği sıklıklarının bilinmesi; hasta seçimi, kullanılacak... more Türk Ortopedi ve Travmatoloji Birliği Derneği sıklıklarının bilinmesi; hasta seçimi, kullanılacak cerrahi teknik, seçilecek implant, hasta güvenliği ve fonksiyonel sonuçlar açısından önem arz etmektedir. Bu makalede, primer osteoartit dışı nedenlerle yapılan primer total diz protezlerinde görülebilecek komplikasyonlar ve literatürdeki olgu serileri tartışılacaktır. ROMATOİD ARTRİT HASTALARINDA GÖRÜLEN KOMPLİKASYONLAR Dizin inflamatuvar artrit patogenezi, medikal tedavi, prognoz ve beklenen sonuçları açısından osteoartritten farklılık gösterir. Romatoid artrit inflamatuvar artritler arasında en sık görülendir. Romatoid artrit, otoimmün sinovit zemininde kıkırdak harabiyeti ile sonuçlanan bir hastalıktır. İleri evre romatoid artrit hastalarında diz eklemi %90'a varan oranlarla etkilenir. [2] Primer TDA uygulanan hastaların %8'lik bir bölümünü K omplikasyon, bir hastalığın seyrinde görülen morbid bir süreç veya olay şeklinde tanımlanır. Cerrahi komplikasyonlar; cerrahi sırasında veya sonrasında gelişenler olarak gruplandırılabilir. Cerrahi komplikasyonların bilinmesi ve farkında olunmasıyla, bunlarla karşılaşma oranları azaltılabilir. [1] Primer total diz artroplastisi (TDA) son yüzyılda gerçekleşen en başarılı cerrahi işlemlerden birisidir. TDA günümüzde sıklıkla primer osteoartrit hastalarına uygulanmaktadır. Primer osteoartrit dışında ise romatoid artrit, hemofilik artropati, yüksek tibial osteotomi sonrası gelişen artrit ve nöropatik artropati nedeniyle primer TDA uygulanabilmektedir. Literatürde primer osteoartrit daha sık görüldüğünden, komplikasyonları inceleyen çalışmalar da sıklıkla primer osteoartrit üzerinedir. Primer osteoartit dışında kalan osteoartritlere sekonder TDA sonrası komplikasyonların ve bunların Primer total diz artroplastisinde hastalığa özgü komplikasyonlar
Introduction: A collar can be defined as any projection from the surface of the proximal third of... more Introduction: A collar can be defined as any projection from the surface of the proximal third of the femoral stem that interferes with the capacity of the stem to move distally within the cement mantle and provide optimal load distribution along the calcar area. Contraversy exists concerning the usage of a collared or collarless prosthesis and the ability of the collar to perform its effect on the medial femoral neck. The purpose of this study is to compare the proximal femoral bone resorption and aseptic loosening in cases that had poor or good contact between the collar and the proximal medial femoral neck. MaterialsM the loss was 2.49 for group A, 2.26 for group B and 1.58 for group C. The difference among the groups was not statistically significant (p=0.246) Discussion: Unloading of the proximal femur leads resorption of the medial femoral neck and the proximal support of the prosthesis can be lost ultimately leading to aseptic failure due to excessive stresses on the proximal cement and debonding. Although the main purpose of using a collared femoral stem is to transfer load to the medial femoral neck and to prevent bone resorption, in the current study the collar did not prevent calcar resorption even when ideal contact was achieved between the collar and proximal medial femoral neck. Revision rate seems to be unchanged whether the collar had good or bad contact.
Clinical and Experimental Health Sciences, Jun 30, 2021
The aim of this study was to investigate the relationship between kinesiophobia and functional pe... more The aim of this study was to investigate the relationship between kinesiophobia and functional performance with the ability to forgetthe artificial joint in patients with total hip arthroplasty (THA). Methods: Fifty-seven volunteer patients aged between 40-65 years who have undergone THA surgery in the last 1-3 years were included in this study. The Forgotten Joint Score (FJS-12) for evaluating the ability to forgetting the artificial joint, the 6-Minute Walk Test for determining the functional performance, and the Tampa Scale for Kinesiophobia (TSK) for evaluating kinesiophobia were used. Results: There was a moderate correlation between the FJS-12 and TSK (r=-0.571; p<0.001) scores; and moderate correlation between the FJS-12 and the 6-Minute Walk distances (6-MWD) (r= 0.408; p<0.001). The ability to forget the artificial joint in patients with THA was found to be related to kinesiophobia and functional performance. Conclusion: The results of this study demonstrated that the awareness of artificial joint should be taken into consideration when performing physiotherapy and rehabilitation practices to decrease kinesiophobia and increase functional performance. Additionally, complementary approaches aiming to reduce the awareness of artificial joint should be added to the rehabilitation program of the patients with total hip arthroplasty.
