Sezgin Sarban - Academia.edu (original) (raw)
Papers by Sezgin Sarban
Clinical Orthopaedics and Related Research, Aug 4, 2009
With an aging population the frequency of postmenopausal fractures is increasing. Methods to enha... more With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair. This project was partly supported by Harran University Research Fund (HUBAK 436). Kurtsan Inc. (Istanbul, Turkey) supplied the absorbable collagen sponges for this study. Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
DergiPark (Istanbul University), Aug 1, 2006
Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık red... more Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık redüksiyon ve Salter'in İnnominate Osteotomi (SİO) tedavisi yapılan olguların erken dönem sonuçlarını değerlendirmek amaçlanmıştır. Hastalar ve Yöntemler: 2001-2004 yılları arasında Harran Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniğinde, yürüme çağında GKD tanısı konularak açık redüksiyon ve SİO uygulanan ve en az 2 yıllık takipleri olan, 19 çocuğun 23 kalçası çalışmaya dahil edildi. Ameliyat sırasındaki yaşları ortalaması 34.4 ay (18 ay-52 ay) idi. Hastalardan 16'sı kız, 3'ü erkekti ve 4'ünde iki taraflı tutulum vardı. Ortalama takip süresi 31.8 ay (24-38) olarak bulundu. Preoperatif, postoperatif 1. hafta ve son takiplerde direk grafiyle asetabular indeks (Aİ); preoperatif, postoperatif 1. hafta ve 1.yılda 2 boyutlu bilgisayarlı tomografi (BT) ile aksiyel asetabular indeks (AAİ) ölçümleri yapıldı. Hastalar son takiplerinde klinik olarak McKay sınıflaması ve radyolojik olarak ise Severin kriterlerine göre değerlendirildi. Bulgular: Klinik olarak 19 kalçada (%82.6) mükemmel ve iyi sonuç (14 kalça mükemmel, 5 kalça iyi), 4 kalçada (% 17.4) ise orta sonuç elde edildi. Radyolojik olarak Severin kriterlerine göre; 13 kalçada grup 1 (mükemmel), 5 kalçada grup 2 (iyi), 4 kalçada grup 3 (orta) ve 1 kalçada grup 1 (kötü) sonuç elde edildi. Buna göre 18 kalçada (% 78.3) mükemmel ve iyi sonuca ulaşıldı. 4 ayrı hastada yüzeyel enfeksiyon, redislokasyon, hematom gelişimi ve alçı açıldıktan sonra femur diafiz kırığı olmak üzere, 4 komplikasyon gelişti. Bu komplikasyonların tamamı tedaviye iyi yanıt verdi. Aİ preoperatif 40.43°'den takipte 20.48°'e; AAİ ise 18.09°'den 13.43°'e gerilediği saptandı. Orta ve kötü klinikradyolojik sonuç alanların asetabuler indeksleri (Aİ ve AAİ) ile mükemmel ve iyi sonuç alan grubun değerleri karşılaştırıldığında arada anlamlı fark saptanmadı. Sonuç: Yürüme çağı GKD'li olgularda; açık redüksiyon ve SİO kombinasyonunun etkili bir tedavi seçeneği olduğu görüşündeyiz. Anahtar kelimeler: Gelişimsel kalça displazisi, Cerrahi tedavi, Açık redüksiyon, Salter İnnominat Osteotomisi. SUMMARY The Simultaneous Open Reduction and Salter Innominate Osteotomy in The Treatment of Developmental Dysplasia of The Hip: The Preliminary Results Objectives: This study was conducted to evaluate the early results of open reduction and Salter Innominate Osteotomy (SIO) performed in ambulatory patients with Developmental Dysplasia of the Hip (DDH). Patients and Methods: We reviewed the results of the open reduction and SIO in 23 hips of the 19 patients with DDH in children of walking age who had been operated between 2001 and 2004 at Harran University Department of Orthopedics. All patients had a minimum 2 years follow up. Patients age at the time of operation was 34.4 months (range, 18-52 months). There were 16 female and one male patients. Of them 4 had bilateral, 15 had unilateral disease. The mean follow up was 31.8 months (range, 24-38). Acetabular index were measured preoperatively, at the first postoperative week and at the last follow up by the direct X-ray and axial acetabular index were determined preoperatively, at the first postoperative week and at the first postoperative year by 2 dimentional computed tomography. The clinical results were evaluated according to Mc Kay classification, whereas radiological results according to the Severin scoring criteria. Results:. Clinical results were as follows; 19 hips (82.6 %) were excellent or good, and 4 hips (17.4 %) were fair. According to Severin's radiological scoring 18 hips (78.3 %) were excellent or good, 4 hips (17.4 %) were fair and one was (4.3 %) poor results. The ages of three of four patients with fair results and the patient with poor radiological score were greater than 48 months. Postoperatively, 4 complications developed in four separate patients; which were superficial infection, redislocation, hemotoma formation and femoral diaphyseal fracture after opening the cast. All complications resolved with the treatment. The acetabular index averaged 40.43° preoperatively and 20.48°at the last follow up and the axial acetabular index improved 13.43° at the last follow up from 18.09° preoperatively. Significant differences were not found in the preoperative and recent acetabular indices (AI and AAI) when compared the fair and poor groups versus the excellent and groups. Conclusion: We conclude that the open reduction and SIO combination is an effective treatment in ambulatory DDH patients.
PubMed, 2005
Objectives: This study was designed to compare the biomechanical characteristics of non-anatomic ... more Objectives: This study was designed to compare the biomechanical characteristics of non-anatomic (far from joint) and anatomic (close to joint) levels of tibial tunnel fixation with soft tissue graft using a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Methods: Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after removing soft tissues. Tibial tunnels were prepared with a 7-mm drill with the use of an ACL guide adjusted to 45 degrees . Each tunnel was then dilated to 9 mm in 0.5 mm increments. Digital extensor tendons were fixed at non-anatomic (group I) or anatomic (group II) tibial tunnel levels with a soft tissue metal interference screw, 9 x 30 mm in size. All the specimens were cycled 500 times from 50 to 250 N with 1 Hz frequency in a servo-hydraulic testing machine followed by ultimate load at-failure testing at a rate of 20 mm/min. Statistical analyses were made using the Mann-Whitney U-test. Results: The mean screw insertion torque values were 8.2+/-2.4 Nm and 7.8+/-2.3 Nm in groups I and II, respectively (p=0.88). The mean values of graft displacement (1.9+/-0.75 mm versus 2.2+/-1.2 mm, p=0.63) and stiffness (132.72+/-10.93 N/mm versus 125.14+/-15.93 N/mm, p=0.63) did not differ significantly. Conclusion: The biomechanical properties of ACL reconstruction with soft tissue graft fixation using a soft tissue interference screw are not influenced by the level of tibial tunnel fixation.
