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Şahbat Y, Kocaoğlu B, Ollivier M, Cerciello S, Akgün D, Alentorn-Geli E, Kayaalp ME, Akın HF, Knauer P, Hariri A, Mocini F, Bartroli AP, Seil R. Information videos posted on Instagram by orthopaedics and sports traumatology surgeons mostly explain surgical technique, and the least mentioned topics are injury prevention and complications. Knee Surg Sports Traumatol Arthrosc 2024; 32:1160-1167. [PMID: 38488237 DOI: 10.1002/ksa.12140] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE Social media has become the new information acquisition platform for all content producers. In the current literature, there are no studies examining the content quality and the strengths and weaknesses of videos on Instagram that explain anterior cruciate ligament (ACL) injuries, which is the most discussed topic of sports surgery. The aim of this study was to evaluate the quality, strengths and weaknesses of information pertaining to ACL surgery that is disseminated on Instagram. METHOD An Instagram search was conducted from 30 May 2023 to 30 January 2024. The search encompassed six languages (English, Spanish, German, French, Italian and Turkish) and was performed by six different observers. The investigation focused on eight subheadings derived from current literature on the ACL. These subheadings were addressed in Instagram videos, covering ACL biology or biomechanics, injury mechanism, injury prevention, injury evaluation, surgical technique, injury or surgery complications, injury rehabilitation process and return to sport or work. RESULT The content was assessed of 127 videos from 127 Instagram accounts, spanning six different languages. Across the review of eight subheadings, the average number covered for the entire group was 3 (range, 0-8). Further analysis revealed that surgical technique was the most frequently mentioned subheading for the whole group (68.5%), followed by injury evaluation (54.3%). Prevention (10.2%) and complications (19.6%) were the least mentioned subheadings. The number of followers showed a correlation with video content quality. CONCLUSION Although the video quality scores were found to be moderate, the content often focused on surgery and evaluation subheadings. The prevalence of incomplete information underscores the importance of developing strategies to ensure more comprehensive and accurate dissemination of medical knowledge. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedics and Traumatology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
- Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France
| | - Barış Kocaoğlu
- Department of Orthopedics and Traumatology, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Matthieu Ollivier
- Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France
| | - Simone Cerciello
- Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Casa di Cura Villa Betania, Rome, Italy
| | - Doruk Akgün
- Center for Musculoskeletal Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Eduard Alentorn-Geli
- Instituto Cugat, Hospital Quiron Barcelona, Barcelona, Spain
- Mutualidad de Futbolistas, Federación Española de Fútbol - Delegación Cataluña, Barcelona, Spain
- Fundación García-Cugat, Barcelona, Spain
| | - Mahmut Enes Kayaalp
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department for Orthopaedics and Traumatology, Istanbul Kartal Research and Training Hospital, Istanbul, Turkey
| | - Hasan Furkan Akın
- Department of Orthopaedics and Traumatology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Poroshista Knauer
- Center for Musculoskeletal Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Abdulaziz Hariri
- Institute of Movement Sciences, Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France
| | | | - Aleix Pons Bartroli
- Instituto Cugat, Hospital Quiron Barcelona, Barcelona, Spain
- Mutualidad de Futbolistas, Federación Española de Fútbol - Delegación Cataluña, Barcelona, Spain
- Fundación García-Cugat, Barcelona, Spain
| | - Romain Seil
- Department of Orthopaedic Surgery, Centre Hospitalier Luxembourg-Clinique d'Eich, Luxembourg City, Luxembourg
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Şahbat Y, Chou TFA, An JS, Gülağacı F, Ollivier M. CPAK classification detect the real knee joint apex position in less than half of the knees. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38613184 DOI: 10.1002/ksa.12175] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE Accurate assessment of the knee joint line is essential for surgeries involving the knee. The knee joint line obliquity (KJLO) is a radiological measurement that evaluates the position of the knee joint relative to the ground and is frequently used in preoperative planning and clinical follow-up. On the other hand, coronal plane alignment of the knee (CPAK) classifications assesses the joint line as the summation of the medial proximal tibial angle (MPTA) and mechanical lateral distal femoral angle (mLDFA). The purpose of this study is to determine the concordance of these two measurement techniques. METHODS This cross-sectional study evaluated the long-leg standing radiographs (LSRs) of 164 healthy knees. The extremity KJLO and CPAK classification JLO were measured twice by two observers at 8-week intervals. The knee joint line apex positions (proximal, neutral and distal) of the two measurement techniques are compared (concordance or discordant). The intraobserver and interobserver reliability were examined using the