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Anatomik Ön Çapraz Bağ Rekonstrüksiyonun Femoral Tünel Oblisitesi İle İlişkisinin Klinik Olarak Değerlendirilmesi
(2019) Turhal, Ozan; Karaduman, Zekeriya Okan; Turhan, Yalçın; Güler, Cemal; Cangür, Şengül; Arıcan, Mehmet
Amaç: Artroskopik ön çapraz bağ (ÖÇB) rekonstrüksiyonlarında hamstring tendon grefti, patellar tendon grefti,allogreft gibi çeşitli tendon greftleri kullanılmaktadır. Çalışmamızda, Otojen Hamstring Tendonlar kullanılarakAnatomik Ön Çapraz Bağ Rekonstrüksiyonu uygulanan hastalarda femoral tünel oblisitesinin sonuçlarını güncelliteratür eşliğinde değerlendirmeyi amaçladık.Gereç ve Yöntemler: Ocak 2013 – Haziran 2016 tarihleri arasında ön çapraz bağ rüptürü nedeniyle kliniğimizdecerrahi olarak tedavi edilen hastalar telefonla aranarak hastaneye davet edildi. Bunlar içerisinden fizik muayeneleri,grafi kontrolleri ve ölçümleri yapılan 64 hasta çalışmaya dâhil edildi.Bulgular: Hastalarımızın 55’i erkek, 9’u bayandı. Hastaların yaş ortalaması 29.3±8.12 (14-47) idi. Ortalama takipsüremiz 14.47±7.44 (6-36) aydır. Kontrol Lysholm ve Tegner skoru ameliyat öncesi değerlerle karşılaştırıldığındaistatistiksel açıdan ileri derecede anlamlı farklılıklar bulundu (p<0.001). International Knee Documentation Committee(IKDC) diz bağları değerlendirme sistemine göre ameliyat öncesi 3 hasta (%4.7) B, 18 hasta (%28.12) C ve 43 hasta(%67.18) D olarak saptandı. Ameliyat sonrası yapılan son kontrol muayenesinde 41 hasta (%64.06) A, 21 hasta(%32.81) B ve 2 hasta (%3.12) C grubuna dâhil edildi. Ortalama femur tüneli oblisitesi 41.2±7.2° bulundu.Sonuç: Ön çapraz bağ’ın rotasyonel stabilitesine oblik femoral tünel yerleşiminin daha fazla yarar sağladığıdüşünülmektedir. Biz bu çalışmamızın sonucunda ön çapraz bağın otojen hamstring tendon grefti kullanarak anatomikteknikle uygulanmasının femoral tünel oblisite artışının fonksiyonel sonuca katkısının daha yararlı olduğukanaatindeyiz.
Aponeurotic Expansion as a Cause for Rotator Cuff Tears but Full Joint Movements in Patients: Magnetic Resonance Arthrography Images of Aponeurotic Expansion and the Clinical Situation
(Springernature, 2024) Uludag, Veysel; Guclu, Derya; Karaduman, Zekeriya Okan; Ogul, Hayri
This case report presents the detailed clinical and radiological findings of a 63-year-old male patient who presented with right shoulder pain. Magnetic resonance imaging (MRI) and magnetic resonance arthrography (MRA) revealed significant tears in most of the rotator cuff muscles. Despite these findings, the patient was able to perform full shoulder movements, suggesting that aponeurotic expansion may play a crucial role in this scenario. This case highlights important clinical findings that could lead to potential changes in shoulder surgery and rehabilitation approaches.
