Ozgür Çetik - Academia.edu (original) (raw)
Papers by Ozgür Çetik
![Research paper thumbnail of [The effectivity of magnetic resonance imaging findings in the diagnosis of bucket handle meniscal tears]](https://attachments.academia-assets.com/88983991/thumbnails/1.jpg)
](Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2012
This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group wh... more This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group who were blinded to the arthroscopic diagnosis in patients with known bucket handle meniscal tears. In this study, MRI scans of 28 patients who were operated due to bucket handle meniscal tear with sufficient documentation were evaluated. Radiographic evaluation was performed by two different groups, including an orthopedist and radiologist. In the first group, evaluation of MRI scans was performed by the specialists who were aware of the arthroscopic diagnosis and marked the defined MRI signs of bucket handle meniscal tear. In the second group, evaluation was done, remaining blinded to the diagnosis, with only initial complaints at admission. The second group also evaluated the MRI scans and marked the pathologic signs. The sensitivity of radiological signs marked by both groups was compared. Invariables were found using blinded evaluation. Double posterior cruciate ligament and free frag...
Journal of Trauma & Treatment, 2012
European Journal of Orthopaedic Surgery & Traumatology, 2010
Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformit... more Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformity and surgical planning are usually depended on plain radiographic measurements for corrective osteotomies. In most of the cases, the rotational deformity is disregarded in preoperative planning. We aimed to clarify the effect of rotational deformity on radial inclination and dorsal or volar tilt measurements, which are commonly
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Purpose Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of o... more Purpose Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condyle can occur after arthroscopic procedures. Meniscal tears, arthroscopic meniscectomy, and radiofrequency chondroplasty are aetiological factors in the development of osteonecrosis. The aim of this study was to investigate whether the incidence of osteonecrosis increased when mechanical or radiofrequency chondroplasty was used in conjunction with arthroscopic meniscectomy. Methods In this prospective clinical trial, arthroscopic meniscectomy was the primary treatment in 75 patients (mean age 40 ± 13) with stage II and III degenerative changes on the articular cartilage. Patients had to meet the following criteria: 1) have preoperative MRI and plain film radiographs showing no evidence of osteonecrosis; 2) be symptomatic for at least 6 weeks before the preoperative MRI; and 3) have arthroscopically confirmed stage II or III chondral lesion. A preoperative MRI was performed for all patients. For treatment of chondral lesions, debridement with a shaver or chondroplasty with a monopolar RF energy system was used. Patients were divided into three treatment groups. Partial meniscectomy of the medial or lateral (or both) menisci was performed on all patients, but patients in group 2 additionally received mechanical debridement of the chondral lesion, and those in group 3 were additionally treated with RF chondroplasty. Patients in group 1 were treated with partial meniscectomy alone. Patients were reexamined after 6 months, at which time a repeat MRI was performed. Results Development of osteonecrosis was detected during the postoperative MRIs of five patients: two in group 1, two in group 2, and one in group 3. Conclusion The addition of mechanical or RF chondroplasty to meniscectomy did not increase the number of patients with osteonecrosis. Also, RF chondroplasty, which is commonly proposed to be an aetiological factor, resulted in a decrease in the number of patients that developed osteonecrosis. Level of evidence II.
Knee Surgery, Sports Traumatology, Arthroscopy, 2012
Although sutures evolved in last decade and the product spectrum broadened largely, they can be s... more Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation. Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop. Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw. Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.
Journal of Pediatric Orthopaedics B, 2012
Journal of Biomechanics, 2011
Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing n... more Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing number of the pedicle screw instrumentation in elderly osteoporotic population. There are many ways to salvage pedicle screws such as using larger and/or longer size pedicle screws, ...
