36 results on '"Kasım Kılıçarslan"'
Search Results
2. The 'Motionless Gastrocnemius': A Reliable Sign for Safe Graft Harvesting
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Ahmet Fırat, M.D., Enejd Veizi, M.D., Şahin Çepni, M.D., İzzet Özay Subaşı, M.D., and Kasım Kılıçarslan, M.D.
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Orthopedic surgery ,RD701-811 - Abstract
Difficulties in graft harvesting of the hamstring have been the topic of many studies. These difficulties are related to the aponeurotic or fibrous attachments of the hamstrings with the medial head of the gastrocnemius muscle, soleus muscle, and leg fascia. Freeing the graft from these attachments is important because insufficient release prior to stripper insertion can lead to premature transection or amputation. We describe a reliable intraoperative physical examination sign to help understand the sufficient amount by which a tendon graft needs to be released prior to stripper insertion. The presence of the motionless gastrocnemius (“motionless gastroc”) phenomenon is used in our clinic as a sign that the grafts have been sufficiently freed and that a tendon stripper can be used without fear of transection or graft amputation.
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- 2020
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3. Comparison of dermatotraction and negative pressure wound therapy for closure of cruris fasciotomy after 2023 Kahramanmaras earthquake
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Kasım Kılıçarslan, Yasin Erdoğan, Yavuz Karaman, Hilmi Alkan, and Vedat Biçici
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Rehabilitation ,Orthopedics and Sports Medicine ,Surgery - Published
- 2023
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4. The painful joint after COVID-19 treatment: A study on joint osteonecrosis following COVID-19-related corticosteroid use
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Enejd Veizi, Yasin Erdoğan, Başak Sinem Sezgin, Yavuz Karaman, Kasım Kılıçarslan, and Ahmet Fırat
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Rehabilitation ,Orthopedics and Sports Medicine ,Surgery - Published
- 2022
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5. Closure of the femoral medullary canal after retrograde nailing using an in-situ osteochondral autograft–Technical trick and a case series
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Kasım Kılıçarslan, Ahmet Firat, Ali Şahin, Şahin Çepni, Enejd Veizi, and Yasin Erdoğan
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musculoskeletal diseases ,Knee function ,medicine.medical_specialty ,Medullary cavity ,Bone Nails ,law.invention ,Intramedullary rod ,Distal femur ,law ,medicine ,Humans ,Autografts ,General Environmental Science ,Fracture Healing ,Femur fracture ,business.industry ,musculoskeletal system ,Fracture Fixation, Intramedullary ,Surgery ,Knee cartilage ,Treatment Outcome ,Knee pain ,General Earth and Planetary Sciences ,High incidence ,medicine.symptom ,business ,Femoral Fractures - Abstract
Retrograde intramedullary nailing (RIMN) is the favored over antegrade intramedullary nailing in fractures of the distal femur. It provides a longer working length and allows for multiple distal screw insertion and therefore a more stable construct. Concerns remain regarding the violation of the knee cartilage and the effect this has on knee function. Many studies have shown high incidence of knee pain with reports varying from 20 to 86%. We describe a novel technical trick aiming at partially restoring the knee cartilage of the operated side and decreasing the hemorrhage stemming from the medullary canal. Our experience of the technique and the case series shows that closing the entrance point of the medullary canal after a RIMN procedure leads to better function and less knee pain in the postoperative period.
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- 2022
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6. Mason IIIII radial head and neck fractures treated with locking plate fixation
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Kasım Kılıçarslan, Ali Şahin, Mesut Tahta, Şahin Çepni, Ahmet Firat, and Enejd Veizi
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medicine.medical_specialty ,RD1-811 ,business.industry ,medicine.medical_treatment ,Elbow ,Radial head ,Bone healing ,Arthroplasty ,Surgery ,medicine.anatomical_structure ,Locking plate fixation ,medicine ,Internal fixation ,radial head fracture ,radial neck fracture ,elbow function ,In patient ,business ,Fixation (histology) - Abstract
Introduction :Internal fixation of radial head and neck fractures is difficult and postoperative complications are common. Our aim in this study was to evaluate elbow function and postoperative complications in patients who underwent internal fixation with the diagnosis of mason 2 and 3 radial head and neck fractures and we discuss our findings in light of the recent literature Materials and Methods: We included 27 patients with treatment radial head and neck fractures. Patients were an average age of 35.4 years (23 58) and mean follow up time was 31.6 months (13 61). 5 patients (18.5%) had a Mason type 2 fracture and 22 patients (81.5%) Mason type 3 fracture. Postoperative assessments included evaluation of range ofmotion, functional scores, and radiologic findings. We assessed fracture healing, surgical complications,revision surgery, and the need for metal removal. Results: The mean extension deficit was 8° (range 0°- 25°), average elbow flexion 138° (range 95°- 160°), pronation 70° (range 30°- 90°) and supination was 64° (range 20°- 90°). The Mayo Elbow Performance Score showed a mean score of 92 (range 60 100). The mean Disability of Arm, Shoulder and Hand score was 15.5 (range 2.5 - 55.2). There were 7 (25,9 %) complications. A total of 6 patients underwent a revision surgery (22.2 %). Conclusions: In conclusion, internal fixation could be an advantageous treatment modality for type II III radial head and neck fractures. On the other hand, achieving a stable elbow joint should take precedence and arthroplasty should be considered in severely comminuted cases where fixation is not possible. [Hand Microsurg 2021; 10(2.000): 127-133]
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- 2021
7. Tip–neck distance ratio as a novel predictor for failure in cephalomedullary nailing of unstable trochanteric fractures (UTF)
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Ali Şahin, Şahin Çepni, İzzet Özay Subaşı, Ahmet Firat, Kasım Kılıçarslan, and İbrahim Bozkurt
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Trochanteric fractures ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,Bone Screws ,Bone Nails ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Femur ,Reduction (orthopedic surgery) ,Retrospective Studies ,Fixation (histology) ,030222 orthopedics ,Univariate analysis ,Hip Fractures ,business.industry ,030229 sport sciences ,General Medicine ,Fracture Fixation, Intramedullary ,Surgery ,Orthopedic surgery ,Distance ratio ,business - Abstract
Intertrochanteric femur fractures (ITFF) are frequently fixed with proximal femoral nailing (PFN), and a common cause of fixation failure is cut-out of the lag screws. In the literature, many factors have been defined to determine the failure risk, including the tip–apex distance (TAD), calcar-referenced tip–apex distance (CalTAD), the Cleveland zone and Parker's ratio. In this study, a novel technique is described which favors infero-posterior placement of the lag screw and predicts failure risk for PFN. The purpose of this study was to evaluate the tip–neck distance ratio as a factor for the prediction of cut-out after PFN of ITFF. A retrospective evaluation was made of the data of 125 patients applied with PFN for ITFF between October 2016 and September 2019. The occurrence of mechanical complications was analyzed in relation to age, gender, fracture side, American Society of Anaesthesiologists classification, fracture classification, reduction quality, bone quality, Cleveland zone, Parker’s ratio, TAD, CalTAD and the TNDR. A total of 125 patients, including 16 with mechanical complications, were suitable for full analysis. In the univariate analysis, reduction quality (p = 0.003), the TAD (p = 0.048) and the TNDR (p = 0.030) were statistically associated with mechanical complications (p
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- 2021
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8. The Change in Posterior Tibial Slope After Cementless Unicondylar Knee Arthroplasty
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Ahmet Firat, Enejd Veizi, Şahin Çepni, Osman Tecimel, Kasım Kılıçarslan, and İzzet Özay Subaşı
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musculoskeletal diseases ,Knee Joint ,Radiography ,Osteoarthritis ,Prosthesis Design ,03 medical and health sciences ,0302 clinical medicine ,Statistical significance ,medicine ,Humans ,Orthopedics and Sports Medicine ,Unicondylar Knee Arthroplasty ,Arthroplasty, Replacement, Knee ,Orthodontics ,030222 orthopedics ,Tibia ,business.industry ,Osteoarthritis, Knee ,musculoskeletal system ,medicine.disease ,Treatment Outcome ,Coronal plane ,sense organs ,Implant ,Knee Prosthesis ,business ,Tegner Activity Scale ,Oxford knee score - Abstract
The posterior tibial slope (PTS) is an important factor in patients undergoing unicondylar knee arthroplasty. It is an area subjected to high shear and compressive forces. Our objective is to investigate the changes taking place on the tibial slope of cementless unicondylar knee arthroplasties and define its relationship with functional scores.Patients undergoing a cementless unicondylar knee arthroplasty between January 2011 and July 2019 were selected. Exclusion criteria were lack of at least 1 year of follow up, loss to follow-up for any reason, and revision of a metallic component. Overall, 161 cases were included. Patients were analyzed using standard radiographs for changes in PTS, coronal positioning of the implant, and overhanging. Function was analyzed using Oxford Knee Score, Tegner Activity Scale, and Knee Society Score. Changes of the PTS were analyzed for statistical significance and for correlations with all the other variables.All postoperative functional scores showed significant improvement (P.05). Compared to the early postoperative values, increases of ≤5° were detected in 79% of all patients. The greater amount of slope change occurred during the first 6 months postoperatively. Statistical analysis revealed no significant relationship with functional scores of the knee, age, body mass index, overhanging, and coronal alignment of the tibial component.This study showed that, with time, minimal changes take place in the PTS of cementless unicondylar knee arthroplasty. The change mostly takes place during the first 6 months. These changes do not affect functional scores.
