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Öğe Assessment of biocompatibility of novel TiTaHf-based high entropy alloys for utility in orthopedic implants(Elsevier Ltd, 2021) Gürel, Şeyma; Nazarahari, Alireza; Canadinç, Demircan; Çabuk, Haluk; Bal, BurakThis paper presents the findings of experimentally observed corrosion response of novel TiTaHf-based high entropy alloys (HEAs) in fetal bovine serum (FBS) to evaluate their biocompatibility in presence of proteins and potential to be used as implant materials. Particularly, TiTaHfNb, TiTaHfNbZr and TiTaHfMoZr HEAs were subjected to static immersion experiments in FBS media, and both the HEA samples and the immersion fluids underwent thorough characterization. The findings presented herein show that Zr and Mo addition to the TiTaHf solid solution increased the total ion release from the resulting HEAs in FBS, while the TiTaHfNb HEA became prominent in terms of biocompatibility owing to the reduced ion release in FBS. Moreover, hydroxy apatite (HA) formation was evident on the surfaces of all three HEAs upon immersion in FBS, indicating the potential of the three TiTaHf-based HEAs to form desired binding with the human bone. Considering the fact that passive oxide layer formation facilitating lower susceptibility to corrosion in long-term applications was also observed in the studied HEAs, further elaboration on their mechanical and biological responses is warranted for the sake of a comprehensive assessment regarding their utility as orthopedic implant materials.Öğe Comment on "subacromial space volume in patients with rotator cuff tear: the effect of surgical repair" by Pepe et al(Aves Yayincilik, 2021) Turan, Kaya; Çabuk, HalukWe read with interest the article by M. Pepe et al. about the effect of arthroscopic rotator cuff repairs on subacromial space volume.1 It was stated that the group considered healthy was the contralateral side of the patients who had undergone arthroscopic surgery for rotator cuff tears.Öğe Comment on “Subacromial space volume in patients with rotator cuff tear: The effect of surgical repair” by Pepe et al.(2021) Çabuk, Haluk; Turan, KayaDear Editor, We read with interest the article by M. Pepe et al. about the effect of arthroscopic rotator cuff repairs on subacromial space volume.1 It was stated that the group considered healthy was the contralateral side of the patients who had undergone arthroscopic surgery for rotator cuff tears. Physical examination findings of the contralateral shoulders were reported to be normal, but it is a known fact that patients treated for rotator cuff tears have high rates of asymptomatic tears in the contralateral shoulders.2,3 It would be more appropriate to determine the group considered as the healthy group as patients without tear on the contralateral shoulders, and accordingly, the statistical difference between the groups could be more significant. We also agree and believe that arthroscopic rotator cuff repair will contribute to preserving the subacromial volume and improve shoulder functions in the long term.Öğe Comparison of pain, muscle strength, and functional status following unicompartmental knee arthroplasty, total knee arthroplasty, and conservative management of gonarthrosis(Springer, 2021) Atar, Sevgi; Demírhan, Esma; Çabuk, Haluk; Turan, Kaya; Dedeoğlu, Süleyman SemihBackground: Treatment options and surgical decision for grade 3–4 gonarthrosis remains controversial. We aimed to compare the pain level, muscle strength, physical performance, lower extremity functions, and other physical activity levels between patients who underwent arthroplasty and those who received conservative management for grade 3–4 gonarthrosis. Methods: This prospective analytical observational study was conducted in a tertiary referral hospital. A total of 30 unicompartmental knee arthroplasty (UKA) and 30 total knee arthroplasty (TKA) patients as two different study groups and 30 patients were treated conservatively as the control group were included. The rehabilitation and complication rates were recorded. The values of the range of motion, quadriceps diameter, were measured and also the isokinetic muscle strength, pick-up, repeated sit-to-stand, stair ascending and descending, straight-line walking, timed up and go, and 20-m walk tests, the knee