intraclass correlation coefficient (ICC). Possible causes of the discordant were evaluated with univariate and multivariate logistic regression analysis. RESULTS CPAK classification detected the KJLO apex position in 70 extremities (42.7%) only. Subgroups CPAK JLO detected 13.6% of the proximal apex, 20.4% of the neutral, and 90.7% of the distal apex (p < 0.01). Upon multivariate logistic regression analysis, the variable KJLO apex position (proximal, neutral vs. distal, odds ratio (OR) = 10.291, 95% confidence interval [CI] = 2.225-25.656, and (p < 0.01) was determined as a risk factor for discordant. CONCLUSION The CPAK JLO measurement technique can be misleading in defining the KJLO apex position and the concordance between them is less than 50%. It has a high tendency to misleadingly predict proximal and neutral apex positions, which can potentially have negative implications for assessing the joint line. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Yavuz Şahbat
- Institute du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France
- Erzurum Regional Training and Research Hospital, Department of Orthopaedics and Traumatology, Erzurum, Turkey
| | - Te-Feng Arthur Chou
- Institute du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France
- Department of Orthopaedic Surgery, Medstar Union Memorial Hospital, Baltimore, Maryland, USA
| | - Jae-Sung An
- Institute du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Fırat Gülağacı
- Institute du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Matthieu Ollivier
- Institute du Mouvement et de l'appareil locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France
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Şahbat Y, Bekiroğlu GN, Çat G, Gündoğdu M, Ağirdil Y, Çayir H, Onay T, Akgülle AH. Letter to the Editor Regarding. J Pediatr Orthop 2024; 44:e378-e379. [PMID: 38230529 DOI: 10.1097/bpo.0000000000002617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Görkem Çat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mert Gündoğdu
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yücel Ağirdil
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hüseyin Çayir
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Unit of Radiation Health Istanbul, Turkey
| | - Tolga Onay
- Department of Orthopaedic Surgery and Traumatology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul Turkey
| | - Ahmet Hamdi Akgülle
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
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İğrek S, Şahbat Y, Koç E, Çeliksöz AH, Topkar OM. Patellar Lateralization, Absence of Joint Hypermobility, and the Mechanism of Injury Are Associated With Osteochondral Fracture After First-time Acute Lateral Patellar Dislocation in Adolescents: An MRI-based Evaluation. J Pediatr Orthop 2024; 44:273-280. [PMID: 38323412 DOI: 10.1097/bpo.0000000000002629] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Although the risk factors for patellofemoral dislocation are clearly defined, risk factors for osteochondral fracture (OCF) after patellar dislocation are not as well defined. The aim of this study was to investigate the risk factors for OCF by evaluating patients with and without OCF after first-time acute patellar dislocation. METHODS This multicenter study was conducted as a retrospective examination of the radiologic measurements on the magnetic resonance imaging of 306 patients. The patients were divided into the OCF group and non-OCF group, and OCFs were grouped according to whether the fracture was in the patella or femur. Patellar height, patellar lateralization, trochlear morphology, patellofemoral matching, and patella types were evaluated on patient magnetic resonance imaging. The presence of joint hypermobility in the patients was determined according to the Beighton scale score. The injury mechanisms of the patients were grouped as sports-related injuries, injuries resulting from simple falls, and injuries during daily activities. RESULTS A total of 120 OCFs were detected in 108 (35.2%) patients, of which 96 (80%) were in the patella and 24 (20%) in the femur. The rate of OCF after sports-related injuries was found to be significantly higher than in other injury mechanisms ( P =0.001). More joint hypermobility was detected in patients without OCF ( P =0.041). The measurements of tibial tubercle-trochlear groove, tibial tubercle-posterior cruciate ligament distance and lateral patellar displacement were statistically higher in cases with OCF ( P =0.001). In patients with normal joint mobility, the rate of OCF localization in the patella was significantly higher ( P =0.035). No correlation was found between any other parameters and OCF ( P >0.05). The absence of joint hypermobility and the measurements of tibial tubercle-trochlear groove distance, tibial tubercle-posterior cruciate ligament distance, and lateral patellar displacement were independent risk factors for the incidence of OCF according to the logistic regression analysis. CONCLUSIONS The absence of joint hypermobility and patellar lateralization are independent risk factors for the occurrence of OCF after first-time patellar dislocation. Sports-related injury is a nonindependent risk factor for the presence of OCF. In patients with normal joint mobility, the incidence of OCF in the patella is higher than in the femur. These important factors should be considered when evaluating patients and starting their treatment. LEVEL OF EVIDENCE Level III-retrospective cohort study.
