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Öğe Comparison of the radiological parameters between dynamic-referencing tactile guidance robotic system and microplasty (r) instrumentation in unicompartmental knee arthroplasty(TURKISH JOINT DISEASES FOUNDATION, 2022) Çabuk, Haluk; Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Öztürk, Çağatay; Ertürer, Ramazan ErdenObjectives: This study aims to compare the radiological outcomes of unicompartmental knee arthroplasty (UKA) performed by a navigation-based robotic system versus Microplasty (R) instrumentation. Patients and methods: Between January 2018 and January 2019, a total of 90 knees of 75 patients (65 males, 10 females; mean age: 62.0 +/- 9.4 years; range, 50 to 73 years) were included. Among these, 54 knees underwent Oxford mobile-bearing UKA with an Microplasty (R) instrumentation set and 36 knees were operated with the aid of a Restoris (R) MCK with MAKO navigation-based robotic system. Postoperative anteroposterior and lateral X-rays of all patients were evaluated according to nine different parameters. On the femoral side, femoral varus-valgus angle, flexion-extension angle, femoral condyle posterior fit; on tibial side, tibial component varus/valgus, tibial posterior slope, medial, anterior, posterior and lateral fit of tibial component assessed. Results: There was no significant difference between groups in terms of age, sex, and affected side. On the femoral side, no significant difference was observed in the component position between groups. On the tibial side, tibial component medial fit (p=0.032) and anterior fit (p=0.007) were better in navigation-based robotic system group. Conclusion: Microplasty (R) instrumentation may lead to comparable implant positioning compared to a tactile-based navigated robotic instrumentation.Öğe Current approaches and problems faced by orthopedic surgeons in all-inside arthroscopic meniscus repairs(2023) Turan, Kaya; Erturer, Ramazan Erden; Çabuk, Haluk; Muratoğlu, Osman Görkem; Ergün, TuğrulAim: All-inside meniscal sutures are frequently the treatment of choice in arthroscopic practice. However, the literature contains limited evidence of the technical issues experi- enced during the procedure. We aimed to evaluate the technical difficulties encountered during the placement of all-inside meniscal repair sutures according to the surgeon’s ex- perience and the success rate of the suture placement. Materials and Methods: We invited orthopedic surgeons across the country to com- plete a questionnaire through an online platform. Participants were asked ten questions about their demographic information, general surgical approach to meniscal tears, and experience with intraoperative complications specific to all inside meniscus sutures. Results: A total of 100 orthopedic surgeons participated in our study. Of these, 37% had been working as an orthopedic surgeon for more than ten years. Twenty-five per cent performed more than two arthroscopic knee surgeries per week. Fifty-six per cent of the surgeons were protective for the displaced red-white zone meniscal tears. Although 90% of the participants stated that the technique was more effortless, only 12% thought the clinical results were better than the other techniques. More than 50% of the participants indicated that they had difficulty when placing the sutures successfully. The most common problem was the inability to fix the meniscus sufficiently and the deformation of the instruments inside the joint. When we compared the complications according to the surgeon’s experience, even among the surgeons who performed more than 100 arthroscopic surgeries per year, 34% had trouble applying these sutures successfully. Conclusion: Although all-inside meniscus sutures are generally believed to decrease the operative time and be technically more straightforward, even the most experienced surgeons have difficulty applying these sutures, and the reliability of these sutures is low.