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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 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 the cerclage wire in the treatment of subtrochanteric femur fracture with the long proximal femoral nail: A review of 52 cases(Elsevier Science Bv, 2018) Kılınç, Bekir Eray; Oc, Yunus; Kara, Adnan; Ertürer, Ramazan ErdenIntroduction: To present the effect of the cerclage fixation, which was performed for the purpose of preserving the alignment obtained by open reduction, on the long-term clinical and radiological results of subtrochanteric fractures. Materials and methods: The inclusion criterias were at least 2 years of follow-up, no severe cognitive impairment, and to be able to walk independently prior to fracture. Patients with transverse or short oblique subtrochanteric hip fractures (AO/OTA class 32-A3.1), patients underwent previous femoral or hip operation for the same side and those with segmental fractures, bilateral fractures and pathological fractures were not included in the study. The clinical and radiological results of the patients were evaluated. The clinical evaluations were performed with Palmer and Parker Mobility Score (PPM), Lower Extremity Functional Score (LEFS), visual analogue score (VAS) and return to pre-injury activity status. The elapsed time between the trauma and the surgery date, the duration of surgery the estimated amount of bleeding, and the length of hospital stay of patients were assessed. Results: Thirty-two of the 52 patients were female and 20 were male. The mean age of females was 77.80 +/- 9.75 years and the mean age of the males was 79.18 +/- 6.50 years. The mean follow-up period of the patients was 62.25 +/- 34.68 months. The mean time until the patients' surgery was 6.18 +/- 3.32 days. The mean duration of surgery was 52.6 +/- 13.8 min. The mean amount of bleeding was 176 +/- 90 ml. The mean length of patients' hospital stay was 6.2 +/- 3.2 days. The postoperative mean duration of union was found to be 3.8 +/- 1.6 months. The mean value of varus/valgus angulation in coronal plane measurements was 0.52 degrees. No complication was observed in any patient during the cerclage application. The mean number of wire was 1.3. LEFS difference was statistically significant. PPM decline was not statistically significant. Conclusion: Open reduction and the use of cerclage did not produce a negative effect in terms of fracture union. The generation of medial support by anatomical reduction of the fracture prevents the implant failure and provide a basis for union.Öğe Modified lindgren-turan osteotomy for hallux valgus deformity - a review of 60 cases(Galen Sro, 2018) Kılınç, B. E.; Oc, Y.; Ertürer, Ramazan ErdenPURPOSE OF THE STUDY To evaluate the clinical and radiological results of a new modification of relatively less-known Lindgren-Turan osteotomy technique in HV deformity that is performed by combining bunionectomy and capsuloplasty. MATERIAL AND METHODS 60 feet of 52 patients with moderate and heavy deformity who were operated between 2009 and 2014 were included in the study. The patients had clinically severe pain, did not respond to at least 6-month conservative treatment and had moderate and severe deformity before Hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal joint angle (DMAA), proximal phalangeal joint angles (PPAA) and shortening amount in the first metatarsus were measured through preoperative and follow-up radiography. Clinical evaluations were conducted on all patients using American Orthopedic Foot and Ankle Society's (AOFAS) and visual analog scale (VAS). Data of the radiological and clinical evaluations in preoperative and follow-up periods were compared statistically. Statistical significance was accepted at p < 0.05. RESULTS 42 (76.1%) and 10 (23.9%) of 52 patients were female and male, respectively. Mean age of the patients was 50.9 +/- 15.52 years. Mean follow-up period of the patients was 43.3 +/- 2.1. Preoperative and last measurements: HVA: 36.34 degrees +/- 6.36 degrees - 15.6 degrees +/- 2.83 degrees, IMA: 12.62 degrees +/- 2.24 degrees - 5.83 degrees +/- 1.32 degrees, DMAA: 16.3 degrees +/- 3.45 degrees - 10.3 degrees +/- 2.24 degrees, PFAA: 7.24 degrees +/- 1.32 degrees - 6.12 degrees +/- 0.84 degrees (p < 0.001). Shortness of first metatarsus was measured to be 5.94 +/- 1.84 mm. Mean VAS values of the patients which was 8.6 +/- 0.4 before the operation was detected as 0.8 +/- 0.04 after follow-up (p < 0.001). AOFAS score of the patients which was 42.4 +/- 5.3 before the operation was found to be 88.9 +/- 7.6 (p < 0.001). All patients started to work again within 5.22 +/- 1.7 weeks. Union was completely seen along osteotomy line in all cases. Three patients had screw extraction. Two patients had superficial wound infection. DISCUSSION Capsule plication which we apply with osteotomy as part of our surgical procedure is a significant point in correcting deformity and raising stability. First metatarsophalangeal rigidity risk can be avoided with a controlled plication in operation and by giving the final decision after testing. Such flexibility shows that soft tissue contracture is not the main factor of deformity, so lateral release is not indicated. Thus, our opinion is that digital nerve damage and extra scar are avoided during lateral release. The osteotomy we applied which is extraarticular and subcapital, and protection of racket-shaped capsule cannot be attributed to finding no AVN case. CONCLUSIONS Modified Lindgren-Turan surgical procedure which is applied with capsuloplasty and bunionectomy is an effective and reliable method in treatment of moderate and severe HV deformities. It is recommended as a satisfactory option in HV treatment due to its ease in surgery, use of single incision and perfect clinical and radiological long-term results.