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Affiliation(s)
- Servet İğrek
- Department of Orthopaedics and Traumatology, Kartal Dr. Lütfi Kirdar City Hospital
| | - Yavuz Şahbat
- Department of Orthopaedics and Traumatology, Erzurum Training and Research Hospital, Erzurum
| | - Erdem Koç
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, İstanbul
| | | | - Osman Mert Topkar
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, İstanbul
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Charre D, An JS, Khakha R, Kley K, Şahbat Y, Ollivier M. 'One millimetre equals one degree' is a major source of inaccuracy in planning osteotomies around the knee for metaphyseal deformities compared to the digital planning. Knee Surg Sports Traumatol Arthrosc 2024; 32:987-999. [PMID: 38431800 DOI: 10.1002/ksa.12112] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The objective of this study was to compare the accuracy of virtually performed osteotomies around the knee. The comparison was made between the Miniaci method (method 1), considered the gold standard planning, with the widely held dogma that one degree of correction required equates to one millimetre of opening/closing (method 2). METHODS This retrospective cross-sectional study was conducted between December 2018 and September 2022 in patients aged at least 15 years with metaphyseal knee deformity. Osteotomy planning was performed in methods 1 and 2 utilising calibrated long-leg alignment X-rays in the frontal plane. In both methods, the desired correction was defined by the Fujisawa point. The error % in measurement (ratio method 1/method 2) and the difference in millimetres (method 1 - method 2) between the two methods were analysed. RESULTS A total of 107 osteotomies with 27 (25.2%) distal femoral osteotomies, 54 (50.5%) proximal tibial osteotomies and 26 (24.3%) double-level osteotomies were performed virtually with a mean hip-knee-ankle angle of 176.4 ± 6.6. In distal femur osteotomy, the mean error % between methods 1 and 2 was 38.9 ± 16.7% and 22.4 ± 16.8% for the opening and closing groups, respectively. In proximal tibial osteotomies, the mean error % was 22.7 ± 15.6% and 9 ± 10.8% for the opening and closing groups, respectively. In double-level osteotomy, the mean error % of femur-based corrections was 34.9 ± 19% and 19.5 ± 21% for the opening and closing groups, respectively, and the mean error of the tibial-based corrections was 26.4 ± 12.1% for the opening group and 10.8 ± 10% for the closing group, respectively. CONCLUSION Planning one millimeter per degree of desired correction for osteotomies around the knee in metaphyseal deformities is a major source of error when compared with digital planning using the Miniaci method. This was seen most frequently with osteotomies of the distal femur and all opening wedge osteotomies. LEVEL OF EVIDENCE Level Ⅲ, retrospective cross-sectional study.
