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Öğe Comparative evaluation of artificial intelligence models GPT-4 and GPT-3.5 in clinical decision-making in sports surgery and physiotherapy: a cross-sectional study(Bmc, 2025) Saglam, Soenmez; Uludag, Veysel; Karaduman, Zekeriya Okan; Arican, Mehmet; Yucel, Muecahid Osman; Dalaslan, Rasit EminBackground The integration of artificial intelligence (AI) in healthcare has rapidly expanded, particularly in clinical decision-making. Large language models (LLMs) such as GPT-4 and GPT-3.5 have shown potential in various medical applications, including diagnostics and treatment planning. However, their efficacy in specialized fields like sports surgery and physiotherapy remains underexplored. This study aims to compare the performance of GPT-4 and GPT-3.5 in clinical decision-making within these domains using a structured assessment approach. Methods This cross-sectional study included 56 professionals specializing in sports surgery and physiotherapy. Participants evaluated 10 standardized clinical scenarios generated by GPT-4 and GPT-3.5 using a 5-point Likert scale. The scenarios encompassed common musculoskeletal conditions, and assessments focused on diagnostic accuracy, treatment appropriateness, surgical technique detailing, and rehabilitation plan suitability. Data were collected anonymously via Google Forms. Statistical analysis included paired t-tests for direct model comparisons, one-way ANOVA to assess performance across multiple criteria, and Cronbach's alpha to evaluate inter-rater reliability. Results GPT-4 significantly outperformed GPT-3.5 across all evaluated criteria. Paired t-test results (t(55) = 10.45, p < 0.001) demonstrated that GPT-4 provided more accurate diagnoses, superior treatment plans, and more detailed surgical recommendations. ANOVA results confirmed the higher suitability of GPT-4 in treatment planning (F(1, 55) = 35.22, p < 0.001) and rehabilitation protocols (F(1, 55) = 32.10, p < 0.001). Cronbach's alpha values indicated higher internal consistency for GPT-4 (alpha = 0.478) compared to GPT-3.5 (alpha = 0.234), reflecting more reliable performance. Conclusions GPT-4 demonstrates superior performance compared to GPT-3.5 in clinical decision-making for sports surgery and physiotherapy. These findings suggest that advanced AI models can aid in diagnostic accuracy, treatment planning, and rehabilitation strategies. However, AI should function as a decision-support tool rather than a substitute for expert clinical judgment. Future studies should explore the integration of AI into real-world clinical workflows, validate findings using larger datasets, and compare additional AI models beyond the GPT series.Öğe Comparison of a New Radiographic Technique with MRI Measurements for Tibial Tunnel Evaluation in ACL Reconstruction(Mdpi, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Karaduman, Zekeriya Okan; Arican, Mehmet; Akar, Bedrettin; Tural, VolkanBackground/Objectives: The correct angular placement of the tibial tunnel is crucial to ensure graft tension, maintain knee stability, and ensure optimal clinical outcomes after anterior cruciate ligament (ACL) reconstruction. While 3D imaging methods such as MRI and CT are the gold standard for evaluating tunnel positioning, their routine use is limited by cost, availability, and time constraints. In clinical practice, 2D radiographs are more accessible but lack established reliability in accurately estimating tunnel angles. The aim of this study was to convert 2D radiographic angular measurements used in the evaluation of patients undergoing anterior cruciate ligament reconstruction into 3D values with a simple method and to compare these measurements with three-dimensional angles calculated using conventional MRI and CT. Methods: This retrospective study included 38 patients who underwent anatomic anterior cruciate ligament reconstruction. Postoperative radiographs and MR images were analyzed to determine the tibial tunnel angles. The angles calculated from 2D radiographs were statistically analyzed for their correlation with the actual 3D angles measured by MRI. Results: The analysis showed a strong correlation between tibial tunnel angles from radiographs and MRI, with minimal, non-significant differences. This suggests that radiographs can provide a reliable estimate of tibial tunnel angles. Conclusions: These findings suggest that radiographs can predict tibial tunnel angles in ACL reconstruction as accurately as MRI. This method can guide the correct tunnel angle and facilitate postoperative evaluation. Further studies are needed to confirm these results across various populations and techniques.