International Journal of Clinical Practice, 2005
The objective of this study was to compare clinical and postoperative analgesic effects of femora... more The objective of this study was to compare clinical and postoperative analgesic effects of femoral or psoas compartment blocks in patients undergoing arthroscopies. Fifty patients were randomly assigned to one of the two groups. Either femoral (group F) or psoas compartment (group P) block was applied followed by sciatic nerve block. All nerve blocks were provided with a 15 ml of bupivacaine 0.5% + 10 ml of lignocaine (lidocaine) 2%. Systolic and diastolic blood pressure (SBP and DBP), heart rate, and pulse oxymetry (SpO2) were recorded. Quality of anaesthesia, time to first analgesic use, verbal pain scores (VPS), sensorial and motor blockade resolution times and side effects were also recorded. Quality of anaesthesia, complete sensory blockade of obturator and lateral cutaneous nerves were higher in the group P than in group F. However, complete motor blockade findings were similar in both groups. In the group P, VPS values measured at 10 and 15 min were lower than that of group F. These values decreased at 10 min and thereafter as to baseline values. VPS values of the group F declined at 20 min and following measurement times as to baseline values. Durations of motor and sensorial block, and time to first analgesic use were similar between two groups. Total analgesic consumption at first 24 h in group P was lower than those of group F. Regarding heart rates, SpO2, SBP and DBP values, no significant differences were found between the groups. Combined psoas-sciatic technique provided more comfortable intraoperative anaesthesia and better postoperative analgesia when compared with femoral-sciatic technique for arthroscopic procedures.
DergiPark (Istanbul University), Aug 1, 2006
Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık red... more Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık redüksiyon ve Salter'in İnnominate Osteotomi (SİO) tedavisi yapılan olguların erken dönem sonuçlarını değerlendirmek amaçlanmıştır. Hastalar ve Yöntemler: 2001-2004 yılları arasında Harran Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniğinde, yürüme çağında GKD tanısı konularak açık redüksiyon ve SİO uygulanan ve en az 2 yıllık takipleri olan, 19 çocuğun 23 kalçası çalışmaya dahil edildi. Ameliyat sırasındaki yaşları ortalaması 34.4 ay (18 ay-52 ay) idi. Hastalardan 16'sı kız, 3'ü erkekti ve 4'ünde iki taraflı tutulum vardı. Ortalama takip süresi 31.8 ay (24-38) olarak bulundu. Preoperatif, postoperatif 1. hafta ve son takiplerde direk grafiyle asetabular indeks (Aİ); preoperatif, postoperatif 1. hafta ve 1.yılda 2 boyutlu bilgisayarlı tomografi (BT) ile aksiyel asetabular indeks (AAİ) ölçümleri yapıldı. Hastalar son takiplerinde klinik olarak McKay sınıflaması ve radyolojik olarak ise Severin kriterlerine göre değerlendirildi. Bulgular: Klinik olarak 19 kalçada (%82.6) mükemmel ve iyi sonuç (14 kalça mükemmel, 5 kalça iyi), 4 kalçada (% 17.4) ise orta sonuç elde edildi. Radyolojik olarak Severin kriterlerine göre; 13 kalçada grup 1 (mükemmel), 5 kalçada grup 2 (iyi), 4 kalçada grup 3 (orta) ve 1 kalçada grup 1 (kötü) sonuç elde edildi. Buna göre 18 kalçada (% 78.3) mükemmel ve iyi sonuca ulaşıldı. 4 ayrı hastada yüzeyel enfeksiyon, redislokasyon, hematom gelişimi ve alçı açıldıktan sonra femur diafiz kırığı olmak üzere, 4 komplikasyon gelişti. Bu komplikasyonların tamamı tedaviye iyi yanıt verdi. Aİ preoperatif 40.43°'den takipte 20.48°'e; AAİ ise 18.09°'den 13.43°'e gerilediği saptandı. Orta ve kötü klinikradyolojik sonuç alanların asetabuler indeksleri (Aİ ve AAİ) ile mükemmel ve iyi sonuç alan grubun değerleri karşılaştırıldığında arada anlamlı fark saptanmadı. Sonuç: Yürüme çağı GKD'li olgularda; açık redüksiyon ve SİO kombinasyonunun etkili bir tedavi seçeneği olduğu görüşündeyiz. Anahtar kelimeler: Gelişimsel kalça displazisi, Cerrahi tedavi, Açık redüksiyon, Salter İnnominat Osteotomisi. SUMMARY The Simultaneous Open Reduction and Salter Innominate Osteotomy in The Treatment of Developmental Dysplasia of The Hip: The Preliminary Results Objectives: This study was conducted to evaluate the early results of open reduction and Salter Innominate Osteotomy (SIO) performed in ambulatory patients with Developmental Dysplasia of the Hip (DDH). Patients and Methods: We reviewed the results of the open reduction and SIO in 23 hips of the 19 patients with DDH in children of walking age who had been operated between 2001 and 2004 at Harran University Department of Orthopedics. All patients had a minimum 2 years follow up. Patients age at the time of operation was 34.4 months (range, 18-52 months). There were 16 female and one male patients. Of them 4 had bilateral, 15 had unilateral disease. The mean follow up was 31.8 months (range, 24-38). Acetabular index were measured preoperatively, at the first postoperative week and at the last follow up by the direct X-ray and axial acetabular index were determined preoperatively, at the first postoperative week and at the first postoperative year by 2 dimentional computed tomography. The clinical results were evaluated according to Mc Kay classification, whereas radiological results according to the Severin scoring criteria. Results:. Clinical results were as follows; 19 hips (82.6 %) were excellent or good, and 4 hips (17.4 %) were fair. According to Severin's radiological scoring 18 hips (78.3 %) were excellent or good, 4 hips (17.4 %) were fair and one was (4.3 %) poor results. The ages of three of four patients with fair results and the patient with poor radiological score were greater than 48 months. Postoperatively, 4 complications developed in four separate patients; which were superficial infection, redislocation, hemotoma formation and femoral diaphyseal fracture after opening the cast. All complications resolved with the treatment. The acetabular index averaged 40.43° preoperatively and 20.48°at the last follow up and the axial acetabular index improved 13.43° at the last follow up from 18.09° preoperatively. Significant differences were not found in the preoperative and recent acetabular indices (AI and AAI) when compared the fair and poor groups versus the excellent and groups. Conclusion: We conclude that the open reduction and SIO combination is an effective treatment in ambulatory DDH patients.
