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Özbek EA, Runer A, Dadoo S, DiNenna M, Linde M, Smolinski P, Musahl V, Mcclincy MP. The Effect of Lateral Extra-articular Tenodesis in an ACL-Reconstructed Knee With Partial Medial Meniscectomy: A Biomechanical Study. Am J Sports Med 2023; 51:3473-3479. [PMID: 37724758 DOI: 10.1177/03635465231198856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/21/2023]
Abstract
BACKGROUND Knee laxity increases with medial meniscectomy in anterior cruciate ligament (ACL)-reconstructed knees; however, the biomechanical effect of an additional lateral extra-articular tenodesis (LET) is unknown. PURPOSE/HYPOTHESIS The purpose of this study was to determine the kinematic effect of a LET in knees that underwent combined ACL reconstruction (ACL-R) and partial medial meniscus posterior horn (MMPH) meniscectomy. It was hypothesized that the addition of LET would reduce laxity in the ACL-reconstructed knee. STUDY DESIGN Controlled laboratory study. METHODS Ten fresh-frozen human cadaveric knees (mean age, 41.5 years) were tested using a robotic system under 3 loads: (1) 89.0 N of anterior tibial (AT) load, (2) 5 N·m of internal rotation (IR) tibial torque, and (3) a simulated pivot shift-a combined valgus of 7 N·m and IR torque of 5 N·m-at 0°, 15°, 30°, 45°, 60°, and 90° of knee flexion. Kinematic data were acquired in 4 states: (1) intact, (2) ACL-R, (3) ACL-R + partial MMPH meniscectomy (MMPH), and (4) ACL-R + partial MMPH meniscectomy + LET (MMPH+LET). RESULTS In response to AT loading, there was a significant increase seen in AT translation (ATT) in the MMPH state at all knee flexion angles compared with the ACL-R state, with the highest increase at 90° of knee flexion (mean difference, 3.1 mm) (P < .001). Although there was a significant decrease in ATT at 15° of knee flexion with MMPH+LET (P = .022), no significant differences were found at other knee flexion angles (P > .05). In MMPH with IR torque, a significant increase was observed in IR at all knee flexion angles except 90° compared with the ACL-R state (range, 2.8°-4.9°), and this increase was significantly decreased at all flexion angles with the addition of LET (range, 0.7°-1.6°) (P < .05). CONCLUSION Performing a partial MMPH meniscectomy increased ATT and IR in response to AT and IR loads compared with the isolated ACL-R state in a cadaveric model. However, when the LET procedure was performed after partial MMPH meniscectomy, a significant decrease was seen at all knee flexion angles except 90° in response to IR and torque, and a significant decrease was seen at 15° of knee flexion in response to AT load. CLINICAL RELEVANCE LET may be a useful adjunct procedure after ACL-R with partial MMPH meniscectomy to reduce knee laxity.
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Affiliation(s)
- Emre Anıl Özbek
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey
| | - Armin Runer
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department for Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany
| | - Sahil Dadoo
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Michael DiNenna
- Department of Mechanical and Material Science Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Monica Linde
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Patrick Smolinski
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Mechanical and Material Science Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Volker Musahl
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Michael P Mcclincy
- Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Engler ID, Özbek EA, DeFoor MT, Sheean AJ, Bedi A, Musahl V, Lesniak BP. What to Do When It Is Anterior Cruciate Ligament Reconstruction Number Two. Instr Course Lect 2023; 72:461-476. [PMID: 36534873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Several factors contribute to the greater complexity of revision anterior cruciate ligament reconstruction compared with primary anterior cruciate ligament reconstructive surgery. Prior tunnels and hardware may compromise revision tunnel placement and secure fixation. This may necessitate two-stage revision or specific techniques to achieve anatomic revision tunnels. Prior autograft use may limit graft options. Individuals with a failed anterior cruciate ligament reconstruction are more likely to have risk factors for further failure. These may include malalignment, occult instability, knee hyperextension, or increased tibial slope. There are also higher rates of meniscus and cartilage injuries in revision anterior cruciate ligament reconstruction that may require intervention. Successful revision anterior cruciate ligament reconstruction requires thoughtful preoperative planning along with multiple potential intraoperative plans depending on the pathology encountered. It is important to provide the orthopaedic surgeon with an up-to-date, evidence-based overview of how to approach and execute a successful revision anterior cruciate ligament reconstruction.
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Özbek EA, Kocaoğlu H, Karaca MO, Terzi MM, Dursun M, Akmeşe R. Effect of Soft Tissue Interposition and Postoperative Suspensory Cortical Button Migration on Functional Outcomes and Ligamentization After Single-Bundle ACL Reconstruction. Orthop J Sports Med 2022; 10:23259671221122748. [PMID: 36157085 PMCID: PMC9490472 DOI: 10.1177/23259671221122748] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Soft tissue interposition between a suspensory cortical button and the lateral femoral condyle is the most common cause of postoperative suspensory cortical button migration in patients undergoing anterior cruciate ligament reconstruction (ACLR). Purpose: To investigate the effects of soft tissue interposition and suspensory cortical button migration after ACLR on functional outcomes and graft ligamentization. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 249 patients who underwent single-bundle ACLR with hamstring tendon autografts. To measure soft tissue imposition, the patients were divided into 2 groups: those in whom the suspensory cortical button was in contact with (group 1) or at least 1 mm away from (group 2) the lateral femoral condyle on 1-day postoperative radiographs. To measure suspensory cortical button migration, the patients in group 2 were further divided into 2 subgroups: those with button migration (group M) and those without migration (group non-M) as observed on 12-month postoperative radiographs. Ligamentization was evaluated according to Howell classification (grades 1-4) on 12-month follow-up magnetic resonance imaging scans. Also recorded were preoperative and 24-month postoperative Lysholm and Tegner scores and 24-month postoperative arthrometer measurements for anterior knee laxity. Results: There was no significant difference between groups 1 and 2 or between groups M and non-M in terms of demographic characteristics or additional intra-articular pathologies detected intraoperatively. Normal anterior laxity (<3 mm) was detected in 83.7% of the patients postoperatively, and all patients showed statistically significant pre- to postoperative improvement on the Tegner (from 4.1 to 4.3) and Lysholm (from 44.0 to 89.2) scores (P < .05 for both). No significant difference in postoperative functional results or graft ligamentization was found between either the soft tissue interposition groups (groups 1 and 2) or the suspensory cortical button migration groups (groups M and non-M). Conclusion: Differences between patients in soft tissue interposition and suspensory cortical button migration did not significantly affect postoperative clinical or functional outcomes or graft ligamentization after single-bundle ACLR.
