Browsing by Author "Karaytug, Kayahan"

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Factors Leading to Re-revision Surgery Following the Index Total Hip Arthroplasty Revision: Mid-Term Results
(BEZMIALEM VAKIF UNIV, 2019-01-01) Dikmen, Goksel; Ozden, Vahit Emre; Karaytug, Kayahan; Tozun, I. Remzi
Objective: The aim of this study was to evaluate the factors that led to re-revision surgeries in patients who underwent revision total hip arthroplasties (THA). Methods: A total of 352 revision THAs in 274 hips of 252 patients (January 2001-December 2012) were retrospectively analyzed. Patients with a history of a major component revision surgery, replacement of the modular components, debridement and irrigation with liner exchange in the presence of infection and a two-stage revision surgery were included in the study. The mean follow-up period after the revision surgery was 7.5 (range: 2 to 15) years. Results: A re-revision surgery was required in 17.6\% of the index THA revision patients (62 THA re-revisions/352 THA revisions). The mean time between the index revision and re-revision surgeries was 60.4 (range: 0.5 to 348) months. The most common reason for the second revision surgery was aseptic loosening (38 THA revisions
Trends in the treatment of infected knee arthroplasty
(BRITISH EDITORIAL SOC BONE \& JOINT SURGERY, 2020-01-01) Tozun, Ismail Remzi; Ozden, Vahit Emre; Dikmen, Goksel; Karaytug, Kayahan
Essential treatment methods for infected knee arthroplasty involve DAIR (debridement, antibiotics, and implant retention), and one and two-stage exchange arthroplasty. Aggressive debridement with the removal of all avascular tissues and foreign materials that contain biofilm is man datory for all surgical treatment modalities. DAIR is a viable option with an acceptable success rate and can be used as a first surgical procedure for patients who have a well-fixed, functioning prosthesis without a sinus tract for acute-early or late-hematogenous acute infections with no more than four weeks (most favourable being < seven days) of symptoms. Surgeons must focus on the isolation of the causative organism with sensitivities to bactericidal treatment as using one-stage exchange. One-stage exchange is indicated when the patients have: 1. minimal bone loss/soft tissue defect allowing primary wound closure, 2. easy to treat micro-organisms, 3. absence of systemic sepsis and 4. absence of extensive comorbidities. There are no validated serum or synovial biomarkers to determine optimal timing of re-implantation for two-stage exchange. Antibiotic-free waiting intervals and joint aspiration before the second stage are no longer recommended. The decision to perform aspiration should be made based on the index of suspicion for persistent infection. Re-implantation can be performed when the treating medical team feels that the clinical signs of infection are under control and serological tests are trending downwards.
UNNOTICED ETIOLOGY IN ORTHOPEDIC COMPLAINTS : CHRONIC MOUNTAIN SICKNESS
(ISTANBUL UNIV, FAC MEDICINE, PUBL OFF, 2022-01-01) Karaytug, Kayahan; Ekinci, Mehmet; Yucekul, Altug
Objective: Chronic mountain sickness (CMS) is a clinical syndrome with symptoms of polycythemia that may interfere with other nonspecific diseases. The current study aimed to investigate the symptoms of patients living at high altitudes, who initially presented complaints that seemed to be common orthopedic problems, and to examine their relationship with chronic mountain sickness. Materials and Methods: The prospectively collected data of 104 patients were retrospectively evaluated for serum hemo-globin (Hb) and hematocrit (Hct) levels, oxygen saturation (sO(2)), Qinghai CMS questionnaire score, alcohol and tobacco use, ``any history of acute mountain sickness, body mass index (BMI), blood pressure, heart rate, and duration of high-altitude living. Patients grouped according to the Qinghai score as healthy, mild, moderate or severe CMS. The groups were investigated in terms of parameters and demographic characteristics. Results: Of the 104 patients, 33 (31.7\%) had a mild CMS score >= 6 (28 patients, 6-10, 5 patients, 11-14 points)