Öğe Diz artroskopisi sırasında gelişen akut alt ekstremite kompartman sendromunun fasiyotomi ile tedavisi(DergiPark, 2021) Ergün, Tuğrul; Temmuz, Taner; Korkmaz, Mehmet; Ergün, DilanKnee arthroscopy is currently the preferred surgical method for the diagnosis and treatment of intraarticular pathologies of the knee. After arthroscopy; infection, arthrofibrosis, venous thromboembolism, neurovascular damage and compartment syndrome can be seen as complications. Compartment syndrome is a chain of events that will result of ischemia in the extremity because of an increase in intracompartmental pressure that may cause disruption of venous return in the limb. Compartment syndrome is one of the well-known but rare complications of knee arthroscopy. There is an increase in compartment pressure due to the extravasation of arthroscopy fluid, which can progress to compartment syndrome. In this case, the treatment of the hyperacute compartment syndrome due to the extravasation of arthroscopy fluid during knee arthroscopy for meniscus pathology at the age of 40.Öğe Does the clamping method in local and systemic TXA applications in total knee arthroplasty change the game?: a retrospective comparative cohort study(Lippincott Williams and Wilkins, 2022) Turan, Kaya; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, Haluk; Ertürer, Ramazan ErdenMany different methods and drain clamping periods have been described in systemic and local tranexamic acid (TXA) applications, and the superiority of the methods to each other has not been clearly demonstrated. The method of local infusion in combined TXA applications may not alter the Hb drop or total or hidden blood loss. We aim to compare two different combined TXA application methods. We retrospectively analyzed 182 patients who underwent total knee arthroplasty between 2018 and 2021. Patients over 40 years of age who underwent TKA for degenerative knee arthritis were included in the study. Unicondylar, revision, or bilateral arthroplasties and patients with the cardiovascular or cerebrovascular disease were excluded from the study. All patients in the study received 1 g TXA intravenously half an hour before the incision. For the first group, 1 g TXA was given intra-articularly at the drain site after closure, and the clamp was kept closed for 1 hour. In the second group, the drain was clamped for an additional 6 hours, and a 1 g intravenous dose was administered at the 5th hour postoperatively. No local applications were used in the control group. Total, hidden, and visible blood loss (total blood loss, hidden blood loss, visible blood loss), postoperative decreases in hemoglobin and hematocrit level (?Hgb, ?Htc), blood transfusion rates, and hospital stay durations were evaluated. There were 72 patients in the first group, 52 in the second, and 58 in control. A total of 37 patients received one or more blood transfusions postoperatively, and there was no statistical difference in the need for blood transfusions between the groups (P?=?.255). Although a statistically significant difference (P?=?.001) in total blood loss, hidden blood loss, visible blood loss and ?Hgb values was observed between the groups, the difference between the first and second groups was insignificant (P?=?.512). The duration of hospital stay was observed to be less in the first and second groups (P?=?.024). Local and systemic TXA applications were observed to be more effective than only systemic applications in reducing blood loss after total knee arthroplasty, regardless of the local method.Öğe The effect of weekday preference on length of stay in unilateral bicompartmental total knee arthroplasty(Galenos Publishing House, 2022) Turan, Kaya; Ergün, Tuğrul; Muratoğlu, Osman Görkem; Çabuk, Haluk; Öztürk, ÇağatayAim: There are few studies in the literature evaluating the effect of the day of surgery on length of hospital stay. This study evaluates the effect of the day of surgery on the duration of hospitalization in unilateral primary total knee arthroplasty (TKA) in a group of hospitals providing wide-ranging health services and clarifies the implications for reducing economic burdens. Methods: Between March 2020 and January 2022, patients treated by TKA with the code P612420 according to the Health Practice Communique were retrospectively scanned in a group of hospitals with different levels. Patients who underwent bilateral TKA on the same day or during hospitalization, underwent any secondary surgical procedures, or developed early complications were excluded from the evaluation. Results: The data of 743 patients who underwent unilateral TKA were evaluated. The mean hospital stay was 3.32 (2-14) days. It was seen that the shortest hospitalization periods were in the surgeries performed on Saturday (3.15 days), while the longest ones were on Friday (3.62 days). It was found that the patients who underwent surgery on Saturday had significantly shorter hospital stays than on Friday (p=0.006). Conclusion: While planning TKA, the choice of surgery day is a factor that should be addressed to reduce hospital stays and, therefore, costs. © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.