injury and osteoarthritis-outcome-score (KOOS), the hospital for special-surgery-knee-score (HSS), and Oxford-Knee-Score (OKS) were performed. Results: Postoperative rehabilitation and complication rates were significantly higher in the TKA group compared to the UKA group (p = 0.029 and p = 0.026, respectively). Six months after the treatment, the knee extension muscle strength value at 180°/s, knee flexion degree, total work flexion, stair ascending, VAS at night, all KOOS symptom, pain and daily function and total scores in the UKA group was significantly different than the TKA and the control groups (p < 0.001). Total work extension values, knee flexion degree, in the control group were found to be significantly higher than the TKA group (p = 0.033, p < 0.001, respectively). Conclusions: The UKA was significantly superior to TKA and conservative treatment concerning pain, muscle strength, and quality of life. Level of Evidence: IIa. © 2021, Indian Orthopaedics AssociationÖğe Comparison of the radiological parameters between dynamic-referencing tactile guidance robotic system and microplasty (r) instrumentation in unicompartmental knee arthroplasty(TURKISH JOINT DISEASES FOUNDATION, 2022) Çabuk, Haluk; Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Öztürk, Çağatay; Ertürer, Ramazan ErdenObjectives: This study aims to compare the radiological outcomes of unicompartmental knee arthroplasty (UKA) performed by a navigation-based robotic system versus Microplasty (R) instrumentation. Patients and methods: Between January 2018 and January 2019, a total of 90 knees of 75 patients (65 males, 10 females; mean age: 62.0 +/- 9.4 years; range, 50 to 73 years) were included. Among these, 54 knees underwent Oxford mobile-bearing UKA with an Microplasty (R) instrumentation set and 36 knees were operated with the aid of a Restoris (R) MCK with MAKO navigation-based robotic system. Postoperative anteroposterior and lateral X-rays of all patients were evaluated according to nine different parameters. On the femoral side, femoral varus-valgus angle, flexion-extension angle, femoral condyle posterior fit; on tibial side, tibial component varus/valgus, tibial posterior slope, medial, anterior, posterior and lateral fit of tibial component assessed. Results: There was no significant difference between groups in terms of age, sex, and affected side. On the femoral side, no significant difference was observed in the component position between groups. On the tibial side, tibial component medial fit (p=0.032) and anterior fit (p=0.007) were better in navigation-based robotic system group. Conclusion: Microplasty (R) instrumentation may lead to comparable implant positioning compared to a tactile-based navigated robotic instrumentation.Öğe Current approaches and problems faced by orthopedic surgeons in all-inside arthroscopic meniscus repairs(2023) Turan, Kaya; Erturer, Ramazan Erden; Çabuk, Haluk; Muratoğlu, Osman Görkem; Ergün, TuğrulAim: All-inside meniscal sutures are frequently the treatment of choice in arthroscopic practice. However, the literature contains limited evidence of the technical issues experi- enced during the procedure. We aimed to evaluate the technical difficulties encountered during the placement of all-inside meniscal repair sutures according to the surgeon’s ex- perience and the success rate of the suture placement. Materials and Methods: We invited orthopedic surgeons across the country to com- plete a questionnaire through an online platform. Participants were asked ten questions about their demographic information, general surgical approach to meniscal tears, and experience with intraoperative complications specific to all inside meniscus sutures. Results: A total of 100 orthopedic surgeons participated in our study. Of these, 37% had been working as an orthopedic surgeon for more than ten years. Twenty-five per cent performed more than two arthroscopic knee surgeries per week. Fifty-six per cent of the surgeons were protective for the displaced red-white zone meniscal tears. Although 90% of the participants stated that the technique was more effortless, only 12% thought the clinical results were better than the other techniques. More than 50% of the participants indicated that they had difficulty when placing the sutures successfully. The most common problem was the inability to fix the meniscus sufficiently and the deformation of the instruments inside the joint. When we compared the complications according to the surgeon’s experience, even among the surgeons who performed more than 100 arthroscopic surgeries per year, 34% had trouble applying these sutures successfully. Conclusion: Although all-inside meniscus sutures are generally believed to decrease the operative time and be technically more straightforward, even the most experienced surgeons have difficulty applying these sutures, and the reliability of these sutures is low.