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Papers by MEHMET ERSİN

Objective Although the recommended treatment for stage III posterior tibial tendon dysfunction (P... more Objective Although the recommended treatment for stage III posterior tibial tendon dysfunction (PTTD) is triple joint complex fusion, the literature is limited on this topic. No study has specifically investigated the influence of rheumatoid arthritis (RA) on the outcomes of triple arthrodesis. This study aimed (1) to report mid-to-long-term results of triple arthrodesis for stage III PTTD and (2) to investigate the difference in the results of triple arthrodesis between rheumatoid and nonrheumatoid patients. Methods Thirty feet of 25 patients (16 females, 9 males; mean age 53, (39-71)) with stage III PTTD who were treated by triple arthrodesis were retrospectively analyzed. The mean follow-up was 82 (28 – 144) months. Patients were divided into two groups based on etiology: group ID (idiopathic PTTD) and group RA (PTTD secondary to RA). All clinical and radiographic outcomes were compared. The mean American Orthopedic Foot and Ankle Society (AOFAS) score was measured preoperatively...

BMC Musculoskeletal Disorders

Background It has been suggested that the posterior tibial slope (PTS) plays an important role in... more Background It has been suggested that the posterior tibial slope (PTS) plays an important role in increasing the anteroposterior stability following total knee arthroplasty. Although the relationship between the PTS and the flexion range has been investigated many times, studies on the relationship between PTS and anterior-posterior stability are limited. The primary aim of this study was to investigate the relationship and effects of PTS on anteroposterior stability in posterior cruciate retainer total knee arthroplasty. Methods 154 primary TKAs were identified retrospectively to analyze the any association between PTS and anteroposterior laxity following posterior cruciate-retaining total knee arthroplasty in the overall study populations. Anteroposterior displacement was measured at the final follow-up based on the following two procedures: KT-1000 arthrometer and sagittal drawer radiographic images. In addition, the relationship between PTS and functional scores-ROM was examined...

Acta Orthopaedica Belgica

The proximity of the superficial femoral artery (SFA) to the femur exposes the SFA to risks that ... more The proximity of the superficial femoral artery (SFA) to the femur exposes the SFA to risks that have serious complications. Although surgeons have used the lateral or medial approach to lessen these risks, they have not been eliminated. Therefore, this study aimed to identify dangerous and safe zones in terms of the SFA that can be used during femoral surgical procedures, using anatomical reference points. Computed tomography angiography (CTA) of 50 patients aged between 16 and 60 years obtained from the local institution’s database was examined. Radiological and clinical measurements were performed to determine the position of the SFA relative to the femur. The mean age of the patients included in this study was 38.08 ± 9.44 (16–60) years. The average ratio of the distance between the proximal and distal borders of the dangerous zone and the lateral joint spaces (LJS) to the distance between the greater trochanter (GT) and LJS was 0.5722 ± 0.053, respectively. The average ratio of...

Joint Diseases and Related Surgery

In femoral shaft fractures, intramedullary nailing is the gold-standard treatment approach, with ... more In femoral shaft fractures, intramedullary nailing is the gold-standard treatment approach, with a high union rate and low complication rate compared to alternative treatment methods. [1] Femoral nailing can be done with two different techniques: antegrade or retrograde. [2] Both techniques used in intramedullary femoral nailing have different surgical indications and advantages. [3] Ipsilateral acetabular fracture, multi-trauma, ipsilateral proximal femur fracture, floating knee, periprosthetic fracture, and bilateral femur fractures are among the conditions where retrograde femoral nailing is often preferred. [4,5] One of the most technically difficult and dangerous steps in retrograde femoral nailing is proximal locking. [6] Although freehand locking is still the most prevalent way for proximal locking, [7] Objectives: This study aims to identify the most reliable level for the proximal locking screw in retrograde femoral nails and to investigate the preoperative detectability of the length of the proximal locking screw by radiological measurements. Patients and methods: Between April 2020 and June 2021, a total of 50 patients (42 males, 8 females; mean age: 38.1±14.3 years; range, 18 to 60 years) who were suspected of vascular injury after gunshot or stab wounds and underwent lower extremity computed tomography angiography (CTA) from the local institutionʼs database were included in the study. The distances of the femoral neurovascular structures (FNVS) and sciatic nerve (SN) to the femur were measured in the sections determined in the anteroposterior and medial-lateral planes. The anteroposterior length of the femur was measured in selected sections to estimate the appropriate length of the proximal locking screw.