Öğe Evaluating the results of retrograde intramedullary nailing for distal femur fractures: A level 3 trauma center retrospective study(DergiPark, 2022) Ergün, Tuğrul; Bayraktar, Mehmet Kürşad; Taşatan, Ersin; Tekin, Ali Çağrı; Akdaş Tekin, Esra; Gürbüz, Hakan; Karslıoğlu, BülentAim: Distal femur fractures can be treated with modern anatomic plates and nails. This study aimed to examine the clinical and radiological results of displaced distal femur fractures in adult people who had been treated with a retrograde intramedullary nail (RIN). Material and Methods: The study included all patients who underwent RIN surgery for distal femur fracture between January 2013 and April 2018 in a level 3 trauma center. Patients were divided into two groups based on fracture pattern: open fracture and closed fracture. The preoperative and postoperative clinical, radiological and functional characteristics of patients who had RIN for a distal femur fracture were analyzed. Results: Thirty patients were included in the study. 21 (70%) patients were male. The median age of the patients was 39 (range, 18-58) years. 17 (56.7%) of the affected femur were left-sided. The etiology of the fractures was traffic accident and fall in 19 (63.3%) patients and gunshot injury in 11 (36.7%) patients. Of the patients, 17 (56.7%) were closed fractures and 13 (43.3%) were open fractures. There were no significant differences between two groups related to the surgery time (p=0.086), fluoroscopy time (p=0.805), blood loss (p=0.967), and hospitalization time (p=0.967), clinical pain and function scores (p=0.341, p=0.902), and union time (p=0.385) at the postoperative period. Conclusion: RIN is a minimally invasive method that may prevent excessive blood loss and decrease the duration of surgery time. It is an effective and reliable surgical intervention that should be considered for the treatment of distal femur fractures.Öğe Newborn clavicle fractures: does clavicle fracture morphology affect brachial plexus ınjury?(2022) Ergün, Tuğrul; Sarıkaya, SevcanBackground: Newborn clavicle fractures and brachial plexus injuries (BPIs) are rare but serious perinatal complications. Methods: The aim of this study was to examine the clinical relationship between the fracture morphology (spiral, oblique, transfer) of clavicle fractures that develop during delivery in newborns and BPI. We retrospectively reviewed all perinatal clavicle fractures diagnosed at our institution over 6 years. Results: The study included 55 newborn infants with perinatal clavicle fracture. Of these, 60% (n=33) were male. Right-side clavicle fractures were present in 56.4% (n=31) and shoulder dystocia was present in 58.2% (n=32) of the patients. Of the fracture localization of the patients, 85.5% (n=47) (Allman I) and 14.5% (n=8) (Allman II) were lateral. Allman type I fractures were not associated with increased BPI (P>0.05). It was observed that 40% (n=22) of the clavicle fractures were characterized by oblique morphology, 34.5% (n=19) of the fractures by spiral morphology, and 25.5% (n=14) of the fractures by transfer morphology. In all, 41.8% (n=23) of the sample also had BPI. Of the entire sample, 40% (n=22) most frequently showed oblique morphology fractures, whereas the patient group with BPI showed spiral morphology as the most common fracture, at a rate of 52.2% (n=10). After examining the relationship between fracture morphology and BPI, the study determined a statistically significant correlation between spiral and oblique morphology fractures and the development of BPI. Conclusions: To our knowledge, our study is the first to examine the relationship between newborn clavicle fracture morphology and BPI. We think that they should be evaluated for increased BPI risk in newborn patients that have clavicle fractures with spiral and oblique morphology.