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Affiliation(s)
- Emre Anıl Özbek
- Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey
| | - Hakan Kocaoğlu
- Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey
| | | | - Mustafa Mert Terzi
- Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey
| | - Merve Dursun
- Orthopedics and Traumatology Department, Ankara University, Ankara, Turkey
| | - Ramazan Akmeşe
- Orthopedics and Traumatology Department, Haliç University, Istanbul, Turkey
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Abstract
BACKGROUND Surgical treatment is usually required for malignant foot and ankle tumors. In this study, we sought to review factors in treatment that may be associated with morbidity and mortality. METHODS All malignant foot and ankle tumors at our institution between April 1988 and April 2018 were retrospectively reviewed. The surgical modalities used and clinical outcomes of patients according to the anatomic location (Kirby zone) and clinical stage (Enneking system) of each tumor were described. Extent of surgical resection required, recurrence, and death rates were assessed. RESULTS Between April 1988 and April 2018, 80 patients with malignant tumors of the foot and ankle were treated at out institution. Mean age of patients was 42.6 (range, 3-89) years. Mean follow-up was 30.2 months (range, 24-120). Tumors were primary in 75 patients (94%) and metastatic from another organ in 5 patients (6%). Tumors originated from bone in 18 patients (22%) and from soft tissue in 63 patients (78%). Synovial sarcoma was the most common soft tissue tumor, and osteosarcoma was the most common osseous tumor.All patients had surgery to resect their tumor. Twenty-one (26%) had unplanned surgical procedures without initial biopsy at an outside institution prior to referral. Those patients were more likely to be treated with amputation or wide excison and free flap surgery (P < .01). The recurrence rate was 50% for the unplanned surgery group and 22% for the planned surgery group. Mortality rate was 10% for the unplanned group and 6% for the planned group. The recurrence and mortality rate was higher in the unplanned group (P = .03). CONCLUSION Our study suggests that unplanned initial surgeries are associated with higher recurrence and mortality rates and reinforces the notion that these patients should be referred for treatment at a center with specialized expertise in tumor management. LEVEL OF EVIDENCE Level, IV, retrospective case series.
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Affiliation(s)
- Mustafa Onur Karaca
- Department of Orthopedics and
Traumatology, Ankara University, Ankara, Turkey
| | - Kerem Başarır
- Department of Orthopedics and
Traumatology, Ankara University, Ankara, Turkey
| | - Abdullah Merter
- Department of Orthopedics and
Traumatology, Ankara University, Ankara, Turkey
| | - Erdinç Acar
- Department of Orthopaedics and
Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Emre Anıl Özbek
- Department of Orthopedics and
Traumatology, Ankara University, Ankara, Turkey
| | - Mustafa Özyıldıran
- Department of Orthopedics and
Traumatology, Ankara University, Ankara, Turkey,Mustafa Özyıldıran, MD, Ankara University,
School of Medicine, Department of Orthopedics and Traumatology, Ibn-i Sina
Hastanesi Talatpaşa Blvd No. 82 TR06230 Altındağ, Ankara, 06100, Turkey.
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Özbek EA, Armangil M, Karaca MO, Merter A, Dursun M, Kocaoğlu H. Evaluation of the Reliability and Quality of Information in Carpal Tunnel Syndrome Shared on YouTube. J Wrist Surg 2022; 11:295-301. [PMID: 35971474 PMCID: PMC9375686 DOI: 10.1055/s-0041-1735231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/04/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Purpose Most of the internet users search online on YouTube for their health problems and the treatments. The purpose of this study is to evaluate the quality and the reliability of the videos on YouTube for Carpal tunnel syndrome (CTS). Methods The search was made by typing the keywords "Carpal tunnel syndrome" and/or "CTS" into the YouTube search engine, the first 50 videos on the first three pages of YouTube were evaluated. Of these videos, title, duration, number of views, days since uploaded, view ratio (view per day), number of likes, number of dislikes, video power index (VPI), video source, and video content data were recorded. The Journal of the American Medical Association (JAMA) benchmark criteria were used to evaluate the reliability of videos, where the Global Quality Score (GQS) and Carpal tunnel syndrome-specific score (CTS-SS) were used to evaluate the quality of the videos. Results The mean duration of the videos was 364.12 seconds (min 57, max 1,638) and the total duration of videos was 18,206 seconds. The mean number of views was 140,916.1 (min 10,543, max 1,271,040) and total number of views was 7,045,804. The mean JAMA score was 1.8 (min 1, max 4), the mean GQS was 2.72 (min 1, max 5), and the mean CTS-SS was 4.74 (min 1, max 14). There was no significant effect of video content on VPI, JAMA, GQS, or CTS-SS ( p >0.05). The JAMA, GQS, CT-SS scores of the videos from physicians and academic sources were significantly higher compared with other sources ( p <0.05). Conclusion YouTube is one of the most frequently used resource for patients to get information about their diagnosis and treatment methods and it consists of videos with low reliability and quality for CTS. We believe that the creation of an internet-based information resource, which the patients can refer to is one of the current social responsibilities of the physicians and the academicians. Level of Evidence This is a Level V study.