Acta orthopaedica et traumatologica turcica, 2005
This study was designed to compare the biomechanical characteristics of non-anatomic (far from jo... more This study was designed to compare the biomechanical characteristics of non-anatomic (far from joint) and anatomic (close to joint) levels of tibial tunnel fixation with soft tissue graft using a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after removing soft tissues. Tibial tunnels were prepared with a 7-mm drill with the use of an ACL guide adjusted to 45 degrees . Each tunnel was then dilated to 9 mm in 0.5 mm increments. Digital extensor tendons were fixed at non-anatomic (group I) or anatomic (group II) tibial tunnel levels with a soft tissue metal interference screw, 9 x 30 mm in size. All the specimens were cycled 500 times from 50 to 250 N with 1 Hz frequency in a servo-hydraulic testing machine followed by ultimate load at-failure testing at a rate of 20 mm/min. Statistical analyses were made using the Mann-Whitney U-test. The mean screw ...
![Research paper thumbnail of [The effect of anterior or posterior tibial tunnel placement of a soft tissue graft with a soft tissue interference screw on fixation biomechanics]](https://attachments.academia-assets.com/100298579/thumbnails/1.jpg)
](Acta orthopaedica et traumatologica turcica, 2005
We investigated the biomechanical characteristics of anterior or posterior tibial tunnel placemen... more We investigated the biomechanical characteristics of anterior or posterior tibial tunnel placement of the soft tissue graft with a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after they were stripped of all soft tissues. Tibial tunnels were prepared and digital extensor tendons were fixed at nonanatomic (apart from the joint) anterior (n=6, group I) or posterior (n=6, group II) tibial tunnel positions with a soft tissue metal interference screw, 9x30 mm in size. All the specimens were cycled 500 times from 50 to 250 N at 1 Hz frequency in a servo hydraulic test device, after which ultimate load-at-failure testing was performed at a rate of 20 mm/min. The mean screw insertion torque values were 8.2+/-2.4 Nm and 8.4+/-2.8 Nm in groups I and II, respectively (p=0.88). No significant differences were found between the two groups with respect to graft ...
Biological Trace Element Research, 2005
In recent years, a great number of studies have investigated the possible role of trace elements ... more In recent years, a great number of studies have investigated the possible role of trace elements in the etiology and pathogenesis of rheumatoid arthritis (RA) and osteoartritis (OA). We studied synovial fluid and plasma concentrations of selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) in patients with RA and OA and compared them with sex- and age-matched healthy subjects. Plasma albumin levels were measured as an index of nutritional status. Plasma Se, Cu, and Zn concentrations were determined by atomic absorption spectrophotometry and Fe concentrations were determined by the colorimetric method. Although plasma and synovial fluid Se concentration were found to be significantly lower (p < 0.05, and p < 0.05, respectively), Cu concentrations were significantly higher in patients with RA than those of healthy subjects and OA (p < 0.05 and p < 0.05, respectively). There were no significant differences in plasma and synovial fluid Zn concentrations and albumin levels among three groups (p > 0.05). On the other hand, synovial fluid Cu and Fe concentrations were significantly higher in patients with OA than those of healthy subjects (p < 0.05). There was a significantly positive correlation between synovial fluid Se-Cu values and Zn-Fe values in patients with RA. Our results showed that synovial fluid and plasma trace element concentrations, excluding Zn, change in inflammatory RA, but not in OA. These alterations in trace element concentrations in inflammatory RA might be a result of the changes of the immunoregulatory cytokines.
Biological Trace Element Research, 2007
Nitric oxide (NO) participates in the pathogenesis of inflammatory reactions in many autoimmune d... more Nitric oxide (NO) participates in the pathogenesis of inflammatory reactions in many autoimmune diseases such as rheumatoid arthritis (RA). There is a reciprocal pathway between arginase and nitric oxide synthase (NOS) for NO production, and Mn is required for arginase activity and stability. To investigate whether NO production related with the arginine-nitric oxide pathway in patients with RA, we measured synovial fluid and plasma nitrite (NOx) levels, arginase activities, and its cofactor manganese (Mn) concentrations in 21 RA patients and 13 healthy control subjects. Plasma albumin levels were measured as an index of nutritional status. NOx levels were determined after the reduction of nitrates to nitrites using the Griess reaction. Whereas, synovial fluid arginase activities and Mn levels were found to be significantly lower (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, respectively), plasma arginase activities and Mn levels were similar in patients with RA when compared to the control subjects. Plasma and synovial fluid NO levels were similar in patients with RA and in healthy subjects (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05, respectively). There were significantly positive correlations between synovial fluid and plasma arginase activities vs Mn content (r=0.543, p=0.011; r=0.516, p=0.017, respectively) and significantly negative correlations between synovial fluid and plasma NO levels vs arginase activities (r=-0.497, p=0.022; r=-0.508, p=0.019 respectively) in the patients group. Our results indicate that the lower concentration of synovial fluid Mn could cause lower arginase activity and this could also upregulate NO production by increasing L-arginine content in patients with RA.
Knee Surgery, Sports Traumatology, Arthroscopy, 2006
This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, ... more This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, horizontal, and oblique sutures used for meniscal lesion repair. Following repair of vertical longitudinal lesions created in bovine medial menisci, three groups of seven specimens (vertical, horizontal, and oblique sutures) underwent cyclic loading in a randomized test order (5 mm/min, cycling between 5 and 50 N at 1 Hz for 100 cycles) prior to load to failure testing (5 mm/min). Displacement did not differ between groups during cyclic or load to failure testing. Construct stiffness during cyclic testing was superior for the oblique suture (6.9 +/- 1.5 N/mm, P = 0.007) and the vertical suture (6.4 +/- 7 N/mm, P = 0.03) groups compared to the horizontal suture group (4.4 +/- 0.52 N/mm). The oblique suture (171.9 +/- 25.9 N, P &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) and the vertical suture (145.9 +/- 32.3 N, P = 0.001) groups displayed superior load at failure compared to the horizontal suture group (88.8 +/- 8.2 N). Construct stiffness during load to failure testing did not differ between groups. Suture rupture was the failure mode for all specimens of the oblique suture group. Suture rupture was the failure mode for 57% (4/7) of the vertical suture group with the remaining specimens (3/7, 43%) failing from intact suture pullout through meniscal tissue. All horizontal suture group specimens failed by intact suture pulling through meniscal tissue. With comparable stiffness during cyclic testing, comparable load at failure as vertical sutures, and less evidence of intact suture pullout through the meniscus, an oblique suture technique may combine the beneficial characteristics of vertical (superior biomechanical strength) and horizontal (ease of application, longer sutures with a tendency to cover a larger meniscal tissue area) suture-repair techniques.
