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Ercan N, Arıcan G, Şibar K, Özmeriç A, İltar S. Clinical and Functional Outcomes of Suture Versus Headless Screw Fixation for Tibial Eminence Fractures in Children. Am J Sports Med 2024; 52:948-955. [PMID: 38385198 DOI: 10.1177/03635465241227440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
BACKGROUND Suture and screw fixations are widely used to treat tibial eminence fractures (TEFs). Although a few biomechanical and clinical studies have compared suture fixation (SF) and screw fixation in the treatment of TEFs in children, no comparative clinical studies are available regarding headless screw fixation (HSF). PURPOSE To evaluate the clinical and functional outcomes of children with TEF who underwent SF and HSF. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS The study included 24 patients treated with either SF (11 patients) or HSF (13 patients) within 1 month of TEF (type 2 or 3) without associated ligamentous and bone injury between 2015 and 2020. All patients were evaluated at a minimum 2-year follow-up in terms of Lysholm score, Tegner activity level, International Knee Documentation Committee subjective score, and isometric strength test. Knee stability was compared based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference. RESULTS No significant differences were found between the 2 groups in terms of Lysholm score, Tegner activity level, and International Knee Documentation Committee subjective score at follow-up. All patients were able to resume their daily activities within 6 months after the injury. However, flexion deficits (6°-10°) were found in 2 patients in the SF group and 1 patient in the HSF group, and extension deficits (3°-5°) were found in 3 patients in the SF group and 1 patient in the HSF group, without significant intergroup difference. Stability based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference was also similar between the 2 groups at follow-up. No statistically significant difference was found between the 2 groups in isometric tests performed. CONCLUSION The present study is the first to compare the clinical and functional results of SF and HSF techniques. The HSF technique demonstrated comparable clinical and functional outcomes, suggesting its potential as an alternative to the SF technique.
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Affiliation(s)
- Niyazi Ercan
- Department of Orthopedics and Traumatology, Yüksek İhtisas University, Ankara Güven Hospital, Ankara, Turkey
| | - Gökhun Arıcan
- Department of Orthopedics and Traumatology, Yüksek İhtisas University, Medical Park Ankara Hospital, Ankara, Turkey
| | - Kemal Şibar
- Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serkan İltar
- Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
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Özmeriç A, Bahadır Alemdaroğlu K, Fırat A, Şahin Ö. Morphometric measurements for potential dangers of anterior intra-pelvic approach in women: A cadaveric study. Acta Orthop Traumatol Turc 2023; 57:183-188. [PMID: 37670452 PMCID: PMC10544412 DOI: 10.5152/j.aott.2023.23013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/02/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE This study aimed to improve the surgical anatomical knowledge of pelvic/acetabular trauma surgeons by providing detailed morphometric data on some of the most vulnerable arteries and nerves due to constant bony landmarks during anterior intra-pelvic approach fixation of acetabular fractures in women. METHODS Ten hemipelvis were dissected from 5 female cadavers. The following measurements relative to the symphysis were performed: (1) the distance of the corona mortis anastomosis and (2) the bisection of the external iliac vein with the pubic ramus. In addition, dis- tance to the pelvic brim at the level of pectineal convexity of the following structures was measured: (3) depth of obturatory neurovascu- lar bundle, (4) superior vesical artery, and (5) vaginal artery. Also, the clock position of the (6) gluteal superior and inferior vessels due to sciatic notch in the supine position. Due to antero-superior corner of sacroiliac joint (7) location of the common iliac artery bifurcation, (8) location of the bifurcation of internal iliac vessels to truncuses, (9) bifurcation of superior gluteal artery and lateral sacral artery, and (10) L5 nerve were measured. The descriptive statistics were given as medians and ranges as this is a descriptive anatomical study without comparisons. RESULTS The median distance of corona mortis to symphysis pubis was 59.5 mm (range = 58-61). The external iliac vein bisected the pubic arm 68.5 mm (range=65-70) lateral to the symphysis pubis. At the level of pectineal convexity (about the middle of the pelvic brim), obturatory neurovascular bundle, superior vesical artery, and vaginal artery were 15 mm (range=13-16), 24 mm (range=23-25), and 36 mm (range=34-38) inferior to the pelvic brim, respectively. The superior gluteal vessels leave the sciatic notch at 12 o'clock position in supine position. Inferior gluteal vessels leave the sciatic notch at 31⁄2 o'clock position (given for left side). Common iliac artery bifurcation bisects the SI joint 5 mm (4-7) superior to antero-superior corner of the Sacro-iliac (SI) joint. The internal iliac artery gives its posterior trunk 18 mm (range=15-20) straightly anterior to antero-superior corner of the SI joint. Bifurcation of superior gluteal artery and lateral sacral artery was 11 mm (range = 10-12) away from the beginning of the posterior truncus. L5 root's medial margin was 9 mm (range = 7-10) medial to this landmark, where its lateral margin was on the SI joint (2 mm medial to 2 mm lateral). CONCLUSION The majority of the bleeding complications of the major branches of the internal and external iliac arteries and neurologic palsies due to obturatory nerve and L5 nerve root damage within the operative field of the anterior intra-pelvic approach can be avoided or managed by utilizing morphometric data provided from this study. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Ahmet Özmeriç
- University of Health Science, Ankara Training Hospital Orthopaedic and Traumatology, Ankara, Turkey
| | | | - Ayşegül Fırat
- Department of Anatomy, Hacettepe University, Ankara, Turkey
| | - Özgür Şahin
- University of Health Science, Ankara Training Hospital Orthopaedic and Traumatology, Ankara, Turkey