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- 2021
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9. Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans
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Enejd Veizi, Şahan Güven, Kasım Kılıçarslan, Nurdan Cay, Ahmet Firat, and Ali Şahin
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business.industry ,Intraclass correlation ,oxford knee ,Radiography ,medicine.medical_treatment ,correlational study ,General Engineering ,unicondylar knee arthoplasty ,Arthroplasty ,Sagittal plane ,Correlation ,Orthopedics ,medicine.anatomical_structure ,Coronal plane ,medicine ,arthroplasty ,Plain radiographs ,Femoral component ,Nuclear medicine ,business ,knee alignment - Abstract
Background and objective Unicondylar knee replacement (UKR) is one of the most frequently performed arthroplastic operations worldwide. Migration and subsidence regarding the tibial component of UKR is a well-known phenomenon. In this study, we aimed to analyze whether plain radiographs are a reliable means to measure the true coronal and sagittal alignment of the UKR’s tibial component. Methods Patients undergoing a UKR procedure at our center between December 2020 and March 2011 were eligible for this study. Inclusion criteria were as follows: the presence of well-aligned standard and reproducible anteroposterior and lateral X-rays taken one week before or after a low-radiation artifact-reduced CT scan. Sixty-six knees were included in the study. Coronal and sagittal alignment of the tibial component was measured in a standard manner by two observers on both X-rays and CT scans. A correlation analysis was performed, and the margin of error was established. Results Intra-observer reliability was high among the two observers whether for X-ray or CT scan measurements [intraclass correlation coefficient (ICC): >0.900]. On the other hand, coronal plane measurements had lower inter-observer ICC values on both X-rays and CT scans while reliability on the sagittal plane was higher. There was a high correlation between radiographic measurements on X-rays and CT scans on both planes. Conclusion Even though the measurements on plain radiographs were slightly different from the ones obtained from CT scans, the correlation between them was very strong. Caution should be exercised when measuring the coronal alignment of the tibial implant on X-rays since it is more frequently affected by rotational misalignment.
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- 2021
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10. Mid-Term Results of the Metal-on-Metal Total Hip Arthroplasty
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Vedat Biçici, İzzet Bingöl, and Kasım Kılıçarslan
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- 2020
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11. Anesthesia type have the effect of extremity length award in patients with total hip artroplasty?
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Mehmet Asiltürk, Kasım Kılıçarslan, Murat Altay, Anıl Taşkesen, Yüksel Uğur Yaradılmış, and İsmail Demirkale
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medicine.medical_specialty ,total kalça protezi,bacak uzunluk eşitsizliği,genel anestezi,rejyonel anestezi ,business.industry ,Leg length ,Periprosthetic ,Soft tissue ,General Medicine ,Neurovascular bundle ,Malleolus ,Surgery ,Psychiatry and Mental health ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,Health Care Sciences and Services ,Regional anesthesia ,Harris Hip Score ,total hip artroplasty,leg length discrepancy,general anesthesia,regional anesthesia ,medicine ,In patient ,Sağlık Bilimleri ve Hizmetleri ,business - Abstract
Aim: Leg length discrepancy (LLD), instability and periprosthetic infection are most common reasons patient complaint after total hip replacement (THR) surgery. Degree of soft tissue release in operating room may mislead us about LLD. The objective of this study is to report the effect of the anesthesia type on leg lengthening amount.Material and Method: In this study, 36 primary coxarthrosis patients who underwent THR surgery in two different medical centers under different types of anesthesia during2016-2017 were enrolled retrospectively. Patients are divided into two groups. Group 1 (n:18) who underwent general anesthesia, group 2 (n:18) who underwent regional anesthesia. Distance between greater trochanter-ischial tuberocity (GT-IT) is measured radiologically for leg lengthening, umbilicus-medial malleolus distance is measured clinically for LLD. Harris hip score (HHS) is measured for functional scoring.Results: The average follow-up time was 13 months (12-15 months). No deep infection or neurovascular damage were seen in patients. According to GT-IT distance, leg lengthening was 19.76±9.83 mm in group 1 and 3.2±3.96 in group 2 (p:0.000*). According to 12 month umbilicus-medial malleolus distance, 9 patients experienced leg lengthening (, Amaç: Total kalça artroplastisi sonrası ekstremite eşitsizliği, instabilite ve enfeksiyondan sonrası en sık hasta şikayet nedenidir. Kullanılan anestezi yöntemine göre yumuşak doku gevşemesindeki değişkenlik bacak uzunluk eşitsizliği konusunda bizi yanıltabilir. Çalışmamızda total kalça protezi ameliyatında anestezi tipinin bacak uzuma miktarına etkisini araştırdık.Gereç ve Yöntem: Çalışmamızda 2016-2017 tarihleri arasında iki farklı merkezde ameliyat edilen ve anestezi türleri farklı olan 36 primer koksartrozlu hasta retrospektif olarak değerlendirildi. Hastalar genel anestezi uygulananlar [Grup 1 (n:18)] ve rejyonel anestezi uygulananlar [Grup 2 (n:18)] olarak ayrıldı. Hastalar radyolojik olarak trokanter minör - tuberkulum iskiadikum mesafesi (T.İ.-T.M.) ile uzama miktarı, umblicus - medial malleol ölçümü ile bacak uzunluk eşitsizliği belirlendi. Fonksiyonel değerlendirme için hastalara Harris kalça skoru yapıldı.Bulgular: Ortalama takip süresi 13 ay (12-15 ay) idi. Vakaların hiçbirinde derin enfeksiyon ya da damar-sinir yaralanması görülmedi. T.İ.- T.M. mesafesine göre bakıldığında Grup 1’de 19,76 ± 9,83 mm Grup 2’de 3,2 ± 3,96 mm uzama gözlendi (p=0.000*). Hastaların 12. ay umblikus – medial malleol ölçümlerinde Grup 1 de 9 hastada ameliyat edilen bacakta uzama (
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- 2019
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12. Segmental Defect-Bridging Intramedullary Knee Arthrodesis for Osseous Hydatidosis of the Distal Femur: A Case Report
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Ahmet Firat, Şahin Çepni, Enejd Veizi, Kasım Kılıçarslan, and Hacı M İnan
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medicine.medical_specialty ,030204 cardiovascular system & hematology ,osseous hydatidosis ,Bone tissue ,Trauma ,law.invention ,Intramedullary rod ,03 medical and health sciences ,0302 clinical medicine ,law ,parasitic diseases ,Medicine ,Knee arthrodesis ,Echinococcus granulosus ,Pathological ,Pelvis ,hydatid cyst ,Femur fracture ,biology ,business.industry ,General Engineering ,biology.organism_classification ,Surgery ,knee arthrodesis ,medicine.anatomical_structure ,Orthopedics ,Orthopedic surgery ,femur fracture ,business ,030217 neurology & neurosurgery - Abstract
Hydatid cyst is a condition endemic to many parts of the world and is mainly caused by Echinococcus granulosus ( E. granulosus). It rarely affects the bone tissue, with the most commonly impacted sites being the vertebrae and the pelvis. Preoperative diagnosis is challenging and very rarely possible because of its similarities with other pathologies. In this report, we present the case of a 64-year-old patient with osseous hydatidosis of a pathological distal femur fracture. The fracture pattern was not recognized on the initial operation and multiple serial debridements were required to control the disease, leading to a large bone defect and a weakened extensor mechanism. A knee arthrodesis with a segmental defect-bridging intramedullary system was eventually performed, which led to satisfying outcomes. Osseous hydatidosis very often presents itself as a pathological fracture and is difficult to diagnose preoperatively with plain radiographs. Orthopedic surgeons are advised to maintain a high index of suspicion and to test for this disease when cystic bone lesions are detected at fracture sites, especially in patients from endemic regions.