Turkish journal of trauma & emergency surgery, 2011
Kapalı redüksiyon ve perkütan vidalama ile tespiti son zamanlarda pelvis kırıklı hastaların çoğun... more Kapalı redüksiyon ve perkütan vidalama ile tespiti son zamanlarda pelvis kırıklı hastaların çoğunda tedavi seçeneği olmuştur. Bu çalışmanın amacı, anstabil pelvis kırıklı hastalarda uygulanan perkütan tedavinin uzun dönem sonuçlarının ve hastaların yaşam kalitesinin değerlendirilmesidir. GEREÇ VE YÖNTEM Ortalama yaşı 32 (dağılım 11-66 yaş) olan 20 hasta (11 kadın, 9 erkek) çalışmaya dahil edildi. Sonuçların ve yaşam kalitesinin değerlendirilmesi macıyla Kısa Form-36 (KF-36) anketi, Majeed skorlaması, Iowa pelvik skorlaması ve pelvik sonuç değerlendirme skorlaması kullanıldı. BULGULAR En kısa takip süresi 2 yıl (dağılım 2-4 yıl) idi. Ortalama yaralanma şiddet skoru 31 (dağılım 16-50) olarak bulundu. Ortalama KF-36 skorları vücut ağrısı, genel sağlık ve sosyal fonksiyonlarda normal toplum değerleri ile benzer bulundu. Ortalama Majeed skoru 93.3 (dağılım 72-100; 19 mükemmel ve 1 iyi klinik sonuç) ve ortalama Iowa pelvik skoru 86 (dağılım 82-90) olarak bulundu. Ortalama pelvik sonuç değerlendirme skoru ise 33 (dağılım 24-37; en yüksek olası skor, 40) idi. SONUÇ Pelvis kırıklarında perkütan tedavi yöntemi ile iyi sonuçlar elde etmek mümkündür. Geniş cerrahi yaklaşımların önlenmesi, kanamanın, yara problemlerinin az olması ve uzun süreli cerrahilerden kaçınılması tekniğin avantajlarıdır. Anahtar Sözcükler: Pelvis kırıkları; perkütan tedavi; sonuç. BACKGROUND Treatment of unstable pelvic fractures has evolved recently, and percutaneous treatment has become the choice of treatment in most cases. The aim of this study was to evaluate the outcome of percutaneous treatment in patients with unstable pelvic fractures. METHODS Twenty patients (11 females, 9 males; mean age, 32 years, range, 11-66 years) who had unstable pelvic fractures and were treated percutaneously were enrolled in the study. Short Form-36 (SF-36) scores, Majeed scores, Iowa Pelvic Scores, and Pelvic Outcome Scores were determined for the outcome assessment. RESULTS The minimum duration of follow-up was 2 years, (range, 24-48 months). The mean Injury Severity Score (ISS) was 31 (range, 16-50). The average SF-36 scores were comparable with the general population in terms of bodily pain, general health and social function. The mean Majeed functional pelvic score was 93.3 (range, 72-100; 19 excellent and 1 good clinical grades) and the mean Iowa Pelvic Score was 86 (range, 82-90). The mean Pelvic Outcome Score was 33 (range, 24-37; maximum score, 40). CONCLUSION We have demonstrated better outcomes in patients with pelvic fractures treated with percutaneous fixation. The technique may be advantageous as it avoids the use of extensive approaches, bleeding, wound complications, and prolonged surgeries.
Purpose: The aim of this study, was to investigate functional status, balance and kinesiophobia a... more Purpose: The aim of this study, was to investigate functional status, balance and kinesiophobia after Chevron osteotomy in women with Hallux Valgus (HV) in comparison to non-surgical women with HV. Methods: A total of 38 individuals were included in the study, including those aged 20-70 years 19 women with an average of 28 months after surgery, and 19 HV women diagnosed with non-surgical. Individuals' pain intensity (Visual Analogue Scale), thumb joint range of motion (ROM) (universal goniometer), static balance (Single-Leg-Stance Test), dynamic balance (Timed Up and Go Test), functional status, and cosmetic concern (Multidimensional Nil Hallux Valgus Scale), kinesiophobia (Tampa Kinesiophobia Scale) was evaluated. Results: Pain severity, cosmetic concern, range of motion of the thumb, and HV angle (HVA) were lower in women with HV following surgery than non-surgical HV women (p
Background: DDH with coxarthrosis causes significant deformity and bone deficiency. Various recon... more Background: DDH with coxarthrosis causes significant deformity and bone deficiency. Various reconstructive techniques have been proposed to treat developmental dysplasia of the hip. However, the existing literature has not yet reached a consensus on the best technique regarding long-term survival. Objectives: This study aims to evaluate the long-term survival of uncemented hydroxyapatite (HA) coated acetabular components augmented with a femoral head autograft. Methods: We retrospectively reviewed the cases of 31 hips in 29 patients (24 female, 5 male, mean age 45.06 years) treated with HA-coated cementless components and femoral head autograft between 2000-2008 with a minimum follow-up of 10 years. Graft resorption, cup loosening and the anatomical hip centre were determined. Functional outcomes were calculated using the Harris Hip Scoring system. The survival of the acetabular component was evaluated using the Kaplan-Meier method. Results: In 24 hips (77,4%), we reconstructed the ...