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Mısırlıoğlu M, Bingöl İ, Genç C, Akbulut A, Ocak M, Diker NY, Özmeriç A, Koca G, Bahçecitapar M, Şenes M, Fırat A, Kaymaz FF, Çelik HH, Çankaya İİ, Korkmaz M. Investigation of taurine and aqueous garlic extract diet supplementation effect on the healing of rat osteoporotic fractures. Turk J Med Sci 2023; 53:29-39. [PMID: 36945935 PMCID: PMC10388079 DOI: 10.55730/1300-0144.5555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/02/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND We have evaluated the effects of taurine and aqueous garlic extract (AGE) as a dietary supplement on osteoporotic fracture (OPF) healing in the ovariectomized rat femur fracture model. METHODS In this experimental animal study,twenty-four osteoporosis-remodeled female Wistar albino rats were randomly divided into 3 groups (n: 8) according to their supplemented diet; control, taurine, and AGE groups. Unilateral femur middiaphysis mini-open osteotomy was stabilized with Kirschner wires. Six weeks after osteotomy, the rats were sacrificed before the femurs were harvested and OPF healing was evaluated with biochemical, histologic, microcomputed-tomography, and scintigraphic methods. RESULTS As an indicator of the antiosteoporotic effect, the calcium levels of the taurine group were significantly lower than the AGE and control groups in biochemical analyzes (p < 0.01). In histological studies, the new bone diameter and new bone volume values of the taurine group were significantly higher than the control group (p = 0.002 and p = 0.032, respectively), while higher trabecular-compact callus was observed in the taurine and AGE groups, respectively, compared to the control group. In morphological analyses, taurine and AGE groups had significantly higher bone volume/tissue volume, trabecular number, bone surface density, and lower trabecular separation than the control group (p < 0.05). The scintigraphic imaging showed a significant increase in osteoblastic activity of the taurine group compared to the control group (p = 0.005). DISCUSSION Taurine and AGE have positive anabolic effects, respectively, on the healing of OPFs, demonstrated by biochemical, histological, morphological, and scintigraphic methods.
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Affiliation(s)
- Mesut Mısırlıoğlu
- Department of Orthopedics and Traumatology, University of Health Sciences Ankara Oncology Education and Training Hospital, Ankara, Turkey
| | - İzzet Bingöl
- Department of Orthopedics and Traumatology, University of Health Sciences Ankara Oncology Education and Training Hospital, Ankara, Turkey
| | - Coşkun Genç
- Department of Orthopedics and Traumatology, University of Health Sciences Ankara Oncology Education and Training Hospital, Ankara, Turkey
| | - Aylin Akbulut
- Department of Nuclear Medicine, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Mert Ocak
- Department of Anatomy, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Neziha Yağmur Diker
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopedics and Traumatology, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Gökhan Koca
- Department of Nuclear Medicine, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Melike Bahçecitapar
- Department of Statistics, Faculty of Science, Hacettepe University, Ankara, Turkey
| | - Mehmet Şenes
- Department of Medical Biochemistry, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
| | - Ayşegül Fırat
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fevziye Figen Kaymaz
- Department of Histology and Embryology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Hamdi Çelik
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İffet İrem Çankaya
- Department of Pharmaceutical Botany, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Meliha Korkmaz
- Department of Nuclear Medicine, University of Health Sciences Ankara Training and Research Hospital, Ankara, Turkey
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Özmeriç N, Çakal GÖ, Gökmenoğlu C, Özmeriç A, Oduncuoğlu BF, Hacaloğlu T, Kaftanoğlu B. Histomorphometric and biomechanical evaluation of the osseointegration around micro- and nano-level boron-nitride coated titanium dental implants. J Stomatol Oral Maxillofac Surg 2022; 123:e694-e700. [PMID: 35724866 DOI: 10.1016/j.jormas.2022.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Titanium dental implants has been coated with different materials such as polymers and biomimetic agents, bone morphogenetic protein, calcium phosphate to enhance surface properties of the titanium implants for osseointegration. The aim of this study was to evaluate the bone tissue healing around Boron Nitride-coated (BN-coated) titanium implants histomorphometrically and biomechanically and also observe the effect of different coating thicknesses on osseointegration. MATERIALS AND METHODS BN was coated on dental titanium implants with two different coating thicknesses by using RF magnetron sputtering system. Totally fifty-four implants were inserted into the tibias' of 12 New Zealand rabbits bilaterally under general anesthesia. All animals were sacrificed after 4-weeks. Bone-implant contact (BIC) and new bone area/total area ratios (BATA) were calculated. Also, the removal torque (RT) test was performed. RESULTS The highest new bone area in the medullary cavity was around the nano-BN-coated surface with 15.70%. In micro-BN-coated surface and control group, this ratio was determined as 10.48% and 8.23%, respectively. The BIC ratios in upper-side of implants and cortical-associated BIC ratios in lower-side were found significantly higher in control and micro-BN-coated group than nano-BN-coated group (p < 0.05). Similar BIC values were observed between control and micro-BN-coated groups (p > 0.05). BATA values did not show statistically significant differences between all three groups (p > 0.05). The RT values measured in all groups were found comparable and no statistically significant differences were found (p > 0.05). CONCLUSION No inflammatory reaction developed around any implant. Relatively more new bone formation around nano-BN-coated titanium implants indicates the promising osseoinductive effect of BN coating. BN-coated implants showed similar biomechanical and histomorphometrical outcomes to that of the conventional titanium implants through a 4-week evaluation period.