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Affiliation(s)
- Emre Anıl Özbek
- Department of Orthopedics and Traumatology, Ibni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, Ankara, Turkey
| | - Mehmet Armangil
- Department of Orthopedics and Traumatology, Hand Surgery Division, İbni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, 06100 Samanpazarı, Ankara, Turkey
| | - Mustafa Onur Karaca
- Department of Orthopedics and Traumatology, Ibni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, Ankara, Turkey
| | - Abdullah Merter
- Department of Orthopedics and Traumatology, Ibni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, Ankara, Turkey
| | - Merve Dursun
- Department of Orthopedics and Traumatology, Ibni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, Ankara, Turkey
| | - Hakan Kocaoğlu
- Department of Orthopedics and Traumatology, Ibni Sina Training and Research Hospital, University of Ankara, İbni Sina Hospital, Ankara University Medicine Faculty, Ankara, Turkey
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Karaca MO, Özbek EA, Ertan MB, Terzi MM, Akmeşe R. Short-Term Outcomes After Treatment of Isolated Hidden Meniscal Ramp Lesions. Orthop J Sports Med 2022; 10:23259671221085977. [PMID: 35386838 PMCID: PMC8977712 DOI: 10.1177/23259671221085977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/10/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Ramp lesions are encountered in 16% to 24% of all anterior cruciate ligament
(ACL) ruptures. However, isolated ramp lesions without a ruptured ACL have
also been reported. Purpose: To evaluate outcomes after type 3 hidden ramp lesions without ACL rupture
were treated with all-inside sutures passed through the standard anterior
portal. Study Design: Case series, Level of evidence, 4. Methods: Included were 41 patients (26 female; 63.4%) with isolated type 3 ramp
lesions who underwent surgery between January 2017 and January 2019.
Patients with concomitant lateral meniscal injuries and revision meniscal
surgeries were excluded. We retrospectively recorded patient age, sex, and
body mass index (BMI), as well as follow-up periods, comorbidities, and
postoperative and early midterm complications. The Lysholm, visual analog
scale (VAS) for pain, and International Knee Documentation Committee (IKDC)
scores were compared preoperatively to final follow-up. In addition,
patients were classified as having either a sedentary or active lifestyle
according to Sedentary Behavior Research Network (SBRN) criteria. The
Shapiro-Wilk test was used to evaluate the normality of the data, and the
Wilcoxon and Mann-Whitney U tests were used to compare
preoperative and postoperative outcome scores. The Spearman test was
employed to evaluate the correlation between patient variables. Results: The mean follow-up period was at 37.6 (range, 25-49) months. A total of 17
patients (41.46%) had a sedentary lifestyle based on SBRN criteria. All
scores improved significantly from preoperatively to final follow-up (VAS,
from 8.43 ± 1.53 to 2.34 ± 2.9; Lysholm, from 47.73 ± 17.02 to 85.37 ±
14.01; and IKDC, from 27.12 ± 14.81 to 85.32 ± 8.78; P <
.001 for all). Although no significant relationship was established between
patient activity level and postoperative Lysholm and IKDC scores, an inverse
correlation was observed between BMI and Lysholm (r
=–0.9906) and BMI and IKDC (r =–0.9402). Conclusion: Satisfactory postoperative clinical results were obtained in patients with
type 3 ramp lesions not accompanied by ACL rupture who were treated with
all-inside suturing through standard anterior portals.
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Affiliation(s)
| | - Emre Anıl Özbek
- Department of Orthopedic Surgery, Ankara University, Ankara, Turkey
| | - Mehmet Batu Ertan
- Department of Orthopedic Surgery, Yozgat City Hospital, Yozgat, Turkey
| | | | - Ramazan Akmeşe
- Department of Orthopedic Surgery, Haliç University, Istanbul, Turkey
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Karaca MO, Özbek EA, Özyıldıran M, Merter A, Başarır K, Yıldız HY, Sağlık Y. External and internal hemipelvectomy: A retrospective analysis of 68 cases. Jt Dis Relat Surg 2022; 33:132-141. [PMID: 35361087 PMCID: PMC9057530 DOI: 10.52312/jdrs.2022.560] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/16/2022] [Indexed: 11/14/2022] Open
Abstract
Objectives Patients and methods Results Conclusion
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Affiliation(s)
| | - Emre Anıl Özbek
- Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06230 Altındağ, Ankara, Türkiye.