Foot and Ankle Surgery, 2004
We describe a 17-year-old male patient with bilateral postaxial polydactily and traumatic plantar... more We describe a 17-year-old male patient with bilateral postaxial polydactily and traumatic plantar dislocation of the right first metatarsophalangeal joint which was untreated for three months. He had discomfort on the lateral side of both forefoots and a painful deformation on the right great toe. The patient was treated with amputation of both supernumerary toes and open reduction of the first metatarsophalangeal joint by means of medial and dorsal first web space insicions and intramedullary K-wire fixation. A short leg walking cast was applied to the right limb. After six weeks, the cast and the K-wire were removed and physiotherapy of the joint was started. Twenty months after surgery no instability but mild osteoarthritic changes were encountered at the joint.
Clinical Orthopaedics and Related Research®, 2009
With an aging population the frequency of postmenopausal fractures is increasing. Methods to enha... more With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair. This project was partly supported by Harran University Research Fund (HUBAK 436). Kurtsan Inc. (Istanbul, Turkey) supplied the absorbable collagen sponges for this study. Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Clinical Biochemistry, 2005
Objectives: The metabolism of cells in inflammatory and noninflammatory arthritic joint diseases ... more Objectives: The metabolism of cells in inflammatory and noninflammatory arthritic joint diseases is subject to complex environmental controls. The aim of the present study was to investigate the total antioxidant capacity (TAC), levels of lipid peroxidation (LPO), and antioxidant enzyme activities in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Design and methods: Plasma levels of TAC, malondialdehyde (MDA), the activities of some erythrocyte antioxidant enzymes, as well as erythrocyte sedimentation rates (ESR) were estimated in patients with RA and OA and compared with controls. Results: The plasma TAC levels were significantly lower in the RA group than the OA and control group (P < 0.05). Plasma MDA concentrations were significantly higher in patients with RA than those with OA and healthy subjects (P < 0.05). Erythrocyte GSH-Px and CAT activities were found to be significantly lower in patients with RA than those with OA and healthy subjects (P < 0.05, P < 0.05, respectively). However, there were no significant differences in erythrocyte SOD activities between the groups (P > 0.05). ESR were significantly higher in RA patients than in healthy subjects and patients with OA (P < 0.01). Moreover, there were significant negative correlations between TAC vs. MDA, ESR vs. TAC, and a positive correlation between ESR vs. MDA in the RA group (r = À0.398, P < 0.05; r = À0.422, P < 0.05; r = 0.530, P < 0.05, respectively). Conclusions: Our results demonstrated that levels of LPO are increased in patients with RA compared to patients with OA. In addition, plasma TAC levels are decreased in RA due to its inflammatory character. We conclude that detecting plasma TAC levels with this novel method may be used as a routine and rapid test to verify the levels of oxidative stress in RA. Furthermore, correlating TAC and LPO levels with acute phase reactants such as ESR may give some clues about disease activity in RA.
Acta orthopaedica et traumatologica turcica, 2005
OBJECTIVES We evaluated the clinical and subjective functional results of open surgical treatment... more OBJECTIVES We evaluated the clinical and subjective functional results of open surgical treatment in patients with chronic refractory lateral epicondylitis. METHODS Eleven patients (7 females, 4 males; mean age 42 years, range 29 to 56 years) underwent open surgical treatment for chronic refractory lateral epicondylitis. All the patients had received conservative treatment for at least a year without favorable response. Surgical procedure included release of the lateral extensor origin, excision of the degenerative tissue, decortication or drilling of the anterior lateral condyle, and repair of the extensor tendons. The results were evaluated according to the criteria proposed by Verhaar et al. The mean follow-up was 29 months (range 18 to 45 months). RESULTS The results were excellent or good in 10 patients (90.9%) and acceptable in one patient (9.1%). The mean time to return to work was two months. Nine patients were free of pain in the forearm in the postoperative third month. No...
Joint Diseases and Related Surgery
The positive impact of platelet-derived growth factor on the repair of full-thickness defects of ... more The positive impact of platelet-derived growth factor on the repair of full-thickness defects of articular cartilage Trombosit türevli büyüme faktörünün tam kat eklem kıkırdağı defektlerinin tamirine pozitif etkisi
Turkish Journal of Trauma and Emergency Surgery, 2016
BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the tr... more BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted. Malrotation was defined as rotational difference >10°. Operated knees were evaluated with 0.5-mm, fine-cut, 3-dimensional CT scan performed in cooperation with radiology department. Side-to-side difference in tibial torsion angle >10° was considered significant degree of malrotation. All patients were assessed clinically (visual analogue scale [VAS] and American Orthopaedic Foot and Ankle Society [AOFAS] scores) and radiologically at final visit. RESULTS: Mean follow-up period was 20.00±9.46 months (range: 18-51 months). Mean VAS score was 2.58±0.83 (range: 1-4) and mean AOFAS score was 87.50±4.05 (range: 78-93). Mean tibial rotation angle was 31.54±6.00° (range: 18-45°) on healthy side and 32.00±6.24° (range: 10-43°) on the operated side. No statistically significant difference was determined (p>0.05). CONCLUSION: Use of intraoperative fluoroscopy, cable technique, and uninjured extremity as reference, can reduce incidence of rotational malalignment of distal tibial fractures treated with MIPO.