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Affiliation(s)
- Nurdan Özmeriç
- Department of Periodontology, Faculty of Dentistry, Gazi University, Bişkek Caddesi, 06510 Ankara, Turkey
| | - Gaye Özgür Çakal
- Institute of Nuclear Sciences, Ankara University, Tandoğan Campus, 06100 Ankara, Turkey
| | - Ceren Gökmenoğlu
- Department of Periodontology, Faculty of Dentistry, Ordu University, 52100, Ordu, Turkey.
| | - Ahmet Özmeriç
- Department of Orthopedics and Traumatology, SBU Ankara Training and Research Hospital, 06340 Ankara, Turkey
| | - Bahar Füsun Oduncuoğlu
- Department of Periodontology, Faculty of Dentistry, Baskent University, 06590 Ankara, Turkey
| | - Tuğçe Hacaloğlu
- Department of Manufacturing Engineering, Atilim University, Kizilcasar Mah 06836 Ankara, Turkey
| | - Bilgin Kaftanoğlu
- Department of Manufacturing Engineering, Atilim University, Kizilcasar Mah 06836 Ankara, Turkey
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Subaşi İÖ, Alemdaroğlu KB, Arican G, Iltar S, Şibar K, Özmeriç A. Cast revision is effective for critical three-point index values in paediatric forearm fractures: a prospective study. J Pediatr Orthop B 2022; 31:457-464. [PMID: 35132001 DOI: 10.1097/bpb.0000000000000960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Three-point index (TPI) has been reported to be effective in predicting the displacement of forearm fractures. The aim of this prospective study was to investigate the clinical efficacy of recasting critical but acceptable casts according to three-point index (0.6 < TPI < 0.8) before a redisplacement occurs in childhood forearm fractures. A TPI of 0.6-0.8 was determined in 68 patients, and these were separated as group 1 ( n = 34) applied with prophylactic recasting and group 2 ( n = 34) where treatment was continued with same cast. The remaining 28 patients had TPI < 0.6 and were assigned as group 3. Groups were compared in respect of age, initial displacement, cast type, location of fracture, initial and late three-point index values and inter- and intraobserver reliabilities of TPI measurements. Significantly less displacement was seen in group 1 than in group 2 ( P = 0.004). It was found that a 0.1 increase of index value in the initial and late TPIs increases the probability of redisplacement by 5.06 and 7.78 times, respectively. Late TPI, measured 1 week after casting, had better predictive value than the initial TPI with a sensitivity of 77.8%, specificity of 92.3%, positive predictive value of 70% and negative predictive value of 94.7%. Patients in the grey zone will be able to safely complete the cast treatment with prophylactic recasting without surgical intervention. TPI should be remeasured at the end of first week, as its predictive value becomes more accurate after swelling subsides.
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Affiliation(s)
- İzzet Özay Subaşi
- Department of Orthopedics and Traumatology, Erzincan Binali Yildirim University, Erzincan
| | | | - Gökhun Arican
- Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serkan Iltar
- Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Kemal Şibar
- Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey
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Gökgöz MB, Alemdaroğlu B, Özmeriç A, İltar S, Erbay FK, Demir T. The Effect of Lateralization of a Pelvic Brim Plate on the Fixation of an Anterior Column Fracture: A Biomechanical Analysis. Cureus 2022; 14:e24158. [PMID: 35592198 PMCID: PMC9110042 DOI: 10.7759/cureus.24158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
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Arıcan G, Özmeriç A, Fırat A, Kaymaz F, Ocak M, Çelik HH, Alemdaroğlu KB. Micro-ct findings of concentrated growth factors (cgf) on bone healing in masquelet's technique-an experimental study in rabbits. Arch Orthop Trauma Surg 2022; 142:83-90. [PMID: 32945957 DOI: 10.1007/s00402-020-03596-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 09/09/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION A recent histopathological and immunohistochemical study has proved that the addition of concentrated growth factors (CGF) to the Masquelet's technique contributes to the quality of the membrane formed, in respect of inducing inflammation and proliferation, maintaining vascularization on large diaphyseal bone defects, and increasing the number of stem cells. The aim of the study is comparison of radiological results of this combination treatment by micro-CT. MATERIALS AND METHODS The study was planned on a critical bone defect model in rabbit radius. Group I and Group III were the control groups to which only the Masquelet's technique is applied. Group II and Group IV were CGF groups in addition to the Masquelet's technique. CGF was prepared by centrifugation of rabbit's own blood. For early phase, Groups I and II were evaluated in the 8th week, while for late phase, Group III and Group IV were evaluated in the 12th week. Groups were compared in terms of bony union radiologically by micro-CT(μCT) (New Bone Volume (NBV), Total Bone Volume (TBV) and NBV/TBV) and histopathologically. RESULTS The structural parameters, including NBV, TBV, NBV/TBV were higher in the early- (8th week) and late-phase (12th week) CGF group. There was no statistically significant difference between CGF and control groups in early phase, (p = 0.153), while in late phase, CGF group was significantly higher of new bone volume than the control group, 246.3 mm3 (196.1-258) and 169.6 mm3 (154.3-235.9), respectively (p = 0.028). For early phase, control group was significantly lower than late-phase control group, 121.8 mm3 (88.8-144.4) and 169.6 mm3 (154.3-235.9), respectively (p = 0.006). The ratio of New Bone Volume to Total Bone Volume (NBV/TBV ratio) in CGF groups was significantly higher compared to the control groups 27.3% (24.7-29.6), 35.3% (32.1-38.6) (p = 0.032) and 39.7% (36.7-41.6), 55.3% (52-57.5) (p = 0.002), respectively. Histopathologically, Microscopic New Bone Formation had no statistically significant difference between control and CGF groups in early phase (8th week) (p = 0.153), while in late phase (12th week), CGF group had significantly higher amount of new bone formation than the control group, 0.29 µm2 (0.27-0.36), 0.51 µm2 (0.42-0.59), respectively (p = 0.008). CONCLUSION The addition of CGF to the Masquelet's technique is an important method for supporting new bone formation in large diaphyseal bone defects. LEVEL EVIDENCE Level III, therapeutic/care management.