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- 2021
13. Total diz protezi ve aseptik gevşeme
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Kasım Kılıçarslan and Enejd Veizi
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- 2021
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14. The 'Motionless Gastrocnemius': A Reliable Sign for Safe Graft Harvesting
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Kasım Kılıçarslan, İzzet Özay Subaşı, Şahin Çepni, Enejd Veizi, and Ahmet Firat
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Soleus muscle ,Tendon stripper ,Orthopedic surgery ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,030229 sport sciences ,musculoskeletal system ,Surgery ,03 medical and health sciences ,Gastrocnemius muscle ,0302 clinical medicine ,Leg fascia ,surgical procedures, operative ,Amputation ,Technical Note ,medicine ,Orthopedics and Sports Medicine ,business ,Tendon graft ,Hamstring ,RD701-811 - Abstract
Difficulties in graft harvesting of the hamstring have been the topic of many studies. These difficulties are related to the aponeurotic or fibrous attachments of the hamstrings with the medial head of the gastrocnemius muscle, soleus muscle, and leg fascia. Freeing the graft from these attachments is important because insufficient release prior to stripper insertion can lead to premature transection or amputation. We describe a reliable intraoperative physical examination sign to help understand the sufficient amount by which a tendon graft needs to be released prior to stripper insertion. The presence of the motionless gastrocnemius (“motionless gastroc”) phenomenon is used in our clinic as a sign that the grafts have been sufficiently freed and that a tendon stripper can be used without fear of transection or graft amputation.
- Published
- 2020
15. Does Body Mass Index Cause a Clinical Difference in Simultaneous Bilateral and Unilateral Knee Arthroplasty?
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Hakan Çiçek, Fırat Seyfettinoğlu, Ümit Tuhanioğlu, Ali Aydoğdu, Hasan Ulaş Oğur, and Kasım Kılıçarslan
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musculoskeletal diseases ,medicine.medical_specialty ,WOMAC ,medicine.medical_treatment ,Osteoarthritis ,Morbidly obese ,Body Mass Index ,Postoperative Complications ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Arthroplasty, Replacement, Knee ,Retrospective Studies ,business.industry ,Perioperative ,Osteoarthritis, Knee ,medicine.disease ,Arthroplasty ,Surgery ,Obesity, Morbid ,Treatment Outcome ,Complication ,business ,Body mass index - Abstract
This study aims to investigate clinical and functional factors in patients undergoing unilateral and simultaneous bilateral total knee arthroplasty (TKA) who were classified into subgroups of nonobese, obese, and morbidly obese, and to determine perioperative and postoperative complications. We conducted an evaluation of 489 nonobese, obese, and morbidly obese patients who underwent TKA due to primary knee osteoarthritis between January 2006 and December 2013. The arthroplasties were performed by three different surgeons. Patients who underwent unilateral (group 1) or simultaneous bilateral (group 2) TKAs were divided into subgroups in accordance with BMI levels, that is, (a) nonobese (BMI 0.05), except for morbidly obese patients. Most intraoperative and early postoperative complications occurred in the morbidly obese group, especially in those undergoing simultaneous bilateral TKA procedures (p
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- 2020
16. Gold standard treatment of the patients with total knee arthroplasty infection
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Mahmut Nedim Aytekin, Nihat Tosun, Kasım Kılıçarslan, Mahmut Uğurlu, and Kaan Yüksel
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medicine.medical_specialty ,business.industry ,Total knee arthroplasty ,Medicine ,Gold standard (test) ,business ,Surgery - Published
- 2018
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17. A Comparison of Anterolateral and Posterolateral Approaches in Primary Total Hip Arthroplasty
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Kasım Kılıçarslan, Bahar Anaforoğlu, Faruk Buğlak, İzzet Korkmaz, and Mehmet Atıf Erol Aksekili
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medicine.medical_specialty ,business.industry ,Medicine ,business ,Total hip arthroplasty ,Surgery - Published
- 2017
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18. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire: A Turkish validation study
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Mehmet Atıf Erol Aksekili, Kasım Kılıçarslan, Mesut Akyol, Selcuk Korkmazer, Lale Aktekin, and Nihat Tosun
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Cross-Cultural Comparison ,Male ,medicine.medical_specialty ,Turkey ,Turkish ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,Japan ,Cronbach's alpha ,Surveys and Questionnaires ,Back pain ,Humans ,Medicine ,Outpatient clinic ,Translations ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Physical Examination ,Societies, Medical ,business.industry ,Middle Aged ,Low back pain ,language.human_language ,Test (assessment) ,Orthopedics ,Orthopedic surgery ,language ,Physical therapy ,Female ,Surgery ,medicine.symptom ,business ,Low Back Pain ,Intervertebral Disc Displacement ,030217 neurology & neurosurgery - Abstract
Background The aim of this study was to apply cross-cultural adaptation and validity assessment to the Turkish translation of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire applied to patients conservatively monitored for lumbar disc hernia and narrowing of the lumbar canal. Methods The questionnaire was translated into Turkish based on guidelines. In respect of the comprehensibility of the obtained pre-final version of the questionnaire, a pilot test was applied to 20 healthy individuals. The patients were requested to complete the final version of the questionnaire after an orthopedic and physical therapy assistant doctor (resident) had completed the diagnosis and demographic information. To evaluate the retest reliability, the test was applied a second time, 14 days (±3 days) after the first application, again in the Orthopedics and Physical Therapy Outpatient Clinic. Results The study was completed with a total of 215 individuals, comprising 107 patients and 108 healthy volunteers. When Turkish version of the questionnaire scale was evaluated of the patients and healthy volunteers together, the internal consistency was determined at the levels of Cronbach's α excellent. The lowest correlations of all the questionnaire scale items with the scale sub-dimensions was at the level of r = 0.509, which demonstrated that there was a sufficient validity level of the Turkish translated questionnaire scale. A statistically significant direct correlation at a high level was seen between the pre and post points in all the scale sub-dimensions. Conclusions The results of the current study showed that Turkish version of the questionnaire had sufficient reliability and validity in the evaluation of low back pain and resulting dysfunction and disability in patients with LDH and narrowing of the lumbar canal.