Turkish Journal of Trauma and Emergency Surgery

of blood loss may cause problems related to anemia in the elderly and fragile patient group, who ... more of blood loss may cause problems related to anemia in the elderly and fragile patient group, who may require a blood transfusion. [3,4] Allogenic blood transfusion carries some risks, including prolonged hospitalization, delayed mobiliza

Medical Bulletin of Haseki

Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatm... more Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatment approach in Gartland type II fractures is controversial. The purpose of our study was to compare the effectiveness of cast and splint in conservative treatment of type II supracondylar humerus fractures. Methods: Sixty-nine pediatric patients admitted to our clinic due to gartland type II supracondylar humerus fractures between 2015 and 2020 were retrospectively evaluated. Closed reduction upper-elbow cast was applied to 26 patients, and closed reduction upperelbow splint treatment was applied to 43 patients. Radiological results of the patients were compared. Results: The mean age of the patients participating in the study was 4.86±2.61 (1-12). Fourty two of 69 patients were male and 27 were female. Neurovascular deficit and compartment syndrome were not observed in any of the patients. When compared radiologically, no significant difference was found between the two groups. Conclusion: Type II supracondylar humerus fractures, where conservative treatment is planned, the upper elbow casting or splint selected for immobilization shows similar effectiveness in protecting reduction.

Istanbul Medical Journal

Introduction: This study evaluated the effect of both postoperative residual varus alignment and ... more Introduction: This study evaluated the effect of both postoperative residual varus alignment and the amount of correction in lower limb alignment (LLA) on postoperative functional outcomes of total knee arthroplasty TKAs in patients with preoperative varus deformity. Methods: Two-hundred and fifty-two knees of 209 patients who underwent a TKA for treating varus gonarthrosis were retrospectively reviewed in the study. Patients were then divided into the three groups according to the postoperative hip-knee-ankle angle (HKAA): the neutral group (NG) (HKAA: 183°-177°); the mild varus group (HKAA: 176.9°-174°); and the severe varus group (HKAA <174°). Patients were also categorized into the three groups based on the amount of correction in LLA; group A (<5); group B (5° to 10°), and group C (>10°). Pre-and post-operative functional outcomes were compared among the groups. Results: There were no significant differences in the postoperative Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and visual analog scale (VAS) scores between the mild and NGs (p=0.99, p=0.62, and p=0.33, respectively). The severe group showed lower postoperative KSS, WOMAC, and higher VAS scores compared to other two groups (p<0.001, p<0.001, and p<0.001, respectively). No significant differences were observed in the postoperative knee flexion and extension deficits among the three groups (p=0.79 and p=0.3). Patients with correction in LLA of >10° had higher WOMAC and lower VAS scores than the other patients (p=0.008 and p=0.002, respectively). Conclusion: Postoperative mild varus deformity is not associated with poorer clinical and functional outcomes; however, a postoperative severe varus deformity following TKA can cause a significant deterioration in postoperative clinical and functional outcomes in patients with preoperative varus osteoarthritis.

Haseki Tıp Bülteni, Mar 31, 2022

Malnutrition is reported to be related to higher mortality rates following geriatric hip fracture... more Malnutrition is reported to be related to higher mortality rates following geriatric hip fracture, and new malnutrition indicators are currently being identified. The aim of this study is to analyze prognostic nutritional index (PNI), C-reactive protein (CRP)/albumin ratio (CAR) and CRPI/PNI ratio (CPR) as prognostic factors for first-month, six-month, one-year and overall mortality following hip fracture surgery. Methods: This study was designed as a cross-sectional study. We reviewed the medical records of patients older than 75 years with osteoporotic hip fracture surgery between January 2012 and October 2019. Preoperative serum albumin, total lymphocyte count, and CRP levels were evaluated as laboratory values. PNI, CAR, and CPR were calculated and analyzed as prognostic factors for mortality. Results: Four hundred and thirty patients were included in the study. High American Society of Anesthesiology (ASA) score (p=0.01) and admission to the intensive care unit (ICU) (p=0.016) were found to be independently associated with worse survival in the first month. The admission to the ICU (p=0.004) was independently related to poor survival in the first six months. High ASA score (p=0.018) and admission to the ICU (p=0.016) were independently associated with a poor survival in the first year. High ASA score (p<0.001) and admission to the ICU (p<0.001) were found to be independent prognostic factors for poor overall survival. Conclusion: PNI, CAR, and CPR were not significantly related to poor survival in the first month, six months, one year, and overall follow-up period after geriatric hip fracture surgery.