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Affiliation(s)
- Gökhun Arıcan
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, 06340, Turkey.
| | - Ahmet Özmeriç
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, 06340, Turkey
| | - Ayşegül Fırat
- Department of Anatomy, Hacettepe Univesity Faculty of Medicine, Ankara, 06100, Turkey
| | - Figen Kaymaz
- Department of Histology and Embryology, Hacettepe Univesity Faculty of Medicine, Ankara, 06100, Turkey
| | - Mert Ocak
- Vocational School of Health, Ankara University, Ankara, 06100, Turkey
| | - H Hamdi Çelik
- Department of Anatomy, Hacettepe Univesity Faculty of Medicine, Ankara, 06100, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Department of Orthopaedics, University of Health Sciences Ankara Training and Research Hospital, Ankara, 06340, Turkey
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Özmeriç A, Tanoğlu O, Ocak M, Çelik HH, Fırat A, Kaymaz FF, Koca G, Şenes M, Alemdaroğlu KB, İltar S, Hacaloğlu T, Kaftanoğlu B. Intramedullary implants coated with cubic boron nitride enhance bone fracture healing in a rat model. J Trace Elem Med Biol 2020; 62:126599. [PMID: 32629303 DOI: 10.1016/j.jtemb.2020.126599] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Boron nitride is a biocompatible and an osteo-inductive material for orthopedic applications. The aim of this study was to evaluate the effects of two different allotrope boron nitride coated implants, cubic boron nitride and hexagonal boron nitride, on fracture healing. METHODS In this experimental study, a total of 24 rats were divided into three groups. Group A was the control group with Kirschner wire without coating, while the wires were coated dominantly by cubic boron nitride in Group B and hexagonal boron nitride in Group C. Then a mid-third femoral fracture was created. The fracture healing was examined in terms of new bone formation with micro-CT analysis and histopathological examination, quantitative measurement of bone turnover metabolites and scintigraphic examination of osteoblastic activity on 28th day post fracture. RESULTS Micro-CT measurement results revealed a statistically significant increase in bone volume/tissue volume ratio and bone surface values in group B compared to group A. Cortex diameter and osteoblast counts were statistically higher in group B compared to group A. Inflammatory response was increased in group C compared to groups A and B. Biochemical test results showed significantly increased alkaline phosphatase levels and decreased osteocalcin levels in group B compared to group A. The increase in serum phosphorus and decrease in serum calcium levels was statistically significant in group C compared to Group A. CONCLUSION Both types of boron nitride coating had superior fracture healing features compared to control group. Therefore, c-BN coating can accelerate the fracture healing and could lead to shorten of union time.
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Affiliation(s)
- Ahmet Özmeriç
- SBU Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
| | - Oğuzhan Tanoğlu
- Erzincan Binali Yıldırım University, Faculty of Medicine, Department of Orthopedics and Traumatology, Erzincan, Turkey.
| | - Mert Ocak
- Ankara University, Vocational School of Health, Ankara, Turkey.
| | - Hakan Hamdi Çelik
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey.
| | - Ayşegül Fırat
- Hacettepe University, Faculty of Medicine, Department of Anatomy, Ankara, Turkey.
| | - Fevziye Figen Kaymaz
- Hacettepe University, Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey.
| | - Gökhan Koca
- SBU Ankara Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey.
| | - Mehmet Şenes
- SBU Ankara Training and Research Hospital, Department of Medical Biochemistry, Ankara, Turkey.
| | - Kadir Bahadır Alemdaroğlu
- SBU Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
| | - Serkan İltar
- SBU Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
| | - Tuğçe Hacaloğlu
- Atılım University, Department of Manufacturing Engineering, Ankara, Turkey.
| | - Bilgin Kaftanoğlu
- Atılım University, Department of Manufacturing Engineering, Ankara, Turkey.