Clinical Orthopaedics and Related Research, Aug 4, 2009
With an aging population the frequency of postmenopausal fractures is increasing. Methods to enha... more With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair. This project was partly supported by Harran University Research Fund (HUBAK 436). Kurtsan Inc. (Istanbul, Turkey) supplied the absorbable collagen sponges for this study. Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
DergiPark (Istanbul University), Aug 1, 2006
Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık red... more Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık redüksiyon ve Salter'in İnnominate Osteotomi (SİO) tedavisi yapılan olguların erken dönem sonuçlarını değerlendirmek amaçlanmıştır. Hastalar ve Yöntemler: 2001-2004 yılları arasında Harran Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniğinde, yürüme çağında GKD tanısı konularak açık redüksiyon ve SİO uygulanan ve en az 2 yıllık takipleri olan, 19 çocuğun 23 kalçası çalışmaya dahil edildi. Ameliyat sırasındaki yaşları ortalaması 34.4 ay (18 ay-52 ay) idi. Hastalardan 16'sı kız, 3'ü erkekti ve 4'ünde iki taraflı tutulum vardı. Ortalama takip süresi 31.8 ay (24-38) olarak bulundu. Preoperatif, postoperatif 1. hafta ve son takiplerde direk grafiyle asetabular indeks (Aİ); preoperatif, postoperatif 1. hafta ve 1.yılda 2 boyutlu bilgisayarlı tomografi (BT) ile aksiyel asetabular indeks (AAİ) ölçümleri yapıldı. Hastalar son takiplerinde klinik olarak McKay sınıflaması ve radyolojik olarak ise Severin kriterlerine göre değerlendirildi. Bulgular: Klinik olarak 19 kalçada (%82.6) mükemmel ve iyi sonuç (14 kalça mükemmel, 5 kalça iyi), 4 kalçada (% 17.4) ise orta sonuç elde edildi. Radyolojik olarak Severin kriterlerine göre; 13 kalçada grup 1 (mükemmel), 5 kalçada grup 2 (iyi), 4 kalçada grup 3 (orta) ve 1 kalçada grup 1 (kötü) sonuç elde edildi. Buna göre 18 kalçada (% 78.3) mükemmel ve iyi sonuca ulaşıldı. 4 ayrı hastada yüzeyel enfeksiyon, redislokasyon, hematom gelişimi ve alçı açıldıktan sonra femur diafiz kırığı olmak üzere, 4 komplikasyon gelişti. Bu komplikasyonların tamamı tedaviye iyi yanıt verdi. Aİ preoperatif 40.43°'den takipte 20.48°'e; AAİ ise 18.09°'den 13.43°'e gerilediği saptandı. Orta ve kötü klinikradyolojik sonuç alanların asetabuler indeksleri (Aİ ve AAİ) ile mükemmel ve iyi sonuç alan grubun değerleri karşılaştırıldığında arada anlamlı fark saptanmadı. Sonuç: Yürüme çağı GKD'li olgularda; açık redüksiyon ve SİO kombinasyonunun etkili bir tedavi seçeneği olduğu görüşündeyiz. Anahtar kelimeler: Gelişimsel kalça displazisi, Cerrahi tedavi, Açık redüksiyon, Salter İnnominat Osteotomisi. SUMMARY The Simultaneous Open Reduction and Salter Innominate Osteotomy in The Treatment of Developmental Dysplasia of The Hip: The Preliminary Results Objectives: This study was conducted to evaluate the early results of open reduction and Salter Innominate Osteotomy (SIO) performed in ambulatory patients with Developmental Dysplasia of the Hip (DDH). Patients and Methods: We reviewed the results of the open reduction and SIO in 23 hips of the 19 patients with DDH in children of walking age who had been operated between 2001 and 2004 at Harran University Department of Orthopedics. All patients had a minimum 2 years follow up. Patients age at the time of operation was 34.4 months (range, 18-52 months). There were 16 female and one male patients. Of them 4 had bilateral, 15 had unilateral disease. The mean follow up was 31.8 months (range, 24-38). Acetabular index were measured preoperatively, at the first postoperative week and at the last follow up by the direct X-ray and axial acetabular index were determined preoperatively, at the first postoperative week and at the first postoperative year by 2 dimentional computed tomography. The clinical results were evaluated according to Mc Kay classification, whereas radiological results according to the Severin scoring criteria. Results:. Clinical results were as follows; 19 hips (82.6 %) were excellent or good, and 4 hips (17.4 %) were fair. According to Severin's radiological scoring 18 hips (78.3 %) were excellent or good, 4 hips (17.4 %) were fair and one was (4.3 %) poor results. The ages of three of four patients with fair results and the patient with poor radiological score were greater than 48 months. Postoperatively, 4 complications developed in four separate patients; which were superficial infection, redislocation, hemotoma formation and femoral diaphyseal fracture after opening the cast. All complications resolved with the treatment. The acetabular index averaged 40.43° preoperatively and 20.48°at the last follow up and the axial acetabular index improved 13.43° at the last follow up from 18.09° preoperatively. Significant differences were not found in the preoperative and recent acetabular indices (AI and AAI) when compared the fair and poor groups versus the excellent and groups. Conclusion: We conclude that the open reduction and SIO combination is an effective treatment in ambulatory DDH patients.
PubMed, 2005
Objectives: This study was designed to compare the biomechanical characteristics of non-anatomic ... more Objectives: This study was designed to compare the biomechanical characteristics of non-anatomic (far from joint) and anatomic (close to joint) levels of tibial tunnel fixation with soft tissue graft using a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Methods: Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after removing soft tissues. Tibial tunnels were prepared with a 7-mm drill with the use of an ACL guide adjusted to 45 degrees . Each tunnel was then dilated to 9 mm in 0.5 mm increments. Digital extensor tendons were fixed at non-anatomic (group I) or anatomic (group II) tibial tunnel levels with a soft tissue metal interference screw, 9 x 30 mm in size. All the specimens were cycled 500 times from 50 to 250 N with 1 Hz frequency in a servo-hydraulic testing machine followed by ultimate load at-failure testing at a rate of 20 mm/min. Statistical analyses were made using the Mann-Whitney U-test. Results: The mean screw insertion torque values were 8.2+/-2.4 Nm and 7.8+/-2.3 Nm in groups I and II, respectively (p=0.88). The mean values of graft displacement (1.9+/-0.75 mm versus 2.2+/-1.2 mm, p=0.63) and stiffness (132.72+/-10.93 N/mm versus 125.14+/-15.93 N/mm, p=0.63) did not differ significantly. Conclusion: The biomechanical properties of ACL reconstruction with soft tissue graft fixation using a soft tissue interference screw are not influenced by the level of tibial tunnel fixation.