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Akmeşe R, Özbek EA, Kocaoğlu H, Ertan MB, İnanç İ, Erdemli E. Comparison of All Arthroscopic Implantation of Chitosan-Based Liquid Scaffold and Hyaluronan-Based Soft Scaffold in the Treatment of Condylar Osteochondral Lesions in the Knee. J Knee Surg 2022; 35:222-230. [PMID: 33930897 DOI: 10.1055/s-0041-1729550] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cell-free scaffolds used in cartilage regeneration are produced from different materials. The aim of this study is to compare the clinical and radiological results of two different scaffolds with hyaluronan- or chitosan-based structure used in the treatment of symptomatic condylar osteochondral lesions. The study comprises 69 patients who were operated for osteochondral lesion repair with hyaluronan- (n = 37) or chitosan-based (n = 32) scaffold. The International Knee Documentation Committee (IKDC), Lysholm Knee Scoring Scale and Visual Analog Scale (VAS) scores were collected for both groups at the preoperative and postoperative 3rd, 12th, and 24th months. Magnetic resonance imaging was performed between the 12th and 15th months postoperatively and this with magnetic resonance observation of cartilage repair tissue (MOCART) scoring were compared. Within group assessments demonstrate significant improvement in IKDC, Lysholm, and VAS scores at postoperative 3rd and 12th months. However, in both groups, IKDC, Lysholm and, VAS scores at the postoperative 24th month indicate no significant further improvement, compared with the 12th month results. There was no significant difference between the groups in terms of IKDC, Lysholm, VAS, and MOCART scores at any time period. This study shows that both scaffolds are useful in cartilage regeneration but have no clinical or radiological superiority to each other. Surgeons should select the method with which they feel comfortable. This is a level III, retrospective comparative study.
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Affiliation(s)
- Ramazan Akmeşe
- Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey
| | - Emre Anıl Özbek
- Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey
| | - Hakan Kocaoğlu
- Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey
| | - Mehmet Batu Ertan
- Department of Orthopedics and Traumatology, Ankara University, Ankara, Turkey
| | - İrem İnanç
- Department of Histology and Embryology, Ankara University, Ankara, Turkey
| | - Esra Erdemli
- Department of Histology and Embryology, Ankara University, Ankara, Turkey
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Başarır K, Kalem M, Şahin E, Özbek EA, Karaca MO, Küçükkarapınar İ, Tönük E. The Relationship Between Arthroplasty Surgeons' Experience Level and Optimal Cable Tensioning in the Fixation of Extended Trochanteric Osteotomy. Geriatr Orthop Surg Rehabil 2021; 12:21514593211063324. [PMID: 34925952 PMCID: PMC8671821 DOI: 10.1177/21514593211063324] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction In this study, our aim was to examine the relationship between the arthroplasty surgeons’ experience level and their aptitude to adjust the cable tension to the value recommended by the manufacturer when asked to provide fixation with cables in artificial bones that underwent extended trochanteric osteotomy (ETO). Materials and Methods A custom-made cable tensioning device with a microvoltmeter was used to measure the tension values in Newtons (N). An ETO was performed on 4 artificial femur bones. Surgeons at various levels of experience attending the IXth National Arthroplasty Congress were asked to fix the osteotomized fragment using 1.7-mm cables and the tensioning device. The participants’ demographic and experience data were investigated and recorded. The surgeons with different level of experience repeated the tensioning test 3 times and the average of these measurements were recorded. Results In 19 (35.2%) of the 54 participants, the force applied to the cable was found to be greater than the 490.33 N (50 kg) value recommended by the manufacturer. No statistically significant difference was determined between the surgeon’s years of experience, the number of cases, and the number of cables used and the tension applied over the recommended maximum value (P = .475, P = .312, and P = .691, respectively). Conclusions No significant relationship was found between the arthroplasty surgeon’s level of experience and the adjustment of the cable with the correct tension level. For this reason, we believe that the use of tensioning devices with calibrated tension gauges by orthopedic surgeons would help in reducing the number of complications that may occur due to the cable.
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Affiliation(s)
- Kerem Başarır
- Department of Orthopedics and Traumatology, University of Ankara, Ankara University Medicine Faculty, Ankara, Turkey
| | - Mahmut Kalem
- Department of Orthopedics and Traumatology, University of Ankara, Ankara University Medicine Faculty, Ankara, Turkey
| | - Ercan Şahin
- Faculty of Medicine, Department of Orthopedics & Traumatology, Bülent Ecevit University, Zonguldak, Turkey
| | - Emre Anıl Özbek
- Department of Orthopedics and Traumatology, University of Ankara, Ankara University Medicine Faculty, Ankara, Turkey
| | - Mustafa Onur Karaca
- Department of Orthopedics and Traumatology, University of Ankara, Ankara University Medicine Faculty, Ankara, Turkey
| | - İbrahim Küçükkarapınar
- Department of Orthopedic Surgery and Traumatology Polatlı State Hospital, Ankara, Turkey
| | - Ergin Tönük
- Department of Mechanical Engineering, Middle East Technical University, Ankara, Turkey
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Özbek EA, Ayduğan MY, Akmeşe R. The effectiveness of peripheral compartment first access and periportal capsulotomy technique for arthroscopic management of femoroacetabular impingement: A prospective case series. Acta Orthop Traumatol Turc 2021; 55:486-492. [PMID: 34967736 DOI: 10.5152/j.aott.2021.21174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the functional results of hip arthroscopy for femoroacetabular impingement (FAI) performed via the periportal capsulotomy technique combined with capsular thinning and peripheral compartment first access. METHODS This prospective study included 34 patients (20 female, 14 male; mean age = 32.3 ± 12.5 years) treated for combined type FAI and labral tears between January 2016 and January 2018. In radiographic evaluation, center-edge angle (CEA) and alpha angle were measured preoperatively and postoperatively. Patients' functional status was assessed at 3, 6, 12, and 24 months using the modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score - Activities of Daily Living (HOOS-ADL), and Hip Disability and Osteoarthritis Outcome Score - Sports-Specific Subscale (HOOS-SSS), and visual analog scale (VAS). RESULTS The mean alpha angle decreased from 55.5°±2.9° preoperatively to 48.3° ± 2.6° postoperatively. The mean CEA decreased from 39.2° ± 3.0° preoperatively to 32.9° ± 2.6° postoperatively. The mean duration of surgery was 96.7 ± 21.1 minutes; the mean traction time was 45.5 ± 14.6 minutes. The mean mHHS at the 3rd , 6th, 12th, and 24th months showed a statistically significant increase compared to the preoperative value (P < 0.05). The mean HOOS-ADL and HOOS-SSS at the postoperative 3rd, 6th, and 12th months demonstrated a statistically significant increase compared to the preoperative values (P < 0.05). The same scores measured at the 24th month, however, did not demonstrate a significant increase. The mean VAS scores at the 3rd and 6th months postoperative illustrated a significant decrease compared to the preoperative values (P < 0.05) whereas this significant decrease was not observed at the 12th and 24th months. CONCLUSION The combined technique of periportal capsulotomy and capsular thinning used in this study seems to be a reliable surgical method with favorable functional results, a low complication rate, and a low risk of hip instability. LEVEL OF EVIDENCE Level IV, Therapeutic Study.