Foot & Ankle International, 2010
Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the cr... more Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the creation of stable enough fixation to allow early range of motion. It was documented that the weakest point in a suture loop is the knot. Thus, we hypothesized that moving the knot away from the repair junction (over-the-top Krackow technique) would increase the strength of the repair. Transected bovine tendons were repaired by the traditional Krackow and over-the-top Krackow techniques using four suture materials (Fiberwire Nos. 5 and 2, Ethibond Nos. 5 and 2). Tendons were cyclically tested at incremental loads beginning from 50 N until 5-mm gap formation. Then all tendons were loaded to failure. The number of cycles to 5-mm gapping, ultimate failure loads and knot slip were compared using t-test and Mann-Whitney tests (with Tukey corrections for multiple comparisons). Mean number of cycles to 5-mm gapping did not reveal significant differences (p = 0.113) between repair groups. Mean failure load of tendons repaired by over-the-top Krackow technique were significantly higher (p < 0.0001) for all four paired groups than tendons repaired by traditional Krackow technique. Ethibond No. 5, No. 2, and Fiberwire No. 2 suture repairs with over-the-top configuration did not reveal any knot slip. Over-the-top Krackow technique increases the ultimate failure load of repaired tendons. But 5-mm gapping resistivity was not enhanced either by the technique or the suture material. The knot itself is a stress-riser in the suture loop so we suggest that freeing it from tension by our modificiation may achieve more durable repairs.
Knee Surgery, Sports Traumatology, Arthroscopy, 2004
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2001
We performed a 2-staged arthroscopic-assisted surgical procedure to treat a patient with a large ... more We performed a 2-staged arthroscopic-assisted surgical procedure to treat a patient with
a large osteochondral lesion of the knee joint. The osteochondral lesion was too comminuted to
reattach; in addition, the underlying bony defect was too deep. In the first stage, autogenous cortical
bone was used for grafting the bony defect along with screw fixation. The second stage consisted of
screw removal and transplantation of autogenous osteochondral graft overlying the chondral defect.
The osteochondral grafts were taken from the non–weight bearing areas of the same knee.
Journal of Trauma & Treatment, 2012
Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile... more Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Engineering Advances in Pharmacoepidemiology & Drug Safety Advances in Robotics & Automation Aeronautics & Aerospace ...
Journal of Biomechanics, 2011
Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing n... more Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing number of the pedicle screw instrumentation in elderly osteoporotic population. There are many ways to salvage pedicle screws such as using larger and/or longer size pedicle screws, ...
Knee Surgery, Sports Traumatology, Arthroscopy, 2012
Although sutures evolved in last decade and the product spectrum broadened largely, they can be s... more Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation. Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop. Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw. Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.
Journal of Pediatric Orthopaedics B, 2012
Increased femoral anteversion in cerebral palsy alters biomechanics of gait. Femoral subtrochante... more Increased femoral anteversion in cerebral palsy alters biomechanics of gait. Femoral subtrochanteric derotational osteotomies are increasingly performed to improve gait in cerebral palsy. The amount of angular correction can be determined and planned preoperatively but, accuracy in achieving planned angular correction has not been tested experimentally before. The aim of this study was to evaluate the accuracy of the two techniques in achieving planned angular correction. Sixteen dry femora were used in this study. Specimens in both groups were derotated to achieve a desired amount of correction with two different techniques, consecutively. In technique one, the cross section of the femur was assumed to be circular and the desired amount of angular correction was calculated and expressed in terms of surface distance by a geometric formula (surface distance=2×π×radius of femur). In both groups, derotations were made based on this surface distance calculation. Consecutively the same specimens were derotated by pins and guide technique. Femoral anteversion of specimens were measured before and after derotation by computerized tomography. There was a statistically significant differance in planned and achieved correction angles (P=0.038) in both subgroups derotated by the surface distance technique. When the two techniques were compared, there was significant difference (P=0.050) between high magnitude correction subgroups (subgroups 2 vs. 4). In conclusion, the results of this study highlighted the difficulty in achieving accurate derotation angles. Derotations based on guide-pins technique yielded more accurate results than derotations based on surface distance technique. In addition, surface diameter technique was not suitable when higher degrees of derotations are needed. In achieving a planned derotation angle two techniques are described for accuracy. Both the techniques have potential pitfalls resulting in malrotations. Surgeons must be aware of these obstacles and try to avoid them.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2012
This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group wh... more This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group who were blinded to the arthroscopic diagnosis in patients with known bucket handle meniscal tears. In this study, MRI scans of 28 patients who were operated due to bucket handle meniscal tear with sufficient documentation were evaluated. Radiographic evaluation was performed by two different groups, including an orthopedist and radiologist. In the first group, evaluation of MRI scans was performed by the specialists who were aware of the arthroscopic diagnosis and marked the defined MRI signs of bucket handle meniscal tear. In the second group, evaluation was done, remaining blinded to the diagnosis, with only initial complaints at admission. The second group also evaluated the MRI scans and marked the pathologic signs. The sensitivity of radiological signs marked by both groups was compared. Invariables were found using blinded evaluation. Double posterior cruciate ligament and free frag...