Cerrahi Tedavi Uygulanan Kalça Kırığı olan Geriatrik Hastalardaki Erken Dönem Mortalite Oranları ve Cerrahi Tipleri
(2024) Özel, Zafer; Karaduman, Zekeriya Okan; Arıcan, Mehmet; Turhan, Yalçın; Tuncer, Cengiz; Uludağ, Veysel
Amaç: Bu çalışmanın amacı, basit düşme sonrası kalça kırığı gelişen ve cerrahi olarak tedavi edilen 65 yaş üstü hastalarda cerrahi sonrası 30 gün içinde mortalite ile kırık, implant tipi ve cerrahi zamanlaması arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: 01 Ocak 2010 - 31 Temmuz 2020 tarihleri Düzce Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalına başvuran hastalar incelendi. Bu hastalar arasından belirtilen tarihler arasında izole kalça kırığı tanısı ile protez veya proksimal femoral çivi/plak vida ameliyatı yapılan 65 yaş üstü hastalarda cinsiyet, yaş, ameliyat zamanı, ameliyat tipi ve ameliyat sonrası mortalite oranları arasındaki ilişki retrospektif olarak değerlendirildi. Bu çalışmada, belirtilen zaman aralığında tedavi edilen 450 hasta değerlendirildi ve 308 hasta çalışmamızın kriterlerini karşıladı. Bulgular: Mortalite oranları ile cerrahi (implant) arasında istatistiksel olarak anlamlı bir fark vardı (p<0,05). Ayrıca Anestezi tipi ile mortalite oranları arasında istatistiksel olarak anlamlı bir fark vardı (p<0,001). Hastaneye yatış ile ameliyat arasında geçen süre (gün) ve ameliyat ile taburculuk arasında geçen süre (gün) ile mortalite oranları arasında istatistiksel olarak anlamlı bir fark yoktu (p=0,984). Ameliyat yaşı ile mortalite oranları arasındaki fark istatistiksel olarak anlamlıydı (p<0,001). Sonuç: Bu çalışmada ameliyat sonrası birinci ayda mortalite oranı %8,1 olarak bulundu ve mortaliteyi etkileyen en önemli faktörlerin ameliyat tipi ve anestezi tipi olduğu saptandı.
The Characteristics and Outcomes of Contralateral Non-Concurrent Hip Fractures: A Retrospective Study in Geriatric Patients
(Mdpi, 2024) Saglam, Sonmez; Arican, Mehmet; Karaduman, Zekeriya Okan; Yucel, Mucahid Osman; Degirmenci, Erdem; Uludag, Veysel
Background and Objectives: This study aimed to determine the relationship between non-simultaneous contralateral hip fractures, urban and rural differences, fracture localization, time between fractures, physiotherapy applications, comorbidity, and the second fracture outcomes. Materials and Methods: We retrospectively analyzed 107 patients aged 65 and older with proximal femur fractures (PFFs) who underwent surgery at D & uuml;zce University Medical Faculty between January 2010 and December 2022. High-energy fractures, pathological fractures, and patients with a history of old fractures were excluded. Results: The study included 66 females (61.7%) and 41 males (38.3%), with a mean age of 83.76 years. The mean interval between two fractures was 28.3 months. There was no statistical difference between the localization of the first and second fractures (p = 0.107). However, there was a significant difference in the first PFF localizations of patients living in rural areas (p = 0.023). Patients with heart failure, respiratory failure, osteoporosis, and cognitive impairment had shorter intervals between fractures (p < 0.001). Conclusions: This study shows that age, female gender, place of residence, comorbid diseases, and whether physical therapy is received after the first fracture are significant risk factors for a second hip fracture in patients over 65 years of age.
Chondroprotective effect of Nigella sativa oil in the early stages of osteoarthritis: an experimental study in rabbits
(Jmni, 2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Turhal, Ozan; Gamsızkan, Mehmet; Aydın, Davut; Özkan, Korhan
Purpose: Nigella sativa oil possesses a well-known ability to protect certain organs from oxidative, neoplastic, and inflammatory damage. This study investigated the potential chondroprotective effects of intraarticular injections of Nigella sativa oil in a rabbit osteoarthritis model. Methods: Osteoarthritis models were created by performing anterior cruciate ligament transections in 20 New Zealand rabbits. Rabbits were randomly divided into two groups of 10 and given intraarticular injections in their right knees weekly for 5 weeks, beginning in the third week post-operation. Injections given to the first group contained whole Nigella sativa oil, whereas the second group was injected with a saline solution. Knee joints were harvested 8 weeks after surgery. Knee joint surfaces were examined macroscopically, and medial femoral condyle sections were examined microscopically. Results: There was a statistically significant difference in the macroscopic grading results of the groups, with the Nigella sativa group having better results (p=0.001). The Nigella sativa group also received significantly better total Osteoarthritis Research Society International (OARSI) scores (p=0.035). Conclusions: Intraarticular administration of Nigella sativa oil has the potential to protect cartilage from degeneration in the early stages of osteoarthritis.
Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up
(Sage Publications Ltd, 2019) Arıcan, Mehmet; Turhan, Yalçın; Karaduman, Zekeriya Okan; Ayanoğlu, Tacettin
Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 +/- 9.19 (38-77) years were included. The mean surgery time was 35.33 +/- 5.34 (28-55) min. The mean follow-up time was 28.31 +/- 3.03 (24-36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 +/- 7.46 (13-41) to 81.25 +/- 3.77 (74-87; p = 0.0001) and the Q-DASH score had decreased from 82.34 +/- 10.37 (65.91-100) to 10.28 +/- 6.88 (0-23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline-final follow-up between the small, medium, large, and massive tear groups (p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.
Clinical and functional outcomes of extracorporeal shock wave therapy in isolated medial epicondylitis
(Prusa Medical Publishing, 2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan
Objective: To evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) for the patients with isolated medial epicondylitis refractory to other conservative methods. Methods: A retrospective analysis of 57 patients with the diagnosis of isolated medial epicondylitis refractory to conservative measures was done. 36 of them who met our eligibility criteria were included. Patients were subjected to three sessions of extracorporeal shock wave therapy with 2000 pulses per a session in a dose of 0.06-0.12 mJ/mm2. Pain and clinical/functional scores were measured by visual analogue scale (VAS) and Quick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) respectively before the treatment and at 1st week and 12th week of the last session. Results: Mean age of the patients was 47.3 (25-67) years and there was a higher female presentation (24 female and 12 male patients). The VAS scores were improved from a mean of 7.8 before the treatment to 5.3 at 1st week (p < 0.001) and to 2.9 at 12th week (p < 0.001). Also the results of the Q-DASH showed a mean improvement from 50.4 before the treatment to 27.1 at 1st week (p < 0.001) and 9.6 at 12th week (p < 0.001). There were no significant differences in the improvements of VAS and Q-DASH scores by the time between the male and female patients. Conclusion: According to the results of this study which will be one of the limited studies about isolated medial epicondylitis; ESWT is a good conservative treatment option for medial epicondylitis in refractory cases like in lateral epicondylitis.
Clinical and functional outcomes of extracorporeal shock wave therapy in isolated medial epicondylitis
(2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan
Objective: To evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) for the patients withisolated medial epicondylitis refractory to other conservative methods.Methods: A retrospective analysis of 57 patients with the diagnosis of isolated medial epicondylitis refractoryto conservative measures was done. 36 of them who met our eligibility criteria were included. Patients weresubjected to three sessions of extracorporeal shock wave therapy with 2000 pulses per a session in a dose of0.06-0.12 mJ/mm2. Pain and clinical/functional scores were measured by visual analogue scale (VAS) andQuick-Disabilities of the Arm, Shoulder and Hand (Q-DASH) respectively before the treatment and at 1st weekand 12th week of the last session.Results: Mean age of the patients was 47.3 (25-67) years and there was a higher female presentation (24 femaleand 12 male patients). The VAS scores were improved from a mean of 7.8 before the treatment to 5.3 at 1stweek (p < 0.001) and to 2.9 at 12th week (p < 0.001). Also the results of the Q-DASH showed a meanimprovement from 50.4 before the treatment to 27.1 at 1st week (p < 0.001) and 9.6 at 12th week (p < 0.001).There were no significant differences in the improvements of VAS and Q-DASH scores by the time betweenthe male and female patients.Conclusion: According to the results of this study which will be one of the limited studies about isolated medialepicondylitis; ESWT is a good conservative treatment option for medial epicondylitis in refractory cases likein lateral epicondylitis.
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 Emin
Background 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.