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- 2016
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19. What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists (ASA) class III patients with femoral neck fractures? Cemented or cementless
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Hakan Çiçek, Hasan Ulaş Oğur, Levent Öztürk, Kasım Kılıçarslan, Erkan İnkaya, and Fırat Seyfettinoğlu
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Male ,medicine.medical_specialty ,Time Factors ,Turkey ,Class iii ,Severity of Illness Index ,Femoral Neck Fractures ,Group B ,law.invention ,Risk Factors ,law ,Intensive care ,medicine ,Humans ,Stage (cooking) ,Cementation ,Aged ,Retrospective Studies ,General Environmental Science ,Femoral neck ,business.industry ,Bone Cements ,Intensive care unit ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Radiological weapon ,Practice Guidelines as Topic ,General Earth and Planetary Sciences ,Female ,Hemiarthroplasty ,business ,Follow-Up Studies - Abstract
The hypothetical basis of this trial specifies that hemiarthroplasty applications without cement will prove to be superior to applications with cement in terms of survival, complications, clinical and radiological improvements in the early stages of femoral neck fracture cases, which belongs to the Society of Anesthesiologists (ASA) class III group. Society of Anesthesiologists (ASA) class III elderly patients (minimum 70 years of age), who had undergone surgical interventions for femoral neck fractures were classified into two groups as those undergoing the intervention without cement (Group A) and those undergoing the procedure with cement (Group B), and these were retrospectively evaluated. The patients were followed up for a mean duration of 47.4 and 44.8 months, respectively. Survival in the early stage, duration of stay in the intensive care, intraoperative cardiac indexes, complications, clinical and radiological parameters were the main factors used in the evaluation and comparisons. The mean duration of operation in Group B cases was determined to be statistically significantly longer than that of Group A (p
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- 2015
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20. Simultaneous Disruption of the Pubic Symphysis and Sacroiliac Joint during Vaginal Birth
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Hakan Çiçek, H. Levent Keskın, Hasan Ulaş Oğur, Kasım Kılıçarslan, and Ümit Tuhanioğlu
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musculoskeletal diseases ,Sacroiliac joint ,medicine.medical_specialty ,business.industry ,Vaginal birth ,Vaginal delivery ,medicine.medical_treatment ,Pubic pain ,Case Report ,Pubic symphysis ,General Medicine ,medicine.disease ,Bed rest ,Surgery ,body regions ,lcsh:RD701-811 ,medicine.anatomical_structure ,lcsh:Orthopedic surgery ,Diastasis ,medicine ,business ,Complication - Abstract
Background. Puerperal diastasis of the pubic symphysis is a rare intrapartum complication. This report presents the case of a woman who experienced synchronous pubic symphysis and sacroiliac joint separations induced by vaginal delivery.Case. A 32-year-old woman (gravida 2, parity 2) with an uncomplicated prenatal course developed acute-onset anterior pubic pain during vaginal delivery. The pain persisted postpartum and was exacerbated by leg movement. Physical and radiographic examinations showed a pubic symphyseal separation of 2.4 cm, accompanied by a 10 mm disruption of the left sacroiliac joint. The patient was treated conservatively with pain-relief medication; bed rest, mostly in the left lateral decubitus position; closed reduction and application of a pelvic binder; use of a walker; and physical therapy.Conclusion. The patient responded to conservative management. She was essentially pain-free and regained movement and ambulation by 12 weeks postpartum.
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- 2015
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21. Determination of structural femoral head allograft viability and integrity with a novel diagnostic tool: SPECT/CT. A preliminary study
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Kasım Kılıçarslan, Şeyda Türkölmez, Izzet Bingol, Elif Özdemir, Nadir Yalcin, and Vedat Biçici
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Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Femoral head ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Aged ,Retrospective Studies ,Tomography, Emission-Computed, Single-Photon ,030222 orthopedics ,business.industry ,Retrospective cohort study ,Acetabulum ,Femur Head ,Middle Aged ,Allografts ,Arthroplasty ,Prosthesis Failure ,medicine.anatomical_structure ,Fresh frozen ,Surgery ,Female ,Hip Joint ,Radiology ,Tomography ,Range of motion ,business ,Tomography, X-Ray Computed - Abstract
Objective To evaluate the viability and integrity of fresh frozen bulk femoral head allografts obtained from the institutional bone bank that were used to reconstruct severe acetabular defects and to validate the SPECT/CT method which gives both anatomical and functional data for this purpose. Methods We retrospectively reviewed 9 patients (6 female, 3 male; mean age 63.6 years). Preoperative and postoperative leg lengths, existence of the Trendelenburg sign, range of motion of the hip, visual analogue score (VAS), Harris Hip Score (HHS) and any complication were assesed at each follow-up. Radiographically, position of the cup, signs of loosening or migration, and union of the graft were all determined. At the latest follow-up, patients were evaluated with hybrid SPECT/CT. Results The average duration of follow-up was 38.1 months (24-50 months). The overall mean HHS and VAS scores were significantly improved (pConclusions Institutional bank allografts are still excellent options for treating large acetabular defects in revision total hip arthroplasty where trabecular metals are not available or in common use. The Hybrid SPECT/CT method is a reliable, noninvasive method for evaluating both the integrity and viability of a bulk graft in 3-D.
- Published
- 2017
22. Nondrainage Decreases Blood Transfusion Need and Infection Rate in Bilateral Total Knee Arthroplasty
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Hakan Şeşen, İsmail Demirkale, Kasım Kılıçarslan, Metin Doğan, Osman Tecimel, and Murat Altay
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Male ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Total knee arthroplasty ,Postoperative Hemorrhage ,Suction ,Infections ,Pneumatic tourniquet ,Humans ,Medicine ,Blood Transfusion ,Orthopedics and Sports Medicine ,Arthroplasty, Replacement, Knee ,Aged ,Retrospective Studies ,Aged, 80 and over ,Tourniquet ,business.industry ,Retrospective cohort study ,Middle Aged ,equipment and supplies ,Infection rate ,Surgery ,body regions ,surgical procedures, operative ,Hemostasis ,Anesthesia ,Female ,business ,Bandage - Abstract
This retrospective study enrolled 526 patients undergoing bilateral total knee arthroplasties at our institution. In nondrainage group (Group 1) of 255 patients (510 knees), a disposable elastic sterile exsanguination tourniquet (HemaClear), wound closure in layers and Jones Bandage, without pre-tourniquet removal hemostasis or Hemovac drain were used. In drainage group (Group 2) of 227 patients (454 knees), pneumatic tourniquet, post-deflation hemostasis, a Hemovac drain and Jones bandage were used. The maximal drop in hemoglobin was significantly greater in Group 2 than Group 1 (P0.001). Also infection rate was significantly lower in Group 1 (P = 0.017). The use of sterile tourniquet removed after wound closure without Hemovac drain decreases blood transfusion need, infection rate, tourniquet related pain and postoperative complications.