European Journal of Orthopaedic Surgery & Traumatology, 2010
Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformit... more Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformity and surgical planning are usually depended on plain radiographic measurements for corrective osteotomies. In most of the cases, the rotational deformity is disregarded in preoperative planning. We aimed to clarify the effect of rotational deformity on radial inclination and dorsal or volar tilt measurements, which are commonly
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condy... more Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condyle can occur after arthroscopic procedures. Meniscal tears, arthroscopic meniscectomy, and radiofrequency chondroplasty are aetiological factors in the development of osteonecrosis. The aim of this study was to investigate whether the incidence of osteonecrosis increased when mechanical or radiofrequency chondroplasty was used in conjunction with arthroscopic meniscectomy. In this prospective clinical trial, arthroscopic meniscectomy was the primary treatment in 75 patients (mean age 40 ± 13) with stage II and III degenerative changes on the articular cartilage. Patients had to meet the following criteria: 1) have preoperative MRI and plain film radiographs showing no evidence of osteonecrosis; 2) be symptomatic for at least 6 weeks before the preoperative MRI; and 3) have arthroscopically confirmed stage II or III chondral lesion. A preoperative MRI was performed for all patients. For treatment of chondral lesions, debridement with a shaver or chondroplasty with a monopolar RF energy system was used. Patients were divided into three treatment groups. Partial meniscectomy of the medial or lateral (or both) menisci was performed on all patients, but patients in group 2 additionally received mechanical debridement of the chondral lesion, and those in group 3 were additionally treated with RF chondroplasty. Patients in group 1 were treated with partial meniscectomy alone. Patients were re-examined after 6 months, at which time a repeat MRI was performed. Development of osteonecrosis was detected during the postoperative MRIs of five patients: two in group 1, two in group 2, and one in group 3. The addition of mechanical or RF chondroplasty to meniscectomy did not increase the number of patients with osteonecrosis. Also, RF chondroplasty, which is commonly proposed to be an aetiological factor, resulted in a decrease in the number of patients that developed osteonecrosis. II.
Foot & Ankle International, 2010
Background: Currently a major concern for the surgical treatment of Achilles tendon rupture repai... more Background: Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the creation of stable enough fixation to allow early range of motion. It was documented that the weakest point in a suture loop is the knot. Thus, we hypothesized that moving the knot away from the repair junction (over-the-top Krackow technique) would increase the strength of the repair. Materials and Methods: Transected bovine tendons were repaired by the traditional Krackow and over-the-top Krackow techniques using four suture materials (Fiberwire Nos. 5 and 2, Ethibond Nos. 5 and 2). Tendons were cyclically tested at incremental loads beginning from 50 N until 5-mm gap formation. Then all tendons were loaded to failure. The number of cycles to 5-mm gapping, ultimate failure loads and knot slip were compared using t-test and Mann-Whitney tests (with Tukey corrections for multiple comparisons). Results: Mean number of cycles to 5-mm gapping did not reveal significant differences (p = 0.113) between repair groups. Mean failure load of tendons repaired by over-the-top Krackow technique were significantly higher (p < 0.0001) for all four paired groups than tendons repaired by traditional Krackow technique. Ethibond No. 5, No. 2, and Fiberwire No. 2 suture repairs with over-the-top configuration did not reveal any knot slip. Conclusion: Over-the-top Krackow technique increases the For information on pricings and availability of reprints, call 410-494-4994, x232. ultimate failure load of repaired tendons. But 5-mm gapping resistivity was not enhanced either by the technique or the suture material. Clinical Relevance: The knot itself is a stressriser in the suture loop so we suggest that freeing it from tension by our modificiation may achieve more durable repairs.