Comparative Study of the Functional and Clinical Outcomes of Two Different Rotator Cuff Repair Techniques: Suture Anchor versus Transosseous Sharc-FT
(2020) Karaduman, Zekeriya Okan; Arıcan, Mehmet; Turhal, Ozan; Turhan, Yalçın; Solak, Kazım; Akkurt, Mehmet Orçun; Cangür, Şengül
Aim: The aim of the present study was to compare the functional and clinical outcomes of suture anchor andtransosseous Sharc-FT fixation options in mini-open repair of rotator cuff tears.Material and Methods: Between January 2010 and July 2016, 60 patients were operated on in the Orthopedics andTraumatology Clinics of Duzce University Hospital and Duzce State Hospital. Thirty patients in whom repair wasperformed with suture anchor (Group 1) and 30 patients in whom repair was performed with Transosseous Sharc-FT®(Group 2) were compared. Preoperative and postoperative shoulder ranges of motion, the visual analog scale scores,constant shoulder scores, Oxford shoulder scores, and Q-DASH shoulder scores were evaluated in Group 1 and Group 2patients.Results: A total of 62% of the participants were male and 38% were female. Gender distribution was homogeneous inboth groups (P=0.426). The mean age of the subjects was 57.35 ± 8.69 (41-78) years. No significant difference wasnoted between the groups in terms of mean age (P=0.232). On the basis of the post-hoc test results, the postoperativeconstant score was significantly higher in Group 2 compared with that in Group 1 (P<0.001).Conclusion: Rotator cuff repair using transosseous Sharc-FT fixation material provides tighter stability compared withsuture anchor and has superior functional, radiological, and pain scores. Furthermore, early rehabilitation is anotheradvantage of using Transosseous Sharc-FT in patients who prefer undergoing rotator cuff repair over other fixationoptions.
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, Volkan
Background/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.
Comparison of histopathological and biomechanical changes of ligamentum mucosum in patients with anterior cruciate ligament rupture
(Turkish Joint Diseases Foundation, 2024) Turhan, Yalcin; Arican, Mehmet; Karaduman, Zekeriya Okan; Sungur, Mehmet Ali; Gamsizkan, Mehmet
Objectives: The aim of this study was to identify the biomechanical and histopathological changes of ligamentum mucosum (LM) in patients with intact versus ruptured anterior cruciate ligament (ACL). Patients and methods: A total of 67 patients (45 males, 22 females; mean age: 33.2 +/- 7.9 years; range, 18 to 45 years) who underwent arthroscopic knee surgery for intraarticular pathologies between July 2022 and January 2023 were prospectively analyzed. The patients with LM were divided into two groups as the ACL intact group (n=31) and ACL ruptured group (n=36). Biomechanical tests and histopathological examinations were performed in all LM patients. Results: Age and body mass index distributions were similar between the groups (p>0.05). Peak force values of the LM in the ACL ruptured group were significantly higher than the ACL intact group (p=0.037). No significant difference was found between the groups in terms of collagen index (p=0.103) and fibroblast count (p=0.821). Conclusion: The peak force values of the LM were significantly higher in the ACL ruptured group as compared to the ACL intact group, which is probably due to the adaptation of LM in patients with ACL rupture against increased deforming forces to maintain knee stability.