BACKGROUND: This study aims to evaluate the radiological and clinical mid-term results of the pat... more BACKGROUND: This study aims to evaluate the radiological and clinical mid-term results of the patients with displaced acetabular fractures surgically treated with open reduction and internal fixation using an anterior intra-pelvic approach (AIP). METHODS: In this study, we retrospectively reviewed 12 patients with displaced acetabular fractures treated surgically via the AIP approach. Patients were analyzed for Letournel's acetabular fracture classification, associated injuries, time to surgery, additional surgical procedures needed, perioperative and postoperative complications, radiologic and functional results. RESULTS: Of the 12 patients, the male/female ratio was 1/2; the mean age was 40.5±16.2 (16-64) years. The mean follow-up time was 59.8±32.2 (12-124) months. Seven patients had both column fractures, three patients had anterior column + posterior hemitransverse fractures, one patient had transverse + posterior wall and one patient had anterior column fracture. The mean time to surgery was 6.6±4.4 (2-16) days. The mean intraoperative blood transfusion was 830 (300-2000) ml. Intra-operative and post-operative complications were noted in eight patients. The mean Merle d'Aubigné and Postel score was 14.5±2.7 (10-18). Six patients with an anatomical reduction of the fracture showed excellent/good functional and radiologic outcomes. Three patients with a non-anatomic reduction developed post-traumatic arthrosis that was treated with total hip arthroplasty. CONCLUSION: AIP approach provides a satisfactory exposure for the surgical treatment of displaced anterior wall/column and both column acetabular fractures. Clinical outcome is directly related to the reduction quality. Patients with poor reduction are most likely to develop mid-term complications, such as hip joint arthrosis.
Background The influence of preoperative comprehensive geriatric assessment and frailty on postop... more Background The influence of preoperative comprehensive geriatric assessment and frailty on postoperative morbidity, mortality, delirium were examined. Methods A total of 108 patients were evaluated. The Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Brody Instrumental Activities of Daily Living Scale (IADL), the Mini-Nutrition Assessment test (MNA), the Mini-Mental State Examination (MMSE), Yesavage Geriatric Depression Scale (GDS) were performed. Fried Criteria were used to assess physical frailty. We used the Physiological and Operative Severity Scores for the Enumeration of Mortality and Morbidity score (POSSUM), the American Society of Anesthesiologists Score (ASA), and the Charlson Comorbidity Index (CCI) to determine the risk of postoperative morbidity and mortality. Assessment Test for Delirium (4AT) was applied for detection of delirium. Results The median age was 71 years (min-max: 65-84). IADL (p = 0.032), MNA (p = 0.01), MMSE scores (p = 0.026) were found to be significantly lower in patients with morbidity. POSSUM physiology score (p = 0.005), operative score (p = 0.015) and CCI (p = 0.029) were significantly higher in the patients with morbidity. Patients developed morbidity were found to be more frail (p \ 0.001). The patients with delirium were found to have lower IADL (p = 0.049) and MMSE scores (p = 0.004), higher POSSUM physiology score (p = 0.005) and all of them were frail. It was found that frailty (OR = 23.695 95% CI: 6.912-81.231 p \ 0.001), POSSUM operative score (OR:1.118 95% CI: 1.021-1.224 p = 0.016) and preoperative systolic blood pressure (OR:0.937%95 CI: 0.879-0.999 p = 0.048) were independently related factors for postoperative morbidity. Conclusion In our study, CGA and frailty in preoperative period were found to be indicators for postoperative morbidity and delirium.
Objectives: The aim of this study is to investigate the effect of the novel coronavirus-2019 (COV... more Objectives: The aim of this study is to investigate the effect of the novel coronavirus-2019 (COVID-19) pandemic on the operational trends in the orthopedic surgery department of a tertiary referral center. Patients and methods: A total of 305 orthopedic surgical procedures in 245 patients (136 males, 109 females; mean age: 34±26.6 years; range, 0 to 91 years) between March 16th and June 27th, 2020 were retrospectively analyzed. The same period of the year before including 860 procedures in 783 patients (364 males, 419 females; mean age: 33.6±25.8 years; range, 0 to 95 years) was also reviewed as a pre-pandemic control group. Patient demographics, surgical indications, COVID-19 polymerase chain reaction (PCR) test status, method of anesthesia, surgical subspecialties (trauma, sports, etc.), trauma mechanisms, and surgical priorities were evaluated. The pandemic and the pre- pandemic periods were compared. Results: The rate of elective surgeries decreased compared to the previous yea...