Knee Surgery, Sports Traumatology, Arthroscopy, 2005
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2012
This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group wh... more This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group who were blinded to the arthroscopic diagnosis in patients with known bucket handle meniscal tears. In this study, MRI scans of 28 patients who were operated due to bucket handle meniscal tear with sufficient documentation were evaluated. Radiographic evaluation was performed by two different groups, including an orthopedist and radiologist. In the first group, evaluation of MRI scans was performed by the specialists who were aware of the arthroscopic diagnosis and marked the defined MRI signs of bucket handle meniscal tear. In the second group, evaluation was done, remaining blinded to the diagnosis, with only initial complaints at admission. The second group also evaluated the MRI scans and marked the pathologic signs. The sensitivity of radiological signs marked by both groups was compared. Invariables were found using blinded evaluation. Double posterior cruciate ligament and free frag...
Journal of Trauma & Treatment, 2012
European Journal of Orthopaedic Surgery & Traumatology, 2010
Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformit... more Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformity and surgical planning are usually depended on plain radiographic measurements for corrective osteotomies. In most of the cases, the rotational deformity is disregarded in preoperative planning. We aimed to clarify the effect of rotational deformity on radial inclination and dorsal or volar tilt measurements, which are commonly
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Purpose Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of o... more Purpose Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condyle can occur after arthroscopic procedures. Meniscal tears, arthroscopic meniscectomy, and radiofrequency chondroplasty are aetiological factors in the development of osteonecrosis. The aim of this study was to investigate whether the incidence of osteonecrosis increased when mechanical or radiofrequency chondroplasty was used in conjunction with arthroscopic meniscectomy. Methods In this prospective clinical trial, arthroscopic meniscectomy was the primary treatment in 75 patients (mean age 40 ± 13) with stage II and III degenerative changes on the articular cartilage. Patients had to meet the following criteria: 1) have preoperative MRI and plain film radiographs showing no evidence of osteonecrosis; 2) be symptomatic for at least 6 weeks before the preoperative MRI; and 3) have arthroscopically confirmed stage II or III chondral lesion. A preoperative MRI was performed for all patients. For treatment of chondral lesions, debridement with a shaver or chondroplasty with a monopolar RF energy system was used. Patients were divided into three treatment groups. Partial meniscectomy of the medial or lateral (or both) menisci was performed on all patients, but patients in group 2 additionally received mechanical debridement of the chondral lesion, and those in group 3 were additionally treated with RF chondroplasty. Patients in group 1 were treated with partial meniscectomy alone. Patients were reexamined after 6 months, at which time a repeat MRI was performed. Results Development of osteonecrosis was detected during the postoperative MRIs of five patients: two in group 1, two in group 2, and one in group 3. Conclusion The addition of mechanical or RF chondroplasty to meniscectomy did not increase the number of patients with osteonecrosis. Also, RF chondroplasty, which is commonly proposed to be an aetiological factor, resulted in a decrease in the number of patients that developed osteonecrosis. Level of evidence II.
Knee Surgery, Sports Traumatology, Arthroscopy, 2012
Although sutures evolved in last decade and the product spectrum broadened largely, they can be s... more Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation. Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop. Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw. Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.
Journal of Pediatric Orthopaedics B, 2012
Journal of Biomechanics, 2011
Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing n... more Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing number of the pedicle screw instrumentation in elderly osteoporotic population. There are many ways to salvage pedicle screws such as using larger and/or longer size pedicle screws, ...
Foot & Ankle International, 2010
Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the cr... more Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the creation of stable enough fixation to allow early range of motion. It was documented that the weakest point in a suture loop is the knot. Thus, we hypothesized that moving the knot away from the repair junction (over-the-top Krackow technique) would increase the strength of the repair. Transected bovine tendons were repaired by the traditional Krackow and over-the-top Krackow techniques using four suture materials (Fiberwire Nos. 5 and 2, Ethibond Nos. 5 and 2). Tendons were cyclically tested at incremental loads beginning from 50 N until 5-mm gap formation. Then all tendons were loaded to failure. The number of cycles to 5-mm gapping, ultimate failure loads and knot slip were compared using t-test and Mann-Whitney tests (with Tukey corrections for multiple comparisons). Mean number of cycles to 5-mm gapping did not reveal significant differences (p = 0.113) between repair groups. Mean failure load of tendons repaired by over-the-top Krackow technique were significantly higher (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) for all four paired groups than tendons repaired by traditional Krackow technique. Ethibond No. 5, No. 2, and Fiberwire No. 2 suture repairs with over-the-top configuration did not reveal any knot slip. Over-the-top Krackow technique increases the ultimate failure load of repaired tendons. But 5-mm gapping resistivity was not enhanced either by the technique or the suture material. The knot itself is a stress-riser in the suture loop so we suggest that freeing it from tension by our modificiation may achieve more durable repairs.