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Affiliation(s)
- Dimitri Charre
- Institut du mouvement et de l'appareil locomoteur, Marseille, France
| | - Jae-Sung An
- Institut du mouvement et de l'appareil locomoteur, Marseille, France
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Kristian Kley
- Harley Street Specialist Hospital, London, UK
- Orthopädie Maximilium, Donauwörth, Germany
| | - Yavuz Şahbat
- Institut du mouvement et de l'appareil locomoteur, Marseille, France
- Erzurum Regional Training and Research Hospital, Orthopaedic Surgery and Traumatology, Erzurum, Turkey
| | - Matthieu Ollivier
- Institut du mouvement et de l'appareil locomoteur, Marseille, France
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Büyüktopçu Ö, Baysal Ö, Ağırdil Y, Şahbat Y, Shammadli Z, Şirin E, Erol B. Midterm Donor Site Morbidity After Vascularized Free Fibula Flap Harvesting. Foot Ankle Int 2024; 45:364-372. [PMID: 38361397 DOI: 10.1177/10711007241226620] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Vascularized fibula grafts (VFGs) have become one of the most preferred grafts for the reconstruction of bone defects. However, despite the many advantages over other graft options, recipient and donor site morbidities are also common. Donor site morbidity has been reported at rates ranging from 5% to 67%. The aim of this study was to present a single-center series examining the clinical, functional, and radiologic aspects of donor site morbidity following VFG harvesting. METHODS The study included 69 patients who underwent biological reconstruction with VFG for bone tumors, avascular necrosis of the femoral head, or bone defects after trauma. Patients were evaluated functionally, clinically, and radiologically for donor site morbidity. RESULTS Donor site morbidity was observed in 33 of 69 patients (48%). The most complications were sensation deficits around the feet and ankles (20 of 69; 29%). Knee laxity was more common in patients who underwent osteoarticular fibular resection (P = .006). CONCLUSION We found VFG to be an effective method for the reconstruction of large bone defects, but associated with a relatively high rate of complications. Complications requiring surgical intervention were rare and the majority of patients did not have long-term functional limitations. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Ömer Büyüktopçu
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Özgür Baysal
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Yücel Ağırdil
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Yavuz Şahbat
- Erzurum Regional Training and Research Hospital, Department of Orthopaedics and Traumatology, Erzurum, Turkey
| | - Ziya Shammadli
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Evrim Şirin
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Bülent Erol
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
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Şahbat Y, Bekiroğlu GN, Çat G, Gündoğdu M, Ağirdil Y, Çayir H, Onay T, Akgülle AH. Reliability of Gordon Lateral Rotation Percentage and Prabhakar Percentage of Metaphyseal Overhang for Pediatric Supracondylar Humerus Fracture; Is it Clinically Reliable for John Hopkins Classification Coronal Fracture Subtypes? J Pediatr Orthop 2023; 43:603-607. [PMID: 37694552 DOI: 10.1097/bpo.0000000000002512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 09/12/2023]
Abstract
BACKGROUND Rotational malalignment is a common problem in pediatric supracondylar humerus fractures (SCHF). Several techniques have been described to evaluate the true rotation value. Although the Prabhakar and Gordon techniques are used frequently, their superiority to each other in terms of measurement quality is unknown. QUESTIONS/PURPOSES The aim of this study was to investigate the clinical compatibility of the 2 techniques and to evaluate whether they are suitable for all subtypes. METHODS This cross-sectional study included 40 patients with SCHF (including subtypes; Typical, Medial Oblique, Lateral Oblique, and High fracture pattern). The Gordon lateral rotation percentage and Prabhakar percentage of metaphyseal overhang were measured twice by 4 experienced Orthopedics and Traumatology surgeons at 8-week intervals. The interobserver and intraobserver reliability were examined using the intraclass correlation coefficient. RESULTS The interobserver reliability for Gordon and Prabhakar technique was 0.816 and 0.762 for the first measurement and 0.811 and 0.811 for the second measurement, respectively.The medial oblique fracture pattern was determined to have the best interobserver agreement among the subtypes. The result was excellent for the medial and lateral oblique subtypes, good for the typical fracture pattern, and fair for the high fracture pattern. The intraobserver reliability for Gordon and Prabhakar technique was excellent, 0.924 and 0.922, respectively. CONCLUSION The main finding of this study was that the Gordon and Prabhakar techniques have similar interobserver and intraobserver reliability. Although the Gordon technique tends to have higher interobserver reliability, the difference was clinically insignificant. These measurements should not be relied upon in cases of SCHF with a high fracture pattern because of the different anatomic features of that region. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Görkem Çat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Mert Gündoğdu