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Abstract
The aim of this study was to compare the sensitivity, specificity, accuracy, positive and negative predictive values of magnetic resonance imaging (MRI), and clinical examination in the diagnosis of meniscus tears with the findings obtained from the knee joint arthroscopy. A retrospective study was made of 452 patients who underwent knee arthroscopy due to meniscus tears between 2012 and 2017. Physical examination was performed using the Thessaly's, McMurray's, and Joint line tenderness tests (JLTT). On preoperative MRI, medial meniscal tears were observed in 292 patients, lateral meniscal tears in 96 patients, and medial and lateral meniscal tears in 64 patients. According to the arthroscopy results, 284 patients had medial meniscal tears, 108 patients had lateral meniscal tears, and 60 patients had medial and lateral meniscal tears. Sensitivity and specificity of the JLTT was determined as 93 and 86% respectively for medial meniscal tears and 94 and 89% for lateral meniscal tears. The McMurray's test was 60% sensitive, 68% specific for medial meniscal tears (MMT), and 73% sensitive and 68% specific for lateral meniscus tears (LMT). The Thessaly's test was 93% sensitive and 87% specific for medial meniscal tears; and 94% sensitive and 88% specific for LMT. Compared with the arthroscopic findings, MRI was observed to have sensitivity of 94% for MMT and 84% for LMT. For specificity, the values were 89% for MMT and 91% for LMT. Accuracy was 89% for MMT and 86% for LMT. In comparison with the arthroscopic findings, the triple test was determined to have sensitivity of 92% for MMT and 89% for LMT. The specificity was 88% for MMT and 91% for LMT. The results of this study showed that a combination of selected physical examination methods is as sensitive as MRI in the diagnosis of meniscus tears.
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Affiliation(s)
- Gökhun Arıcan
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Özgür Şahin
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serkan İltar
- Department of Orthopaedics, University of Health Sciences (UHS), Ankara Training and Research Hospital, Ankara, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Department of Orthopaedics, University of Health Sciences (UHS), Ankara Training and Research Hospital, Ankara, Turkey
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Arıcan G, Kahraman HÇ, Özmeriç A, İltar S, Alemdaroğlu KB. Monitoring the Prognosis of Diabetic Foot Ulcers: Predictive Value of Neutrophil-to-Lymphocyte Ratio and Red Blood Cell Distribution Width. INT J LOW EXTR WOUND 2020; 19:369-376. [DOI: 10.1177/1534734620904819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The aim of this study was to investigate the prognostic values of neutrophil-to-lymphocyte ratio and red blood cell distribution width in diabetic foot ulcers treatment. A total of 250 adult patients who were treated in our clinic between 2007 and 2018 for diabetic foot ulcers were evaluated retrospectively. Diabetic foot ulcers were divided into 4 groups: major amputation, minor amputation, chronic wound, and complete healing. The mean age of our study groups was 60 years (range = 55-65 years). The mean follow-up period was 28 ± 4.3 months. Neutrophil-to-lymphocyte ratio and red blood cell distribution width cutoff values were determined as 4.3 and 12.1, respectively, for patients in complete recovery group (C sig. = .995 and .871, respectively; P < .05). Neutrophil-to-lymphocyte ratio and red blood cell distribution width cutoff values for patients in the major amputation group were 6.73 and 13.4 (C sig. = .864 and .951, respectively; P < .05), respectively. According to the χ2 comparison of the groups, major amputation was seen in patients with neutrophil-to-lymphocyte ratio >6.3, and complete recovery was seen in patients with neutrophil-to-lymphocyte ratio <4.3. In patients with red blood cell distribution width >13.4, major amputation was found to be significant ( P < .05). According to these results, neutrophil-to-lymphocyte ratio and red blood cell distribution width are inexpensive and easy to access predictive parameters in the diagnosis and follow-up of diabetic foot ulcers.
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Affiliation(s)
- Gökhun Arıcan
- SBU Ankara Training and Research Hospital, Ankara, Turkey
| | | | - Ahmet Özmeriç
- SBU Ankara Training and Research Hospital, Ankara, Turkey
| | - Serkan İltar
- SBU Ankara Training and Research Hospital, Ankara, Turkey
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ARICAN GÖKHUN, Subaşı Ö, Özmeriç A, İltar S, Alemdaroğlu KB, Dinçel VE. Talon Proksimal Femoral Çivileme(Pfn) Proksimal Femoral Çivi-Antirotasyon (Pfna) Kadar Başarılı Mı? Acta Medica Alanya 2019. [DOI: 10.30565/medalanya.567751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Tanoğlu O, Gökgöz MB, Özmeriç A, Alemdaroğlu KB. Two-Stage Surgery for the Malleolar Fracture-Dislocation With Severe Soft Tissue Injuries Does Not Affect the Functional Results. J Foot Ankle Surg 2019; 58:702-705. [PMID: 31079983 DOI: 10.1053/j.jfas.2018.11.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 02/03/2023]
Abstract
Soft tissue injuries associated with malleolar fracture-dislocations may increase postoperative rates of wound complication. Ankle-spanning frame plays a fundamental role in the local damage control orthopedics while gaining time for definitive surgery. The objective of this study was to evaluate the effect of a 2-stage surgery for the unstable malleolar fracture-dislocations with severe soft tissue injuries compared to a 1-stage surgery in terms of the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle and Olerud-Molander ankle scores (OMAS). We analyzed 45 patients who met our study criteria. The patients were divided into 2 groups according to staged surgeries. Demographic data of patients, comorbidities, alcohol and tobacco use, Tscherne soft tissue injury scores, the AOFAS hindfoot-ankle and OMAS, postoperative complications, total hospitalization times, waiting time between stages, and waiting time from admission to surgery times were investigated. There was a statistically significant difference between the groups in terms of the mean total hospitalization times (p = .007), waiting time from admission to surgery (p < .001), gender (p = .005), and Tscherne soft tissue injury scores (p < .001). The mean AOFAS hindfoot-ankle and OMAS of the groups did not differ statistically at a minimum of 12 months of the follow-up period (p = .094 and p = .126, respectively). A 2-stage surgery can be performed safely in the carefully selected patients with the unstable malleolar fracture-dislocations with Tscherne grades 2 and 3 soft tissue injuries, and this surgery does not affect the postoperative AOFAS hindfoot-ankle and OMAS statistically compared to a 1-stage surgery at a minimum of 12 months of the follow-up period.
