Araştırma Çıktıları
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Item Do we need to stabilize and treat the os acromiale when performing reverse shoulder arthroplasty?(ELSEVIER MASSON, CORPORATION OFFICE, 2019-01-01) Ersen, Ali; Bayram, Serkan; Atalar, Ata Can; Demirhan, MehmetIntroduction: The purpose of this study is to investigate the incidence of os acromiale in patients who had reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy and the effect of presence of os acromiale on the functional results. Hypothesis: We hypothesize than in the presence of os acromiale, the contraction strength of the deltoid would decrease due to the dynamic downward depression of the bony fragment leading to less favorable clinical results. Material and method: A total 46 patients with a mean age of 70.8 who had RSA and a minimum follow-up of 24 months were included in this study. Preoperative radiographs, computerized tomography scans and magnetic resonance images were examined to determine the presence of os acromiale. Results: A total of 10 patients out of 46 (22\%) with os acromiale, all of which were of mesoacromion type, were followed up for 59.7 months. While both groups had significant improvements in Constant, Q-DASH and VAS scores compared to their preoperative status, a significant difference between the groups could not be found. The radiological evaluation showed that the average acromiohumeral distance significantly increased postoperatively in both groups. The acromiohumeral distance was significantly shorter in patients with os acromiale. Discussion: While the presence of os acromiale does not have an adverse effect on the clinical results of the RSA, the loose fragment can migrate distally in the postoperative period due to the tension in the deltoid. (C) 2018 Elsevier Masson SAS. All rights reserved.Item Arthroscopic versus open release of internal rotation contracture in the obstetrical brachial plexus paralysis (OBPP) sequela(MOSBY-ELSEVIER, 2019-01-01) Pehlivanoglu, Tuna; Ersen, Ali; Bayram, Serkan; Atalar, Ata Can; Demirhan, MehmetBackground: Latissimus dorsi (LD) and teres major (TM) tendon transfers are effective surgical procedures to improve shoulder abduction and external rotation for children with obstetrical brachial plexus palsy (OBPP). Open pectoralis major (PM) tendon Z-plasty and arthroscopic subscapularis (SS) release are 2 options for the release of internal rotation contractures to enhance muscle transfers. This study compared the functional results of LD and TM tendon transfers with open PM tendon Z-plasty or arthroscopic SS release. Methods: The study included 24 patients who underwent LD and TM tendon transfers for OBPP (9 arthroscopic SS release, 15 open PM tendon Z-plasty) with a mean follow-up of 41.33 months (range, 3660 months) and 47.2 months (range, 36-60 months), respectively. Functional evaluation was made according to range of motion and Mallet scoring system. Results: Shoulder abduction-external rotation degrees and scores in all sections of the Mallet scoring system significantly increased in both groups (P < .001). Postoperatively, the arthroscopic SS release group had significantly better abduction degrees (P = .003), total Mallet scores (P < .001), and superior abduction (P = .043), active external rotation (P = .043), hand-to-head (P = .043), and hand-to-mouth (P < .001) scores for the Mallet scoring system. Discussion: Transfer of LD together with TM tendons combined with one of the internal rotation contracture release procedures yielded good clinical and functional results in patients younger than age 7, regardless of the type of release method. However, arthroscopic SS release, although requiring an experienced surgeon, revealed better clinical and functional outcomes and is considered to be a less invasive and superior method. (C) 2018 Published by Elsevier Inc. on behalf of Journal of Shoulder and Elbow Surgery Board of Trustees.Item Isokinetic Evaluation of Shoulder Strength and Endurance after Reverse Shoulder Arthroplasty: A Comparative Study(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2019-01-01) Ersen, Ali; Birisik, Fevzi; Bayram, Serkan; Sahinkaya, Turker; Demirel, Mehmet; Atalar, Ata Can; Demirhan, MehmetObjective: The present study aimed to compare the isometric strength and endurance of shoulder abduction and internal and external rotation between operated shoulders and nonoperated, contralateral shoulders of patients who underwent reverse shoulder replacement due to unilateral rotator cuff tear arthropathy. Patients and methods: With a diagnosis of cuff tear arthropathy, 41 consecutive patients (mean age of 70.8 yearsItem Surgical Approach Algorithm in the Treatment of Lumbar and Thoracolumbar Pyogenic Spondylodiscitis(TURKISH NEUROSURGICAL SOC, 2022-01-01) Akgul, Turgut; Bayram, Serkan; Korkmaz, Murat; Karalar, Sahin; Dikici, Fatih; Sar, CuneytAIM: To reveal the efficiency of our surgical approach algorithm in patients with thoracolumbar pyogenic spondylodiscitis based on the involvement of anatomical structure. MATERIAL and METHODS: Data of patients who underwent debridement or stabilization surgery for thoracolumbar pyogenic spondylodiscitis from January 2012 to December 2018 were reviewed. Lumbar and thoracolumbar spondylodiscitis was classified into four stages based on anatomical involvement. Infection was limited in the disc space, which had not spread to the endplate in stage 1 and progressed as two-level corpus involvement of >1/2 of vertebral corpus bony destruction or as failed treatment in stage 4. Neurological function was evaluated using Frankel's grading postoperatively. Functional outcomes were categorized according to the Kirkaldy-Willis criteria. RESULTS: The study included 39 patients, with a mean age of 58.2 years. Of these patients, 10, 12, 13, and 4 had stages 1, 2, 3, and 4 spondylodiscitis, respectively. The mean follow-up period was 60.2 (12-184) months. All patients with stages 1 and 2 spondylodiscitis had grade E injuryItem Posterior Approach Alone Versus Combined Anterior and Posterior Approach in the Management of Vertebral Tuberculosis(TURKISH NEUROSURGICAL SOC, 2019-01-01) Demirel, Mehmet; Akgul, Turgut; Pehlivanoglu, Tuna; Karademir, Gokhan; Bayram, Serkan; Dikici, Fatih; Sar, CuneytAIM: To compare posterior surgery alone versus combined anterior and posterior surgery for the management of spinal tuberculosis. MATERIAL and METHODS: Data from 31 consecutive patients who underwent surgery for spinal tuberculosis were analyzed retrospectively. Patients were divided into two groups as group A (posterior surgery alone) or group B (combined anterior and posterior surgery), and groups were compared in terms of invasiveness of the procedure, spinal deformity, fusion, neurological status, and postoperative complications. RESULTS: Group A included 16 patients (mean age: 56 years, range: 29-75) with a mean follow-up period of 29 months (range 12-60) while group B included 15 patients (mean age: 60 years, range: 35-73) with a mean follow-up period of 28 months (range 12-60). Procedurally, average operation time and mean length of hospitalization were shorter, and mean blood loss was lower in group A (p<0.05) compared to group B. Postoperative bone fusion took significantly (p<0.05) longer time in group A (10.5 +/- 2.1 months)than in group B (9.3 +/- 3.1 months), and all patients with a neurological deficit recovered completely during the postoperative period. No significant differences were observed between two groups with respect to postoperative complications (p>0.05). CONCLUSION: Combined anterior-posterior surgery may not be required for treating vertebral tuberculosis as posterior surgery alone appears to be sufficient.