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yücel Ağirdil
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hüseyin Çayir
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Unit of Radiation Health, Istanbul, Turkey
| | - Tolga Onay
- Department of Orthopaedic Surgery and Traumatology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Hamdi Akgülle
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
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Çimen O, Irgıt KS, Bekmezci T, Büyüktopçu Ö, Şahbat Y, Korucu A. Midterm results of intra-articular stromal vascular fraction injection for the treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2023; 31:5012-5017. [PMID: 37665373 DOI: 10.1007/s00167-023-07555-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE This study aimed to evaluate the safety and efficacy of intra-knee stromal vascular fraction (SVF) injection in patients with symptomatic knee osteoarthritis at the midterm (3-year) follow-up. METHODS SVF injection was applied to 25 knees of 20 patients. Eighteen patients (90%) were female, and the means ± standard deviations of age was 61.9 ± 7.8 (range, 50-76) years. Patients who received conservative treatment for at least 6 months and had radiographic Kellgren-Lawrence (K-L) grades 2 and 3 varus gonarthrosis were included in the study. SVF was obtained from the umbilical region by liposuction using local anaesthesia. Patients were followed-up for 36 months. Their visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Lysholm scores were evaluated before and at 6, 12, 24 and 36 months post-SVF injection. RESULTS A statistically significant improvement (p < 0.05) was observed in VAS, WOMAC and Lysholm scores at the first 2-year follow-up compared to baseline. However, no statistically significant difference (n.s.) was observed in VAS, WOMAC and Lysholm scores at the 3-year follow-up compared with baseline. CONCLUSION Intra-articular SVF injection decreased pain and significantly improved the functional outcomes in the first 2 years in knees with grade 2-3 osteoarthritis; however, these positive effects of the injection disappeared in the 3rd year. Although short-term successful results of SVF have been reported in the literature, prospective studies are needed for medium- and long-term results.
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Affiliation(s)
- Oğuzhan Çimen
- Deparment of Orthopaedics and Traumatology, Orthopedic Surgeon, Medistanbul Hospital, Yunus Emre Amh. Lütfi Aykaç Blv. No: 80/G, Sultangazi/Istanbul, Turkey.
| | - Kaan Süleyman Irgıt
- Fulya mah. Yesilcimen sk. Polat Tower Residence, Blok No:12 ic kapi no:407, Şişli, Istanbul, Turkey
| | - Taner Bekmezci
- Clinic of Orthopedics and Traumatology, Orthopedic Surgeon, Teşvikiye, Hakkı Yeten Cd., 34365, Şişli, Istanbul, Turkey
| | - Ömer Büyüktopçu
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Fevziçakmak Yazmacı Sk. No:7 Pendik, Istanbul, Turkey
| | - Yavuz Şahbat
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Fevziçakmak Yazmacı Sk. No:7 Pendik, Istanbul, Turkey
| | - Alperen Korucu
- Deparment of Orthopaedics and Traumatology, Orthopedic Surgeon, Silivri State Hospital, Istanbul, Turkey
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Şahbat Y, Baysal Ö, Ağırdil Y, Polat M, Büyüktopçu Ö, Shammadli Z, Erol B, Akgülle AH. Is radiological rotation measurement affected by the fracture pattern in pediatric supracondylar humeral fractures? Acta Radiol 2023; 64:2748-2756. [PMID: 37592919 DOI: 10.1177/02841851231189881] [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] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
BACKGROUND In supracondylar humerus fractures (SCHF), the most frequently used method to calculate rotation is the Gordon lateral rotation percentage (GLRP) defined by Gordon et al. However, this technique includes only typical fractures (49%-80% of all fractures) from the Johns Hopkins (J-H) fracture classification system. PURPOSE The aim of the study was to investigate (1) is Gordon criteria useful for John Hopkins subgroups of supracondylar fractures and (2) is Gordon criteria affected by internal and external rotation. MATERIAL AND METHODS This study was designed using four pediatric left humerus bones obtained from the Sawbone© company. For each bone, an osteotomy was made to mimic each of the J-H coronal fracture patterns. The cut bones were placed in a wooden rotation apparatus. The GLRP measurements were taken by five blinded observers. RESULTS In the repeated measurements of the observers, <20° rotation typical and <30° medial oblique and lateral oblique fracture pattern were measured as within the limits of an acceptable amount of rotation according to the Gordon criteria. However, for high fracture pattern (HFP), ≤30° internal rotation and <60° external rotation were determined to be within the acceptable rotation criteria according to the Gordon criteria. CONCLUSIONS All fracture patterns have different characteristics; however, based on the data of this study, the Gordon criteria can be used safely for typical, medial oblique, and lateral oblique fracture patterns but it is necessary to lower the acceptable rate of 50% for HFP.