Öğe Patient anxiety levels in orthopedic outpatient clinics at hospitals with different patient population densities(DergiPark, 2022) Turan, Kaya; Tuncez, Mahmut; Muratoğlu, Osman Görkem; Ergün, Tuğrul; Çabuk, HalukBackground/Aim: Prolonged wait times for examination and delayed hospital appointment times can negatively affect patients. Increased anxiety in orthopedic outpatient clinic patients can disrupt diagnosis and treatment, and increase psychological tension in both patients and healthcare professionals. The aim of our study is to compare the anxiety levels of patients at institutions with different patient population densities. Methods: This cross-sectional survey study included 189 patients who voluntarily completed the Beck Anxiety Scale while registering for treatment of non-traumatic conditions at the orthopedics and traumatology outpatient clinics of two tertiary health care hospitals. Patients were grouped by hospital attended. The study assessed patients’ age, education level, estimated monthly income levels, and anxiety levels. Results: 99 patients from the public hospitals and 90 from the private hospitals participated in the survey. A significant positive correlation existed between educational status and income level (P<0.001). No significant difference in income level existed between the two groups (P=0.063), but the education level of patients in the private hospital group was significantly higher than in the public hospital group (P<0.001). The anxiety levels of the patients in the private hospital group was significantly higher (P=0.043); this difference was correlated to education level rather than income level. Patients with higher education levels demonstrated significantly higher anxiety levels (P<0.001). Conclusion: The study concluded that the anxiety levels of patients who applied to the orthopedic outpatient clinics were independent of facility patient density and related primarily to patient attributes. Prospective studies are needed examining the relationship between patient anxiety levels and waiting time.Öğe Treatment of ingrown toenail with a minimally invasive nail fixator: Comparative study with winograd technique(Sheridan Publications, 2022) Ergün, Tuğrul; Korkmaz, Mehmet; Ergün, Dilan; Turan, Kaya; Muratoğlu, Osman Görkem; Çabuk, HalukBackground: Many surgical techniques have been reported for the treatment of ingrown toenails. Occurrences of infection after matricectomy procedures could cause clinicians to prefer using external braces to treat ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique. Methods: Patients who underwent ingrown toenail surgery were retrospectively reviewed. The patients' demographic characteristics (age, gender, body mass index [BMI] morphology according to Heifetz classification, surgical technique, visual analog scale (VAS) values, time to return to daily activities (days), complications, and satisfaction levels were all recorded. Results: Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients' age, gender, BMI, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and VAS values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique. Conclusion: Nail fixation can be an effective surgical treatment option for an ingrown toenail.Öğe Ultrasonography vıew for acute ankle ınjury: comparison of ultrasonography and magnetic resonance ımaging(Springer, 2022) Ergün, Tuğrul; Peker, Ahmet; Aybay, Muhsin N.; Turan, Kaya; Muratoğlu, Osman Görkem; Çabuk, HalukIntroduction: We aim to asses the diagnostic performance of ankle ultrasonography in patients presenting with acute ankle sprain injury, with comparison to MRI (Manyetik Rezonans İmaging). Materials and methods: The study included patients who applied to the hospital within 48 h after an ankle sprain, and who presented with signs of pain, swelling, and tenderness in the ankle. Ankle ultrasonography examination was performed and an ankle MRI took place the same day. Results: 30 patients were included in the study. 53.3% (n = 16) were female. The mean age was 30 ± 6.4 years. The ultrasonography examination determined 76.6% (n = 23) of the patients to have anterior talofibular ligament (ATFL) injury, 33.3% to have (n = 10) CFL injury, and 33.3% to have (n = 10) anterior inferior tibia-fibular ligament (AITFL) injury. The MRI of the patients determined 73.3% (n = 22) of the patients to have ATFL injury, 43.3% (n = 13) to have calcaneal fibular ligament (CFL) injury, and 33.3% to have (n = 10) AITFL injury. The ATFL, CFL, and AITFL injuries diagnosed on ultrasonography correlated with the MRI results (ICC = 0.875, ICC = 0.879, and ICC = 0.858). However, among the ATFL injuries observed on MRI, 26.6% (n = 8) were grade I, 26.6% (n = 8) were grade II, and 20% (n = 6) were grade III injuries. Of the ATFL injuries observed on ultrasonography, 46.6% (n = 14) were grade I, 8.6% (n = 2) were grade II, and 30.4% (n = 7) were grade III injuries. Conclusions: Findings on all types of ATFL, CFL and AITFL appear to have a higher degree of correlation. Ultrasonography could have an added role as a triaging tool, to fast-track MRI.