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    Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2016-01-01) Ates, Ahmet; Gemalmaz, Halil Can; Deveci, Mehmet Ali; Simsek, Sezai Aykin; Cetin, Engin; Senkoylu, Alpaslan
    Objective: The aim of this study was to compare the functional and radiological outcomes of vertebroplasty and kyphoplasty in patients with osteoporotic vertebra fractures. Methods: The files of the patients who underwent vertebroplasty or kyphoplasty for osteoporotic vertebrae fractures were retrieved from the archives. Forty-three patients with complete follow-up data were included in the study group. The patients were evaluated for radiological outcomes in terms of local kyphosis angle, wedging index, compression ratio, visual analog pain scale (VAS) and Oswestry Disability Index (ODI). Results: In the study group, kyphoplasty was performed on 24 vertebrae of 22 patients (17 females, 5 males
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    Postoperative mechanical alignment analysis of total knee replacement patients operated with 3D printed patient specific instruments: A Prospective Cohort Study
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2019-01-01) Gemalmaz, Halil Can; Sariyilmaz, Kerim; Ozkunt, Okan; Sungur, Mustafa; Kaya, Ibrahim; Dikici, Fatih
    Objective: Total knee replacement (TKR) is a surgical treatment for final stage gonarthrosis. The lifespan of the prosthetic implants used in TKR surgery is a major interest for the orthopaedic research community. Previously, proper implant alignment of the implants has been advocated for longevity of the TKR surgery. Recently, patient-specific (PSI) instruments have been proposed to improve the mechanical alignment of the TKR by permitting better implant positioning over conventional TKR surgery. The aim of this study is to compare the mechanical alignment results of patients operated with PSIs and conventional instruments. Methods: Two groups of 20 patients chosen in a quasi-random manner have been compared in this study. In the first group femoral distal and tibial osteotomies were made by a PSI which was produced by the patients' computed tomography scans. All osteotomies in the control group were made with the TKR set's routine instruments by conventional means. Patients' preoperative and postoperative mechanical femorotibal angles (mFTA), femoral coronal angles (FCA), tibial coronal angles (TCA) were measured and the number of outliers which showed more than 3 degrees of malalignment were counted in both groups for comparison. Results: The average postoperative mFTA was found to be 2.09 degrees for the PSI group and in was found to be 2.84 degrees for the control which was not statistically significant. The comparison of postoperative FCA and TCA also did not show significant difference between the groups. The number of outliers showing more than 3 degrees of malalignment per group were found to be 1 out of 20 (5\%) for the PSI group and 7 out of 20 (35\%) for the control which was statistically significant. Conclusion: In this study patient-specific instrumentation provided significantly better mechanical alignment compared to conventional TKR for the frequency of outlier cases with malalignment beyond 3 degrees. PSI proved no significant difference when the groups were compared for mFTA, FCA and TCA. Our findings support that PSI may improve TKR alignment by improving the ratio of the outlier patients with marked malalignment. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.
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    Analysing the change of sagittal balance in patients with Lenke 5 idiopathic scoliosis
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2017-01-01) Ozkunt, Okan; Karademir, Gokhan; Sariyilmaz, Kerim; Gemalmaz, Halil Can; Dikici, Fatih; Domanic, Unsal
    Objective: The aim of this study was to evaluate preoperative and postoperative spinopelvic parameters and the influence of lowest instrumented vertebrae on sagittal parameters in Lenke 5 Adolescent Idiopathic Scoliosis (AIS) patients. Methods: A total of 42 patients (37 females, 5 males
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    Role of a combination dietary supplement containing mucopolysaccharides, vitamin C, and collagen on tendon healing in rats
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2018-01-01) Gemalmaz, Halil Can; Sanyilmaz, Kerim; Ozkunt, Okan; Gurgen, Seren Gulsen; Silay, Sena
    Objective: The aim of this study was to investigate the effect of mucopolysaccharide, vitamin C, and collagen supplementation on the healing of Achilles tendon in rats. Methods: Sixteen rats were separated into 2 groups. Both Achilles tendons of all rats were transected 5 mm above the insertion and repaired using a Kessler suture. After the surgical repair, the study group received the daily recommended amount of the supplement by gastric gavage, while the control group received a placebo. At the end of the third week, the animals were sacrificed. The biomechanical properties of the groups were compared with ultimate tensile strength and stiffness tests. The biological properties of the 2 groups were assessed with a histomorphometric comparison to determine the amount of collagen type I (COL1), proliferating cell nuclear antigen (PCNA), and transforming growth factor beta 1 (TGF-beta 1) expression in 3 different tissue subgroups (collagen matrix, tenocytes, and endotenon fibroblasts). Results: Analysis of histomorphometric results revealed that the rats receiving dietary supplements demonstrated a significant increase in PCNA (mean value of 86 in the control group and 168.85 in the trial group
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    Investigation of efficacy of treatment in spinal cord injury: Erythropoietin versus methylprednisolone
    (SAGE PUBLICATIONS INC, 2017-01-01) Ozkunt, Okan; Sariyilmaz, Kerim; Gemalmaz, Halil Can; Gurgen, Seren Gulsen; Yener, Ulas; Dikici, Fatih
    Background: Investigation of the expression of platelet-derived growth factor (PDGF)-beta and glial fibrillary acidic protein (GFAP) in rats with spinal cord injury as a marker of neurologic recovery between groups treated with erythropoietin (EPO) and methylprednisolone (MP). Methods: Thirty adult female rats were randomly divided into three even groups. A laminectomy was applied to thoracic ninth vertebra and contusion injury was induced by extradural application of an aneurysm clip. Group 1 rats received one-time intrathecal administration of normal saline, group 2 rats received MP, and group 3 rats received EPO. Motor neurological function was evaluated by the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale. Thirty days after the surgery, T8-10 segments of the spinal cords were extracted and the immunohistochemical assay revealed the number of PDGF-beta- and GFAP-positive cells. Results: Evaluation of the last control animal showed that BBB score in the EPO group showed an increase from 1 to 12 (p < 0.05). The immunohistochemical assay revealed that the number of PDGF-beta- and GFAP-positive cells was significantly higher in EPO group (p = 0.000) when compared to MP and control groups. After studying the effect of PDGF-beta expression on the locomotor function, we determined that PDGF-beta expression and locomotor function after a spinal injury has a strong relationship (p < 0.05). Conclusion: EPO seems to better increase the expression of PDGF-beta, thus produce better results in locomotor functions when compared to MP.