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Affiliation(s)
- Emre Anıl Özbek
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, Ankara, Turkey
| | - Mehmet Yağız Ayduğan
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, Ankara, Turkey
| | - Ramazan Akmeşe
- Department of Orthopaedic Surgery, Haliç University, School of Medicine, İstanbul, Turkey
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Özbek EA, Binnet MS. Effect of Early Residual Laxity After Anterior Cruciate Ligament Reconstruction on Long-term Laxity, Graft Failure, Return to Sports, and Subjective Outcome at 25 Years: Letter to the Editor. Am J Sports Med 2021; 49:NP72-NP73. [PMID: 34855552 DOI: 10.1177/03635465211049375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Ünsal ŞS, Bezirgan U, Özbek EA, Özyıldıran M, Yıldırım T, Armangil M. Poland's syndrome concomitant with congenital proximal and distal radioulnar synostosis: A rare case report. Jt Dis Relat Surg 2021; 32:814-817. [PMID: 34842120 PMCID: PMC8650673 DOI: 10.52312/jdrs.2021.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/07/2021] [Indexed: 11/20/2022] Open
Abstract
Radioulnar synostosis is a rare disease which causes supination and pronation restriction as a result of osseous or fibrous connections between the radius and ulna. Radioulnar synostosis includes both congenital and post-traumatic types. Post-traumatic radioulnar synostosis can be seen in the proximal, middle, and distal part of the forearm, depending on the location of the trauma. Congenital proximal radioulnar synostosis occurs as a result of a separation defect between the radius and ulna in the embryonic period. In the presence of congenital proximal radioulnar synostosis, the patient should be evaluated for accompanying syndromes and possible developmental anomalies. In this report, we present a rare case of both proximal and distal radioulnar synostosis. Hypoplasia of the right pectoral muscle mass, hypoplastic appearance of the right nipple, presence of proximal and distal radioulnar synostosis in the right forearm, and accompanying symbrachydactyly suggested Poland syndrome. To the best of our knowledge this is the first case of congenital proximal and distal radioulnar synostosis with Poland syndrome.
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Affiliation(s)
| | | | - Emre Anıl Özbek
- Ankara Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, 06590 Çankaya, Ankara, Türkiye.
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Bezirgan U, Acar E, Özbek EA. Can headless screw used in fixation of the scaphoid proximal pole fracture be broken after wrist trauma? An unreported complication of scaphoid surgery. Jt Dis Relat Surg 2021; 32:779-785. [PMID: 34842114 PMCID: PMC8650677 DOI: 10.52312/jdrs.2021.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 04/05/2021] [Indexed: 11/14/2022] Open
Abstract
The post-traumatic impairment of blood supply of the scaphoid bones' proximal pole is the subject of controversy in the surgical techniques which would heal this fracture. In a surgery performed with a dorsal approach, the main goal is to make a strong fixation with a small incision and a good implant without disturbing the blood supply of the bone. To date, complications related to surgical treatment of scaphoid proximal pole fractures have been reported in detail. However, there is no other study which presents headless screw failure which placed for the scaphoid proximal pole fracture surgery. Although implant technologies have been developed nowadays, our case report highlights that the endurance of these implants has not been carried out in such proximal pole fractures of the scaphoid, yet. Herein, we present the explanation of a broken headless screw which was placed into the proximal pole fracture of scaphoid, avoiding to affect bone stock of the scaphoid surgical technique. We believe that this surgical technique would be helpful to manage similar difficult situations for orthopedic surgeons.
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Affiliation(s)
| | | | - Emre Anıl Özbek
- Ankara Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 06590 Çankaya, Ankara, Türkiye.