Amac: Bu calismanin amaci, kalca osteoartriti nedeniyle total kalca artroplastisi (TKA) cerrahisi... more Amac: Bu calismanin amaci, kalca osteoartriti nedeniyle total kalca artroplastisi (TKA) cerrahisi geciren hastalarin egzersiz yapma suresinin yapay eklemi unutma yetenegi, agri ve fonksiyonel durum uzerine etkisini arastirmakti. Yontem: Calismaya tek tarafli TKA cerrahisi gecirmis toplam 42 hasta (26’si kadin, 16’si erkek) dahil edildi. Hastalar egzersiz yapma surelerine gore 6 aydan kisa egzersiz yapan grup (Yas ortalamasi: 53,9±15,1 yil, vucut kutle indeksi: 27,2±1,5 kg/cm2, N=24) ve 6 aydan uzun sure egzersiz yapan grup (57,5±13,3 yil, Vucut kutle indeksi: 27,2±5,2 kg/cm2, N=18) olmak uzere iki gruba ayrildi. TKA cerrahisi sonrasi hastalarin yapay kalca eklemlerini unutma yetenegini belirlemek amaciyla Unutulan Eklem Olcegi-12 (UEO-12) uygulandi. Fonksiyonel durumu belirlemek amaciyla, Western Ontario ve McMaster Osteoartrit Indeksi (WOMAC) kullanildi. Bulgular: Gruplar arasinda WOMAC tutukluk puaninda fark yoktu (p>0,05). WOMAC agri ve WOMAC fonksiyon puanlari, uzun su...
Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and... more Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and management differs compared to elderly. Different geometric parameters in the hip joint can play a role in fracture morphology regarding to the age. Present study aims to compare hip morphology between young and elderly population Materials and methods: 45 patients with isolated femoral neck fracture included to the study. Patients were divided into two regarding to the age; group 1 (younger than 60 yr.) and group 2 (older than 60 yr.). Garden and Pauwels classifications, Sharp angle (acetabular index-AI), acetabular depth (AD), Hip-axis length (HLA), Neck-shaft angle (NSA), Center-edge angle (CE), Singh indexes and femur head extrusion indexes were compared between groups. Results: The mean age of group 1 (22 patients) was 48 ± 10.4 while the mean age of group 2 (23 patients) was 77 ± 6.3. Significant differences found in 3 parameters; the mean HLA (13.4 ± 1.4 cm vs 12 ± 1.1 cm) (p: 0,...
The aim of this study was to investigate the indicators of adapting to an artificial joint in ter... more The aim of this study was to investigate the indicators of adapting to an artificial joint in terms of age, period after surgery, fear of falling, quality of life and physical function following Total Hip Arthroplasty (THA). Material and Methods: This cross-sectional design included 52 patients with OA who underwent THA, aged between 46-74 years, and with a mean period of 1.96±0.76 years after surgery (1-3). Fear of falling, joint-specific functional outcome measurements and health-related quality of life questionnaires were assessed with the supervision of physiotherapists. Fear of falling was assessed with 0-10 cm Visual Analogue Scale (VAS). Health related quality of life and joint-specific function were assessed with EuroQol 5-Dimension 3-Level (EQ-5D-3L) VAS scale and Hip disability and Osteoarthritis Outcome Score (HOOS)-Physical Function Short form (HOOS-PS), respectively. The Forgotten Joint Score (FJS-12) was used to assess patient's adaptation in daily life to their artificial joint. Results: The FJS-12 scores were inversely related with fear of falling in patients with THA (r=-0.418; p=0.002). FJS-12 scores were strongly correlated with EQ-5D-3L VAS (r=0.536); and HOOS-PS scores (r=-0.519) (p<0.001). In linear regression analysis, strongest significant indicators of the dependent variable (FJS-12) were fear of falling, EQ-5D-3L VAS and HOOS-PS (R2=0.48; p<0.05). Conclusion: Detailed assessment about fear of falling, physical function and quality of life can explain adaptability to artificial joint in patients with THA. Therefore, rehabilitation programmes that are individualised according to patients' fear of falling, physical function and health-related quality of life should also be considered to decrease fear leading to activity limitation and participation in daily life following THA.