Turkish Journal of Physical Medicine and Rehabilitation, 2021

Objectives: This study aims to evaluate patients with conservatively treated stable lateral malle... more Objectives: This study aims to evaluate patients with conservatively treated stable lateral malleolar fractures with isokinetic tests. Patients and methods: Between January 2016 and November 2017, a total of 24 patients (12 males, 12 females; mean age 40.8±15.0 years; range, 18 to 68 years) with an isolated stable lateral malleolar fracture treated conservatively with the circular cast were included in this prospective study. Calf circumferences, ankle range of motion (ROM), pain levels, and functional outcomes were recorded. The muscle strengths and endurance of the injured side were compared with the non-injured side. All patients were evaluated by isokinetic test after removal of the cast, and three and six months after the rehabilitation period. Results: The ROM was found to be lower after removal of the plaster cast, compared to the contralateral ankle. During cast removal, we also found that both dorsiflexor and plantar flexor muscle strength decreased by 25.6% and 44.7%, resp...

Journal of Laboratory Physicians, 2020

We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee re... more We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee replacement for the first time. A 69-year-old female was prediagnosed with prosthetic knee infection, and a two-stage revision arthroplasty was applied. A. defectiva was cultured by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) from the synovial fluid aspirates. Penicillin G and gentamicin had been administered. One year postoperatively, a scintigraphy showed no recurrence. A. defectiva may be missed in culture negative patients with knee or hip arthroplasty. They should be carefully evaluated if they have undergone recent dental procedures.

Knee Surgery, Sports Traumatology, Arthroscopy

Lupus

Objective Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse ... more Objective Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse of the architectural bone structure secondary to the death of the bone marrow and trabecular bone. Osteonecrosis may accompany many conditions, especially rheumatic diseases. Among rheumatic diseases, osteonecrosis is most commonly associated with systemic lupus erythematosus (SLE). We assessed prevalence and distribution pattern of symptomatic ON in patients with SLE and compare the natural courses of hip and knee ON. Methods 912 SLE patients admitted between 1981 and 2012 were reviewed. SLE patients with symptomatic ON were retrospectively identified both from the existing SLE/APS database. The prevalence of symptomatic ON was calculated; with ON, the joint involvement pattern was determined by examining the distribution of the joints involved, and then the data about the hip and knee joints were entered in the Kaplan-Meier analysis. Kaplan-Meier methods were used to calculate 5- and 1...

Medicine Science | International Medical Journal

Journal of Shoulder and Elbow Surgery

Acta Orthopaedica et Traumatologica Turcica

Hip & Pelvis

The rate of periprosthetic infection after total hip arthroplasty (THA) is reported to be 1-2% 1)... more The rate of periprosthetic infection after total hip arthroplasty (THA) is reported to be 1-2% 1). These infections are associated with an increase in hospital stay, need for repeat surgery, increase in costs, long-term antibiotic use, and decreased quality of life 2). While isolated organisms are most commonly Gram-positive cocci, rarely Gramnegative bacteria are also reported as causative organisms 2). Periprosthetic joint infections (PJIs) due to Salmonella are rare with only 30 cases reported in the literature 3). The incidence of Salmonella infection increases in patients with sickle cell anemia, collagen vascular diseases, alcoholism, malignancies, immunosuppression, and past history of gastrointestinal system surgeries. Also the infections caused by Salmonella, the spread of the infection is hematogenous 4,5). There is no consensus in the literature as to whether periprosthetic Salmonella infections should be treated with one or two-step revision surgery 4). There are reports of success with both treatment modalities 6). We aimed to present two patients with immunosuppression due to azathioprine and prednisolone treatments who had PJIs caused by Salmonella and were treated with two-step revision surgery.

Case Reports in Orthopedics, 2016

Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and... more Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. Presentation of Case. We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient’s vital signs were stable. Discussion. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region injury ...

Case reports in orthopedics, 2016

Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and... more Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. Presentation of Case. We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient's vital signs were stable. Discussion. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region inj...