Knee Surgery, Sports Traumatology, Arthroscopy, 2004
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2001
We performed a 2-staged arthroscopic-assisted surgical procedure to treat a patient with a large ... more We performed a 2-staged arthroscopic-assisted surgical procedure to treat a patient with
a large osteochondral lesion of the knee joint. The osteochondral lesion was too comminuted to
reattach; in addition, the underlying bony defect was too deep. In the first stage, autogenous cortical
bone was used for grafting the bony defect along with screw fixation. The second stage consisted of
screw removal and transplantation of autogenous osteochondral graft overlying the chondral defect.
The osteochondral grafts were taken from the non–weight bearing areas of the same knee.
Journal of Trauma & Treatment, 2012
Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile... more Journals »». A Accounting & Marketing Addiction Research & Therapy Advances in Automobile Engineering Advances in Pharmacoepidemiology & Drug Safety Advances in Robotics & Automation Aeronautics & Aerospace ...
Journal of Biomechanics, 2011
Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing n... more Over the years, spine surgeons have been obliged to revise pedicle screws due to the increasing number of the pedicle screw instrumentation in elderly osteoporotic population. There are many ways to salvage pedicle screws such as using larger and/or longer size pedicle screws, ...
Knee Surgery, Sports Traumatology, Arthroscopy, 2012
Although sutures evolved in last decade and the product spectrum broadened largely, they can be s... more Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation. Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop. Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw. Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.
Journal of Pediatric Orthopaedics B, 2012
Increased femoral anteversion in cerebral palsy alters biomechanics of gait. Femoral subtrochante... more Increased femoral anteversion in cerebral palsy alters biomechanics of gait. Femoral subtrochanteric derotational osteotomies are increasingly performed to improve gait in cerebral palsy. The amount of angular correction can be determined and planned preoperatively but, accuracy in achieving planned angular correction has not been tested experimentally before. The aim of this study was to evaluate the accuracy of the two techniques in achieving planned angular correction. Sixteen dry femora were used in this study. Specimens in both groups were derotated to achieve a desired amount of correction with two different techniques, consecutively. In technique one, the cross section of the femur was assumed to be circular and the desired amount of angular correction was calculated and expressed in terms of surface distance by a geometric formula (surface distance=2×π×radius of femur). In both groups, derotations were made based on this surface distance calculation. Consecutively the same specimens were derotated by pins and guide technique. Femoral anteversion of specimens were measured before and after derotation by computerized tomography. There was a statistically significant differance in planned and achieved correction angles (P=0.038) in both subgroups derotated by the surface distance technique. When the two techniques were compared, there was significant difference (P=0.050) between high magnitude correction subgroups (subgroups 2 vs. 4). In conclusion, the results of this study highlighted the difficulty in achieving accurate derotation angles. Derotations based on guide-pins technique yielded more accurate results than derotations based on surface distance technique. In addition, surface diameter technique was not suitable when higher degrees of derotations are needed. In achieving a planned derotation angle two techniques are described for accuracy. Both the techniques have potential pitfalls resulting in malrotations. Surgeons must be aware of these obstacles and try to avoid them.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery, 2012
This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group wh... more This study aims to test the efficacy of magnetic resonance imaging (MRI) evaluation by a group who were blinded to the arthroscopic diagnosis in patients with known bucket handle meniscal tears. In this study, MRI scans of 28 patients who were operated due to bucket handle meniscal tear with sufficient documentation were evaluated. Radiographic evaluation was performed by two different groups, including an orthopedist and radiologist. In the first group, evaluation of MRI scans was performed by the specialists who were aware of the arthroscopic diagnosis and marked the defined MRI signs of bucket handle meniscal tear. In the second group, evaluation was done, remaining blinded to the diagnosis, with only initial complaints at admission. The second group also evaluated the MRI scans and marked the pathologic signs. The sensitivity of radiological signs marked by both groups was compared. Invariables were found using blinded evaluation. Double posterior cruciate ligament and free frag...