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, Dec 1, 2012
Bu çal›flman›n amac› femur k›r›¤› nedeniyle cerrahiye al›nan hastalara uygulanan anestezi teknikl... more Bu çal›flman›n amac› femur k›r›¤› nedeniyle cerrahiye al›nan hastalara uygulanan anestezi tekniklerinin postoperatif morbidite ve mortaliteye etkisinin incelenmesidir. Gereç ve Yöntem: Hacettepe Üniversitesi Anesteziyoloji ve Reanimasyon Anabilim Dal›'nda 2000-2009 y›llar› aras›nda femur k›r›¤› nedeniyle opere olan hastalarda retrospektif dosya incelemesi yap›ld›. Bulgular: Çal›flmaya 83 (%67.5) kad›n ve 36 (%29.3) erkek toplam 119 hasta dahil edildi, ortalama yafl 79.5±8.2 idi. Genel anestezi 48(%39) hastaya, rejyonel anestezi ise 71(%61) hastaya uygulanm›flt›r. Rejyonel ve genel anestezi alan hastalar aras›nda intraoperatif, yo¤un bak›m ya-t›fl› s›ras›nda, birinci, üçüncü, alt›nc› ve onikinci ay mortaliteleri aç›s›ndan fark bulunamam›flt›r. Ay-n› zamanda, yo¤un bak›ma yat›fl oranlar› ve yat›fl süreleri benzerdi. Genel anestezi alan hastalarda rejyonel anestezi uygulananlara göre kan kayb› (p=0.038) anlaml› flekilde yüksektir. Hastalar›n %21'inde intraoperatif hipotansiyon geliflmifl ve genel anestezi alan hastalarda daha s›k görülmüfltür (p=0.012). Postoperatif serebrovasküler olay rejyonel anestezi uygulanan hastalarda daha yüksek bulunmufltur (p=0.049). Tüm hastalar›n 12 ayl›k mortalite h›z› %20.3'tür. Sonuç: Sonuç olarak femur k›r›¤› nedeniyle opere olan hastalarda genel anestezi uygulanma-s› rejyonel anestezi ile karfl›laflt›r›ld›¤›nda kan kayb› ve hipotansiyon daha fazla olmaktad›r fakat genel ve rejyonel anestezinin mortalite oranlar› benzerdir.
Türk Ortopedi ve Travmatoloji Birliği Derneği dergisi, 2019
Türk Ortopedi ve Travmatoloji Birliği Derneği sıklıklarının bilinmesi; hasta seçimi, kullanılacak... more Türk Ortopedi ve Travmatoloji Birliği Derneği sıklıklarının bilinmesi; hasta seçimi, kullanılacak cerrahi teknik, seçilecek implant, hasta güvenliği ve fonksiyonel sonuçlar açısından önem arz etmektedir. Bu makalede, primer osteoartit dışı nedenlerle yapılan primer total diz protezlerinde görülebilecek komplikasyonlar ve literatürdeki olgu serileri tartışılacaktır. ROMATOİD ARTRİT HASTALARINDA GÖRÜLEN KOMPLİKASYONLAR Dizin inflamatuvar artrit patogenezi, medikal tedavi, prognoz ve beklenen sonuçları açısından osteoartritten farklılık gösterir. Romatoid artrit inflamatuvar artritler arasında en sık görülendir. Romatoid artrit, otoimmün sinovit zemininde kıkırdak harabiyeti ile sonuçlanan bir hastalıktır. İleri evre romatoid artrit hastalarında diz eklemi %90'a varan oranlarla etkilenir. [2] Primer TDA uygulanan hastaların %8'lik bir bölümünü K omplikasyon, bir hastalığın seyrinde görülen morbid bir süreç veya olay şeklinde tanımlanır. Cerrahi komplikasyonlar; cerrahi sırasında veya sonrasında gelişenler olarak gruplandırılabilir. Cerrahi komplikasyonların bilinmesi ve farkında olunmasıyla, bunlarla karşılaşma oranları azaltılabilir. [1] Primer total diz artroplastisi (TDA) son yüzyılda gerçekleşen en başarılı cerrahi işlemlerden birisidir. TDA günümüzde sıklıkla primer osteoartrit hastalarına uygulanmaktadır. Primer osteoartrit dışında ise romatoid artrit, hemofilik artropati, yüksek tibial osteotomi sonrası gelişen artrit ve nöropatik artropati nedeniyle primer TDA uygulanabilmektedir. Literatürde primer osteoartrit daha sık görüldüğünden, komplikasyonları inceleyen çalışmalar da sıklıkla primer osteoartrit üzerinedir. Primer osteoartit dışında kalan osteoartritlere sekonder TDA sonrası komplikasyonların ve bunların Primer total diz artroplastisinde hastalığa özgü komplikasyonlar
Introduction: A collar can be defined as any projection from the surface of the proximal third of... more Introduction: A collar can be defined as any projection from the surface of the proximal third of the femoral stem that interferes with the capacity of the stem to move distally within the cement mantle and provide optimal load distribution along the calcar area. Contraversy exists concerning the usage of a collared or collarless prosthesis and the ability of the collar to perform its effect on the medial femoral neck. The purpose of this study is to compare the proximal femoral bone resorption and aseptic loosening in cases that had poor or good contact between the collar and the proximal medial femoral neck. MaterialsM the loss was 2.49 for group A, 2.26 for group B and 1.58 for group C. The difference among the groups was not statistically significant (p=0.246) Discussion: Unloading of the proximal femur leads resorption of the medial femoral neck and the proximal support of the prosthesis can be lost ultimately leading to aseptic failure due to excessive stresses on the proximal cement and debonding. Although the main purpose of using a collared femoral stem is to transfer load to the medial femoral neck and to prevent bone resorption, in the current study the collar did not prevent calcar resorption even when ideal contact was achieved between the collar and proximal medial femoral neck. Revision rate seems to be unchanged whether the collar had good or bad contact.