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Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Özgür Baysal
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Yücel Ağırdil
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Murat Polat
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Ömer Büyüktopçu
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Ziya Shammadli
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Bülent Erol
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
| | - Ahmet Hamdi Akgülle
- Department of Orthopaedics and Traumatology, Marmara University, Istanbul, Turkey
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İğrek S, Şahbat Y, Akgülle AH, Erol B. Does radiation exposure during pediatric supracondylar humeral fracture surgery change according to the C-arm position? A comparison of two different techniques. Injury 2023; 54:110962. [PMID: 37544117 DOI: 10.1016/j.injury.2023.110962] [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] [Received: 03/21/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION In the surgical treatment of supracondylar humeral fractures (SHF), the surgeon has to stand right next to the fluoroscopy device, so it is very important to know how to use it in the most appropriate way to reduce radiation exposure. The aim of this study was to investigate the effect of using C-arm in uniplanar (inverted) and biplanar (standard-horizontal) configurations on (1) the radiation exposure to the surgeon, and (2) surgical time and fluoroscopy exposure time. MATERIAL AND METHODS This prospective randomised study was conducted on 20 patients who underwent fluoroscopy during closed reduction and percutaneous pinning for a SHF. In the first configuration, the C-arm was inverted and the image intensifier was used as a surgical table. In the second configuration, the C-arm was used biplanar. The operations were performed by 5 surgeons, with each surgeon using each method only twice. During the operation, to find a value closed to direct radiation exposure measurement was made by attaching a dosimeter to the wrist and scatter radiation exposure was measured by attaching a dosimeter to the neck and waist of the surgeons. The operation time and fluoroscopy exposure time were determined. RESULTS The duration of operations performed with the biplanar C-arm position and the fluoroscopy exposure time in operations performed with the uniplanar method were found to be statistically significantly longer (p = 0.001). The measurements on the dosimeter worn on the neck of surgeons were found to be statistically significantly higher while using the uniplanar C-arm configuration (p = 0.001). There was no statistically significant difference between the dosimeter measurements on the wrists and waists of the surgeons and the C-arm configurations (p = 0.820; p = 0.185). CONCLUSIONS Although the use of biplanar C-arm has no effect on radiation exposure to the surgeon's wrist, the most important advantages are that the neck area is exposed to less radiation and it shortens the fluoroscopy time so the use of a biplanar C-arm can be recommended. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Servet İğrek
- Department of Orthopaedics and Traumatology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
| | - Yavuz Şahbat
- Erzurum Regional Training and Research Hospital, Department of Orthopaedics and Traumatology, Erzurum, Turkey.
| | - Ahmet Hamdi Akgülle
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Marmara University, Istanbul, Turkey
| | - Bülent Erol
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Marmara University, Istanbul, Turkey
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Şahbat Y, Bekiroğlu GN, Koç E, Canşı M, İğrek S, Kart H, Topkar OM, Baysal Ö. Foot and Ankle Forklift Injuries; Diagnosis to Treatment Options, Return to Work and Functional Outcomes. J Foot Ankle Surg 2023:S1067-2516(23)00173-4. [PMID: 37524242 DOI: 10.1053/j.jfas.2023.07.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
As our tertiary-level trauma center is close to an industrial zone and associated international port, industrial injuries are seen more often than is expected in routine practice. The aim of this study was to present the demographic data, treatment options, and changes in work-life of patients with foot and ankle injuries due to a forklift accident, and to determine the factors affecting the clinical outcome. The study was conducted in our university hospital and included patients who presented with a foot and ankle injury resulting from a forklift accident. Data were collected including age, sex, dominant extremity, history of trauma, presence of fracture, management (surgical or conservative), complications, time of return to work, workforce loss, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Short Form Health Survey (SF-36) scores at the final follow-up examination. Evaluation was made of 132 patients, comprising 113 (85.6%) males and 19 (14.4%) females with a mean age of 32 years (range 16-65 years). The most frequently recorded occupational group was shipyard workers (50%). The most common mechanism of injury was crushing under the forklift wheel (n = 63, 47.7%). The most frequently injured foot region was the forefoot (47%). A total of 90 (68.1%) patients continued to work in the same position on return to work. The lowest mean AOFAS score (73.4) and SF-36 (physical component) score (37.3) were determined in cases with mixed region injuries (p = .0001, p = .0001). The wearing of protective footwear had no effect on the rate of return to work (p = .195), workforce loss (p = .34) and AOFAS score (p = .166). This study is the largest series of patients with foot and ankle injuries related to forklift accidents. Forklift injuries can be treated conservatively or surgically according to the clinical condition of the patient. The main indicators of return to work and functional outcome are which foot region is injured and whether or not the injury causes a fracture.