Öğe Does the clamping method in local and systemic TXA applications in total knee arthroplasty change the game?: a retrospective comparative cohort study(Lippincott Williams and Wilkins, 2022) Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, Haluk; Ertürer, Ramazan ErdenMany different methods and drain clamping periods have been described in systemic and local tranexamic acid (TXA) applications, and the superiority of the methods to each other has not been clearly demonstrated. The method of local infusion in combined TXA applications may not alter the Hb drop or total or hidden blood loss. We aim to compare two different combined TXA application methods. We retrospectively analyzed 182 patients who underwent total knee arthroplasty between 2018 and 2021. Patients over 40 years of age who underwent TKA for degenerative knee arthritis were included in the study. Unicondylar, revision, or bilateral arthroplasties and patients with the cardiovascular or cerebrovascular disease were excluded from the study. All patients in the study received 1 g TXA intravenously half an hour before the incision. For the first group, 1 g TXA was given intra-articularly at the drain site after closure, and the clamp was kept closed for 1 hour. In the second group, the drain was clamped for an additional 6 hours, and a 1 g intravenous dose was administered at the 5th hour postoperatively. No local applications were used in the control group. Total, hidden, and visible blood loss (total blood loss, hidden blood loss, visible blood loss), postoperative decreases in hemoglobin and hematocrit level (?Hgb, ?Htc), blood transfusion rates, and hospital stay durations were evaluated. There were 72 patients in the first group, 52 in the second, and 58 in control. A total of 37 patients received one or more blood transfusions postoperatively, and there was no statistical difference in the need for blood transfusions between the groups (P?=?.255). Although a statistically significant difference (P?=?.001) in total blood loss, hidden blood loss, visible blood loss and ?Hgb values was observed between the groups, the difference between the first and second groups was insignificant (P?=?.512). The duration of hospital stay was observed to be less in the first and second groups (P?=?.024). Local and systemic TXA applications were observed to be more effective than only systemic applications in reducing blood loss after total knee arthroplasty, regardless of the local method.Öğe Editorial commentary: Knee anterolateral ligament mechanoreceptors: The first step from peripheral to central nervous system(W B Saunders Co-Elsevier Inc, 2019) Çabuk, HalukThe mechanoreceptors around the knee are of interest, including those mechanoreceptors related to the anterolateral ligament. Histopathologic evaluations of mechanoreceptors are the first steps in understanding the exact sensorimotor system of the extremities. Many studies have shown these mechanoreceptors, but more electrophysiologic studies are needed to make sense of the reported phenomena.Öğe The effect of gluteus maximus tenotomy in primary total hip arthroplasty with posterior approach: kinematic analysis of hip extensor strength(SAGE Publications Ltd, 2021) Ímren, Yunus; Karslıoğlu, Bülent; Dedeo?lu, Süleyman Semih; Çabuk, Haluk; Atar, Sevgi; Gürbüz, Serhat; Gürbüz, HakanBackground: The posterior approach (PA) is the most commonly used surgical approach for total hip arthroplasty (THA), but the proximity of the sciatic nerve may increase the likelihood of sciatic nerve injury (SNI). Gluteus maximus tenotomy can be performed to prevent SNI because tenotomy increases the distance between the femoral neck and sciatic nerve and prevents compression of the sciatic nerve