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    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, Sonmez
    Objectives: 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.
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    Innovative approaches in the treatment of chronic plantar fasciitis: comparison of pulsed radiofrequency ablation and surgical intervention
    (Springer, 2024) Armagan, Celal; Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Kaban, Ilyas; Uludag, Veysel
    Purpose This study aimed to compare the effectiveness of Pulsed Radiofrequency Ablation (PRFA) and surgery for treating chronic plantar fasciitis, focusing on pain relief and functional outcomes. Methods A prospective study involved 30 patients with chronic plantar fasciitis unresponsive to 12 months of conservative treatment. Patients were divided into PRFA (n = 17) and surgical (n = 13) groups. Clinical evaluations were conducted preoperatively and at three, six and 12 months postoperatively using VAS, AOFAS, FFI, and RMS scores. Radiological measurements assessed foot structure impact. Results Both PRFA and surgery significantly reduced pain and improved function. PRFA had a shorter operative time and quicker return to activities (p < 0.001). At 3 months, PRFA showed superior VAS, FFI, and RMS scores (p < 0.05). Long-term outcomes were similar. No major complications occurred, but minor complications were higher in the surgical group (p < 0.01). Conclusions PRFA is a minimally invasive, effective treatment for chronic plantar fasciitis with quicker recovery and lower complication rates compared to surgery. Both treatments offer comparable long-term benefits. Further studies are needed to confirm these findings.
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    Patient-Reported Outcomes of Microfracture, Nanofracture, and K-Wire Drilling in Talus Osteochondral Lesions
    (Mdpi, 2025) Kasapoglu, Ahmet Gorkem; Arican, Mehmet; Tekce, Yildiray; Tekce, Giray; Kaban, Ilyas
    Background/Objectives: Different patient-reported outcomes and radiological results are reported depending on whether microfracture, drilling, or nanofracture is utilized in the arthroscopic treatment of talus osteochondral lesions, but the first-line treatment is still controversial. The aim of this study is to evaluate the early patient-reported outcomes of microfracture, nanofracture, and antegrade drilling methods in talus anteromedial osteochondral lesions. Methods: A total of 77 patients who presented with ankle pain between October 2016 and June 2022, were diagnosed with talus osteochondral lesions, and underwent microfracture (n: 27), nanofracture (n: 25), and K-wire drilling (n: 25) were included. Demographic data of the patients were evaluated, such as age, gender, lesion side, dominant extremity, body mass index (BMI), smoking status, smoking (pack/day-year), and symptom duration. Patient-reported outcomes of the patients were evaluated with VAS (visual analog scale) and AOFAS (American Orthopedic Foot & Ankle Society) scores measured before surgery and at 6 and 12 months after surgery. The results were evaluated at the significance level of p < 0.05. Results: There were no statistically significant differences among the microfracture, nanofracture, and drilling groups in terms of age, gender, lesion side, dominant extremity, BMI, smoking, or daily cigarette use (p = 0.121, p = 0.852, p = 0.956, p = 0.731, p = 0.881, p = 0.769, p = 0.124). Similarly, the mean duration of symptoms did not differ significantly between the groups (p = 0.336). Although AOFAS and VAS scores significantly improved in all groups (p = 0.0001), there were no statistically significant differences between the microfracture, nanofracture, and drilling groups at preoperative, 6th-, and 12th-month measuring points. The microfracture group showed a significantly higher AOFAS improvement from preop to 6 months compared to the other groups (p = 0.012), though no differences were found between nanofracture and drilling or in 12-month changes. VAS percentage changes showed no significant differences among groups at either time point. Conclusions: All treatment groups had similar baseline characteristics and outcomes, with the microfracture group showing a greater functional improvement at 6 months.