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- 2014
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23. Crowe Type I and II Ddh Managed by Large Diameter Metal-on-Metal Total Hip Arthroplasty
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Nadir Yalçın, Kasım Kılıçarslan, Hasan Yildirim, Çetin Kayaalp, and Hakan Cicek
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Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Time Factors ,Arthroplasty, Replacement, Hip ,Context (language use) ,Prosthesis Design ,Lower risk ,Osteoarthritis, Hip ,medicine ,Humans ,Orthopedics and Sports Medicine ,Large head ,Retrospective Studies ,Fixation (histology) ,business.industry ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Dysplasia ,Harris Hip Score ,Metal-on-Metal Joint Prostheses ,Female ,Hip Prosthesis ,business ,Range of motion ,Follow-Up Studies ,Total hip arthroplasty - Abstract
Large bearing metal-on-metal (MOM) total hip arthroplasty (THA) may offer advantages relating to stability and range of motion in patients with Crowe Type I and II developmental dysplasia of the hip (DDH). The purpose of this study was to provide an analysis of the clinical and radiological results of MOM THA in this context and compare the results with a cohort of patients treated with metal-on-polyethylene (MOP) bearing surfaces. 75 hips in 65 patients were treated with cementless MOM THA using large femoral heads (36–56 mm). The mean age of the patients was 47.4 years (29 to 59) and 54 were female. A group of 47 hips (41 patients) treated with conventional THA (screwed cup-polyethylene insert-28mm head) was used for comparison. The study group was followed up for a mean of 62.1 months (32 to 76). No difference was found between the two groups in relation to improvement in Harris hip score (HHS) (43.1 to 90.3 points in the study group, 42.6 to 89.5 points in the control group, p>0.05). Although the preoperative range of motion in all planes were similar in both groups, the large head group demonstrated greater motion in all planes postoperatively, which was significant (all p=0.001). Additionally, there was a significant difference between groups in relation to the necessity for acetabular structural graft (8% and 31.9%, respectively; p=0.001). No major complications or adverse reactions to metal debris (ARMD) were observed in the study group. The results of large head MOM THA in young and active patients with DDH are similar to conventional THA at early follow-up, but the former offers the advantages of secure acetabular fixation without screws, greater range of motion, and lower risk of dislocation.
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- 2011
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24. The effect of total synovectomy in total knee arthroplasty: a prospective randomized controlled study
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Kasım Kılıçarslan, Hamdi Ozkan, Yunus Dogramaci, Mahmut Uğurlu, Hakan Cicek, Nadir Yalçın, and Hasan Yildirim
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Male ,musculoskeletal diseases ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Blood Loss, Surgical ,Total knee arthroplasty ,Synovectomy ,Osteoarthritis ,Risk Assessment ,Severity of Illness Index ,Statistics, Nonparametric ,law.invention ,Postoperative Complications ,Randomized controlled trial ,Reference Values ,law ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Range of Motion, Articular ,Arthroplasty, Replacement, Knee ,Aged ,Pain Measurement ,Aged, 80 and over ,Postoperative Care ,business.industry ,Recovery of Function ,Middle Aged ,Osteoarthritis, Knee ,Hemarthrosis ,medicine.disease ,Combined Modality Therapy ,Arthroplasty ,Surgery ,Radiography ,Treatment Outcome ,Orthopedic surgery ,Female ,business ,Follow-Up Studies - Abstract
The apparent synovial hypertrophy in some cases of noninflammatory knee osteoarthritis suggests that total synovectomy may provide beneficial inflammatory and pain relief after total knee arthroplasty. The aim of the study was to compare the effect of synovectomy on the postoperative pain, bleeding and functional outcome after surgical treatment of knee osteoarthritis. A total of 50 patients with bilateral, non inflammatory, primary knee osteoarthritis were included in the study. Bilateral total knee replacement was performed at the same session. Total synovectomy and total knee arthroplasty (study group) were applied to a randomly selected side, and the total knee arthroplasty alone (as control group) was applied to the contralateral side of the same patient. The overall efficacy of both procedures was assessed postoperatively by determination of blood loss from the drain, pain and functional scores. The Visual Analogue Scale of pain and the Knee Society Knee Score were used to compare the two groups at 3rd, 6th and 12th months, postoperatively. During the postoperative 48 h, the mean blood loss in the study group (with synovectomy) was significantly higher than the control group (P = 0.005). However, in the postoperative follow-up time, there was no significant difference in pain relief and in the Knee Society Score between the two groups. Performing synovectomy in patients with primary knee osteoarthritis does not seem to have any clinical advantage besides it might increase blood loss and recurrent hemarthrosis postoperatively. Thus, during arthroplasty surgery, it should not be performed routinely.
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- 2010
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25. Hoffa fracture, eminentia fracture and posterior cruciate ligament damage: An unusual knee injury
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Kasım Kılıçarslan, Tughan Kalkan, Ali Ocguder, Mahmut Uğurlu, and Murat Bozkurt
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Orthodontics ,medicine.anatomical_structure ,business.industry ,Posterior cruciate ligament ,Emergency Medicine ,Fracture (geology) ,medicine ,Surgery ,Orthopedics and Sports Medicine ,Knee injuries ,business - Published
- 2008
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26. How do different designs of femoral stem affect total hip arthroplasty applied to Crowe type III and type IV dysplastic hips
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Hakan Çiçek, Nadir Yalçın, Ümit Tuhanioğlu, Kasım Kılıçarslan, and Tansel Mutlu
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Nonunion ,Osteoarthritis ,Osteotomy ,Prosthesis Design ,Osteoarthritis, Hip ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Hip Dislocation ,Humans ,Orthopedics and Sports Medicine ,Retrospective Studies ,Hip surgery ,Hip dysplasia ,030222 orthopedics ,business.industry ,030229 sport sciences ,Middle Aged ,medicine.disease ,Arthroplasty ,Surgery ,Treatment Outcome ,Harris Hip Score ,Dysplasia ,Female ,Hip Prosthesis ,business - Abstract
Purpose A comparison was made of the clinical and radiological results of cylindrical fully porous-coated femoral stems (Group A) and Zweymüller-type femoral stems (Group B) used for the treatment of hip osteoathrosis, secondary to Crowe III and IV dysplasia, with total hip arthroplasty combined with femoral transverse shortening osteotomy. Method This study is a retrospective evaluation of 86 hips in 50 patients. Group A comprised of 43 hips and Group B comprised of 43 hips. During final follow-up evaluation, patients were clinically assessed with Harris Hip Score (HHS), Merle d'Aubigne-Postel scale (MAP), and SF-36 scale. For radiological examination the Gulman THA score was used. Femoral osteotomy union, osteolysis around the components and component migration were also recorded and evaluated. Results In Group B, nonunion of the osteotomy site was found in 18.6% and delayed union in 20.9% of the hips. In Group A, delayed union was found in 7% of the hips. Patients’ mean daily walking distance was found to be lower in Group A when compared to Group B. When the postoperative clinical HSS, and MAP and the radiological Gulman scores were compared, no statistically significant differences (p = 0.275) were found. Conclusions Patients with hip osteoarthritis secondary to Crowe III and IV dysplasia, who were treated with THA and transverse osteotomy showed a higher incidence of osteotomy complications when the Zweymüller femoral stem was used. However, these complications did not affect clinical outcomes.