European Journal of Orthopaedic Surgery & Traumatology, 2010
Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformit... more Malunited distal radius fractures are 3D deformities. The preoperative evaluation of the deformity and surgical planning are usually depended on plain radiographic measurements for corrective osteotomies. In most of the cases, the rotational deformity is disregarded in preoperative planning. We aimed to clarify the effect of rotational deformity on radial inclination and dorsal or volar tilt measurements, which are commonly
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condy... more Spontaneous subchondral osteonecrosis of the knee joint confined to a localized area of one condyle can occur after arthroscopic procedures. Meniscal tears, arthroscopic meniscectomy, and radiofrequency chondroplasty are aetiological factors in the development of osteonecrosis. The aim of this study was to investigate whether the incidence of osteonecrosis increased when mechanical or radiofrequency chondroplasty was used in conjunction with arthroscopic meniscectomy. In this prospective clinical trial, arthroscopic meniscectomy was the primary treatment in 75 patients (mean age 40 ± 13) with stage II and III degenerative changes on the articular cartilage. Patients had to meet the following criteria: 1) have preoperative MRI and plain film radiographs showing no evidence of osteonecrosis; 2) be symptomatic for at least 6 weeks before the preoperative MRI; and 3) have arthroscopically confirmed stage II or III chondral lesion. A preoperative MRI was performed for all patients. For treatment of chondral lesions, debridement with a shaver or chondroplasty with a monopolar RF energy system was used. Patients were divided into three treatment groups. Partial meniscectomy of the medial or lateral (or both) menisci was performed on all patients, but patients in group 2 additionally received mechanical debridement of the chondral lesion, and those in group 3 were additionally treated with RF chondroplasty. Patients in group 1 were treated with partial meniscectomy alone. Patients were re-examined after 6 months, at which time a repeat MRI was performed. Development of osteonecrosis was detected during the postoperative MRIs of five patients: two in group 1, two in group 2, and one in group 3. The addition of mechanical or RF chondroplasty to meniscectomy did not increase the number of patients with osteonecrosis. Also, RF chondroplasty, which is commonly proposed to be an aetiological factor, resulted in a decrease in the number of patients that developed osteonecrosis. II.
Foot & Ankle International, 2010
Background: Currently a major concern for the surgical treatment of Achilles tendon rupture repai... more Background: Currently a major concern for the surgical treatment of Achilles tendon rupture repairs is the creation of stable enough fixation to allow early range of motion. It was documented that the weakest point in a suture loop is the knot. Thus, we hypothesized that moving the knot away from the repair junction (over-the-top Krackow technique) would increase the strength of the repair. Materials and Methods: Transected bovine tendons were repaired by the traditional Krackow and over-the-top Krackow techniques using four suture materials (Fiberwire Nos. 5 and 2, Ethibond Nos. 5 and 2). Tendons were cyclically tested at incremental loads beginning from 50 N until 5-mm gap formation. Then all tendons were loaded to failure. The number of cycles to 5-mm gapping, ultimate failure loads and knot slip were compared using t-test and Mann-Whitney tests (with Tukey corrections for multiple comparisons). Results: Mean number of cycles to 5-mm gapping did not reveal significant differences (p = 0.113) between repair groups. Mean failure load of tendons repaired by over-the-top Krackow technique were significantly higher (p < 0.0001) for all four paired groups than tendons repaired by traditional Krackow technique. Ethibond No. 5, No. 2, and Fiberwire No. 2 suture repairs with over-the-top configuration did not reveal any knot slip. Conclusion: Over-the-top Krackow technique increases the For information on pricings and availability of reprints, call 410-494-4994, x232. ultimate failure load of repaired tendons. But 5-mm gapping resistivity was not enhanced either by the technique or the suture material. Clinical Relevance: The knot itself is a stressriser in the suture loop so we suggest that freeing it from tension by our modificiation may achieve more durable repairs.
Knee Surgery, Sports Traumatology, Arthroscopy, 2005