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Kalem M, Özbek EA, Kocaoğlu H, Merter A, Karaca MO, Şahin E, Başarir K. The increase in paediatric orthopaedic trauma injuries following the end of the curfew during the COVID-19 period. J Child Orthop 2021; 15:409-414. [PMID: 34476032 PMCID: PMC8381397 DOI: 10.1302/1863-2548.15.210071] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/13/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The aim of this study was to compare the injury patterns of orthopaedic trauma patients in the paediatric age group who presented to our hospital during and after lifting the curfew due to the pandemic, with the patients of the same age group who presented to our institution during the same time period last year. METHODS Patients, aged 0 years to 18 years, who presented to our clinic between 21 March 2020 and 31 May 2020 (during curfew) (Group A1, n = 111), between 01 June 2020 and 31 August 2020 (Group A2, n = 214) and during the same periods in 2019 Group B1 (n = 220) and Group B2 (n = 211) were included. Patients with pathological fractures, traumas occurring earlier than the aforementioned date range and those consulted while being hospitalized in another department were excluded from study. Patients' demographics, the department they presented to, the anatomical region affected by trauma, trauma mechanism, the location of trauma, the treatment applied and the length of hospital stay were recorded. RESULTS The prevalence of outdoor traumas (72.9% versus 61.1%), high-energy traumas (40.1% versus 26.5%), the rate of the patients treated with surgery (28% versus 17.1%) and the rate of admission to the emergency department (90.2% versus 58.3%) were significantly higher in Group A2 when compared with Group B2 (p < 0.05). CONCLUSION The significant increase was observed in the number of outdoor injuries, high-energy traumas and fracture patterns that require surgical treatment during the first three months following the lift of the curfew, in comparison with the corresponding dates from last year. We think that children's lower extremity muscle strength and neuromuscular control was decreased due to staying home for a prolonged period of time. LEVEL OF EVIDENCE Level III, Case-control study.
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Affiliation(s)
- Mahmut Kalem
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey
| | - Emre Anıl Özbek
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey,Correspondence should be sent to E. A. Özbek, İbn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, İbn’i Sina Hospital, Ankara University Medicine Faculty, 06100 Samanpazarı, Ankara, Turkey. E-mail:
| | - Hakan Kocaoğlu
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey
| | - Abdullah Merter
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey
| | - Mustafa Onur Karaca
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey
| | - Ercan Şahin
- Bulent Ecevit University School of Medicine Hospital Orthopedic Surgery Department, Zonguldak, Turkey
| | - Kerem Başarir
- İn’i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, Ankara, Turkey
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Kalem M, Kocaoğlu H, Merter A, Karaca MO, Özbek EA, Kınık HH. Effects of COVID-19 pandemic curfew on orthopedic trauma in a tertiary care hospital in Turkey. Acta Orthop Traumatol Turc 2021; 55:191-195. [PMID: 34100357 PMCID: PMC10566346 DOI: 10.5152/j.aott.2021.20263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/25/2020] [Revised: 08/26/2020] [Accepted: 10/06/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study aimed to investigate whether various curfew practices affect trauma prevalence, epidemiological differences among the population admitted to hospital because of trauma, and treatment practices used after trauma. METHODS Patients who suffered from fractures or soft-tissue trauma between March 21, 2020, and June 1, 2020, (group pandemic) and during the same period in 2019 (control group) were included in our single-center retrospective study. Each group was also divided into 3 subgroups according to the age of patients (≤ 20 years, 21-64 years, and ≥ 65 years). Data including anatomical region subjected to trauma, place of admission, mechanism of trauma, location of trauma, mode of treatment, type of surgery (if performed), duration of hospitalization (if hospitalized), time elapsed until surgery, and duration of postoperative hospitalization were collected and compared between groups. RESULTS A total of 361 patients were admitted to the hospital with new trauma during the pandemic, and 708 patients had been admitted during the same period in 2019. The number of admissions decreased significantly by 50.9% (P < 0.001). The mechanism of trauma that occurred with low energy was significantly increased in the pandemic group (73.9%) compared with the control group (47.6%) (P < 0.001). Similarly, the distribution of trauma throughout the skeletal system, especially in the upper extremity, was significantly increased in the pandemic group (49.9% vs. 30.5%, P < 0.001). However, there was no significant decrease in individuals aged above 65 years (P = 0.115). Similar to the general outlook, the 3 groups differed in terms of the mechanism of trauma, location of trauma, and distribution of the anatomical region subjected to trauma (P < 0.001). Majority of the patients received inpatient treatment in all 3 groups (P < 0.001). CONCLUSION The results of this study showed that the pandemic dramatically reduced the number of hospital admissions related to orthopedic trauma. The rate of low energy, upper extremity traumas that occurred indoors increased during the pandemic period compared with that of the previous year. However, the rate of hospital admissions did not differ in the ≥65-year-old subgroup during the pandemic period compared with that of the previous year.
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Affiliation(s)
- Mahmut Kalem
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hakan Kocaoğlu
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Abdullah Merter
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Mustafa Onur Karaca
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Emre Anıl Özbek
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hüseyin Hakan Kınık
- Department of Orthopedics and Traumatology, İbn'i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
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Özbek EA, Başarır K, Yıldız HY. Brodie's abscess of the calcaneus in an adult patient. Acta Orthop Traumatol Turc 2020; 54:344-347. [PMID: 32442124 DOI: 10.5152/j.aott.2020.03.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Brodie's abscess of the calcaneus is an uncommon benign lesion that has rarely been reported in the literature. This study presents a rare case of a Brodie's abscess of the calcaneus caused by Staphylococcus aureus in an adult patient. A 46-year-old immunocompetent man had undergone nonsurgical treatment since childhood owing to the diagnosis of a heel spur. Radiological evaluation revealed a benign radiolucent cystic lesion of the calcaneus surrounded by a sclerotic rim. This condition was accompanied by perilesional bone marrow edema. Thereafter, surgical treatment was planned. During surgery, the content of the lesion was observed to be purulent. Meticulous intralesional debridement was performed, and antibiotic-loaded bone cement beads were placed. Subsequent to microbiological and pathological examinations, the cystic lesion was confirmed to be a Brodie abscess; however, direct clinical evidence of an intraosseous infection was lacking. The patient was followed up for 14 months with no complications until recovery. A Brodie abscess may mimic bone tumors. The onset of a Brodie abscess is insidious, and the clinical findings of such lesions may be obscure. A Brodie abscess of the calcaneus should be considered in the differential diagnosis of patients with chronic heel pain when suspicious radiological findings are evident.