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Affiliation(s)
- Yavuz Şahbat
- Erzurum Regional Training and Research Hospital, Department of Orthopaedics and Traumatology, Erzurum, Turkey.
| | | | - Erdem Koç
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Mehmet Canşı
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Servet İğrek
- Dr. Lütfi Kirdar Kartal Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Hayati Kart
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Osman Mert Topkar
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
| | - Özgür Baysal
- Marmara University School of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey
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Şahbat Y, Kütük E, Çat G, Ünsalan O, Kart H, Topkar OM, Baysal Ö, Erol B. An unusual injury pattern: arm wrestling injury, treatment modalities, clinical outcomes, and return to sport. Ulus Travma Acil Cerrahi Derg 2023; 29:733-740. [PMID: 37278079 DOI: 10.14744/tjtes.2023.34247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND In the sport of arm wrestling, the great rotational force is applied to the upper extremity, which can result in muscle and tendon injuries in the shoulder, elbow, and wrist joints, and even bone fractures. The aim of this study was to present the treatment modalities, functional outcomes, and return to sport after arm wrestling injuries. METHODS A retrospective evaluation was made of the trauma mechanisms, treatment modalities, clinical outcomes, and time of return to sports of patients admitted to our hospital with an arm wrestling injury between 2008 and 2020. At the final follow-up examination, the functional scores (DASH score and constant score) of the patients were evaluated. RESULTS Evaluation was made of 22 patients comprising 18 (82%) males and 4 (18%) females with a mean age of 20±6.1 years (range, 12-33 years). Two (10%) patients were professional arm wrestlers. The DASH scores at the final follow-up (mean 4 years) examination were 0.57 (min: 0 and max: 1.7) for the patients with humerus shaft fracture. All the patients with isolated soft-tissue injuries returned to sports within 1 month. Patients with humeral shaft fractures returned to sports later and had a lower functional score (P<0.05). There was no disability in any patient during long-term follow-up. Patients with soft-tissue injuries continued arm wrestling more than patients with bone injuries (P<0.001). CONCLUSION This study constitutes the largest patient series evaluating patients presenting at a health-care institution with any complaint after arm wrestling. Arm wrestling is not a sport that only results in bone pathologies. Therefore, providing the participants in this sport with information that they may be injured in arm wrestling but there will be a full recovery, may reassure and encourage them.
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Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedic Surgery and Traumatology, Maresal Cakmak State Hospital, Erzurum-Türkiye
| | - Emir Kütük
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Görkem Çat
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Oğulcan Ünsalan
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Hayati Kart
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Osman Mert Topkar
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Özgür Baysal
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
| | - Bülent Erol
- Department of Orthopaedics and Traumatology, Marmara University School of Medicine, Istanbul-Türkiye
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Temiz A, Şahbat Y, Pepe IM, Aktekin CN. The Relationship between the Shoulder Functional Score and the Change in Labral Morphology after Arthroscopic Bankart Repair. Acta Chir Orthop Traumatol Cech 2023; 90:400-407. [PMID: 38191541] [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] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE OF THE STUDY The aim of arthroscopic Bankart repair is restoration of the anterior block mechanism and regaining stability. There are few studies that have tested the adequacy of the angle made with the glenoid and the height from the glenoid level of the repaired labral tissue, but the correlation with the clinical results is not clear. The aim of this study was to defi ne the correlation of the height and slope of the repaired labral tissue in the glenoid anterior with the clinical results. MATERIAL AND METHODS This prospective study included 20 patients who underwent an arthroscopic Bankart repair. To evaluate the labrum anatomy of the affected shoulder, 4 measurement parameters were defi ned as axial height (Ah), axial slope (As), oblique coronal height (Ch), and oblique coronal slope (Cs) on non-contrast T2 MRI. The measurements were taken preoperatively of the affected shoulder and at 1 year postoperatively of both the affected shoulder and the contralateral asymptomatic shoulder. The