Clinical and Experimental Health Sciences, Jun 30, 2021
The aim of this study was to investigate the relationship between kinesiophobia and functional pe... more The aim of this study was to investigate the relationship between kinesiophobia and functional performance with the ability to forgetthe artificial joint in patients with total hip arthroplasty (THA). Methods: Fifty-seven volunteer patients aged between 40-65 years who have undergone THA surgery in the last 1-3 years were included in this study. The Forgotten Joint Score (FJS-12) for evaluating the ability to forgetting the artificial joint, the 6-Minute Walk Test for determining the functional performance, and the Tampa Scale for Kinesiophobia (TSK) for evaluating kinesiophobia were used. Results: There was a moderate correlation between the FJS-12 and TSK (r=-0.571; p<0.001) scores; and moderate correlation between the FJS-12 and the 6-Minute Walk distances (6-MWD) (r= 0.408; p<0.001). The ability to forget the artificial joint in patients with THA was found to be related to kinesiophobia and functional performance. Conclusion: The results of this study demonstrated that the awareness of artificial joint should be taken into consideration when performing physiotherapy and rehabilitation practices to decrease kinesiophobia and increase functional performance. Additionally, complementary approaches aiming to reduce the awareness of artificial joint should be added to the rehabilitation program of the patients with total hip arthroplasty.
Turkish journal of trauma & emergency surgery, 2011
Kapalı redüksiyon ve perkütan vidalama ile tespiti son zamanlarda pelvis kırıklı hastaların çoğun... more Kapalı redüksiyon ve perkütan vidalama ile tespiti son zamanlarda pelvis kırıklı hastaların çoğunda tedavi seçeneği olmuştur. Bu çalışmanın amacı, anstabil pelvis kırıklı hastalarda uygulanan perkütan tedavinin uzun dönem sonuçlarının ve hastaların yaşam kalitesinin değerlendirilmesidir. GEREÇ VE YÖNTEM Ortalama yaşı 32 (dağılım 11-66 yaş) olan 20 hasta (11 kadın, 9 erkek) çalışmaya dahil edildi. Sonuçların ve yaşam kalitesinin değerlendirilmesi macıyla Kısa Form-36 (KF-36) anketi, Majeed skorlaması, Iowa pelvik skorlaması ve pelvik sonuç değerlendirme skorlaması kullanıldı. BULGULAR En kısa takip süresi 2 yıl (dağılım 2-4 yıl) idi. Ortalama yaralanma şiddet skoru 31 (dağılım 16-50) olarak bulundu. Ortalama KF-36 skorları vücut ağrısı, genel sağlık ve sosyal fonksiyonlarda normal toplum değerleri ile benzer bulundu. Ortalama Majeed skoru 93.3 (dağılım 72-100; 19 mükemmel ve 1 iyi klinik sonuç) ve ortalama Iowa pelvik skoru 86 (dağılım 82-90) olarak bulundu. Ortalama pelvik sonuç değerlendirme skoru ise 33 (dağılım 24-37; en yüksek olası skor, 40) idi. SONUÇ Pelvis kırıklarında perkütan tedavi yöntemi ile iyi sonuçlar elde etmek mümkündür. Geniş cerrahi yaklaşımların önlenmesi, kanamanın, yara problemlerinin az olması ve uzun süreli cerrahilerden kaçınılması tekniğin avantajlarıdır. Anahtar Sözcükler: Pelvis kırıkları; perkütan tedavi; sonuç. BACKGROUND Treatment of unstable pelvic fractures has evolved recently, and percutaneous treatment has become the choice of treatment in most cases. The aim of this study was to evaluate the outcome of percutaneous treatment in patients with unstable pelvic fractures. METHODS Twenty patients (11 females, 9 males; mean age, 32 years, range, 11-66 years) who had unstable pelvic fractures and were treated percutaneously were enrolled in the study. Short Form-36 (SF-36) scores, Majeed scores, Iowa Pelvic Scores, and Pelvic Outcome Scores were determined for the outcome assessment. RESULTS The minimum duration of follow-up was 2 years, (range, 24-48 months). The mean Injury Severity Score (ISS) was 31 (range, 16-50). The average SF-36 scores were comparable with the general population in terms of bodily pain, general health and social function. The mean Majeed functional pelvic score was 93.3 (range, 72-100; 19 excellent and 1 good clinical grades) and the mean Iowa Pelvic Score was 86 (range, 82-90). The mean Pelvic Outcome Score was 33 (range, 24-37; maximum score, 40). CONCLUSION We have demonstrated better outcomes in patients with pelvic fractures treated with percutaneous fixation. The technique may be advantageous as it avoids the use of extensive approaches, bleeding, wound complications, and prolonged surgeries.