Öğe Diabetes, Inflammatory Markers, and Tissue Thickness in Septic and Aseptic Hip Revision Surgeries(Int Scientific Information, Inc, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Celik, Mucahit; Kose, Mehmet AkifBackground: Septic and aseptic loosening are the most common indications for revision hip arthroplasty (RHA), and infection-related revisions pose significant diagnostic and management challenges. This study compared septic and aseptic RHA cases in terms of inflammatory markers, prevalence of diabetes mellitus (DM), surgical time, blood transfusion requirements, soft-tissue thickness, and mortality rates in a cohort of 49 patients. Material/Methods: This retrospective study included 49 patients who underwent RHA between 2015 and 2020. Patients were divided into aseptic (n=34) and septic (n=15) groups. Demographic characteristics, comorbidities, preoperative erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, soft-tissue thickness, and revision surgery time were compared. Results: ESR and CRP levels were significantly higher in the septic group (P=0.002, P=0.001), soft-tissue thickness was lower (p=0.003), blood transfusion requirements (P<0.001) and surgical times (P<0.00001) were higher, while no significant difference was found in mortality rates between the groups (P=0.576). Conclusions: This study examined septic and aseptic loosening in revision hip arthroplasty, finding higher inflammatory markers, increased transfusion needs, longer operative times, and greater infection risk with diabetes in septic cases. In our study, soft-tissue thickness was found to be lower in infected cases, unlike reports in the literature. While previous studies suggested that soft-tissue thickness was the cause of infection, our study indicates that the decrease in soft-tissue thickness is a consequence of infection.Öğe Effect of Oral plus Topical and Only Topical Tranaxamic Acid Application on Blood Loss and Postoperative Transfusion in Primary Total Hip Arthroplasty(Mdpi, 2025) Mutlu, Tansel; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Yalcin; Kaban, Ilyas; Dalaslan, Rasit Emin; Saglam, SonmezObjectives: Total hip arthroplasty is one of the most common procedures performed to reduce pain and improve hip functions in patients with advanced hip osteoarthritis, but perioperative blood loss, acute anemia and transfusion requirement increase the risk of morbidity and mortality during and after surgery and negatively affect functional recovery. We aimed to present the comparative results of oral + topical and only topical tranexamic acid application to reduce blood loss and postoperative transfusion in primary total hip arthroplasty. Methods: We retrospectively evaluated the patients who applied to the Orthopedics and Traumatology outpatient clinic with complaints of hip pain and limited movement between January 2014 and December 2020, who underwent primary total hip arthroplasty with the diagnosis of coxarthrosis and who were administered oral + topical and only topical tranexamic acid before and during surgery, in terms of blood loss and transfusion requirement. Results: No statistically significant difference was observed between the preoperative, day 0 and day 1 hemoglobin means in those that were applied oral + topical tranexamic acid and those that were applied only topical (p > 0.05). However, the second- and third-day hemoglobin means in those that were treated with topical medication alone were found to be statistically significantly lower than in those that were treated with oral + topical tranexamic acid (p = 0.032, p = 0.0001). Conclusions: Oral + topical tranexamic acid application in total hip arthroplasty surgery is more effective than topical applications alone when it comes to reducing blood loss, hemoglobin and hematocrit decrease without increasing the risk of thromboembolic diseases and wound complications.Öğe The effect of peripheral dopamine on fracture healing: an experimental study in a rat model(Bmc, 2025) Yucel, Mucahid Osman; Dalaslan, Rasit Emin; Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Banu; Demir, FatihBackgroundDopamine is a versatile biomolecule that functions as a neurotransmitter, hormone, and immune modulator in the body. Although some anabolic effects of dopamine on bone tissue have been described in the literature, its influence on the complex processes involved in fracture healing remains unclear. This study aimed to evaluate the effects of dopamine on bone healing at the peripheral level.MethodsThirty-six male Wistar albino rats were randomly assigned to two groups: a control group with no treatment and a dopamine group that received 12 mg/kg levodopa twice daily via oral gavage following surgery. A standardized femoral fracture was induced under