International Journal of Clinical Practice, 2005
The objective of this study was to compare clinical and postoperative analgesic effects of femora... more The objective of this study was to compare clinical and postoperative analgesic effects of femoral or psoas compartment blocks in patients undergoing arthroscopies. Fifty patients were randomly assigned to one of the two groups. Either femoral (group F) or psoas compartment (group P) block was applied followed by sciatic nerve block. All nerve blocks were provided with a 15 ml of bupivacaine 0.5% + 10 ml of lignocaine (lidocaine) 2%. Systolic and diastolic blood pressure (SBP and DBP), heart rate, and pulse oxymetry (SpO2) were recorded. Quality of anaesthesia, time to first analgesic use, verbal pain scores (VPS), sensorial and motor blockade resolution times and side effects were also recorded. Quality of anaesthesia, complete sensory blockade of obturator and lateral cutaneous nerves were higher in the group P than in group F. However, complete motor blockade findings were similar in both groups. In the group P, VPS values measured at 10 and 15 min were lower than that of group F. These values decreased at 10 min and thereafter as to baseline values. VPS values of the group F declined at 20 min and following measurement times as to baseline values. Durations of motor and sensorial block, and time to first analgesic use were similar between two groups. Total analgesic consumption at first 24 h in group P was lower than those of group F. Regarding heart rates, SpO2, SBP and DBP values, no significant differences were found between the groups. Combined psoas-sciatic technique provided more comfortable intraoperative anaesthesia and better postoperative analgesia when compared with femoral-sciatic technique for arthroscopic procedures.
DergiPark (Istanbul University), Aug 1, 2006
Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık red... more Bu çalışmada, yürüme çağında gelişimsel kalça displazisi (GKD) nedeniyle tanı konularak, açık redüksiyon ve Salter'in İnnominate Osteotomi (SİO) tedavisi yapılan olguların erken dönem sonuçlarını değerlendirmek amaçlanmıştır. Hastalar ve Yöntemler: 2001-2004 yılları arasında Harran Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Kliniğinde, yürüme çağında GKD tanısı konularak açık redüksiyon ve SİO uygulanan ve en az 2 yıllık takipleri olan, 19 çocuğun 23 kalçası çalışmaya dahil edildi. Ameliyat sırasındaki yaşları ortalaması 34.4 ay (18 ay-52 ay) idi. Hastalardan 16'sı kız, 3'ü erkekti ve 4'ünde iki taraflı tutulum vardı. Ortalama takip süresi 31.8 ay (24-38) olarak bulundu. Preoperatif, postoperatif 1. hafta ve son takiplerde direk grafiyle asetabular indeks (Aİ); preoperatif, postoperatif 1. hafta ve 1.yılda 2 boyutlu bilgisayarlı tomografi (BT) ile aksiyel asetabular indeks (AAİ) ölçümleri yapıldı. Hastalar son takiplerinde klinik olarak McKay sınıflaması ve radyolojik olarak ise Severin kriterlerine göre değerlendirildi. Bulgular: Klinik olarak 19 kalçada (%82.6) mükemmel ve iyi sonuç (14 kalça mükemmel, 5 kalça iyi), 4 kalçada (% 17.4) ise orta sonuç elde edildi. Radyolojik olarak Severin kriterlerine göre; 13 kalçada grup 1 (mükemmel), 5 kalçada grup 2 (iyi), 4 kalçada grup 3 (orta) ve 1 kalçada grup 1 (kötü) sonuç elde edildi. Buna göre 18 kalçada (% 78.3) mükemmel ve iyi sonuca ulaşıldı. 4 ayrı hastada yüzeyel enfeksiyon, redislokasyon, hematom gelişimi ve alçı açıldıktan sonra femur diafiz kırığı olmak üzere, 4 komplikasyon gelişti. Bu komplikasyonların tamamı tedaviye iyi yanıt verdi. Aİ preoperatif 40.43°'den takipte 20.48°'e; AAİ ise 18.09°'den 13.43°'e gerilediği saptandı. Orta ve kötü klinikradyolojik sonuç alanların asetabuler indeksleri (Aİ ve AAİ) ile mükemmel ve iyi sonuç alan grubun değerleri karşılaştırıldığında arada anlamlı fark saptanmadı. Sonuç: Yürüme çağı GKD'li olgularda; açık redüksiyon ve SİO kombinasyonunun etkili bir tedavi seçeneği olduğu görüşündeyiz. Anahtar kelimeler: Gelişimsel kalça displazisi, Cerrahi tedavi, Açık redüksiyon, Salter İnnominat Osteotomisi. SUMMARY The Simultaneous Open Reduction and Salter Innominate Osteotomy in The Treatment of Developmental Dysplasia of The Hip: The Preliminary Results Objectives: This study was conducted to evaluate the early results of open reduction and Salter Innominate Osteotomy (SIO) performed in ambulatory patients with Developmental Dysplasia of the Hip (DDH). Patients and Methods: We reviewed the results of the open reduction and SIO in 23 hips of the 19 patients with DDH in children of walking age who had been operated between 2001 and 2004 at Harran University Department of Orthopedics. All patients had a minimum 2 years follow up. Patients age at the time of operation was 34.4 months (range, 18-52 months). There were 16 female and one male patients. Of them 4 had bilateral, 15 had unilateral disease. The mean follow up was 31.8 months (range, 24-38). Acetabular index were measured preoperatively, at the first postoperative week and at the last follow up by the direct X-ray and axial acetabular index were determined preoperatively, at the first postoperative week and at the first postoperative year by 2 dimentional computed tomography. The clinical results were evaluated according to Mc Kay classification, whereas radiological results according to the Severin scoring criteria. Results:. Clinical results were as follows; 19 hips (82.6 %) were excellent or good, and 4 hips (17.4 %) were fair. According to Severin's radiological scoring 18 hips (78.3 %) were excellent or good, 4 hips (17.4 %) were fair and one was (4.3 %) poor results. The ages of three of four patients with fair results and the patient with poor radiological score were greater than 48 months. Postoperatively, 4 complications developed in four separate patients; which were superficial infection, redislocation, hemotoma formation and femoral diaphyseal fracture after opening the cast. All complications resolved with the treatment. The acetabular index averaged 40.43° preoperatively and 20.48°at the last follow up and the axial acetabular index improved 13.43° at the last follow up from 18.09° preoperatively. Significant differences were not found in the preoperative and recent acetabular indices (AI and AAI) when compared the fair and poor groups versus the excellent and groups. Conclusion: We conclude that the open reduction and SIO combination is an effective treatment in ambulatory DDH patients.