by the gluteus maximus tendon (GMT) during hip movements. We aimed to kinematically compare the postoperative hip extensor forces of patients who have and have not undergone gluteus maximus tenotomy to determine whether there is a difference in hip extensor strength. Methods: Seventy-two patients who underwent gluteus maximus tenotomy during THA were included in the group 1, and 86 patients who did not undergo tenotomy were included in group 2. The Harris hip score, body mass index and hip extensor forces were measured both preoperatively, and 6 months after surgery with an isokinetic dynamometer and compared. Results: The mean age was 64.6 ± 2.3 years in group 1 and 63.8 ± 2.1 in group 2. Mean body mass index was 25.7 ± 1.1 in group 1, and 25.5 ± 1.3 in group 2. Baseline Harris hip score (HHS) was 42.36 ± 12 in group 1 and 44.07 ± 9.4 in group 2 (p = 0.31), whereas it was 89.1 ± 7.8 and 88.4 ± 8.1 at 6 months after surgery, respectively. Baseline hip extensor force (HEF) was 2 ± 0.4 Nm/kg in group 1, and 2.1 ± 0.7 Nm/kg in group 2 (p = 0.28), while it was 2.4 ± 0.6 Nm/kg, and 2.5 ± 0.5 Nm/kg, respectively at 6 month follow-up (p = 0.87). Both groups had significantly improved HHS and HEF when comparing baseline and postoperative measurements (p < 0.0001). No cases of sciatic nerve palsy were noted in group 1, whereas there were two (2.32%) cases in group 2, postoperatively. Conclusion: The release of the GMT during primary hip arthroplasty performed with the PA did not lead to significant decrease in hip extension forces. Hip extensor strength improves after THA regardless of tenotomy. Gluteus maximus tenotomy with repair does not reduce muscle strength and may offer better visualization.Öğe The effect of weekday preference on length of stay in unilateral bicompartmental total knee arthroplasty(Galenos Publishing House, 2022) Turan, Kaya; Ergün, Tuğrul; Muratoğlu, Osman Görkem; Çabuk, Haluk; Öztürk, ÇağatayAim: There are few studies in the literature evaluating the effect of the day of surgery on length of hospital stay. This study evaluates the effect of the day of surgery on the duration of hospitalization in unilateral primary total knee arthroplasty (TKA) in a group of hospitals providing wide-ranging health services and clarifies the implications for reducing economic burdens. Methods: Between March 2020 and January 2022, patients treated by TKA with the code P612420 according to the Health Practice Communique were retrospectively scanned in a group of hospitals with different levels. Patients who underwent bilateral TKA on the same day or during hospitalization, underwent any secondary surgical procedures, or developed early complications were excluded from the evaluation. Results: The data of 743 patients who underwent unilateral TKA were evaluated. The mean hospital stay was 3.32 (2-14) days. It was seen that the shortest hospitalization periods were in the surgeries performed on Saturday (3.15 days), while the longest ones were on Friday (3.62 days). It was found that the patients who underwent surgery on Saturday had significantly shorter hospital stays than on Friday (p=0.006). Conclusion: While planning TKA, the choice of surgery day is a factor that should be addressed to reduce hospital stays and, therefore, costs. © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.Öğe From corrosion behavior to radiation response: A comprehensive biocompatibility assessment of a CoCrMo medium entropy alloy for utility in orthopedic and dental implants(ELSEVIER SCI, 2022) Gürel, Şeyma; Nazarahari, Alireza; Canadinç, Demircan; Gerstein, Gregory; Maier, Harald Jacob; Çabuk, Haluk; Bükülmez, Taylan; Cananoğlu, Mert; Yağcı, M. Barış; Toker, S. Mine; Güneş, Şerafettin; Soykan, Merve NurThis paper presents a thorough biocompatibility evaluation of a CoCrMo medium entropy alloy to assess its potential to be utilized in orthopedic and dental implants. For this purpose, a wide range of systematic exper-iments were carried out, including static immersion, cell culture and radiation experiments. In particular, chemical biocompatibility and ion release behavior of the CoCrMo alloy were studied by carrying out static immersion experiments in artificial saliva (AS), simulated body fluid (SBF) and fetal bovine serum (FBS). Detailed analysis of the surfaces of the tested