Purpose: The aim of this study, was to investigate functional status, balance and kinesiophobia a... more Purpose: The aim of this study, was to investigate functional status, balance and kinesiophobia after Chevron osteotomy in women with Hallux Valgus (HV) in comparison to non-surgical women with HV. Methods: A total of 38 individuals were included in the study, including those aged 20-70 years 19 women with an average of 28 months after surgery, and 19 HV women diagnosed with non-surgical. Individuals' pain intensity (Visual Analogue Scale), thumb joint range of motion (ROM) (universal goniometer), static balance (Single-Leg-Stance Test), dynamic balance (Timed Up and Go Test), functional status, and cosmetic concern (Multidimensional Nil Hallux Valgus Scale), kinesiophobia (Tampa Kinesiophobia Scale) was evaluated. Results: Pain severity, cosmetic concern, range of motion of the thumb, and HV angle (HVA) were lower in women with HV following surgery than non-surgical HV women (p
Background: DDH with coxarthrosis causes significant deformity and bone deficiency. Various recon... more Background: DDH with coxarthrosis causes significant deformity and bone deficiency. Various reconstructive techniques have been proposed to treat developmental dysplasia of the hip. However, the existing literature has not yet reached a consensus on the best technique regarding long-term survival. Objectives: This study aims to evaluate the long-term survival of uncemented hydroxyapatite (HA) coated acetabular components augmented with a femoral head autograft. Methods: We retrospectively reviewed the cases of 31 hips in 29 patients (24 female, 5 male, mean age 45.06 years) treated with HA-coated cementless components and femoral head autograft between 2000-2008 with a minimum follow-up of 10 years. Graft resorption, cup loosening and the anatomical hip centre were determined. Functional outcomes were calculated using the Harris Hip Scoring system. The survival of the acetabular component was evaluated using the Kaplan-Meier method. Results: In 24 hips (77,4%), we reconstructed the ...
BACKGROUND: This study aims to evaluate the radiological and clinical mid-term results of the pat... more BACKGROUND: This study aims to evaluate the radiological and clinical mid-term results of the patients with displaced acetabular fractures surgically treated with open reduction and internal fixation using an anterior intra-pelvic approach (AIP). METHODS: In this study, we retrospectively reviewed 12 patients with displaced acetabular fractures treated surgically via the AIP approach. Patients were analyzed for Letournel's acetabular fracture classification, associated injuries, time to surgery, additional surgical procedures needed, perioperative and postoperative complications, radiologic and functional results. RESULTS: Of the 12 patients, the male/female ratio was 1/2; the mean age was 40.5±16.2 (16-64) years. The mean follow-up time was 59.8±32.2 (12-124) months. Seven patients had both column fractures, three patients had anterior column + posterior hemitransverse fractures, one patient had transverse + posterior wall and one patient had anterior column fracture. The mean time to surgery was 6.6±4.4 (2-16) days. The mean intraoperative blood transfusion was 830 (300-2000) ml. Intra-operative and post-operative complications were noted in eight patients. The mean Merle d'Aubigné and Postel score was 14.5±2.7 (10-18). Six patients with an anatomical reduction of the fracture showed excellent/good functional and radiologic outcomes. Three patients with a non-anatomic reduction developed post-traumatic arthrosis that was treated with total hip arthroplasty. CONCLUSION: AIP approach provides a satisfactory exposure for the surgical treatment of displaced anterior wall/column and both column acetabular fractures. Clinical outcome is directly related to the reduction quality. Patients with poor reduction are most likely to develop mid-term complications, such as hip joint arthrosis.