measured values were compared with each other and with the contralateral shoulder. Correlations of the anatomic values with the Constant-Murley scores recorded at 1, 3, 6, and 12 months postoperatively were examined with the Wilcoxon test. RESULTS The mean preoperative Constant score of the patients was 57.7 (32-77) and postoperative scores at 1, 3, 6, and 12 months were 63.6 (44-79), 77.8 (61-90), 89.6 (77-100), and 95.2 (79-100), respectively (p=0.001). There was a statistically signifi cant difference in the preoperative MRI measurements of the axial and oblique coronal plane labral height and slope values compared to the postoperative values and those of the asymptomatic contralateral shoulder (p< 0.05 for all). There was no statistically signifi cant difference between the labral height and slope values of both planes postoperatively compared to the asymptomatic contralateral shoulder (p= 0.776, p= 0.910, p= 0.132, p= 0.589, respectively). These increases in the radiological data were not found to be statistically signifi cant in the correlation analysis with the increases in the Constant-Murley scores (Ah p=0.935, As p=0.587, Ch p=0.078, Cs p=0.105). CONCLUSIONS This prospective study was conducted using conventional T2 magnetic resonance imaging, which was suffi cient for the measurement of labral height and slope. This study results showed no signifi cant correlation between the radiological and clinical outcomes. KEY WORDS Bankart repair, labrum height, labrum slope, functional result.
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Affiliation(s)
- A Temiz
- Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey
| | - Y Şahbat
- Erzurum Regional Training and Research Hospital, Department of Orthopedics and Traumatology Erzurum, Turkey
| | - I M Pepe
- Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey
| | - C N Aktekin
- Ankara Yıldırım Beyazıt University, Department of Orthopedics and Traumatology, Ankara, Turkey
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Akgülle AH, Şahbat Y, Baysal Ö, Kart H, Erol B. Supracondylar Humerus Fractures in Infants and Early Toddlers; Characteristics, Clinical and Radiological Outcomes Compared with Older Children. J INVEST SURG 2022; 35:1797-1805. [DOI: 10.1080/08941939.2022.2123577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ahmet Hamdi Akgülle
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Yavuz Şahbat
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Özgür Baysal
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Hayati Kart
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Bülent Erol
- Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey
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Şahbat Y, Buyuktopcu O, Topkar OM, Erol B. Management of orthopedic oncology patients during coronavirus pandemic. J Surg Oncol 2020; 122:594-601. [PMID: 32617984 PMCID: PMC7361807 DOI: 10.1002/jso.26092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/15/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
The new measures implemented in hospitals also altered the operation of orthopedics and traumatology departments. The main purpose of this article is to discuss how orthopedic oncology clinics should be organized during the pandemic and to present the process management scheme for patients requiring orthopedic surgery, including trauma surgery, from diagnosis to treatment, together with our experiences. Instead of thinking about the global emergence of the epidemic, it is time to act decisively. At first glance, the coronavirus disease 2019 (COVID-19) pandemic and orthopedics may seem to be unrelated disciplines, but the provision of healthcare services to patients who require them proves that these two fields are parts of the same whole. Our experiences in treating neutropenic, lymphocytopenic, and chemotherapy patients seem to have proven beneficial during this process. We operated on 10 biopsy patients, 15 primary bone sarcomas, 9 soft tissue sarcomas, and 82 trauma patients within this time frame. Only three patients were suspected to have COVID-19 before admission. The early identification, strict isolation, and effective treatment of these patients prevented any nosocomial infections and disease-related comorbidities. This success is the result of the multidisciplinary cooperation of the Ministry of Health, our hospital, and our clinic.
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Affiliation(s)
- Yavuz Şahbat
- Department of Orthopaedics and TraumatologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Omer Buyuktopcu
- Department of Orthopaedics and TraumatologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Osman Mert Topkar
- Department of Orthopaedics and TraumatologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Bulent Erol
- Department of Orthopaedics and TraumatologyMarmara University Faculty of MedicineIstanbulTurkey
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