samples demonstrated that both passive oxide layer and hy-droxyapatite formation occur on the CoCrMo sample surfaces immersed in AS, SBF and FBS for 28 days. The response of living cells to the CoCrMo alloy was tested utilizing cell culture experiments, and the evidence of Saos-2 cell viability and proliferation supported the static biocompatibility experiment results, indicating the potential of the CoCrMo alloy to be utilized as an orthopedic implant material. Finally, the effect of a CoCrMo implant on the actual radiation dose induced upon malignant tissue in the vicinity of the implant during a radiotherapy was evaluated by applying medical grade radiation to water phantoms circumventing CoCrMo samples. The results showed that the radiation accumulation in the tissue within the immediate vicinity of a CoCrMo implant would be a minimum, eliminating some of the undesired side effects. Overall, the results of the three different types of experiments reported in this paper have clearly demonstrated that the CoCrMo medium entropy alloy investigated in this study has significant potential to be utilized as a safe implant material in dental and orthopedic implants.Öğe Greater presence of receptors for relaxin in the ligamentum teres of female infants who undergo open reduction for developmental dysplasia of the hip(BMC, 2021) Ayanoğlu, Semih; Çabuk, Haluk; Kuşku Çabuk, Fatmagül; Beng, Kubilay; Yıldırım, Timur; Uyar Bozkurt, SüheylaBackground: While many factors involved in the etiology of developmental dysplasia of the hip (DDH), one of which is the hormone relaxin. Relaxin concentrations in patients with DDH may lead to pathodynamic changes during hip development by altering the physiological nature of the ligament, as well as by long-term exposure to relaxin during pregnancy. Our objective in this study was to determine the number of relaxin receptors in the ligamentum teres and their role in causing DDH. Methods: We identified 26 infants between birth and 3 years of age who had undergone open reduction for DDH between 2010 and 2012. 12 hips of 12 miss abortus fetus between 20 to 35 weeks of gestation were used as control group. Specimens obtained from two groups were stained with Relaxin-2 antibody, and the amount of staining for relaxin receptors was determined using an ordinal H score. Results: The mean (SD) H scores of infants with DDH were significantly higher than those of controls: 215 (59) versus 52 (48); P = 0.00; 95% CI. Statistically significant difference between the two groups in terms of gender was not found. Conclusion: As a result, increased number of relaxin receptors in the ligamentum teres could be a risk factor for DDH. Level of evidence: Level 2, Prospective comparative study.Öğe Increased acromiohumeral distance in a double-row arthroscopic rotator cuff surgery compared to a single-row surgery after 12 months(BioMed Central Ltd, 2021) Turan, Kaya; Çabuk, Haluk; Köroğlu, Cenk; Öztürk, Ça?atayBackground: Arthroscopic rotator cuff surgery is an effective treatment for rotator cuff tears with the considered use of double-row repair techniques becoming popular in the last decade. We aim to compare the effects of double- and single-row arthroscopic rotator cuff repairs (ARCR) on repair integrity (RI) and acromiohumeral distance (AHD). Methods: In this observational study, we retrospectively identified 98 patients with degenerative rotator cuff tear treated with arthroscopic rotator cuff repair between 2016 and 2019. We excluded 22 patients with partial-thickness tears, 15 with associated subscapularis or SLAP tears, 13 with massive tears, and 5 patients lost to follow-up; we included 43 patients who had ARCR for full-thickness cuff tear and clinical, radiologic follow-up. Of these 43 patients, 23 are grouped as double-row repair group (DRG) and 20 as single-row repair group (SRG). A minimum of 12 months after the surgery, bilateral shoulder MRIs were obtained. Contralateral shoulders without asymptomatic rotator cuff tears served as a control group (CG). The operating surgeon and two other surgeons experienced in arthroscopy blindly measured the AHD and determined the RI at the control MRIs in all groups. Functional assessments relied on UCLA and qDASH Scores. Results: The mean age was 57.89 (45–78) years, and the mean follow-up time was 28,65 (21–43) months. The mean AHD of the CG was 9.7 ± 0.96 mm, the preoperative AHD of DRG was 8.62 ± 1.45 mm, and SRG was 9.71 ± 0.95 mm. The postoperative mean AHD of DRG 9.61 ± 1.83 mm and SRG was 10.21 ± 1.97 mm. AHD differences between the preoperative and postoperative groups were significant (P=0.009). The increase of the AHD in the double-row group was significantly higher than the single-row group (P=0.004). There was a high correlation between the RI and DASH scores (P=0.005). RI did not correlate with the repair method (P=0.580). Conclusion: Although double-row repairs can maintain greater AHD than single-row repairs in the clinical setting, this difference did not affect functional results. Regardless of the surgical intervention, functional results are favourable if RI is achieved. Level of evidence: Level III, Retrospective Cohort Study.Öğe Is pregabalin addition to infraclavicular block, effective in distal radius surgery?(Galenos Publ House, 2022) Kır, Mustafa Çağlar; Özen, Volkan; Mutlu, Mehmet; Çabuk, Haluk; Kir, GülayObjective: Our study evaluated the effects of pregabalin (PR) on wrist function and chronic post-surgical pain (CPSP) following infraclavicular brachial plexus block for surgical repair of distal radius fractures.Methods: Adult patients who underwent ultrasound-guided infraclavicular blockade (IB) plus surgical repair of a distal radius fracture between 2012 and 2017 were evaluated from hospital medical records retrospectively. Two different treatment protocols were used for postoperative analgesia. Group IB received standard analgesia protocol as 15 mg/kg IV paracetamol 4 times a day +/- 2 mg/kg IV tramadol and group PR received oral PR plus the standard protocol. The frequency of Tramadol use during hospital stay (TCHS) was also evaluated. The disability of the arm shoulder and hand (DASH) score and Mayo wrist score (MWS) were used to assess wrist function and a visual analog scale (VAS) was used for subjective pain severity assessment. CPSP and its neuropathic component were evaluated using the douleur neuropathique 4 (DN4) and Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scales.Results: A total of 122 patients with a mean age 39.4 +/- 11.5 years were included in the study (group IB, n=62 and group PR, n=60). The TCHS of group PR was significantly lower than group IB (p=0.030). Better VAS, DASH and MWS scores were found in group PR at months 3, 6, and 12 (p=0.002, p=0.007, p=0.02 for VAS; p=0.01, p=0.01, p=0.01 for DASH; p<0.001, p<0.001, p=0.01 for MWS). The ratio of neuropathic pain according to DN4 and S-LANSS scores of group PR was also significantly lower than group IB at 6-and 12-month visits (p=0.21, p=0.023 for DN4; p=0.034, p=0.038 for S-LANSS).Conclusion: The administration of low dose PR for 2 weeks following distal radius fracture surgery is beneficial for wrist function, chronic pain, and opioid consumption.Öğe Is there a difference between tranexamic acid application routes in hip hemiarthroplasty?(2022) Dedeoğlu, Süleyman Semih; Çabuk, Haluk; Yerli, Mustafa; İmren, Yunus; Yüce, Ali; Bayraktar, Tahsin Olgun; Erkurt, NazımObjectives: This study aimed to define the optimal efficacy route of tranexamic acid treatment given during hemiarthroplasty after femoral neck fracture. Methods: This study examined the files of patients with hip fractures over 65 years of age and treated surgically in our clinic between 2017 and 2019. Patients included in these files were grouped as non-tranexamic acid and topical and systemic tranexamic acid. Then, the demographic information, height and weight of the patient files, haemoglobin and hematocrit levels before and after the surgery, bleeding profiles, tranexamic acid dose and the route of administration, complications in postoperative follow-up, the amount of fluid coming from the drain and duration of drainage, postoperative intensive care follow-up duration of hospitalisation was investigated. Results: A total of 100 patients, 50 of whom were in the control group, 25 of whom were treated with topical tranexamic acid, and 25 of whom were treated with intravenous tranexamic acid, were included in this study. Postoperative blood transfusion was applied to 60% (n = 30) of the control group, 20% (n = 5) of the topical group, and 24% (n = 6) of the intravenous group. When compared