Background The influence of preoperative comprehensive geriatric assessment and frailty on postop... more Background The influence of preoperative comprehensive geriatric assessment and frailty on postoperative morbidity, mortality, delirium were examined. Methods A total of 108 patients were evaluated. The Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Brody Instrumental Activities of Daily Living Scale (IADL), the Mini-Nutrition Assessment test (MNA), the Mini-Mental State Examination (MMSE), Yesavage Geriatric Depression Scale (GDS) were performed. Fried Criteria were used to assess physical frailty. We used the Physiological and Operative Severity Scores for the Enumeration of Mortality and Morbidity score (POSSUM), the American Society of Anesthesiologists Score (ASA), and the Charlson Comorbidity Index (CCI) to determine the risk of postoperative morbidity and mortality. Assessment Test for Delirium (4AT) was applied for detection of delirium. Results The median age was 71 years (min-max: 65-84). IADL (p = 0.032), MNA (p = 0.01), MMSE scores (p = 0.026) were found to be significantly lower in patients with morbidity. POSSUM physiology score (p = 0.005), operative score (p = 0.015) and CCI (p = 0.029) were significantly higher in the patients with morbidity. Patients developed morbidity were found to be more frail (p \ 0.001). The patients with delirium were found to have lower IADL (p = 0.049) and MMSE scores (p = 0.004), higher POSSUM physiology score (p = 0.005) and all of them were frail. It was found that frailty (OR = 23.695 95% CI: 6.912-81.231 p \ 0.001), POSSUM operative score (OR:1.118 95% CI: 1.021-1.224 p = 0.016) and preoperative systolic blood pressure (OR:0.937%95 CI: 0.879-0.999 p = 0.048) were independently related factors for postoperative morbidity. Conclusion In our study, CGA and frailty in preoperative period were found to be indicators for postoperative morbidity and delirium.
Objectives: The aim of this study is to investigate the effect of the novel coronavirus-2019 (COV... more Objectives: The aim of this study is to investigate the effect of the novel coronavirus-2019 (COVID-19) pandemic on the operational trends in the orthopedic surgery department of a tertiary referral center. Patients and methods: A total of 305 orthopedic surgical procedures in 245 patients (136 males, 109 females; mean age: 34±26.6 years; range, 0 to 91 years) between March 16th and June 27th, 2020 were retrospectively analyzed. The same period of the year before including 860 procedures in 783 patients (364 males, 419 females; mean age: 33.6±25.8 years; range, 0 to 95 years) was also reviewed as a pre-pandemic control group. Patient demographics, surgical indications, COVID-19 polymerase chain reaction (PCR) test status, method of anesthesia, surgical subspecialties (trauma, sports, etc.), trauma mechanisms, and surgical priorities were evaluated. The pandemic and the pre- pandemic periods were compared. Results: The rate of elective surgeries decreased compared to the previous yea...
Amac: Bu calismanin amaci, kalca osteoartriti nedeniyle total kalca artroplastisi (TKA) cerrahisi... more Amac: Bu calismanin amaci, kalca osteoartriti nedeniyle total kalca artroplastisi (TKA) cerrahisi geciren hastalarin egzersiz yapma suresinin yapay eklemi unutma yetenegi, agri ve fonksiyonel durum uzerine etkisini arastirmakti. Yontem: Calismaya tek tarafli TKA cerrahisi gecirmis toplam 42 hasta (26’si kadin, 16’si erkek) dahil edildi. Hastalar egzersiz yapma surelerine gore 6 aydan kisa egzersiz yapan grup (Yas ortalamasi: 53,9±15,1 yil, vucut kutle indeksi: 27,2±1,5 kg/cm2, N=24) ve 6 aydan uzun sure egzersiz yapan grup (57,5±13,3 yil, Vucut kutle indeksi: 27,2±5,2 kg/cm2, N=18) olmak uzere iki gruba ayrildi. TKA cerrahisi sonrasi hastalarin yapay kalca eklemlerini unutma yetenegini belirlemek amaciyla Unutulan Eklem Olcegi-12 (UEO-12) uygulandi. Fonksiyonel durumu belirlemek amaciyla, Western Ontario ve McMaster Osteoartrit Indeksi (WOMAC) kullanildi. Bulgular: Gruplar arasinda WOMAC tutukluk puaninda fark yoktu (p>0,05). WOMAC agri ve WOMAC fonksiyon puanlari, uzun su...
Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and... more Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and management differs compared to elderly. Different geometric parameters in the hip joint can play a role in fracture morphology regarding to the age. Present study aims to compare hip morphology between young and elderly population Materials and methods: 45 patients with isolated femoral neck fracture included to the study. Patients were divided into two regarding to the age; group 1 (younger than 60 yr.) and group 2 (older than 60 yr.). Garden and Pauwels classifications, Sharp angle (acetabular index-AI), acetabular depth (AD), Hip-axis length (HLA), Neck-shaft angle (NSA), Center-edge angle (CE), Singh indexes and femur head extrusion indexes were compared between groups. Results: The mean age of group 1 (22 patients) was 48 ± 10.4 while the mean age of group 2 (23 patients) was 77 ± 6.3. Significant differences found in 3 parameters; the mean HLA (13.4 ± 1.4 cm vs 12 ± 1.1 cm) (p: 0,...
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