The expression of vascular endothelial growth factor has been strongly implicated in the pathogen... more The expression of vascular endothelial growth factor has been strongly implicated in the pathogenesis of conditions leading to inappropriate blood vessel growth in the eye. As such, vascular endothelial growth factor is an attractive target for anti-angiogenic therapies designed to treat neovascular eye diseases. One such therapy, antisense gene therapy, is a technique based on the ability of single-stranded DNA or RNA sequences to alter the expression of targeted genes. Recombinant adenoviruses have demonstrated ef®cient ocular cell transduction with a high level of transgene production. Cauterization of the normally avascular rat cornea results in a strong neovascular response, making it an ideal animal model for the testing of anti-angiogenic therapies. In this study, a recombinant adenovirus system was assessed for the ability to express biologically relevant antisense RNA to reduce vascular endothelial growth factor expression in a rat model of corneal neovascularization. Recombinant adenovirus constructs expressing short and long antisense and sense vascular endothelial growth factor cDNA, under the control of cytomegalovirus major immediate early promoter or the RNA polymerase III promoter, VA1, were constructed. The expression of short and long antisense RNAs was demonstrated by Northern blot hybridization. All constructs were capable of producing RNA, and the highest level of antisense RNA production was detected in retinal pigment epithelial cells which had been transduced with the longer antisense cDNA construct under the control of the VA1 promoter. This construct was also the most ef®cient in reducing in vitro vascular endothelial growth factor production (P 5 0. 05) and human endothelial cell proliferation. This construct was subsequently injected into rat eyes 24 hr prior to cauterization of the cornea and antisense vascular endothelial growth factor expression was demonstrated by in situ hybridization. The resulting neovascular response was clearly inhibited at 4, 7 and 14 days post-cautery, compared to the control injections which demonstrated an intense neovascular response. Only one out of six eyes injected with the long antisense cDNA construct under the control of the VA1 promoter demonstrated any vascular response to cautery. The reduction in the neovascular response was correlated, with signi®cantly lower amounts of vascular endothelial growth factor protein in the corneas (P 0. 006). These observations suggest that the speci®c down-regulation of vascular endothelial growth factor production is suf®cient to reduce the corneal neovascular response and that recombinant adenovirus might be a useful vehicle to produce antisense RNA in situ to down-regulate ocular gene expression.

Objective Although the recommended treatment for stage III posterior tibial tendon dysfunction (P... more Objective Although the recommended treatment for stage III posterior tibial tendon dysfunction (PTTD) is triple joint complex fusion, the literature is limited on this topic. No study has specifically investigated the influence of rheumatoid arthritis (RA) on the outcomes of triple arthrodesis. This study aimed (1) to report mid-to-long-term results of triple arthrodesis for stage III PTTD and (2) to investigate the difference in the results of triple arthrodesis between rheumatoid and nonrheumatoid patients. Methods Thirty feet of 25 patients (16 females, 9 males; mean age 53, (39-71)) with stage III PTTD who were treated by triple arthrodesis were retrospectively analyzed. The mean follow-up was 82 (28 – 144) months. Patients were divided into two groups based on etiology: group ID (idiopathic PTTD) and group RA (PTTD secondary to RA). All clinical and radiographic outcomes were compared. The mean American Orthopedic Foot and Ankle Society (AOFAS) score was measured preoperatively...

BMC Musculoskeletal Disorders

Background It has been suggested that the posterior tibial slope (PTS) plays an important role in... more Background It has been suggested that the posterior tibial slope (PTS) plays an important role in increasing the anteroposterior stability following total knee arthroplasty. Although the relationship between the PTS and the flexion range has been investigated many times, studies on the relationship between PTS and anterior-posterior stability are limited. The primary aim of this study was to investigate the relationship and effects of PTS on anteroposterior stability in posterior cruciate retainer total knee arthroplasty. Methods 154 primary TKAs were identified retrospectively to analyze the any association between PTS and anteroposterior laxity following posterior cruciate-retaining total knee arthroplasty in the overall study populations. Anteroposterior displacement was measured at the final follow-up based on the following two procedures: KT-1000 arthrometer and sagittal drawer radiographic images. In addition, the relationship between PTS and functional scores-ROM was examined...