- Published
- 2016
27. Immunohistochemical analysis of mechanoreceptors in transverse acetabular ligament and labrum: a prospective analysis of 35 cases
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Aydan Kilicarslan, Mahmut Uğurlu, Kasım Kılıçarslan, Mehmet Atıf Erol Aksekili, İsmail Demirkale, and Mahmut Nedim Aytekin
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Male ,Pathology ,medicine.medical_specialty ,Arthroplasty, Replacement, Hip ,Osteoarthritis ,Osteoarthritis, Hip ,Vascularity ,Transverse acetabular ligament ,Health Care Sciences and Services ,Koksartroz ,labrum ,mekanoreseptör ,transvers asetabular ligament ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Sağlık Bilimleri ve Hizmetleri ,Aged ,High-power field ,Hip surgery ,Labrum ,urogenital system ,business.industry ,Acetabulum ,General Medicine ,Anatomy ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Ligaments, Articular ,Female ,Hip Joint ,Surgery ,medicine.symptom ,Coxarthrosis,labrum,mechanoreceptors,transverse acetabular ligament ,business ,Mechanoreceptors ,Free nerve ending - Abstract
Objective: The labrum and transverse acetabular ligament (TAL) are classically described as distinct anatomical structures with abundant mechanoreceptors and free nerve fibers. They deepen the joint and act as natural barriers against dislocation, thus providing additional stability. We hypothesized that severe coxarthrosis leads to elimination of labrum and TAL mechanoreceptors. This study evaluated the microscopic anatomy of the labrum and TAL and specifically investigated the neurological status of these structures.Methods: Labral and TAL specimens from 35 consecutive patients with coxarthrosis undergoing total hip arthroplasty were dissected into a total of 4 specimens per hip. Formaldehyde-fixed specimens were evaluated for the presence of mechanoreceptors and free nerve endings by neurofilament protein and S-100 protein immunohistochemistry and microscopy.Results: Mechanoreceptors were identified in the labral (2.3/high power field) but not TAL specimens, with a sharp delineation between the tissues. In contrast, both labrum and TAL showed good vascularity with abundant free nerve fibers within fibrous connective tissue (mean, 2.6 sensory fibers/high power field vs 3.1/high power field, respectively).Conclusion: This study demonstrated that the TAL lacks mechanoreceptors. However, TAL and labrum free nerve fibers suggest potential roles as hip pain generators., Amaç: Klasik literatürde labrum ve transvers asetabular ligament (TAL), bol miktarda mekanoreseptör ve serbest sinir lifleri içeren özel anatomic yapılar olarak tanımlanmıştır. Eklemi derinleştirirler ve çıkığa karşı doğal bir bariyer vazifesini üstlenerek stabiliteye katkıda bulunurlar. Hipotezimize göre, ciddi koksartroz labrum ve TAL’daki mekanoreseptörleri yok etmektedir. Bu çalışmanın amacı, labrum ve TAL’ın nörolojik yapısını immünohistokimyasal analizle inceleyerek söz konusu yapıların mikroskopik anatomisini değerlendirmektir.Çalışma planı: Koksartroz nedeniyle total kalça artroplastisi yapılan ardışık otuz beş hastanın kalçalarından dörder numune halinde labrum ve TAL örnekleri diseke edilmiştir. Formaldehitle tespit edilen örnekler, Mihalko tarafından tanımlanan immünohistokimyasal analiz yöntemiyle mekanoreseptör ve serbest sinir ucu varlığı yönünden değerlendirilmiştir.Bulgular: TAL örneklerinde mekanoreseptör bulunamamış olup, labrum ve TAL’da fibröz bağ dokusunun iyi damarlanmış olduğu ve bolca serbest sinir ucu içerdiği gözlenmiştir (sırasıyla ortalama 2.6 duyu lifi/hpf ve 3.1 duyu lifi/hpf ). Labrumda ortalama 2.3 mekanoreseptör/hpf bulunmakta olup, mekanoreseptör yoğunluğu değerlendirildiğinde labrum ve TAL arasında keskin bir fark bulunmaktadır.Çıkarımlar: Bu çalışmadaki bulgular, TAL’ın mekanoreseptörden yoksun olduğunu göstermektedir. Ancak, TAL ve labrumda bulunan serbest sinir uçlarının, kalça ağrısının oluşumunda potansiyel bir rolü olduğunu düşündürmektedir
- Published
- 2015
28. Minimally Invasive Percutaneous Plate Osteosynthesis Does Not Increase Complication Rates in Extra Articular Distal Tibial Fractures
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Kaan Yüksel, Tolga Tulunay, Kasım Kılıçarslan, Nadir Yalçın, Vedat Biçici, and Izzet Bingol
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medicine.medical_specialty ,Percutaneous ,business.industry ,Callus formation ,Soft tissue ,Retrospective cohort study ,Metaphysis ,medicine.disease ,Article ,law.invention ,Surgery ,Intramedullary rod ,Diaphysis ,medicine.anatomical_structure ,law ,Minimal invasive surgery ,medicine ,treatment outcome ,Malunion ,tibial fractures ,business - Abstract
Background : Selection of a treatment method in cases of unstable, nonarticular distal tibial fractures is still a matter of discussion. Intramedullary nailing, which is a “gold standard” for tibial shaft fractures, does not always work for this specific transition area between diaphysis and metaphysis. Instead, new minimally invasive techniques with special implants are popular. Aims : To determine the functional and radiological results of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Study Design : Retrospective cohort analysis. Methods : Thirty distal tibial fractures treated with MIPPO method, between January 2006 and December 2010, were evaluated retrospectively. All patients were classified according to AO/OTA classification. Period of hospital stay, time of fracture union, time to allow full weight bearing, early and late complications were inquired. Functional outcomes were assessed by AOFAS scores. Results : There were 13 male and 17 female patients with an average age of 44.26 (range, 22-77 years). One superficial infection and one malunion were observed. Two patients were revised for the loss of reduction and healed uneventfully. According to the AO/OTA classification, 23 patients were 43-A1 (76.6%), 3 were 43-A2 (10%) and 4 were 43-A3 (13.3%). Post-operative mean stay of patients at the hospital was 2.6 ± 1.42 days (range, 1-7 days). Mean full weight-bearing period of the patients was found out as 13.16 ± 2.6 weeks (range, 10-22 weeks). The mean period of union of fracture for patients was found out as 19.8 ± 2.99 weeks (range, 16-34 weeks). Conclusion : Treatment of distal tibial fractures with MIPPO method provides a successful treatment strategy as long as used as per the technique, and it respects and does not harm soft tissues which allows early callus formation and rapid healing that enable the patient to walk as early as possible after the operation. The overall clinical and functional outcome is still good despite minor complications.