Öğe Yenidoğan brakiyal pleksus yaralanmaları; Obstetrik brakiyal pleksus yaralanması olan yenidoğanların doğum özelliklerinin retrospektif değerlendirilmesi(DergiPark, 2022) Ergün, Tuğrul; Sarıkaya, SevcanAmaç: Perinatal brakial pleksus yaralanması(BPY) görülen yenidoğan hastalarının doğum özelliklerini ve eşlik eden ek patolojilerini incelemektir. Gereç ve Yöntem: 2016-2021 yılları arasında perinatal BPY nedeniyle ortopedi ve travmatoloji kliniğine konsulte edilen hastalar retrospektif olarak tarandı. Hastaların doğum özellikleri ve eşlik eden perinatal patolojileri kayıt altına alınarak istatistiksel analizleri gerçekleştirildi. Bulgular: 4687 canlı doğum arasında 75 hastada BPY görüldü. Hastaların %78.7(n=59)’sinin spontan vajinal yol ile , % 21.3(n=16)’ünün sezaryen doğum ile doğurtulduğu gözlemlendi. Hastaların % 53.3(n=40)’ü erkeklerden oluşmaktayken, %73.3 (n=55)’ünde pleksus hasarı sağ ekstremitede idi. %57.3(n=43)’ünde eşlik eden omuz distosisi, %20(n=15)’sinde klavikula kırığı bulunmaktaydı. Omuz distosili hastaların doğum ağırlığı, boy uzunlukları ve baş çevresi uzunluklarının omuz distosisi olmayan hastalara göre istatistiksel olarak anlamlı derecede yüksek olduğu gözlemlendi.(p=0.001,p=0.037,p=0.023) Klavikula kırığı gözlenen hastaların doğum ağırlığı, boy uzunlukları ve baş çevresi ve göğüs çevresi uzunluklarının klavikula kırığı olmayan hastalara göre istatistiksel olarak anlamlı derecede yüksek olduğu gözlemlendi.(p=0,000, p=0.012, p=0.044, p=0.035). Sonuç: Yenidoğan bebeklerde artmış doğum ağırlığı, kafa çapı uzunluğu, boy uzunluğu ve göğüs çevresi uzunluğu artmış perinatal komplikasyonlarla ilişkili olduğu gözlemlendi. Bu yenidoğan bebeklerin; BPY, omuz distosisi ve klavikula kırığı oluşması açısından değerlendirilmeleri önerilir.Öğe YouTube provides insufficient information on patellofemoral instability(AVES, 2022) Yüce, Ali; İğde, Niyazi; Ergün, Tuğrul; Mısır, AbdulhamitObjective: Videos uploaded to YouTube do not go through a review process, and therefore, videos related to patellofemoral instability may have little educational value. The purpose of this study was to assess the educational quality of YouTube videos regarding patellofemoral instability. Methods: A standard search was performed on the YouTube database using the following terms: “unstable kneecap,” “patellar instability,” “patellofemoral instability,” “kneecap dislocation,” and “patellar dislocation,” and the top 50 videos based on the “relevance” assignment of the YouTube algorithm were included for analysis. The properties, content, and source of each video were recorded. The educational quality of videos was analyzed according to scores obtained using DISCERN, the criteria of Journal of the American Medical Association, Global Quality Score, and Patellofemoral Instability Specific Score, and the quality of the videos was evaluated according to the groupings of these scoring systems. Results: A total of 250 videos were identified, of which 89 were included in the study for analysis. The mean video duration was 11.72 ± 22.03 minutes. The median number of views was 4516.5 (range, 3-6 044 971). The content of the videos was disease-specific in 60%, 20% were related to surgical technique or approach, and 14.1% were exercise videos. Most of the videos were uploaded by physicians (33.7%). The Global Quality Score and DISCERN scores were significantly correlated with video duration. The Patellofemoral Instability Specific Score was significantly correlated with video duration, number of views, view rate, likes, and Video Power Index. According to the DISCERN classification, 69.9% of the videos were very insufficient or insufficient. According to the Patellofemoral Instability Specific Score, 65.2% of videos were evaluated as very low or low. According to the Global Quality Score, 60.7% of videos were rated as poor quality. Conclusion: The quality of YouTube videos about Patellofemoral instability is insufficient. It was found that viewers tend to watch short and low-quality videos.