Öğe The results of hemivertebra resection by the posterior approach in children with a mean follow-up of five Years(Hindawi Ltd, 2017) Ertürer, Ramazan Erden; Kılınç, Bekir Eray; Gökçen, Hüseyin Bahadır; Erdoğan, Sinan; Kara, Gökhan Kürşat; Öztürk, ÇağatayAim. To evaluate the radiologic and clinical results of patients who underwent deformity correction and stabilization for congenital spinal deformities using pedicle screws after hemivertebra resection. Material and Method. Nine patients, mean age 9.2, who underwent posterior hemivertebrectomy and transpedicular fixation for congenital spinal deformity and had longer than five years of follow-up were evaluated retrospectively. The hemivertebrae were located in the thoracic region in 4 patients and thoracolumbar transition region in 5 patients. The patients were evaluated radiologically and clinically in the postoperative period. Results. Mean length of follow-up was 64.2 months. The mean operating time was 292 minutes. The mean blood loss was 236 mL. The average hospitalization timewas 7 days. The amount of correction on the coronal planeswasmeasured as 31%. Themean segmental kyphosis angle was 45.7 degrees preoperatively and it wasmeasured 2.7 degrees in the follow-up period. There were no statistically significant differences between the early postoperative period and final follow-up X-rays with respect to coronal and sagittal plane deformities. Conclusion. The ability to obtain a sufficient and balanced correction in the cases accompanied by long compensator curvatures that have a structural character in hemivertebra may require longer fusion levels.Öğe The treatment method and results of percutaneous pinning and dynamic external fixator application for unstable distal radius fractures(Yerkure Tanitim Yayincilik Hizmetleri As, 2018) Kara, Adnan; Ertürer, Ramazan Erden; Seçkin, Faik; Akman, Şenol; Öztürk, İrfanclosed reduction and percutaneous fixation followed by application of the Pennig dynamic wrist fixator to allow early wrist motion. Methods: Twenty-five patients diagnosed with distal radius fracture and treated with closed reduction and percutaneous fixation followed by application of a dynamic wrist fixator were included in the study. There were 15 (60%) male and 10 (40%) female patients. The mean age of the patients was 47.32 (20–76) years. The mean period between initial trauma and operation was 8.52 (1–23) days. All patients were allowed active shoulder, elbow, and finger exercises immediately after surgery. Results: Radiological evaluation was performed according to the criteria described by Sarmiento and modified by Lidström. Results were excellent in 12 (46.15%), good in 11 (42.30%), and fair in 3 (11.55%) patients. No patient had poor result. Functional scores were assessed according to the Gartland–Werley classification and modified by Sarmiento. Results were excellent in 14 (56%), good in 8 (32%), and moderate in 3 (12%) patients. Conclusion: Use of the Pennig dynamic wrist fixator in the treatment of unstable distal radius fractures has advantages, such as ease of use, minimal surgical trauma, allowing early rehabilitation, and early return to daily activities as well as increased anatomical and functional results.Öğe Treatment of midshaft clavicle fracture with superior plate placement(Atha Comunicacao & Editora, 2020) Kılınç, Bekir Eray; Oc, Yunus; Ertürer, Ramazan ErdenObjective: To evaluate the late clinical and radiological results of patients had locking plate anatomically compatible from superior surface and muscle cover on plate due to clavicle mid-region. Materials and Methods: Forty patients were included retrospectively. Patients had a routine right shoulder anterior posterior graph after examination. The results were assessed by returning to the patient's daily activities, Constant score, the Disability of the Arm, and Shoulder and Hand scoring, followed by radiological and clinical examination. Results: Fourteen (35%) patients were female and 26 (65%) were male. The mean age was 36.2 years. Twenty-six patients had right clavicle fracture and 14 patients had left. Twenty-three fractures were type 2B1 and 17 fractures were type 2B2. Mean follow-up time was 36.4 months. Radiologic union was at a mean of 9.1 +/- 1.3 weeks. All patients had excellent results. The mean Constant score was 97.2 +/- 1.8, the mean Disability of the Arm, and Shoulder and Hand score was 3.8 +/- 2.4. Conclusion: It is possible to obtain complete union with high patient satisfaction by avoiding the complications and difficulties of the conservative treatment with the use of the anatomically compatible locking plates in superior fixation and our surgical dissection.
