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Öğe Clinical and radiological outcomes of total knee arthroplasty performed with midvastus and medial parapatellar approaches in obese patients(Hindawi Limited, 2021) Güler, Olcay; Gümüşsuyu, Gürkan; Sofu, Hakan; Gökçen, Hüseyin BahadırAbstract Abstract Background. The use of total knee arthroplasty (TKA) for primary osteoarthritis of the knee has remarkably increased recently. We aimed to compare the clinical and radiological outcomes of TKA in obese patients (>30 kg/m2) operated with midvastus (MV) or medial parapatellar (MPP) approaches. Methods. This retrospective study was performed using data derived from 80 patients (70 women; 10 men) with an average age of 66.17 ± 5.42 (range: 54 to 77). Patients were allocated into 2 groups as for the type of approach conducted during TKA: group I (n = 41) underwent TKA by MV approach, while the MMP technique was used in group II (n = 39). Results. Demographic, clinical, and radiological parameters included age, side of involvement, sex, BMI, diameters of thigh and calf, length of incision, duration of operation, amount of bleeding and transfusion, duration of hospitalization and follow-up, complications, and range of motion, as well as Knee Society Score (KSS) and Knee Society Function Score (KSFS). Patients with a higher BMI (?35 kg/m2) experienced more profound bleeding and needed more transfusion of erythrocyte suspension. The range of motion was more favorable in groups with BMI <35 kg/m2. The functional outcomes as reflected in KSS and KSFS were much better in patients with BMI <35 kg/m2. Conclusions. Our data indicated that obesity can adversely influence the clinical and radiological outcomes after TKA performed by both MV and MPP approaches. A careful analysis of patient characteristics and selection of appropriate operative procedures is critical. Further randomized, controlled trials on larger series must be designed to elucidate the relationship between obesity and therapeutic outcomes after TKA with different approaches.Öğe Effect of graduation centers on the academic career of orthopedic surgeons in Turkey(DergiPark, 2019) Üçpunar, Hanifi; Çamurcu, Yalkın; Çöbden, Adem; Özcan, Seçkin; Saygılı, Hakan; Sofu, HakanPurpose: The aim of this study was to assess whether orthopedic surgeons’ graduation centers affect their academic career. Materials and Methods: In this observational study, we have reached the education and working information of 1767 orthopedic surgeons currently working in Turkey. Orthopedic surgeons’ graduation centre and city, current affiliation, current academic status and duration of practice were investigated through web. According to their graduation centre, orthopedic surgeons were divided into two groups as a university hospital and training and research hospital. Results: Orthopedic surgeons’ current affiliations were significantly associated with their graduation centres and cities. Besides, orthopedic surgeons graduated from university hospitals were more likely to have an academic career than those graduated from training and research hospitals; however, no significant association was found between the city of graduation and academic career. According to regression analysis, orthopedic surgeons graduated from university hospitals were more likely to affiliate in university hospitals and private hospitals. Conclusion: Orthopedic surgeons graduated from university hospitals were significantly more likely to affiliate in universityÖğe Lesion size and varus malalignment are the major determinants leading to poorer clinical outcomes after combined microfracture treatment for focal cartilage lesions during anterior cruciate ligament reconstruction(SPRINGER, 2021) Sofu, Hakan; Gümüşsuyu, Gürkan; Guler, Olcay; Ucpunar, Hanifi; Duman, Serda; Camurcu, YalkinThe purposes of this study were to evaluate the clinical effects of microfracture (MFX) performed for Outerbridge grade 3 or 4 focal cartilage lesion during the same surgery with arthroscopic anterior cruciate ligament (ACL) reconstruction and to analyze the major determinants of these potential effects on the clinical outcome. The clinical and radiographic data of 119 patients were evaluated. The mean follow-up time was 32.6 +/- 6 months. Isolated arthroscopic ACL reconstruction was performed in 70 patients (Group 1), whereas MFX for Outerbridge grade 3 or 4 chondral lesion during ACL surgery was performed in 49 patients (Group 2). Visual analogue scale (VAS) score, Lysholm knee score, and Tegner activity