Acta Orthopaedica Belgica

The proximity of the superficial femoral artery (SFA) to the femur exposes the SFA to risks that ... more The proximity of the superficial femoral artery (SFA) to the femur exposes the SFA to risks that have serious complications. Although surgeons have used the lateral or medial approach to lessen these risks, they have not been eliminated. Therefore, this study aimed to identify dangerous and safe zones in terms of the SFA that can be used during femoral surgical procedures, using anatomical reference points. Computed tomography angiography (CTA) of 50 patients aged between 16 and 60 years obtained from the local institution’s database was examined. Radiological and clinical measurements were performed to determine the position of the SFA relative to the femur. The mean age of the patients included in this study was 38.08 ± 9.44 (16–60) years. The average ratio of the distance between the proximal and distal borders of the dangerous zone and the lateral joint spaces (LJS) to the distance between the greater trochanter (GT) and LJS was 0.5722 ± 0.053, respectively. The average ratio of...

Joint Diseases and Related Surgery

In femoral shaft fractures, intramedullary nailing is the gold-standard treatment approach, with ... more In femoral shaft fractures, intramedullary nailing is the gold-standard treatment approach, with a high union rate and low complication rate compared to alternative treatment methods. [1] Femoral nailing can be done with two different techniques: antegrade or retrograde. [2] Both techniques used in intramedullary femoral nailing have different surgical indications and advantages. [3] Ipsilateral acetabular fracture, multi-trauma, ipsilateral proximal femur fracture, floating knee, periprosthetic fracture, and bilateral femur fractures are among the conditions where retrograde femoral nailing is often preferred. [4,5] One of the most technically difficult and dangerous steps in retrograde femoral nailing is proximal locking. [6] Although freehand locking is still the most prevalent way for proximal locking, [7] Objectives: This study aims to identify the most reliable level for the proximal locking screw in retrograde femoral nails and to investigate the preoperative detectability of the length of the proximal locking screw by radiological measurements. Patients and methods: Between April 2020 and June 2021, a total of 50 patients (42 males, 8 females; mean age: 38.1±14.3 years; range, 18 to 60 years) who were suspected of vascular injury after gunshot or stab wounds and underwent lower extremity computed tomography angiography (CTA) from the local institutionʼs database were included in the study. The distances of the femoral neurovascular structures (FNVS) and sciatic nerve (SN) to the femur were measured in the sections determined in the anteroposterior and medial-lateral planes. The anteroposterior length of the femur was measured in selected sections to estimate the appropriate length of the proximal locking screw.

Turkish Journal of Trauma and Emergency Surgery

of blood loss may cause problems related to anemia in the elderly and fragile patient group, who ... more of blood loss may cause problems related to anemia in the elderly and fragile patient group, who may require a blood transfusion. [3,4] Allogenic blood transfusion carries some risks, including prolonged hospitalization, delayed mobiliza

Medical Bulletin of Haseki

Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatm... more Most of the childhood elbow area fractures constitute supracondylar humerus fractures. The treatment approach in Gartland type II fractures is controversial. The purpose of our study was to compare the effectiveness of cast and splint in conservative treatment of type II supracondylar humerus fractures. Methods: Sixty-nine pediatric patients admitted to our clinic due to gartland type II supracondylar humerus fractures between 2015 and 2020 were retrospectively evaluated. Closed reduction upper-elbow cast was applied to 26 patients, and closed reduction upperelbow splint treatment was applied to 43 patients. Radiological results of the patients were compared. Results: The mean age of the patients participating in the study was 4.86±2.61 (1-12). Fourty two of 69 patients were male and 27 were female. Neurovascular deficit and compartment syndrome were not observed in any of the patients. When compared radiologically, no significant difference was found between the two groups. Conclusion: Type II supracondylar humerus fractures, where conservative treatment is planned, the upper elbow casting or splint selected for immobilization shows similar effectiveness in protecting reduction.