anesthesia in all the rats, which were then fixed with an intramedullary Kirschner wire. Each group consisted of 18 rats, and six rats from each group were randomly sacrificed on postoperative days 15, 30, and 45. The harvested femurs were first evaluated radiologically, followed by biomechanical analysis via a three-point bending test, and finally subjected to histopathological examination.ResultsNo significant differences were observed between the groups on days 15 and 30. However, on day 45, histopathological scores were significantly lower in the dopamine group (p = 0.015), and biomechanical strength was also lower (p = 0.004). Radiological scores were not significantly different between the groups at any time point.ConclusionDespite the known anabolic effects of dopamine on bone cells, it may adversely affect fracture healing. The negative impact of dopamine on bone union could be attributed to the multifactorial and complex nature of fracture healing, the dynamics of inflammatory processes, and the cumulative effects of various dopamine receptor subtypes.Öğe Investigation of the effects of pentoxifylline and alpha tocopherol treatment on recovery in rats with Achilles tendon rupture(Wiley, 2024) Toker, Mustafa; Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Coskun, Sinem Kantarcioglu; Dalaslan, Rasit Emin; Celik, MuecahitAlthough the Achilles tendon is the largest and strongest tendon in the body, healing of the Achilles tendon is the most common injury, and this process is difficult due to poor tendon circulation; moreover, the underlying mechanism has not been fully elucidated. In our study, we aimed to investigate the effects of pentoxifylline and alpha-tocopherol administered separately or in combination on rats with Achilles tendon injury. Forty-eight male Wistar rats weighing 230 +/- 30 g were used in the study. The rats were randomly divided into eight groups of six animals each. Tendons were evaluated histopathologically and biomechanically. According to the statistical analysis, the vascularity density in the pentoxifylline group on day 14 was significantly greater than that in the other groups (p < 0.05). The collagen arrangement in the pentoxifylline and alpha-tocopherol groups on day 14 was found to be firmer and smoother than that in the control group (p < 0.05). The collagen arrangement in the pentoxifylline group on day 28 was greater than that in the other groups (p < 0.05). The biomechanical results were significantly greater in all groups (p < 0.05). Pentoxifylline contributed to tendon healing both through neovascularization in the early period and by improving collagen orientation in the late period, while alpha-tocopherol had a positive effect on collagen orientation in the early period. No beneficial effects were observed when pentoxifylline and alpha-tocopherol were used together. We believe that further research is needed to understand the effects of this combination therapy on tendon healing.Öğe The role of tranexamic acid and cryotherapy on acute postoperative pain and blood loss: a randomized controlled study following total knee arthroplasty(Springernature, 2025) Saglam, Soenmez; Karaduman, Zekeriya Okan; Arican, Mehmet; Yucel, Muecahid Osman; Dalaslan, Rasit Emin; Cangur, Sengul; Uludag, VeyselPurpose Blood loss and pain management are significant concerns in total knee arthroplasty (TKA). Tranexamic acid (TA) and cryotherapy have been used separately to address these issues, but their comparative effectiveness is not well studied. This study aimed to evaluate the efficacy of intravenous TA and cryotherapy in reducing blood loss and improving clinical outcomes after TKA. Methods A randomized controlled trial with 76 patients assigned to three groups: Group 1 received pre- and postoperative cryotherapy, Group 2 received intravenous tranexamic acid (TA), and Group 3 (control) received a standard cold pack. Hemoglobin (Hb), hematocrit (Hct), prothrombin time, international normalized ratio (INR), knee flexion and extension angles, and visual analog scale (VAS) pain scores were monitored preoperatively and postoperatively at 6, 24, and 48 h. Results The mean age of patients was 65 +/- 7 years. The tranexamic acid group showed significantly lower blood loss compared to the control group (p < 0.001). Knee flexion and extension angles were significantly better in the cryotherapy group compared to the control group (p < 0.001). VAS pain scores were significantly lower in the cryotherapy group at all time points compared to both the tranexamic acid and control groups (p < 0.001). Conclusion Both tranexamic acid and cryotherapy are effective in reducing blood loss and improving clinical outcomes following TKA. Tranexamic acid significantly reduces blood loss, while cryotherapy effectively manages postoperative pain and range of motion. These methods can enhance patient recovery after TKA.