scale were the instruments used as outcome measures to evaluate the clinical status of the patients. Routine X-ray and MRI were also performed for all patients pre-operatively as well as at the latest follow-up visit. Lineer regression analysis was performed to determine major factors predicting the poorer clinical outcome. Clinical outcomes were similar between isolated ACL reconstruction and combined procedure. On the other hand, according to lineer regression analysis, cartilage lesion size > 2 cm(2) and > 5 degrees of varus alignment were detected as the major determinants leading to poorer outcomes in combined ACL reconstruction and MFX. Level of evidence: III - Retrospective Comparative Study.Öğe Paediatric orthopaedics through paintings(British Editorial Soc Bone Joint Surgery, 2018) Çamurcu, Yalkın; Sofu, Hakan; Üçpunar, Hanifi; Duman, S.; Çöbden, AdemPurpose Some famous artistic representations created throughout the centuries can reveal a hidden or mysterious diagnosis of some diseases and these paintings have always drawn the attention of physicians interested in art. Artistic illustration of a child with a malformation or disability can reflect the characteristic appearance of a disease and its historic perspective. Some articles have revealed the definite diagnosis of a child with achondroplasia through portraits of dwarfs and some studies have discussed the secret diagnosis of a crippled child with Pes Equinovarus or poliomyelitis. In this study, we aim to introduce some paintings that reveal musculoskeletal diseases related to paediatric orthopaedics. Methods Paintings painted since the Renaissance were reviewed and collected via web searches. Artistic paintings depicting children with suspected paediatric orthopaedic diseases were analyzed in this study. Results Paintings in which artists have depicted children with achondroplasia, poliomyelitis and clubfoot were found. Conclusion The investigation of a drawing depicting a disabled child may encourage an orthopaedic surgeon to introduce an analytical approach using visual cues. These paintings may also enhance the observational skills of paediatric orthopaedic surgeons, give information about the historical process of a disease and demonstrate the impact of the disease at the time the painting was painted.Öğe Should orthopedic surgeons consider reducing the negative effects of Outerbridge grade 2 patellofemoral chondral lesion on early postoperative recovery during anterior cruciate ligament reconstruction(Springer-Verlag France, 2019) Sofu, Hakan; Çamurcu Yalkın; Issin, Ahmet; Üçpunar Hanifi; Özcan Seçkin; Duman, SerdaPurpose: The purpose of this study was to comparatively evaluate the effectiveness of intra-articular PRP and HA injections applied as the treatment of Outerbridge grade 2 chondral lesions in patellofemoral joint during arthroscopic ACL reconstruction. Methods: The clinical and radiographic data of 61 patients between 18 and 45 years of age were evaluated. The patients were separated into three groups. Hyaluronic acid injection was applied in 22 knees (Group 1), PRP injection was applied in 18 knees (Group 2), and 21 knees did not have any specific treatment except ACL reconstruction (Group 3). All patients were followed clinically at least for 12 months. Clinical examination of the operated knee, visual analogue scale (VAS) score, Lysholm knee score, and Tegner activity scale were the outcome measures. Routine X-ray and MRI were also performed for all patients at 12-month postoperative follow-up visit. Results: Although the mean VAS and Lysholm scores at 3-month follow-up were better in Group 1 and 2 than Group 3, the efficacy of intra-articular PRP on healing process regarding progression of the mean VAS and Lysholm scores through 6- and 12-month follow-ups was significantly better and longer than HA. No statistically significant differences were detected according to Tegner activity scale between the groups at 3 and 6 months; however, Group 2 had better activity level than both Group 1 (p < 0.001) and 3 (p < 0.001) at the end of 12 months after surgery. Conclusion: Intra-articular PRP injection applied as the treatment of concomitant Outerbridge grade 2 chondral lesion in patellofemoral joint during ACL reconstruction revealed better and durable clinical outcomes via decreasing the potentially negative effects of chondral pathology on postoperative healing with respect to HA injection. Level of evidence: III—retrospective comparative study. © 2018, Springer-Verlag France SAS, part of Springer Nature.
