Araştırma Çıktıları
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Item Does pedicle screw density matter in Lenke type 5 adolescent idiopathic scoliosis?(LIPPINCOTT WILLIAMS \& WILKINS, 2018-01-01) Sariyilmaz, Kerim; Ozkunt, Okan; Karademir, Gokhan; Gemalmaz, Halil Can; Dikici, Fatih; Domanic, UnsalThe aim of this study is to compare the effects of high versus low implant density on correction in Lenke type 5 adolescent idiopathic scoliosis (AIS) patients. A retrospective study of 59 Lenke type 5 AIS patients treated at a single institution were divided into to 2 groups according to implant density. Implant density, preoperative, early postoperative, and last follow-up thoracolumbar/lumbar (TL/L) curves were measured. Thirty-one constructs were high and 28 constructs were low density. The groups were similar in terms of age, sex, Cobb angle, and follow-up time. Mean implant density in low density group and high density group was 75.4\% and 96.6\%, respectively. High versus low-density comparison showed that there is no significant difference with regard to curve correction in early postoperative and last follow-up periods. The results show that pedicle screw density being low or high, does not affect curve correction rates in the short and long term in our patients.Item A Novel 3D Printed Custom Antibiotic Spacer Mold for Osteomyelitis Cases which are Prone to Instability(GAZI UNIV, FAC MED, 2018-01-01) Gemalmaz, Halil Can; Sariyilmaz, Kerim; Ozkunt, Okan; Sungur, Mustafa; Kaya, Ibrahim; Dikici, FatihPresence of complex bone defects in osteomyelitis treatment may be challenging for the surgeon. Antibiotic cement spacers take a role in managing these defects. The available techniques and systems of antibiotic cement spacers have their pros and cons. There are cases in which these standard options may fail, mainly due to stability related issues. In this report, we present an antibiotic spacer technique in a very complex bone defect that is prone to failure if managed by routine spacer applications. Anticipating that any standard spacer application methodology will fail, we decided to make our own custom antibiotic cement spacer. We used the patient's uninjured side's tomography data to create a custom 3D spacer mold model with the help of a computer software. Later this 3D spacer mold model was printed with a 3D printer. The print out was sterilized and used to cast a custom antibiotic cement spacer resulting in a perfect fit in the defect.Item Linear Frictional Properties of a Barbed Suture in the Tendon Tissue(GAZI UNIV, FAC MED, 2019-01-01) Gemalmaz, Halil CanObjective: The barbed suture has been around for some time with some important theoretical advantages for tendon repairs such as resistance to suture slippage and knotless application. However, these theoretical advantages are not yet proven to be practically important. The literature on the barbed suture for tendon repair has a focus on in-vivo or ex-vivo preclinical investigations of established tenorrhaphy methods. Current literature is poor in knowledge on its fundamental properties thus basic research. Our study attracts attention on the lack of basic research on barbed suture for tendon repair and investigates a barbed suture's linear frictional performance in the tendon. Methods: Thirty-two fresh frozen porcine forefoot digital flexor tendons were separated into four groups of eight tendons. In group 1 a barbed suture was introduced to the tendons 1 cm proximal to the distal cut-end and was advanced through the core of the tendon tissue leaving the distal cut-end at the core. In group 2 the suture was introduced in the same way purchasing 2 cm of tendon tissue, in group 3 and 4 the suture purchase length was 3 and 4 cm respectively. Ultimate tensile strength generated by anchorage of the barbs of the suture in the tendon tissue was assessed with a mechanical testing machine and the results were statistically compared between groups. Results: Mean ultimate tensile strength was found to be 5.4N for group 1, 7.45N in group 2, 4.87N in group 3 and 5.76N for group 4. Intergroup comparison was made with a data set corrected for suture purchase length which was obtained by dividing each sample's ultimate tensile value by the distance of suture purchase length accordingly. Statistical analysis with corrected data set revealed that group 1 versus 2 showed no difference whereas comparison of group 1 vs 3 and group 1 vs 4 showed a significant difference. Discussion: Our results showed that the frictional forces generated by the barbed suture were directly proportional to the suture purchase length only to some extent. Statistical analysis confirmed the direct linear relation between pullout strength and suture purchase length up to 2 centimeters of suture purchase. Pullout strength in samples with 3 and 4 centimeters of suture purchase showed deterioration. Conclusion: The tissue grasping strength of the barbed suture we tested in our study is not directly proportional to the suture purchase length. More basic research on barbed suture for tendon repair is needed to better understand how its theoretical advantages can be appreciated practically. Suture producing companies should investigate and produce barbed sutures specially tailored for tendon repair.Item A Biomechanical Comparison of Tendon Repair with a Knotless Barbed Suture and a Conventional Monofilament Suture Material: An ex-vivo Animal Experiment(GALENOS YAYINCILIK, 2020-01-01) Gemalmaz, Halil CanObjective: Our aim is to compare the ultimate tensile strength and stiffness of a 2/0 barbed suture and a 3/0 polypropylene monofilament suture in a porcine tendon repair model. Methods: Sixteen porcine Achilles tendons were transected and separated into two groups. In group I tendons were repaired with a modified knotless four-strand Kessler technique using a 2/0 V-Loc barbed suture. In group II tendons were repaired with a four-strand Kessler technique using a 3/0 monofilament conventional suture and knots were tied. All specimens were biomechanically tested for ultimate tensile strength (UTS) and stiffness. Mode of failure was also noted. Results: Five specimens in group I failed by stripping of the suture from the tendon tissue, three failed due to suture breakage. In group II two out of eight tendons failed by stripping of the suture and remaining six failed by suture breakage. Median UTS value was found to be 85.96 N (range: 63.24) in group I and 64.29 N (range: 56.84) in group II. Median stiffness value of the samples in group I was found to be 5.67 N/mm (range: 4.32) and in group II it was found to be 4.53 N/mm (range: 6.23). The statistical analysis of UTS and stiffness values revealed no significant difference between the groups (p=0.17 and p=0.56 respectively). Conclusion: A knotless Kessler tendon repair made with a 2/0 barbed suture is biomechanically equivalent to a knotted Kessler tendon repair made with a 3/0 conventional polypropylene suture in ex-vivo conditions.Item The effect of tourniquet usage on cement penetration in total knee arthroplasty A prospective randomized study of 3 methods(LIPPINCOTT WILLIAMS \& WILKINS, 2018-01-01) Ozkunt, Okan; Sariyilmaz, Kerim; Gemalmaz, Halil Can; Dikici, FatihBackground: It is a randomized study to compare cement penetration on x-rays after total knee arthroplasty (TKA) among 3 different ways to use tourniquets