- Published
- 2015
29. Bone Pathology: Osteopoikilosis
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Cheikh Moustapha Mohamed Lemine, Tolga Tolunay, Arslan Kaan Arslan, Mehmet Eren, Kasım Kılıçarslan, Vedat Biçici, and Izzet Bingol
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medicine.medical_specialty ,Dysplasia ,business.industry ,Radiological weapon ,Radiography ,Bone pathology ,medicine ,Osteopoikilosis ,Radiology ,medicine.disease ,Sclerotic bone ,business ,Left ankle - Abstract
Osteopoikilosis is a rare benign sclerotic bone dysplasia. The disease which usually develops asymptomatically is coincidentally diagnosed with direct radiographs. Our subject, a 52-year-old male was admitted to our policlinic two days ago due to turning of his left ankle causing pain and swelling on his left ankle. We asked for bilateral direct radiograph of left ankle. The left ankle radiograph indicates multiple, small oval/round hyperdense sclerotic regions. As a result of available clinical finding and radiological viewing, the patient was diagnosed with osteopoikilosis.
- Published
- 2013
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30. Konservatif Tedaviye Dirençli Koksidinili Olgularda Cerrahi Tedavinin Etkinliği
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Nadir Yalçın and Kasım Kılıçarslan
- Published
- 2012
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31. Free coracoacromial ligament graft for augmentation of massive rotator cuff tears treated with mini-open repair
- Author
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Ali Ocguder, Nadir Yalçın, Bulent Bektaser, Sukru Solak, Emel Gonen, and Kasım Kılıçarslan
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Adult ,medicine.medical_specialty ,Coracoacromial ligament ,Shoulder flexion ,Rotator cuff,coracoacromial ligament,massive rotator cuff tears,surgery ,Rotator Cuff ,Health Care Sciences and Services ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedic Procedures ,Orthopedics and Sports Medicine ,Rotator cuff ,Sağlık Bilimleri ve Hizmetleri ,Aged ,Rupture ,Mini open ,business.industry ,Dissection ,Suture Techniques ,Mean age ,General Medicine ,Middle Aged ,Plastic Surgery Procedures ,Tendon ,Surgery ,medicine.anatomical_structure ,Ligaments, Articular ,Tears ,Female ,Ultrasonography ,business - Abstract
Objectives: Repair of massive rotator cuff tears is a challenging and complex procedure. The tissue at the end of the torn tendons is often friable and weak, because ruptures are old and degenerated, and thus the ends must be sutured effectively and strongly to achieve a satisfactory outcome. We aimed to evaluate the effectiveness of free total or partial coracoacromial ligament (CAL) graft to protect and augment the repair of massive rotator cuff tears.Methods: Forty six patients ((32 females, mean age 54.3 years (range 39-66 years)) operated for massive rotator cuff tears between January 2003 and June 2009 were included in the study. Twenty nine of these patients had right-sided tears, and 17 had left-sided tears. Fifteen of the tears were 3-4 cm wide (mean 3.5 cm); 27 were >4 cm wide (mean 4.5 cm), and 4 were >5 cm wide. The mean follow-up period was 26 months (range 16-52 months). Patients were operated with a mini-open technique, and reconstructed after primary repair with 18 total and 28 partial free transfer of the CAL. Patients were evaluated by Constant-Murley score, and the degree of active flexion and abduction. Tendon thickness was measured with ultrasonography during follow-up.Results: Mean preoperative shoulder flexion was 27.5° (range 5-40°), and mean abduction was 22.5° (range 10-30°). Shoulder flexion was significantly greater postoperatively (mean 102.6°, range 70-150°), as was shoulder abduction (mean 96.5°, range 60-150°). Mean preoperative and postoperative Constant-Murley score was 45 and 80, respectively. Surgical complications, particularly recurrence, did not occur in any patient during the follow-up period. The integrity and tendon thickness of the repairs were similar to those of normal tendons at the end of follow-up.Conclusion: Augmentation with a free transfer of the coracoacromial ligament provides excellent and promising functional results in the operative treatment of massive rotator cuff tears witha mini-open technique.
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- 2014
32. The effect of the Tscherne injury pattern on the outcome of operatively treated Lisfranc fracture dislocations
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Kasım Kılıçarslan, Ali Ocguder, İsmail Çelik, Osman Tecimel, Metin Doğan, and İsmail Demirkale
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Adult ,Male ,medicine.medical_specialty ,Activities of daily living ,Time Factors ,medicine.medical_treatment ,Bone Screws ,Joint Dislocations ,Osteoarthritis ,Tarsal Joints ,Fracture Fixation, Internal ,Fractures, Bone ,Young Adult ,Medicine ,Internal fixation ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Reduction (orthopedic surgery) ,Metatarsal Bones ,Retrospective Studies ,Lisfranc injury ,business.industry ,Soft tissue ,Recovery of Function ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Soft tissue injury ,Female ,Ankle ,business ,Follow-Up Studies - Abstract
Lisfranc fracture dislocations cause severe tarso-metatarsal malalignment. The research question of this study was to evaluate the severity of the soft tissue injury on the final clinical outcome and compare that with the effect of various determinants on the disability in daily living activities after open reduction and internal fixation of a Lisfranc injury.This study consisted of a retrospective analysis of patients with Lisfranc fracture dislocations who were treated by open reduction and internal fixation beween 2004 and 2009. Evaluation focused mainly on the severity of the soft tissue injury, age, fracture classification, time to operation, posttraumatic osteoarthritis, and the results were compared with American Foot and Ankle Society (AOFAS) scores, and Foot and Ankle Disability Index (FADI). Eight patients had Tscherne Grade 1, 13 had Grade 2, and 11 had Grade 3 soft tissue injuries. Myerson classification revealed 11 type A, 8 type B and 13 type C fractures. Six patients' operations were delayed beyond 8h.Of the 38 patients treated in the study period, 32 patients (11 female, 21 male;30 y-old: 14,30 y-old: 18) were available for complete follow-up (average, 55.5 months). The comparison of treatment results revealed that those patients with high grade soft tissue injuries had lower AOFAS and FADI scores (43.8±15.9, 53.7±9.4, respectively) when compared to Tscherne Grade 1 injuries (82.8±6.1, 109±13.9, respectively) (p0.001). The overall negative impact of the severity of soft tissue injury on functional outcomes had similar significance with regard to post-traumatic osteoarthritis, and fracture type. There was also a statistically significant difference between outcome measures and post-reduction quality (p=0.002). Patient age (p=0.9) and delayed surgery (p=0.5) had no statistically significant effect on the final outcome.Satisfactory results can be achieved with open reduction for Lisfranc injuries. However, despite this treatment, both the severity of the soft tissue injury and non-anatomic reduction are negative prognostic factors in the treatment of Lisfranc fracture dislocations.