statistically, it was found that topical and intravenous groups were lower than the control group (p = 0.001 and p = 0.002, respectively), but there was no significant difference between them (p = 0.759). When the blood loss calculations made by the Gross method were examined, the average of the control group was 1011.5 ml (179-1837 ml), the topical group was 695.7 ml (11-2503 ml), and the intravenous group was 710.9 ml (173-11315 ml) calculated as. When analysed statistically in terms of blood loss, it was found that the control group was significantly higher than the topical and intravenous groups, but there was no significant difference between the topical and intravenous groups (p = 0.002). Conclusions: Tranexamic acid applied to reduce blood loss during arthroplasty surgery can be used effectively either by topical or systemic methods.Öğe Late presenting pediatric radial neck fracture: a case report and review of the literature(2021) Turan, Kaya; Köroğlu, Cenk; Çabuk, HalukIntroduction: A pediatric radial neck fracture, when the diagnosis is delayed, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient with late presenting radial neck fracture and results of open reduction and fixation with Kirschner wires. Case report: A 13-year-old right-handed girl fell on an out-stretched right arm after being tackled during playing basketball and had a radial neck fracture. However, the diagnosis of her fracture was delayed for 3 weeks. At the first radiologic examination, the anteroposterior and lateral radiographs were showing over 80 degrees of angulation at the radial neck and subluxation of the radiocapitellar joint. We tried to obtain a closed reduction, but we could not succeed. Then, we performed open reduction while preserving medial periosteal continuity and vascular supply of the radial head by meticulous surgical dissection. Sixth-month radiography control and clinical examination confirmed the complete healing of the fracture without any epiphyseal injury. Painless full range of motion without any restriction of pronation and supination was achieved. The patient and her parents were satisfied with the outcome. Conclusions: Even if the diagnosis of pediatric radial fractures is delayed if we can preserve medial periosteal continuity and vascularity of the radial head with open reduction, satisfactory results are obtainable.Öğe Patient anxiety levels in orthopedic outpatient clinics at hospitals with different patient population densities(DergiPark, 2022) Turan, Kaya; Tuncez, Mahmut; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, HalukBackground/Aim: Prolonged wait times for examination and delayed hospital appointment times can negatively affect patients. Increased anxiety in orthopedic outpatient clinic patients can disrupt diagnosis and treatment, and increase psychological tension in both patients and healthcare professionals. The aim of our study is to compare the anxiety levels of patients at institutions with different patient population densities. Methods: This cross-sectional survey study included 189 patients who voluntarily completed the Beck Anxiety Scale while registering for treatment of non-traumatic conditions at the orthopedics and traumatology outpatient clinics of two tertiary health care hospitals. Patients were grouped by hospital attended. The study assessed patients’ age, education level, estimated monthly income levels, and anxiety levels. Results: 99 patients from the public hospitals and 90 from the private hospitals participated in the survey. A significant positive correlation existed between educational status and income level (P<0.001). No significant difference in income level existed between the two groups (P=0.063), but the education level of patients in the private hospital group was significantly higher than in the public hospital group (P<0.001). The anxiety levels of the patients in the private hospital group was significantly higher (P=0.043); this difference was correlated to education level rather than income level. Patients with higher education levels demonstrated significantly higher anxiety levels (P<0.001). Conclusion: The study concluded that the anxiety levels of patients who applied to the orthopedic outpatient clinics were independent of facility patient density and related primarily to patient attributes. Prospective studies are needed examining the relationship between patient anxiety levels and waiting time.