Comparison of peripheral nerve repair using ethylcyanoacrylate and conventional suture technique in a rat sciatic nerve injury model
(2020) Atam, Camettin; Orhan, Zafer; Toplu, Gaye; Serin, Merdan; Karaduman, Zekeriya Okan; Öztürk, Ayhan
Objective: The aim of this study was to compare the outcomes of primary nerve repair using either ethyl-cyanoacrylate orconventional microsuture technique in a rat peripheral nerve injury model.Methods: In this study, a total of 30 Wistar Albino rats weighing between 220 and 275 g were used. The rats were randomlydivided into three groups (10 in each), including one control (group 1) and two experimental groups (group 2, conventionalmicrosuture repair; group 3, cyanoacrylate repair). In each group, the sciatic nerve was identified and transected. No furtherintervention was performed in group 1. The nerve was repaired using the epineural technique with a 10/0 atraumaticnylon in group 2 and synthetic cyanoacrylate adhesive in group 3. At the fifth postoperative week, needle electromyography(EMG) was performed to measure distal latency, combined muscle action potential (CMAP), and motor nerve conductionvelocity (MNCV). Following the EMG recordings, animals were euthanized. Nerve samples were collected to evaluate vacuolardegeneration, fibrosis, and foreign body reaction histopathologically.Results: In the EMG analysis, mean distal latency was significantly shorter in group 1 (0.85±0.09 ms) than in groups 2(1.17±0.25 ms) (p=0.0052) and 3 (1.14±0.14 ms) (p=0.0026) while no significant differences existed between groups 2 and3 (p>0.9999). The mean CMAP was greater in group 1 (10.5±0.35 mV) than in groups 2 (2.86±1.28 mV) (p=0.011) and 3(2.16±1.34 mV) (p=0.0002), but there was no significant difference between groups 2 and 3 (p>0.9999). The mean MNCVwas 53.5±5.95, 39.62±7.31, and 39.84±4.73 mm/sec in groups 1, 2, and 3, respectively. There was a significant differencebetween groups 1 and 2 (p=0.0052) and between 1 and 3 (p=0.0026), but not between 2 and 3 (p>0.9999). In the histopathologicalevaluation, the mean vacuolar degeneration score was 0, 2.12, and 1.88 in groups 1, 2, and 3, respectively. No obviousdifference was observed between groups 2 and 3 (p=0.743). The mean fibrosis score was 0, 1.62, and 1.77 in groups 1, 2,and 3, respectively. There was no significant difference between groups 2 and 3 (p=0.888). The mean foreign body reactionscore was 0, 2.5, and 2.44 in groups 1, 2, and 3, respectively. No difference was present between groups 2 and 3 (p=0.743).Conclusion: Primary nerve repair using the cyanoacrylate adhesive may provide similar electrophysiological and histopathologicalresults as compared to the conventional microsuture repair.
Comparison of the Effects of Nigella sativa Oil and Nano-silver on Wound Healing in an Experimental Rat Model
(Kowsar Publ, 2019) Turhan, Yalçın; Arıcan, Mehmet; Karaduman, Zekeriya Okan; Turhal, Ozan; Gamsızkan, Mehmet; Aydın, Davut; Özkan, Korhan
Background: Various topical treatments are available for skin defects. Chronic and complicated wounds can affect a patient's quality of life and cause significant economic burden and even mortality. Nigella sativa (NS) oil and silver-containing solutions are separately used to treat various skin disorders. Objectives: The current study aimed at examining the healing potential of NS oil, Nano-silver (AgNPs) solution, and their combination to manage skin wounds in a rat model. Methods: The current clinical experimental study was conducted in the Experimental Animal Unit of Abant Izzet Baysal University, Bolu, Turkey, in 2017. Full-thickness skin defects with a 1 cm(2) surface area were created on the backs of 20 adult Wistar albino rats. The wounds were covered with 1 cm(2) of absorbable oxidized regenerated cellulose (SURGICEL). The rats were numbered and assigned to four groups by simple random sampling. The agents to be compared (saline, NS oil, and AgNPs solution) were administered to the wounds twice daily forts days. The wounds were observed for the percentage reduction in original wound size every three days. Scars were harvested on day15 for histological morphometric analysis. Results: There were no significant differences in the mean vertical scar thickness among the saline (group 1) [1.06 +/- 0.18], NS oil (group 2) [0.76 +/- 0.14], AgNPs (group 3)10.98 +/- 0.44], and NS oil + AgNPs (group 4) [0.87 +/- 0.38] groups (P = 0.556). However, the mean collagen density was significantly lower in groups 1 and 3 [56.50 +/- 11.18 and 59.60 +/- 3.16] compared with groups 2 and 4 [73.57 +/- 6.30 and 80.99 +/- 7.19] (P < 0.001). Conclusions: Wounds treated with the combination of NS oil and Nano-silver healed significantly faster, with less scar formation, than the ones treated with NS oil or Nano-silver alone.