Acta orthopaedica et traumatologica turcica, 2005
This study was designed to compare the biomechanical characteristics of non-anatomic (far from jo... more This study was designed to compare the biomechanical characteristics of non-anatomic (far from joint) and anatomic (close to joint) levels of tibial tunnel fixation with soft tissue graft using a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after removing soft tissues. Tibial tunnels were prepared with a 7-mm drill with the use of an ACL guide adjusted to 45 degrees . Each tunnel was then dilated to 9 mm in 0.5 mm increments. Digital extensor tendons were fixed at non-anatomic (group I) or anatomic (group II) tibial tunnel levels with a soft tissue metal interference screw, 9 x 30 mm in size. All the specimens were cycled 500 times from 50 to 250 N with 1 Hz frequency in a servo-hydraulic testing machine followed by ultimate load at-failure testing at a rate of 20 mm/min. Statistical analyses were made using the Mann-Whitney U-test. The mean screw ...
Acta orthopaedica et traumatologica turcica, 2005
We investigated the biomechanical characteristics of anterior or posterior tibial tunnel placemen... more We investigated the biomechanical characteristics of anterior or posterior tibial tunnel placement of the soft tissue graft with a soft tissue interference screw in anterior cruciate ligament (ACL) reconstruction. Twelve bovine tibiae and digital extensor tendons were divided into two homogeneously equal groups after they were stripped of all soft tissues. Tibial tunnels were prepared and digital extensor tendons were fixed at nonanatomic (apart from the joint) anterior (n=6, group I) or posterior (n=6, group II) tibial tunnel positions with a soft tissue metal interference screw, 9x30 mm in size. All the specimens were cycled 500 times from 50 to 250 N at 1 Hz frequency in a servo hydraulic test device, after which ultimate load-at-failure testing was performed at a rate of 20 mm/min. The mean screw insertion torque values were 8.2+/-2.4 Nm and 8.4+/-2.8 Nm in groups I and II, respectively (p=0.88). No significant differences were found between the two groups with respect to graft ...
Biological Trace Element Research, 2005
In recent years, a great number of studies have investigated the possible role of trace elements ... more In recent years, a great number of studies have investigated the possible role of trace elements in the etiology and pathogenesis of rheumatoid arthritis (RA) and osteoartritis (OA). We studied synovial fluid and plasma concentrations of selenium (Se), zinc (Zn), copper (Cu), and iron (Fe) in patients with RA and OA and compared them with sex- and age-matched healthy subjects. Plasma albumin levels were measured as an index of nutritional status. Plasma Se, Cu, and Zn concentrations were determined by atomic absorption spectrophotometry and Fe concentrations were determined by the colorimetric method. Although plasma and synovial fluid Se concentration were found to be significantly lower (p < 0.05, and p < 0.05, respectively), Cu concentrations were significantly higher in patients with RA than those of healthy subjects and OA (p < 0.05 and p < 0.05, respectively). There were no significant differences in plasma and synovial fluid Zn concentrations and albumin levels among three groups (p > 0.05). On the other hand, synovial fluid Cu and Fe concentrations were significantly higher in patients with OA than those of healthy subjects (p < 0.05). There was a significantly positive correlation between synovial fluid Se-Cu values and Zn-Fe values in patients with RA. Our results showed that synovial fluid and plasma trace element concentrations, excluding Zn, change in inflammatory RA, but not in OA. These alterations in trace element concentrations in inflammatory RA might be a result of the changes of the immunoregulatory cytokines.
Biological Trace Element Research, 2007
Nitric oxide (NO) participates in the pathogenesis of inflammatory reactions in many autoimmune d... more Nitric oxide (NO) participates in the pathogenesis of inflammatory reactions in many autoimmune diseases such as rheumatoid arthritis (RA). There is a reciprocal pathway between arginase and nitric oxide synthase (NOS) for NO production, and Mn is required for arginase activity and stability. To investigate whether NO production related with the arginine-nitric oxide pathway in patients with RA, we measured synovial fluid and plasma nitrite (NOx) levels, arginase activities, and its cofactor manganese (Mn) concentrations in 21 RA patients and 13 healthy control subjects. Plasma albumin levels were measured as an index of nutritional status. NOx levels were determined after the reduction of nitrates to nitrites using the Griess reaction. Whereas, synovial fluid arginase activities and Mn levels were found to be significantly lower (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001, respectively), plasma arginase activities and Mn levels were similar in patients with RA when compared to the control subjects. Plasma and synovial fluid NO levels were similar in patients with RA and in healthy subjects (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05, respectively). There were significantly positive correlations between synovial fluid and plasma arginase activities vs Mn content (r=0.543, p=0.011; r=0.516, p=0.017, respectively) and significantly negative correlations between synovial fluid and plasma NO levels vs arginase activities (r=-0.497, p=0.022; r=-0.508, p=0.019 respectively) in the patients group. Our results indicate that the lower concentration of synovial fluid Mn could cause lower arginase activity and this could also upregulate NO production by increasing L-arginine content in patients with RA.
Knee Surgery, Sports Traumatology, Arthroscopy, 2006
This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, ... more This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, horizontal, and oblique sutures used for meniscal lesion repair. Following repair of vertical longitudinal lesions created in bovine medial menisci, three groups of seven specimens (vertical, horizontal, and oblique sutures) underwent cyclic loading in a randomized test order (5 mm/min, cycling between 5 and 50 N at 1 Hz for 100 cycles) prior to load to failure testing (5 mm/min). Displacement did not differ between groups during cyclic or load to failure testing. Construct stiffness during cyclic testing was superior for the oblique suture (6.9 +/- 1.5 N/mm, P = 0.007) and the vertical suture (6.4 +/- 7 N/mm, P = 0.03) groups compared to the horizontal suture group (4.4 +/- 0.52 N/mm). The oblique suture (171.9 +/- 25.9 N, P &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) and the vertical suture (145.9 +/- 32.3 N, P = 0.001) groups displayed superior load at failure compared to the horizontal suture group (88.8 +/- 8.2 N). Construct stiffness during load to failure testing did not differ between groups. Suture rupture was the failure mode for all specimens of the oblique suture group. Suture rupture was the failure mode for 57% (4/7) of the vertical suture group with the remaining specimens (3/7, 43%) failing from intact suture pullout through meniscal tissue. All horizontal suture group specimens failed by intact suture pulling through meniscal tissue. With comparable stiffness during cyclic testing, comparable load at failure as vertical sutures, and less evidence of intact suture pullout through the meniscus, an oblique suture technique may combine the beneficial characteristics of vertical (superior biomechanical strength) and horizontal (ease of application, longer sutures with a tendency to cover a larger meniscal tissue area) suture-repair techniques.