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Affiliation(s)
- Emre Anıl Özbek
- Department of Orthopedic Surgery and Traumatology Yozgat City Hospital, Yozgat, Turkey
| | - Kerem Başarır
- Department of Orthopedic Surgery and Traumatology, İbn-i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hüseyin Yusuf Yıldız
- Department of Orthopedic Surgery and Traumatology, İbn-i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
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Özbek EA, Başarır K, Yıldız HY. Brodie's abscess of the calcaneus in an adult patient. Acta Orthop Traumatol Turc 2020. [PMID: 32442124 PMCID: PMC7586775 DOI: 10.5152/j.aott.2020.02.33] [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] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Brodie's abscess of the calcaneus is an uncommon benign lesion that has rarely been reported in the literature. This study presents a rare case of a Brodie's abscess of the calcaneus caused by Staphylococcus aureus in an adult patient. A 46-year-old immunocompetent man had undergone nonsurgical treatment since childhood owing to the diagnosis of a heel spur. Radiological evaluation revealed a benign radiolucent cystic lesion of the calcaneus surrounded by a sclerotic rim. This condition was accompanied by perilesional bone marrow edema. Thereafter, surgical treatment was planned. During surgery, the content of the lesion was observed to be purulent. Meticulous intralesional debridement was performed, and antibiotic-loaded bone cement beads were placed. Subsequent to microbiological and pathological examinations, the cystic lesion was confirmed to be a Brodie abscess; however, direct clinical evidence of an intraosseous infection was lacking. The patient was followed up for 14 months with no complications until recovery. A Brodie abscess may mimic bone tumors. The onset of a Brodie abscess is insidious, and the clinical findings of such lesions may be obscure. A Brodie abscess of the calcaneus should be considered in the differential diagnosis of patients with chronic heel pain when suspicious radiological findings are evident.
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Affiliation(s)
- Emre Anıl Özbek
- Department of Orthopedic Surgery and Traumatology Yozgat City Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Kerem Başarır
- Department of Orthopedic Surgery and Traumatology, İbn-i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
| | - Hüseyin Yusuf Yıldız
- Department of Orthopedic Surgery and Traumatology, İbn-i Sina Training and Research Hospital, Ankara University, School of Medicine, Ankara, Turkey
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Özbek EA, Ayanoğlu T, Armangil M. How effective is skyline view for avoiding dorsal cortex penetration in volar plate fixation of intra-articular and dorsal cortex comminuted distal radius fractures. Injury 2019; 50:1684-1688. [PMID: 31371169 DOI: 10.1016/j.injury.2019.07.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/23/2019] [Revised: 07/10/2019] [Accepted: 07/16/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The incidence of osteosynthesis is increased by volar anatomic plate used for treatment of distal radius fractures and this increases the incidence of wrist extensor tendon irritation, a postoperative complication of the aforementioned surgical technique. The purpose of this study; was to evaluate the intraoperative skyline view which is commonly used to prevent dorsal cortex penetration of distal screws during the surgical treatment of intra-articular distal radius fractures with comminuted dorsal cortex with CT (computed tomography) scanning to determine its effectiveness. In the literature review, no other study focused on similar fracture types was found. METHODS 52 patients with a minimum follow-up of 13 months were included in the study. These patients were operated by two different national board certified surgeons. One of the surgeons unlike the other, adopted intraoperative skyline view method. X-ray and CT scans which were performed preoperative and postoperative first day, were evaluated by a senior author with a blind evaluation method. Fractures were classified according to AO/OTA (Orthopaedic Trauma Association) classification and postoperative dorsal cortex penetrations were registered. RESULTS Intra-articular distal radius fractures with comminuted dorsal cortex (AO/OTA 2R3C2, C3) were detected in 25 of the patients and no significant difference between two groups for the distribution of these patients was found. The CT scan of 14 patients showed dorsal cortex screw penetration and this rate was significantly higher in the group, in which intraoperative skyline view was not used (p > 0,05). In the postoperative CT examination, the most common dorsal cortex penetration was related to the 4th distal screw (42.9%) which were inserted the nearest ulnar hole of plate. CONCLUSION The insertion of a distal screw 2 mm (millimeter) shorter than the length measured with the help of skyline view is considered to be a more effective method than other intraoperative methods for preventing dorsal cortex penetration. In addition, more comprehensive studies are required in order to recommend the mono-cortex fixation, in which distal screws measuring 4 mm shorter are used.
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Affiliation(s)
- Emre Anıl Özbek
- Yozgat City Hospital, Orthopedics and Traumatology Department, Viyana Avenue, 66100, Yozgat, Turkey.
| | - Tacettin Ayanoğlu
- Yozgat City Hospital, Orthopedics and Traumatology Department, Viyana Avenue, 66100, Yozgat, Turkey.
| | - Mehmet Armangil
- İbn'i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, İbn'i Sina Hospital, Ankara University Medicine Faculty, 06100, Samanpazarı, Ankara, Turkey.