Istanbul Medical Journal

Introduction: This study evaluated the effect of both postoperative residual varus alignment and ... more Introduction: This study evaluated the effect of both postoperative residual varus alignment and the amount of correction in lower limb alignment (LLA) on postoperative functional outcomes of total knee arthroplasty TKAs in patients with preoperative varus deformity. Methods: Two-hundred and fifty-two knees of 209 patients who underwent a TKA for treating varus gonarthrosis were retrospectively reviewed in the study. Patients were then divided into the three groups according to the postoperative hip-knee-ankle angle (HKAA): the neutral group (NG) (HKAA: 183°-177°); the mild varus group (HKAA: 176.9°-174°); and the severe varus group (HKAA <174°). Patients were also categorized into the three groups based on the amount of correction in LLA; group A (<5); group B (5° to 10°), and group C (>10°). Pre-and post-operative functional outcomes were compared among the groups. Results: There were no significant differences in the postoperative Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and visual analog scale (VAS) scores between the mild and NGs (p=0.99, p=0.62, and p=0.33, respectively). The severe group showed lower postoperative KSS, WOMAC, and higher VAS scores compared to other two groups (p<0.001, p<0.001, and p<0.001, respectively). No significant differences were observed in the postoperative knee flexion and extension deficits among the three groups (p=0.79 and p=0.3). Patients with correction in LLA of >10° had higher WOMAC and lower VAS scores than the other patients (p=0.008 and p=0.002, respectively). Conclusion: Postoperative mild varus deformity is not associated with poorer clinical and functional outcomes; however, a postoperative severe varus deformity following TKA can cause a significant deterioration in postoperative clinical and functional outcomes in patients with preoperative varus osteoarthritis.

Haseki Tıp Bülteni, Mar 31, 2022

Malnutrition is reported to be related to higher mortality rates following geriatric hip fracture... more Malnutrition is reported to be related to higher mortality rates following geriatric hip fracture, and new malnutrition indicators are currently being identified. The aim of this study is to analyze prognostic nutritional index (PNI), C-reactive protein (CRP)/albumin ratio (CAR) and CRPI/PNI ratio (CPR) as prognostic factors for first-month, six-month, one-year and overall mortality following hip fracture surgery. Methods: This study was designed as a cross-sectional study. We reviewed the medical records of patients older than 75 years with osteoporotic hip fracture surgery between January 2012 and October 2019. Preoperative serum albumin, total lymphocyte count, and CRP levels were evaluated as laboratory values. PNI, CAR, and CPR were calculated and analyzed as prognostic factors for mortality. Results: Four hundred and thirty patients were included in the study. High American Society of Anesthesiology (ASA) score (p=0.01) and admission to the intensive care unit (ICU) (p=0.016) were found to be independently associated with worse survival in the first month. The admission to the ICU (p=0.004) was independently related to poor survival in the first six months. High ASA score (p=0.018) and admission to the ICU (p=0.016) were independently associated with a poor survival in the first year. High ASA score (p<0.001) and admission to the ICU (p<0.001) were found to be independent prognostic factors for poor overall survival. Conclusion: PNI, CAR, and CPR were not significantly related to poor survival in the first month, six months, one year, and overall follow-up period after geriatric hip fracture surgery.

Turkish Journal of Physical Medicine and Rehabilitation, 2021

Objectives: This study aims to evaluate patients with conservatively treated stable lateral malle... more Objectives: This study aims to evaluate patients with conservatively treated stable lateral malleolar fractures with isokinetic tests. Patients and methods: Between January 2016 and November 2017, a total of 24 patients (12 males, 12 females; mean age 40.8±15.0 years; range, 18 to 68 years) with an isolated stable lateral malleolar fracture treated conservatively with the circular cast were included in this prospective study. Calf circumferences, ankle range of motion (ROM), pain levels, and functional outcomes were recorded. The muscle strengths and endurance of the injured side were compared with the non-injured side. All patients were evaluated by isokinetic test after removal of the cast, and three and six months after the rehabilitation period. Results: The ROM was found to be lower after removal of the plaster cast, compared to the contralateral ankle. During cast removal, we also found that both dorsiflexor and plantar flexor muscle strength decreased by 25.6% and 44.7%, resp...

Journal of Laboratory Physicians, 2020

We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee re... more We present a case of Abiotrophia defectiva in a prosthetic knee infection following total knee replacement for the first time. A 69-year-old female was prediagnosed with prosthetic knee infection, and a two-stage revision arthroplasty was applied. A. defectiva was cultured by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) from the synovial fluid aspirates. Penicillin G and gentamicin had been administered. One year postoperatively, a scintigraphy showed no recurrence. A. defectiva may be missed in culture negative patients with knee or hip arthroplasty. They should be carefully evaluated if they have undergone recent dental procedures.

