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    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 Semih
    Background: 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 Association
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    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, Nazım
    Objectives: 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.