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Özbek EA, Armangil M, Bilgin SS. First dorsal compartment musculotendinous avulsion accompanied by close radial styloid fracture: Case report. Int J Surg Case Rep 2018; 53:79-84. [PMID: 30390489 PMCID: PMC6218697 DOI: 10.1016/j.ijscr.2018.10.007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/27/2018] [Accepted: 10/06/2018] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Radial styloid fracture and concomitant first dorsal compartment proximal musculotendinous avulsion is extremely rare injury. This togetherness is difficult to diagnose fully on routine physical examination. PRESENTATION OF CASE In this study, we present a thirty nine year old male patient who suffered musculotendinous avulsion injury of the extensor pollicis brevis (EPB) tendon and abduc- tor pollicis longus (APL) tendon that is rarely accompanied by a closed, non-displaced radial styloid fracture developed following an in-car traffic accident. Diagnosis of avulsion was made with preop- erative magnetic resonance imaging (MRI) and the fracture was fixed with open reduction. The measurements of isometric APL and EPL muscle strength for two thumb were performed using a digital hand dynamometer, no statistically significant difference was found between the muscle strengths of the affected and non-affected thumbs at the postoperative second year follow- up (p > 0.05). DISCUSSION The literature does not hold enough cases to establish the grounds for hypotheses related to the injury mechanism in the 1 st extensor tendon musculotendinous injuries ac- companying radial styloid fractures. Although the diagnosis of the injury in our case was inadver- tently made with preoperative MRI, the routine application of MRI does not seem to be cost-effec- tive. CONCLUSION We suggest that checking and assuring the intactness of the 1 st extensor compartment with a gentle traction during surgery should be a routine step in the treatment of radial styloid fractures treated with open reduction.
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Affiliation(s)
- Emre Anıl Özbek
- Yozgat City Hospital, Orthopedics and Traumatology Department, Yozgat City Hospital, 66100 Viyana Avenue, Yozgat, Turkey.
| | - Mehmet Armangil
- İbn'i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, İbn'i Sina Hospital, Ankara University Medicine Faculty, 06100, Samanpazarı, Ankara, Turkey.
| | - Sırrı Sinan Bilgin
- İbn'i Sina Training and Research Hospital, University of Ankara, Orthopedics and Traumatology Department, İbn'i Sina Hospital, Ankara University Medicine Faculty, 06100, Samanpazarı, Ankara, Turkey.
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Erdemli B, Özbek EA, Başarir K, Karahan ZC, Öcal D, Biriken D. Proinflammatory biomarkers' level and functional genetic polymorphisms in periprosthetic joint infection. Acta Orthop Traumatol Turc 2018; 52:143-147. [PMID: 29305046 PMCID: PMC6136306 DOI: 10.1016/j.aott.2017.11.002] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/11/2017] [Accepted: 11/06/2017] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The aims of this study were 1) to identify the level of inflammatory biomarkers interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-17, C-reactive protein (CRP), granulocyte colony-stimulating factor (GCSF), ferritin, and tumor necrosis factor (TNF)-α in serum and synovial fluid samples of patients who underwent revision arthroplasty surgery; 2) to establish the relationship between serum and synovial fluid levels; 3) to determine if any of the 11 genetic polymorphisms of TNFα, IL-1, IL-6, IL-8, IL-17, and GCSF on the encoding genes was associated with periprosthetic joint infection (PJI). METHODS Synovial fluid and serum was collected from 88 patients who underwent revision arthroplasty surgery. The Musculoskeletal Infection Society definition was used to classify these patients into 2 groups: 36 PJIs and 52 aseptic failures. Synovial fluid and serum samples were tested for 9 biomarkers using a micro enzyme-linked immunosorbent assay. Genetic polymorphisms were evaluated with polymerase chain reaction and restriction endonuclease analysis. RESULTS Synovial fluid-derived IL-1α, IL-1β, IL-8, IL-17, CRP, GCSF, TNFα, and serum-derived IL-6, IL-17, ferritin, CRP were found suitable to classify PJI and aseptic failure. In addition, IL-17 and CRP levels demonstrated a positive correlation between synovial fluid and serum. TNFα-238, IL6-174, GCSF3R, and IL1 RN-VNTR genetic polymorphisms occurred more frequently in individuals with septic failure. CONCLUSION Significant differences between the two groups were observed in the functional polymorphisms of the genes encoding the cytokines investigated. These differences could be interpreted as indicating that there is an association between PJI and genetic polymorphisms. LEVEL OF EVIDENCE Level III, diagnostic study.
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Affiliation(s)
- Bülent Erdemli
- Ankara University Medicine Faculty, İbn'i Sina Hospital, Orthopedics and Traumatology Department, Ankara, Turkey.
| | - Emre Anıl Özbek
- Ankara University Medicine Faculty, İbn'i Sina Hospital, Orthopedics and Traumatology Department, Ankara, Turkey.
| | - Kerem Başarir
- Ankara University Medicine Faculty, İbn'i Sina Hospital, Orthopedics and Traumatology Department, Ankara, Turkey.
| | - Zeynep Ceren Karahan
- Medical Microbiology Department, Ankara University Medicine Faculty, Ankara, Turkey.
| | - Duygu Öcal
- Ataturk Training and Research Hospital, Department of Medical Microbiology, Ankara, Turkey.
| | - Derya Biriken
- Medical Microbiology Department, Ankara University Medicine Faculty, Ankara, Turkey.
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