Knee Surgery, Sports Traumatology, Arthroscopy

Lupus

Objective Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse ... more Objective Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse of the architectural bone structure secondary to the death of the bone marrow and trabecular bone. Osteonecrosis may accompany many conditions, especially rheumatic diseases. Among rheumatic diseases, osteonecrosis is most commonly associated with systemic lupus erythematosus (SLE). We assessed prevalence and distribution pattern of symptomatic ON in patients with SLE and compare the natural courses of hip and knee ON. Methods 912 SLE patients admitted between 1981 and 2012 were reviewed. SLE patients with symptomatic ON were retrospectively identified both from the existing SLE/APS database. The prevalence of symptomatic ON was calculated; with ON, the joint involvement pattern was determined by examining the distribution of the joints involved, and then the data about the hip and knee joints were entered in the Kaplan-Meier analysis. Kaplan-Meier methods were used to calculate 5- and 1...

Medicine Science | International Medical Journal

Journal of Shoulder and Elbow Surgery

Acta Orthopaedica et Traumatologica Turcica

Hip & Pelvis

The rate of periprosthetic infection after total hip arthroplasty (THA) is reported to be 1-2% 1)... more The rate of periprosthetic infection after total hip arthroplasty (THA) is reported to be 1-2% 1). These infections are associated with an increase in hospital stay, need for repeat surgery, increase in costs, long-term antibiotic use, and decreased quality of life 2). While isolated organisms are most commonly Gram-positive cocci, rarely Gramnegative bacteria are also reported as causative organisms 2). Periprosthetic joint infections (PJIs) due to Salmonella are rare with only 30 cases reported in the literature 3). The incidence of Salmonella infection increases in patients with sickle cell anemia, collagen vascular diseases, alcoholism, malignancies, immunosuppression, and past history of gastrointestinal system surgeries. Also the infections caused by Salmonella, the spread of the infection is hematogenous 4,5). There is no consensus in the literature as to whether periprosthetic Salmonella infections should be treated with one or two-step revision surgery 4). There are reports of success with both treatment modalities 6). We aimed to present two patients with immunosuppression due to azathioprine and prednisolone treatments who had PJIs caused by Salmonella and were treated with two-step revision surgery.

Case Reports in Orthopedics, 2016

Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and... more Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. Presentation of Case. We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient’s vital signs were stable. Discussion. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region injury ...

Case reports in orthopedics, 2016

Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and... more Introduction. Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury. Presentation of Case. We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient's vital signs were stable. Discussion. Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region inj...

The expression of vascular endothelial growth factor has been strongly implicated in the pathogen... more The expression of vascular endothelial growth factor has been strongly implicated in the pathogenesis of conditions leading to inappropriate blood vessel growth in the eye. As such, vascular endothelial growth factor is an attractive target for anti-angiogenic therapies designed to treat neovascular eye diseases. One such therapy, antisense gene therapy, is a technique based on the ability of single-stranded DNA or RNA sequences to alter the expression of targeted genes. Recombinant adenoviruses have demonstrated ef®cient ocular cell transduction with a high level of transgene production. Cauterization of the normally avascular rat cornea results in a strong neovascular response, making it an ideal animal model for the testing of anti-angiogenic therapies. In this study, a recombinant adenovirus system was assessed for the ability to express biologically relevant antisense RNA to reduce vascular endothelial growth factor expression in a rat model of corneal neovascularization. Recombinant adenovirus constructs expressing short and long antisense and sense vascular endothelial growth factor cDNA, under the control of cytomegalovirus major immediate early promoter or the RNA polymerase III promoter, VA1, were constructed. The expression of short and long antisense RNAs was demonstrated by Northern blot hybridization. All constructs were capable of producing RNA, and the highest level of antisense RNA production was detected in retinal pigment epithelial cells which had been transduced with the longer antisense cDNA construct under the control of the VA1 promoter. This construct was also the most ef®cient in reducing in vitro vascular endothelial growth factor production (P 5 0. 05) and human endothelial cell proliferation. This construct was subsequently injected into rat eyes 24 hr prior to cauterization of the cornea and antisense vascular endothelial growth factor expression was demonstrated by in situ hybridization. The resulting neovascular response was clearly inhibited at 4, 7 and 14 days post-cautery, compared to the control injections which demonstrated an intense neovascular response. Only one out of six eyes injected with the long antisense cDNA construct under the control of the VA1 promoter demonstrated any vascular response to cautery. The reduction in the neovascular response was correlated, with signi®cantly lower amounts of vascular endothelial growth factor protein in the corneas (P 0. 006). These observations suggest that the speci®c down-regulation of vascular endothelial growth factor production is suf®cient to reduce the corneal neovascular response and that recombinant adenovirus might be a useful vehicle to produce antisense RNA in situ to down-regulate ocular gene expression.