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Affiliation(s)
- Oğuzhan Tanoğlu
- Specialist in Orthopedics, Department of Orthopedics and Traumatology, Erzincan University Mengucek Gazi Research and Training Hospital, Erzincan, Turkey.
| | - Mehmet Burak Gökgöz
- Resident Doctor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Associate Professor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Professor in Orthopedics, Department of Orthopedics and Traumatology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, Turkey
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Gültaç E, İltar S, Özmeriç A, Koçak A, Aydoğan NH, Alemdaroğlu KB. Surgical treatment of acetabulum posterior wall fractures: Comparison between undercountering and marginal impaction reconstruction method with odd methods. J Clin Orthop Trauma 2019; 10:900-903. [PMID: 31528065 PMCID: PMC6738499 DOI: 10.1016/j.jcot.2019.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 06/23/2018] [Accepted: 01/28/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Modern treatment principles for posterior wall fractures have become widespread in the last decade in many countries by means of international or local courses. The purpose of this study was to compare the clinical and radiologic outcomes of acetabulum posterior wall fractures using unconventional methods of fixation, including plates placed in unusual directions, or, in the case of reoperation, only interfragmentary screws. In addition, we examined acetabulum posterior wall fractures treated by open reduction and internal fixation with standard undercountered plates from ischion to iliac bone in latter cases. METHODS Twenty-one patients who had open reduction and internal fixation of an unstable unilateral fracture of the posterior wall of the acetabulum between 2009 and 2013 were included. Group 1 was composed of 10 former patients who were treated with unconventional methods that included a compression technique with a direct plate or solely screw fixation. Group 2 was composed of latter 11 patients who were treated with standard surgery that included undercountered plates oriented from the ischial tuberosity to the iliac bone proximally and reconstruction of marginal impaction if necessary. The functional outcome was evaluated with the use of the clinical grading system adopted by Merle d'Aubigné and Postel. The Kellgren-Lawrence radiologic criteria were used for the radiologic assessments. The reduction of the fracture, posterior dislocation, marginal impaction, mean fracture particle amount, trochanteric osteotomy and avascular necrosis were compared between the two groups and examined with the Mann-Whitney U test. RESULTS In Groups 1 and 2, the median score of the modified Merle d'Aubigné and Postel clinical scoring system was 16 (8-18) and 18 (14-18), respectively. The clinical scores between the two groups were statistically significant (p < 0.01). When two groups were compared using the Kellgren-Lawrence radiographic criteria for the development of osteoarthritis, the median value in Groups 1 and 2 was 3 (0-4) and 1 (0-3), respectively (p < 0.01). CONCLUSIONS This study displays the evolution of the surgical treatment of acetabular fractures of the posterior wall in our clinic. The older methods failed in terms of exposure, diagnosis of fracture anatomy and fixation techniques. Patients treated after the surgeons took courses in this field showed evidence of superior clinical and radiological scores. We attribute these benefits to exposure, definition and treatment of marginal impaction and fixation principles.
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Affiliation(s)
- Emre Gültaç
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serkan İltar
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey,Corresponding author. Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, 06534, Ankara, Turkey.
| | - Aykut Koçak
- Department of Orthopaedics, Ankara Training and Research Hospital, Ankara, Turkey
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Abstract
Alkaptonuria is a hereditary disorder of phenylalanine and tyrosine, with an incidence of approximately 1/200,000 to 1/1,000,000. Ochronosis is the accumulation of homogentisic acid and its metabolites in connective tissues such as the tendons, cartilage, and skin. In the present case study, a 50-year-old male presented with a nontraumatic calcaneal avulsion without a previous diagnosis of ochronosis. To the best of our knowledge, little information has been reported of this pathology in the Achilles tendon and the surgical management.