A Comparison of the Modified Bosworth and Endobutton Techniques in the Surgical Treatment of Rockwood Type III Acromioclavicular Joint Dislocations
(2020) Karaduman, Zekeriya Okan; Orhan, Zafer; Turhan, Yalçın; Arıcan, Mehmet; Değirmenci, Erdem; Turhal, Ozan
Aim: In this study, we aimed to retrospectively compare the long-term clinical and radiological outcomesobtained with the modified Bosworth technique and Endobutton technique in surgical treatment of type IIIacromioclavicular dislocations.Materials and Methods: Thirty-two patients (26 males, 6 females) (mean age 37, range 15–78 years) weretreated surgically for acromioclavicular joint (ACJ) dislocation. All patients had type III dislocation. Twentytwo patients had right ACJ dislocation and 10 patients had left ACJ dislocation. Of the dislocations, 18 occurred due to falls; 9, sports injuries; and 5, traffic accidents. Of the patients, 18 were operated on with theEndobutton technique and 14 with the modified Endobutton technique. Patients were evaluated postoperatively in terms of functional Constant, DASH, and VAS scores and radiologically with coracoclavicular distance(CCD) assessment. The mean follow-up was 52 (37–66) months.Results: The alignment of the acromioclavicular joint was normal in all patients. No joint degeneration wasobserved in any patient. Shoulder movements were painless and complete in all patients. The mean postoperative 3rd, 12th, and 24th month Constant scores were found significantly higher for the Endobutton group thanfor the modified Bosworth group (p=0.001). The mean postoperative 3rd, 12th, and 24th month DASH scoreswere significantly lower for the Endobutton Group than for the modified Bosworth group (p=0.003). Themean postoperative 3rd, 12th, and 24th month VAS scores were significantly lower for the Endobutton groupthan for the modified Bosworth group (p=0.001). However, no statistically significant difference was foundbetween the mean preoperative and postoperative CCD values of the two groups (p=0.104).Discussion and Conclusion: The Endobutton technique is a good alternative to the modified Bosworthtechnique in the surgical treatment of acromioclavicular dislocations.
Comparison of transtibial and anteromedial portal techniques used in anterior cruciate ligament repair using autogenous hamstring tendon graft
(Duzce University Medical School, 2019) Karaduman, Zekeriya Okan; Turhal, Ozan; Turhan, Yalçın; Arıcan, Mehmet; Cangür, Şengül
Aim: The aim of this study was to investigate the effects of transtibial (TT) and anteromedial portal (AMP) techniques used in anterior cruciate ligament repair on knee joint function after anterior cruciate ligament reconstruction. Material and Methods: Sixty patients who were surgically treated in our clinic for anterior cruciate ligament tear were included in the study. Thirty patients underwent TT technique and 30 patients underwent AMP. Functional evaluations were performed according to Lysholm, International Knee Documentation Committee (IKDC) and Tegner scoring preop and postop. The angle between the femoral tunnel and the distal joint face was measured in postoperative Anteroposterior and Lateral knee graphs and its effect on the knee joint functional outcome was examined. Results: Eighty percent of the patients included in the study were male (n=47) and 20% were female (n=13). The gender distribution according to the groups was homogeneous (p=0.476). The mean age of the subjects was 32.75±8.81 (16-53) years. The postoperative Lysholm score was significantly higher in the AMP group than in the TT group (p<0.001). The postoperative Tegner score was significantly higher in the AMP group than in the TT group (p<0.001). Mean femoral tunnel obliquity was 59.3° in the TT group and 41.4° in the AMP group. Conclusion: It is thought that oblique femoral tunnel placement is more beneficial for the rotational stability of anterior cruciate ligament. In our study, we think that AMP technique is more beneficial than femoral obliquity in terms of functional outcome. © 2019, Duzce University Medical School. All rights reserved.