- Published
- 2012
33. What Happens at the Adjacent Knee Joint After Total Hip Arthroplasty of Crowe Type III and IV Dysplastic Hips?
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Hakan Cicek, Erdal Cila, Kasım Kılıçarslan, Nadir Yalçın, and Hasan Yildirim
- Subjects
Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Knee Joint ,Arthroplasty, Replacement, Hip ,medicine.medical_treatment ,Medial Collateral Ligament, Knee ,Iliotibial tract ,Genu Valgum ,Fascia lata ,Prevalence ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Postoperative Period ,Prospective Studies ,Hip Dislocation, Congenital ,Reduction (orthopedic surgery) ,Aged ,Retrospective Studies ,Hip dysplasia ,Medial collateral ligament ,business.industry ,Anatomy ,Middle Aged ,medicine.disease ,Arthralgia ,Arthroplasty ,Biomechanical Phenomena ,Surgery ,Radiography ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Hip Joint ,business - Abstract
We prospectively evaluated 30 hips of 22 patients who had normal knees with a mean age of 53.4 years (range, 38-72 years). In the early postoperative period, genu valgum deformity was observed in all knees. Of 22 patients, 17 complained of severe pain owing to strain in the medial collateral ligament and iliotibial tract. Postoperatively, the ipsilateral extremities of the patients were extended by a mean of 16.5 mm (8-25 mm). Q angles of the patients increased by a mean of 4.4 degrees +/- 2.5 degrees (P < .001). Although the Harris hip scores were improved (40.7-87.8 points), postoperative Lysholm-Gillquist knee scores were significantly reduced (92-76 points, P < .001). Reduction of displaced hips into the anatomical hip center and lengthening the extremity despite shortening procedure may lead to strain at the knee joint iatrogenically, particularly with the mechanical effect of tensor fascia lata, which results with changes in the knee biomechanics.
- Published
- 2012
34. [Ultrasonographic measurement of the effect of rotatory cuff repair with coracoacromial ligament transfer on humeral head migration]
- Author
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Süleyman Bülent, Bektaşer, Nadir, Yalçın, Durmuş Ali, Oçgüder, Ali, Ipek, Hasan Uluş, Oğur, Kasım, Kılıçarslan, and Temel, Oğuz
- Subjects
Adult ,Male ,Rupture ,Middle Aged ,Arthroplasty ,Rotator Cuff ,Treatment Outcome ,Shoulder Impingement Syndrome ,Ligaments, Articular ,Humeral Head ,Humans ,Female ,Range of Motion, Articular ,Aged ,Ultrasonography - Abstract
In this study we evaluated whether ligament transfer caused humeral head migration in patients whose massive rotator cuff ruptures were repaired with total or partial coracoacromial ligament (CAL) transfer. The necessity of harvesting the ligament totally or partially in massive rotator cuff repairs was investigated with respect to the effect of the excision and transfer of the CAL on humeral head migration.Forty patients (12 males, 28 females; mean age 54.3 years; range 39 to 66 years) operated on with free CAL transfer for massive rotator cuff rupture between January 2003 and June 2008 were included in the study. The operations were performed by obtaining total CAL grafts in the first 13 cases and partial CAL grafts in the other 27 cases. Mean follow-up period was 26.5 months (range 12 to 52 months). Twenty-nine patients had the rupture on the right side and 11 patients had the rupture on the left side. In 31 patients the dominant side was affected.In the early postoperative period (3-6 weeks) adequate acromiohumeral (AH) distance could not be obtained in patients underwent total excision and transfer of CAL (mean 9 mm; range 8.6 to 9.2 mm). Humeral migration was found to be regressed three months after active motion and recovery of normal cuff strength. During the follow-up the mean AH distance was found to be 10 mm (range 8 to 10.5 mm). Humeral head migration was not detected by ultrasonography in the early postoperative period in patients who underwent repair with partial CAL transfer.Functionally good results have been obtained in the rotatory cuff repairs performed by CAL excision and transfer. Although humeral head migration was not detected ultrasonographically in the patients who had partial CAL excision and transfer at the early postoperative period, we observed a decrease in the AH distance in the patients who had total CAL excision and transfer. This migration was regressed and the cuff strength was recovered after intense rehabilitation with strengthening exercises and active motion.
- Published
- 2011
35. Cementless total hip arthroplasty for dysplastic and dislocated hips
- Author
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Kasım, Kılıçarslan, Nadir, Yalçın, Fuat, Karataş, Faruk, Catma, and Hasan, Yıldırım
- Subjects
Adult ,Male ,Young Adult ,Patient Satisfaction ,Arthroplasty, Replacement, Hip ,Hip Dislocation ,Humans ,Female ,Middle Aged ,Aged ,Retrospective Studies - Abstract
We evaluated the clinical and radiographic results of exclusively the same type and standard sized cementless total hip prostheses applied to all dysplastic and dislocated hips.In this study, we retrospectively reviewed 69 patients' (63 females, 6 males; mean age 45.6 years; range 20 to 72 years) 103 dysplastic or dislocated hips on which cementless total hip arthroplasty was performed between January 1998 and January 2006. The mean duration of follow-up was 7.2 years (range 2.0-10.1 years). Eighteen hips (17%) were type I, 29 hips (28%) were type II, 23 hips (22%) were type III and 33 hips (32%) were type IV according to the Crowe classification. Functional and clinical analyses were performed by Harris hip scores. At the last follow-up, the patients were asked whether they were satisfied or not after the operation.The average preoperative Harris hip score of 39.3 was progressed to 89.5 at the latest follow-ups (p0.001). Sixty patients (86.9%) reported that they were satisfied after surgery. We observed 41 (39.8%) complications in total, nine of which were intraoperative. There were no findings of symptomatic septic or aseptic loosening at the latest follow-ups.Cementless total hip arthroplasty is an effective procedure for developmental dysplastic and dislocated hips.
- Published
- 2011
36. Cementless total hip arthroplasty with subtrochanteric transverse shortening osteotomy for severely dysplastic or dislocated hips
- Author
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Fuat Karatas, Kasım Kılıçarslan, Nadir Yalcin, Hasan Yildirim, and Tansel Mutlu
- Subjects
musculoskeletal diseases ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Arthroplasty, Replacement, Hip ,Osteotomy ,Severity of Illness Index ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Medicine ,Internal fixation ,Hip Dislocation ,Humans ,Orthopedics and Sports Medicine ,Femur ,Displacement (orthopedic surgery) ,030212 general & internal medicine ,Hip Dislocation, Congenital ,Hip dysplasia ,030222 orthopedics ,business.industry ,Middle Aged ,medicine.disease ,Neurovascular bundle ,Arthroplasty ,Surgery ,Female ,Implant ,business - Abstract
Total hip arthroplasty in dislocated developmental hip dysplasia is a complex, technically demanding procedure with high complication rates. Anatomic abnormalities and the young age of the patients influence the results. Restoration of the anatomic hip center often requires shortening of the femur in order to avoid over-stretching of neurovascular structures.We performed cementless total hip arthroplasty with subtrochanteric transverse osteotomy on 44 hips in 31 patients. There were 29 female and 2 male patients. The average age at the time of the operation was 43.2 (range, 22–63 years) and the mean follow up period was 62 months (range, 24–96 months). Harris hip scores improved from 36.2 to 81.2 with good and excellent results in 79.5% of the patients. We stabilized the osteotomy line with low contact plates and screws primarily on 10 hips when rotational stability was in doubt. In the other hips, good initial rotational stability was obtained by the femoral component. However, we observed 5 nonunions in patients whose osteotomies were not stabilized with plates. These patients were later treated succesfully with internal fixation and autogenous bone grafting. The osteotomies healed at a mean time of 4 months (range, 2.5–14 months).Postoperatively two dislocations, one acetabular component displacement under the structural bone autograft and two superficial infections were seen. There were no cases of symptomatic loosening, deep infection, or neurovascular injury.Subtrochanteric transverse osteotomy is a versatile, relatively easy and reliable method for shortening the femur when performing cementless total hip arthroplasty in hip dysplasia cases. This technique makes it possible to implant standard sized cementless femoral stems. When necessary, tortional stability may further be augmented with a plate and screws.
- Published
- 2009
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