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Affiliation(s)
- Oğuzhan Tanoğlu
- Specialist in Orthopaedics, Orthopaedics and Traumatology Clinics, Ankara Research and Training Hospital, Ankara, Turkey.
| | - Gökhun Arıcan
- Resident in Orthopaedics, Orthopaedics and Traumatology Clinics, Ankara Research and Training Hospital, Ankara, Turkey
| | - Ahmet Özmeriç
- Associate Professor in Orthopaedics, Orthopaedics and Traumatology Clinics, Ankara Research and Training Hospital, Ankara, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Professor in Orthopaedics, Orthopaedics and Traumatology Clinics, Ankara Research and Training Hospital, Ankara, Turkey
| | - Muzaffer Çaydere
- Specialist in Pathology, Department of Pathology, Ankara Research and Training Hospital, Ankara, Turkey
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Yılmaz O, Özmeriç A, Alemdaroğlu KB, Celepli P, Hücümenoğlu S, Şahin Ö. Effects of concentrated growth factors (CGF) on the quality of the induced membrane in Masquelet's technique - An experimental study in rabbits. Injury 2018; 49:1497-1503. [PMID: 29907331 DOI: 10.1016/j.injury.2018.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 02/02/2023]
Abstract
AIMS The aim of the study was to test if the addition of CGF to the Masquelet technique contributes to the quality of the membrane formed surrounding the polymethylmethacrylate (PMMA), in terms of inflammation, proliferation and vasculazition in the Masquelet technique in the early and late phases in a rabbit model. MATERIALS AND METHODS A critical bone defect of 15 mm was created in radius diaphysis, leaving 3 cm of intact bone to the joint. To mimic the Masquelet technique and to increase stability, a 6-hole 1.5 mm plate with two screws was applied, although it was initialy stable because of the inherently fixed ulna and radius both proximally and distally in the rabbits. Group 1 and Group 3, were soleley treated with the Masquelet technique as control groups, and were sacrificed at 3 and 6 weeks, respectively. Group 2 and Group 4, were treated with the Masquelet technique + CGF prepared from the rabbit blood groups, and were sacrificed at 3 and 6 weeks, respectively. The groups were compared histopathologically and immunohistochemically, in respect of the means of thickness of the membrane and ratio of elastic fibers, membrane vascularization (CD31), inflammation (MAC387), proliferation (Ki67), and presence of stem cells (STRO-1). RESULTS Thickness of the membrane and CD31 values were significantly higher in Group 4 than Group 3 (p = 0.004 for both). MAC387 was statistically significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.04 for both). Ki67 was significantly higher in Group 2 compared to Group 1 and Group 4 compared to Group 3 (p = 0.05 and p = 0.006, respectively). Proliferation in the membrane was statistically significantly higher in Group 2 compared to Group 1 (p = 0.05). Likewise, the proliferation index of Group 4 was statistically significantly higher than Group 3 (p = 0.06). STRO-1 was significantly higher in Group 2 compared to Group 1 (p = 0036). CONCLUSION The addition of CGF to the Masquelet technique contributes to the quality of the membrane formed, in respect of inducing inflammation and proliferation, maintaining vascularization on large diaphyseal bone defects, and increasing the number of stem cells.
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Affiliation(s)
- Orkun Yılmaz
- Ankara Training and Research Hospital, Department of Orthopaedics, Turkey
| | - Ahmet Özmeriç
- Ankara Training and Research Hospital, Department of Orthopaedics, Turkey
| | | | - Pınar Celepli
- SBU Ankara Training and Research Hospital, Department of Pathology, Turkey
| | - Sema Hücümenoğlu
- SBU Ankara Training and Research Hospital, Department of Pathology, Turkey
| | - Özgür Şahin
- Ankara Training and Research Hospital, Department of Orthopaedics, Turkey
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Tanoğlu O, Alemdaroğlu KB, İltar S, Özmeriç A, Demir T, Erbay FK. Biomechanical comparison of three different fixation techniques for anterior column posterior hemitransverse acetabular fractures using anterior intrapelvic approach. Injury 2018; 49:1513-1519. [PMID: 29934096 DOI: 10.1016/j.injury.2018.06.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 06/01/2018] [Accepted: 06/15/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aim of this study was to biomechanically compare three different fixation methods for the fixation of anterior column posterior hemitransverse type acetabular fracture (ACPHT). METHODS ACPHT fracture models were created on twenty-four foam cortical shell artificial hemipelvis models. Three fixation methods were assessed - Group 1: posterior column lag screws over a suprapectineal plate; Group 2: Posterior column lag screws over a suprapectineal plate and an infrapectineal plate; Group 3: A suprapectineal plate and a vertical infrapectineal plate. Stiffness and displacement amounts of fixation methods under dynamic and static axial loading conditions were measured. RESULTS In the dynamic and static tests, Group 3 showed the less stable fixation compared to Group 2. There was no statistically significant difference between the stiffness values of the fixation groups. In the static tests, there was no statistically significant difference between Group 1 and 2, although less displacements were obtained in Group 2. CONCLUSIONS A combination of posterior lag screws over a suprapectineal plate and an infrapectineal plate supporting the pelvic brim along both sides of the linea terminalis resulted in a better fixation construct than a suprapectineal plate accompanying with a vertical infrapectineal plate provide better stability with less fracture displacement.