Comparison of Two Different Approaches to Treat a Hallux Valgus Deformity: Intramedullary Self-Locked Plates and Herbert Screws
(Mdpi, 2019) Karaduman, Zekeriya Okan; Turhal, Ozan; Turhan, Yalçın; Arıcan, Mehmet; Güler, Cemal; Cangür, Şengül
Background and objectives: Hallux valgus is a complex deformity of the first metatarsophalangeal joint characterized by varus deformity of the first metatarsal bone, valgus deformity of the big toe, and lateral deviation of the extensor tendons and sesamoid bones. Several surgical methods have been described for correction of the deformity. Different materials have been used for the fixation of osteotomy. We compared the functional, radiological, and pain results of intramedullary self-locked plates and Herbert screws for the treatment of a hallux valgus deformity. Materials and Methods: Distal metatarsals were treated with self-locking intramedullary plate-screw systems in 18 feet from 12 patients (Group 1) and with Herbert screws in 18 feet from 12 patients (Group 2). The hallux valgus angle (HVA) and intermetatarsal angle (IMA) in patients of Group 1 and 2 were examined radiologically during the pre- and postoperative periods. We also determined the American Orthopedic Foot and Ankle Society (AOFAS), EQ-5D General Life Quality Scale, and Visual Analogue Scale (VAS) scores during the pre- and postoperative periods and compared the scores between groups. Results: Post hoc test results of HVA and IMA angles measured after the operation were significantly higher in Group 2 than in Group 1. In each group, the AOFAS scores during the preoperation period were significantly lower than those during the postoperation period (p < 0.001). According to the post hoc test results, the VAS scores after the operation were significantly higher in Group 2 than in Group 1 (p < 0.001). Conclusions: For the surgical treatment of hallux valgus, operations using self-locked plates compared to a single screw are superior in terms of providing rigid stability and for functional, radiological, and pain scores.
Decreased Blood Loss with Systemic and Intraarticular Tranexamic Acid Administration after Total Knee Arthroplasty
(2020) Karaduman, Zekeriya Okan
Objective: Perioperative bleeding during total knee arthroplasty (TKA) is a lastingproblem for surgeons. Intravenous or intra-articular administration of tranexamic acid(TXA) can effectively stop bleeding, but there is still no uniform standard for the bestadministration and dosing.Methods: Between October 2017 and September 2019, ninety patients with unilateralprimary knee osteoarthritis requiring knee replacement were retrospectively evaluated andinvestigated in three groups according to the route of TXA administration: Group 1(n=30) intravenous (IV) injection, Group 2 (n=30) intra-articular injection (IAI), andGroup 3 (n = 30) combined IV and IAI. Demographic characteristics, hematologicalindices, and the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE)were studied.Results: Of the patients included in the study, 86% were female (n=78), and 14% weremale (n=12). The gender distribution of the groups was homogeneous (p=0.749). Themean hemoglobin values of Group 2 were significantly lower than those of Group 1 andGroup 3 (p=0.002 and p=0.045, respectively). Less postoperative blood loss was observedin the group receiving combined IV and IA TXA. The mean blood loss from the drain inGroup 3 was significantly lower than that in Group 1 and Group 2 (p=0.001).Postoperative infection, DVT, and PE were not seen in any group.Conclusions: This study demonstrated that the use of intraarticular and intravenoustranexamic acid in primary unilateral TKA significantly reduced postoperative blood lossand consequently decreased the need for blood transfusion without an increase in adverseevents, particularly thromboembolic complications.
Dev Lipom: Olgu Sunumu
(2017) Yücel, İstemi; Solak, Kazım; Karaduman, Zekeriya Okan
Lipom, insan vücudunun mezenkimal kaynaklı en sık görülen neoplazmı olarak karşımıza çıkmaktadır. Asemptomatik olmaları nedeniyle nadiren de olsa dev boyutlara ulaşabilirler. Ayırıcı tanıda birçok benign ve malign tümoral yapı ile karışabilmesine rağmen tedavide total cerrahi eksizyon yeterlidir. Görülme yaşı ortalama 5. dekaddır ve erkeklerde 5-10 kat daha sık ortaya çıkmaktadır. Bu olguda sırtta yaklaşık 18 cm boyutlarında dev kitle şikayeti ile başvuran ve eksizyon sonucu patolojik incelemede lipom olarak değerlendirilen 44 yaşında erkek hasta literatür e şliğinde sunulmuştur.
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 Akif
Background: 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.

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