Foot and Ankle Surgery, 2004
We describe a 17-year-old male patient with bilateral postaxial polydactily and traumatic plantar... more We describe a 17-year-old male patient with bilateral postaxial polydactily and traumatic plantar dislocation of the right first metatarsophalangeal joint which was untreated for three months. He had discomfort on the lateral side of both forefoots and a painful deformation on the right great toe. The patient was treated with amputation of both supernumerary toes and open reduction of the first metatarsophalangeal joint by means of medial and dorsal first web space insicions and intramedullary K-wire fixation. A short leg walking cast was applied to the right limb. After six weeks, the cast and the K-wire were removed and physiotherapy of the joint was started. Twenty months after surgery no instability but mild osteoarthritic changes were encountered at the joint.
Clinical Orthopaedics and Related Research®, 2009
With an aging population the frequency of postmenopausal fractures is increasing. Methods to enha... more With an aging population the frequency of postmenopausal fractures is increasing. Methods to enhance the repair of osteoporotic bone repair therefore become more important to reduce the society burden of care. We asked if absorbable collagen sponges containing recombinant human bone morphogenetic protein-2 (rhBMP-2) have the potential to enhance bone repair. We randomly assigned 40 rats into the ovariectomy and sham operation groups. A segmental defect was created in the right tibia 12 weeks after ovariectomy. rhBMP-2-containing absorbable collagen sponges were implanted into the defect in half of the animals in each group. We analyzed radiographs and histological sections and performed three-point bending tests to assess repair. Radiological scores in the rhBMP-2 applied rats were higher than those in controls at the end of 8 weeks after tibial osteotomy. The specimens failed under higher loads in the rhBMP-2-applied groups and histology revealed a higher fracture healing score, including callus formation, bone union, marrow changes, and cortex remodeling. We observed no adverse tissue responses such as fibrous connective tissue formation and inflammatory cellular infiltration. rhBMP-2 in absorbable collagen sponges enhanced bone repair in segmental tibial defects of ovariectomized rats. The sponges with rhBMP-2 appeared to enhance bone repair. This project was partly supported by Harran University Research Fund (HUBAK 436). Kurtsan Inc. (Istanbul, Turkey) supplied the absorbable collagen sponges for this study. Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Clinical Biochemistry, 2005
Objectives: The metabolism of cells in inflammatory and noninflammatory arthritic joint diseases ... more Objectives: The metabolism of cells in inflammatory and noninflammatory arthritic joint diseases is subject to complex environmental controls. The aim of the present study was to investigate the total antioxidant capacity (TAC), levels of lipid peroxidation (LPO), and antioxidant enzyme activities in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Design and methods: Plasma levels of TAC, malondialdehyde (MDA), the activities of some erythrocyte antioxidant enzymes, as well as erythrocyte sedimentation rates (ESR) were estimated in patients with RA and OA and compared with controls. Results: The plasma TAC levels were significantly lower in the RA group than the OA and control group (P < 0.05). Plasma MDA concentrations were significantly higher in patients with RA than those with OA and healthy subjects (P < 0.05). Erythrocyte GSH-Px and CAT activities were found to be significantly lower in patients with RA than those with OA and healthy subjects (P < 0.05, P < 0.05, respectively). However, there were no significant differences in erythrocyte SOD activities between the groups (P > 0.05). ESR were significantly higher in RA patients than in healthy subjects and patients with OA (P < 0.01). Moreover, there were significant negative correlations between TAC vs. MDA, ESR vs. TAC, and a positive correlation between ESR vs. MDA in the RA group (r = À0.398, P < 0.05; r = À0.422, P < 0.05; r = 0.530, P < 0.05, respectively). Conclusions: Our results demonstrated that levels of LPO are increased in patients with RA compared to patients with OA. In addition, plasma TAC levels are decreased in RA due to its inflammatory character. We conclude that detecting plasma TAC levels with this novel method may be used as a routine and rapid test to verify the levels of oxidative stress in RA. Furthermore, correlating TAC and LPO levels with acute phase reactants such as ESR may give some clues about disease activity in RA.
Acta orthopaedica et traumatologica turcica, 2005
OBJECTIVES We evaluated the clinical and subjective functional results of open surgical treatment... more OBJECTIVES We evaluated the clinical and subjective functional results of open surgical treatment in patients with chronic refractory lateral epicondylitis. METHODS Eleven patients (7 females, 4 males; mean age 42 years, range 29 to 56 years) underwent open surgical treatment for chronic refractory lateral epicondylitis. All the patients had received conservative treatment for at least a year without favorable response. Surgical procedure included release of the lateral extensor origin, excision of the degenerative tissue, decortication or drilling of the anterior lateral condyle, and repair of the extensor tendons. The results were evaluated according to the criteria proposed by Verhaar et al. The mean follow-up was 29 months (range 18 to 45 months). RESULTS The results were excellent or good in 10 patients (90.9%) and acceptable in one patient (9.1%). The mean time to return to work was two months. Nine patients were free of pain in the forearm in the postoperative third month. No...
Joint Diseases and Related Surgery
The positive impact of platelet-derived growth factor on the repair of full-thickness defects of ... more The positive impact of platelet-derived growth factor on the repair of full-thickness defects of articular cartilage Trombosit türevli büyüme faktörünün tam kat eklem kıkırdağı defektlerinin tamirine pozitif etkisi
Turkish Journal of Trauma and Emergency Surgery, 2016
BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the tr... more BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted. Malrotation was defined as rotational difference >10°. Operated knees were evaluated with 0.5-mm, fine-cut, 3-dimensional CT scan performed in cooperation with radiology department. Side-to-side difference in tibial torsion angle >10° was considered significant degree of malrotation. All patients were assessed clinically (visual analogue scale [VAS] and American Orthopaedic Foot and Ankle Society [AOFAS] scores) and radiologically at final visit. RESULTS: Mean follow-up period was 20.00±9.46 months (range: 18-51 months). Mean VAS score was 2.58±0.83 (range: 1-4) and mean AOFAS score was 87.50±4.05 (range: 78-93). Mean tibial rotation angle was 31.54±6.00° (range: 18-45°) on healthy side and 32.00±6.24° (range: 10-43°) on the operated side. No statistically significant difference was determined (p>0.05). CONCLUSION: Use of intraoperative fluoroscopy, cable technique, and uninjured extremity as reference, can reduce incidence of rotational malalignment of distal tibial fractures treated with MIPO.