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Affiliation(s)
- Oğuzhan Tanoğlu
- Erzincan University Mengücek Gazi Training and Research Hospital, Orthopaedics and Traumatology Department, Turkey.
| | | | - Serkan İltar
- SBU Ankara Training and Research Hospital, Orthopaedics and Traumatology Department, Turkey
| | - Ahmet Özmeriç
- SBU Ankara Training and Research Hospital, Orthopaedics and Traumatology Department, Turkey
| | - Teyfik Demir
- TOBB Economics and Technology University, Mechanical Engineering Department, Turkey
| | - Fatma Kübra Erbay
- TOBB Economics and Technology University, Micro-Nanotechnology Programme, Turkey
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Koçak A, Özmeriç A, Koca G, Senes M, Yumuşak N, Iltar S, Korkmaz M, Alemdaroğlu KB. Lateral parapatellar and subvastus approaches are superior to the medial parapatellar approach in terms of soft tissue perfusion. Knee Surg Sports Traumatol Arthrosc 2018; 26:1681-1690. [PMID: 28835987 DOI: 10.1007/s00167-017-4690-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 08/18/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE The arthrotomy techniques of knee surgery may cause varying degrees of disruption to the tissue blood supply. The aim of this study was to investigate the effects of the medial parapatellar (MPPa), midvastus (MVa), subvastus (SVa) and lateral parapatellar (LPPa) approaches on regional tissue perfusion of the knee. METHODS In this experimental study, a total of 28 female rabbits were applied with four different arthrotomy techniques as Group MPPa, Group MVa, Group SVa and Group LPPa. The blood supply of the tissue around the knee was examined by scintigraphic imaging including the perfusion reserve and T max, and biochemical alteration of the oxidative stress parameters including malondialdehyde (MDA), fluorescent oxidation products (FlOPs), and histopathological findings were evaluated on tissue samples after 3 weeks. RESULTS The perfusion reserve was increased in all four groups compared to the healthy, contralateral knees. In the Group LPPa, the vascularity was significantly increased compared to the Group MPPa (p = 0.006). In the examination of biochemical parameters, the increase in MDA levels was statistically significant in the Group MPPa compared with the Group LPPa (p = 0.004), and in the Group MVa compared with the Group LPPa (p = 0.006). The increase in the value of MDA levels was striking in the Group MPPa and Group MVa compared with the control group (p = 0.004, p = 0.004, respectively). The increase in another oxidative stress parameter, the tissue FlOPs levels, was statistically significant in the Group MPPa compared with the control group (p = 0.035). CONCLUSION The LPPa and SVa caused less oxidative stress and less disruption of the muscle blood supply, in biochemical and scintigraphic parameters, compared to the MPPa and MVa. Therefore, in clinical practice, the SVa is preferable to the MPPa and MVa in total knee arthroplasty and the LPPa should be preferred more frequently in selected cases with critical soft tissue viability.
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Affiliation(s)
- Aykut Koçak
- Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, 06534, Ankara, Turkey
| | - Ahmet Özmeriç
- Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, 06534, Ankara, Turkey.
| | - Gökhan Koca
- Department of Nuclear Medicine, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehmet Senes
- Department of Medical Biochemistry, Ankara Training and Research Hospital, Ankara, Turkey
| | - Nihat Yumuşak
- Department of Veterinary Pathology, Harran University, Şanlıurfa, Turkey
| | - Serkan Iltar
- Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, 06534, Ankara, Turkey
| | - Meliha Korkmaz
- Department of Nuclear Medicine, Ankara Training and Research Hospital, Ankara, Turkey
| | - Kadir Bahadır Alemdaroğlu
- Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, 06534, Ankara, Turkey
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Firat A, Alemdaroğlu KB, Özmeriç A, Yücens M, Göksülük D. Morphometric study of the true S1 and S2 of the normal and dysmorphic sacralized sacra. Turk J Med Sci 2017; 47:954-959. [PMID: 28618750 DOI: 10.3906/sag-1505-84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 12/26/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM This study aimed to generate data for the S1 and S2 alar pedicle and body and the alar orientations for both dysmorphic and normal sacra. MATERIALS AND METHODS The study comprised two groups: Group N consisted of 53 normal sacra and Group D included 10 dysmorphic sacra. Various features such as alar pedicle circumference; anterior, middle, and posterior axis of the sacral ala; sacral body height and width; and sagittal thickness were measured. RESULTS In group N, the median anterior axis of the alae was observed to be 30° on the right and 25° on the left, the median midline axis was found to be 20° on the right and 15° on the left, and the median posterior alar axis was -15° on the right and -20° on the left. The true S1 and S2 alar pedicle circumferences were observed to be significantly smaller in group D, which demonstrated a shorter S1 alar pedicle mean circumference, significantly narrower S1 body mean width, and considerably tapered sagittal thickness. CONCLUSION Our analysis indicated that dysmorphic sacra have a lower sagittal thickness and width of bodies and smaller alar pedicles, which explains the difficulties in their percutaneous fixation.
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Affiliation(s)
- Ayşegül Firat
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ahmet Özmeriç
- Department of Orthopedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yücens
- Department of Orthopedics, Ankara Training and Research Hospital, Ankara, Turkey
| | - Dinçer Göksülük
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Aslan A, Özmeriç A, Bilal Ö, Doğar F, Özkaya Z, Uysal E. Comparative evaluation of clinical effectivity and side effects of two different parenteral agents used in the treatment of osteoporosis. ACTA ACUST UNITED AC 2014. [DOI: 10.7243/2055-7000-1-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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