Öğe Proprioception analysis of patients with anterior cruciate ligament reconstruction(2023) Erkurt, Nazım; Yerli, Mustafa; Yüce, Ali; Bayraktar, Tahsin Olgun; Atar, Sevgi; Turan, Kaya; Çabuk, HalukObjectives: This study evaluates the effect of tibial stump mechanoreceptor preservation on proprioception, muscle strength, recovery and functional outcomes after arthroscopic anterior cruciate ligament surgery (ACLS). Methods: Patients undergoing ACLS between January-July 2019 were evaluated by a single surgeon. The HUMAC NORM 2 device measured patients' proprioceptive sensation and muscle strength before and after surgery; KOOS and Oxford scales were used to score patients’ functional results. The patients were divided into two groups: those who underwent stump-preserving surgery (SP group) and those who underwent conventional surgery (C group). Results: Our study evaluated 27 patients, 11 in the SP and 16 in the C groups. The two groups had no statistical difference in muscle strength, proprioception, and functional scores in the first and third postoperative months. In the sixth-month evaluation, significantly better functional scores were found in the C group. Further, the athletic function was better in patients with good proprioception recovery, regardless of the group comparison. Conclusions: Preserving the stump and mechanoreceptors on the tibial face was not determined to provide additional benefit to the patients in the first six months after surgery. Returning to sports was faster and functional scores were better in patients with good proprioception recovery.Öğe The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn anterior cruciate ligament(Springer Nature, 2022) Çabuk, Haluk; Çabuk, Fatmagül Kuşku; Turan, KayaIntroduction: Restoration of proprioceptive function after anterior cruciate ligament (ACL) reconstruction is as important as mechanical stability. For this purpose, remnant of the torn ACL is the only source of nerve endings. Our aim in this study is to investigate the quantity of mechanoreceptors in the remnants ACL stumps in injured knees and to correlate that with the quantity in intact ACL in control cases. Materials and methods: 48 patients that underwent ACL reconstruction between January 2016 and December 2018 as study group and 20 knees of 10 fresh frozen cadavers that as control group included in the study. Remaining stumps from study group and native ACL from control group were collected and investigated with S100 immunostaining. The type and number of mechanoreceptors in standardized areas was determined. The correlation of number of mechanoreceptors and time to surgery after ACL rupture were evaluated. Results: The free nerve endings (FNE) and total number of mechanoreceptors were significantly lower in the study group as compared to the control group (p < 0.001 and p = 0.004, respectively). The number of Golgi-Mazzoni corpuscle decreased significantly with time (p = 0.041 CC: - 0.438). Conclusion: The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn ACL. The surgeon and patient should be aware of the fact that delay in surgery could lead to the loss of mechanoreceptors.Öğe Total diz artroplastisi sonrası geç dönemde gelişen peroneal palsi: Vaka sunumu(DergiPark, 2021) Turan, Kaya; Çabuk, Haluk; Muratoğlu, Osman GörkemTotal diz artroplastisi sonrası gelişen peroneal sinir palsi klinik sonuçları önemli derecede olumsuz etklileyen ve nadir görülen bir sorundur. Bu çalışmamızda 62 yaşında sağ dizde ileri derecede gonartroz nedeniyle total diz artroplastisi uyguladığımız hastada ameliyat sonrası 15. günde gelişen peroneal palsinin klinik ve elektrofizyolojik takip sonuçlarını sunuyoruz. Elektromyografik değerlendirmede peroneal sinir motor dalının fibula başı seviyesinde ağır derecede parsiyel aksonal hasarı izlendi. Medikal tedavi ile takibi sonrası 6. Haftadan itibaren klinik iyileşme bulguları başlayan hastada, peroneal sinir eksplorasyon ve nöroliz gerekliliği olmadan, 6. ayda total klinik ve elektrofizyolojik iyileşme sağlandı. Dejeneratif disk hastalığına bağlı klinik bulgu vermeyen kök basısı olan hastalarda uygulanan total diz artroplastisinde peroneal palsi yatkınlığında artış olabileceği akılda tutulmalıdır.