Öğe Short-Term Clinical Evaluation of Tibial Tunnel Angle and Position in Anatomical Anterior Cruciate Ligament Reconstruction(Mdpi, 2025) Yucel, Muecahid Osman; Dalaslan, Rasit Emin; Saglam, Soenmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Akar, BedrettinBackground and Objectives: This study aimed to evaluate the influence of the angle and position of the tibial tunnel in the coronal and sagittal planes on short-term postoperative clinical outcomes following arthroscopic anterior cruciate ligament reconstruction (ACLR). Materials and Methods: This retrospective study included 40 patients who underwent anatomical ACLR between 1 January 2023 and 31 December 2023 and had a follow-up period of at least 4 months. The angle of the tibial tunnel on the AP radiograph and both the angle and anteroposterior position on the lateral radiograph were measured. Clinical evaluations were conducted using the Visual Analogue Scale (VAS), the International Knee Documentation Committee (IKDC) score, and the Lysholm Knee Score, along with measurements of knee flexion and extension, to assess short-term outcomes at 1, 2, and 4 months postoperatively. Results: In patients whose tibial tunnels were positioned at 40-50 degrees in the coronal plane, Lysholm scores were significantly higher at the 2nd and 4th months compared to other angles. In the sagittal plane, a tunnel angle between 30 degrees and 40 degrees was associated with significantly increased IKDC scores at both the 2nd and 4th months. Additionally, tunnels with an anterior-posterior ratio of 0.4-0.6 in the sagittal plane were associated with limitations in flexion and extension at the 4th month. There was no significant difference in VAS scores between the groups. Conclusions: Our findings suggest that optimizing the tibial tunnel angle in both the coronal and sagittal planes may play a crucial role in early postoperative knee function. Specifically, tibial tunnels placed between 40 degrees and 50 degrees in the coronal plane and 30 degrees and 40 degrees in the sagittal plane were associated with higher functional scores. However, tunnels positioned with an anterior-posterior ratio of 0.4 to 0.6 were linked to greater joint motion limitation. These findings indicate that angular and positional optimization of the tibial tunnel may have contributed to improved functional recovery following ACL reconstruction.Öğe Significance of Preoperative Multidisciplinary Assessment with 30-Second Sit-to-Stand and Timed Up-and-Go Tests in Predicting Postoperative Outcomes(Mdpi, 2025) Yucel, Mucahid Osman; Saglam, Sonmez; Dalaslan, Rasit Emin; Arican, Mehmet; Karaduman, Zekeriya Okan; Akar, Bedrettin; Celik, MucahitBackground/Objectives: Evaluating basic daily activities like sitting, standing, and walking is crucial for predicting preoperative risks and postoperative recovery. These functional abilities can be assessed through patient history or measured using objective tests. For this purpose, the 30-Second Sit-to-Stand (30STS) Test and Timed Up-and-Go (TUG) Test are frequently used in clinical settings. However, few studies have evaluated their effectiveness in anesthesia and orthopedics. In this study, we aimed to assess the applicability of these tests across clinical disciplines. Methods: A total of 43 patients who underwent total knee arthroplasty (TKA) surgery between January and December 2023 with American Society of Anesthesiologists (ASA) scores of 2-3 were retrospectively evaluated. The 30STS, TUG, and VAS scores were recorded preoperatively and on postoperative days 90-180. Results: The preoperative 30STS and TUG scores showed no statistically significant difference between the ASA 2-3 groups, but the ASA 2 group demonstrated a more pronounced performance improvement in both tests during the first 90 days postoperatively. The correlation tests revealed a strong positive relationship with the TUG Test and a moderate positive relationship with the 30STS and VAS scores. Conclusions: The correlation between the preoperative and postoperative results of the 30STS and TUG Tests suggests that preoperative tests can predict post-operative functional performance. However, the lack of a significant statistical relationship between the preoperative tests and ASA scores indicates that these tests may not be sufficiently useful for assessing the functional capacity. The better test outcomes in the ASA 2 patients indicate that combining these assessments with anesthetic evaluations may improve postoperative functional predictions, thereby promoting a multidisciplinary approach.
