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Öğe Asymmetric bilateral hip dislocations and unilateral femoral head fracture: A CASE report(Elsevier Ltd, 2018) Değirmenci, Erdem; Kaya, Yasin Emre; Özturan, Kutay EnginHip is a stabilized joint due to the surrounding ligaments, and muscles, which can dislocate as a result of high energy trauma, high-level falls, and motor vehicle accidents. Traumatic hip dislocations can either be isolated or simultaneously with acetabular and proximal femur fractures. At the same time injury of sciatic, femoral or obturator nerves can be seen. However, avascular necrosis of femoral head, posttraumatic osteoarthritis, and heterotopic ossifications can be seen as prolonged complications. The period prior to the reduction, severity of the trauma, and performing open or close reductions are the major contributors of the prognosis. As an extremely rare entity, bilateral asymmetrical hip dislocations are reported as the 0.01–0.02% of all joint dislocations. Accompanying proximal femoral fractures are pointed out 17%, one of them is femoral head fractures which are orthopedic emergencies that need to be fixed with surgery. However, high incidence of AVN is reported at the end of 2 years even if following early reductions. In our article, traumatic bilateral asymmetric hip dislocations and femoral head fracture is described in the context of a diagnosis, treatment and follow-up. © 2018 The AuthorsÖğe Effect of sedation anesthesia on kinesiophobia and early outcomes after total knee arthroplasty(Sage Publications Ltd, 2020) Degirmenci, Erdem; Ozturan, Kutay Engin; Kaya, Yasin Emre; Akkaya, Akcan; Yucel, IstemiBackground: Total knee arthroplasty (TKA) operation is an effective treatment method in severe osteoarthritis worldwide. However, the number of patients with chronic pain and functional limitations in the postoperative period will continue to increase. Kinesiphobia is an important factor that affects the functional outcomes postoperatively. The aim of this study is to investigate the effects of intraoperative consciousness of the patients during surgery on kinesiophobia development and early functional outcomes of TKA. Methods: Sixty patients with the diagnosis of primary knee osteoarthritis were enrolled in the study. Tampa Scale of Kinesiophabia (TSK) was obtained for each patient at multiple time periods. Regional anaesthesia and deep sedation were performed on group 1 (n = 30), while regional anaesthesia and light sedation were performed on group 2 (n = 30). The same surgical procedures were applied to all participants. Functional tests were performed on the patients at the postoperative 2nd and 5th days. Visual Analogue Scale (VAS) scores and knee flexion angles were also measured postoperatively. Results: The mean age of the participants (19 men (31.7%) and 41women (68.3%)) was 67.7 +/- 6.7 (54-82) years. TSK >= 40 was detected in 18 (30%) patients preoperatively and 33 patients (55%) postoperatively. The number of kinesiophobic patients showed statistically significant increase after operation (20/30 (66.7%)) according to preoperative period (9/30 (30%)) in group 2 (p = 0.003). Postoperative functional scores, knee flexion angles and VAS scores were better in non-kinesiophobic patients. Conclusion: Patient's consciousness during TKA operations is an important factor that interferes with the postoperative kinesiophobia development, which may play a pivotal role affecting the early mobility and functional outcomes.Öğe Effects of tranexamic acid on the recovery of osteochondral defects treated by microfracture and acellular matrix scaffold: an experimental study(Bmc, 2019) Değirmenci, Erdem; Özturan, Kutay Engin; Şahin, Abdullah Alper; Yılmaz, Fahri; Kaya, Yasin EmreBackground: Microfracture and scaffold application in the treatment of osteochondral defects is still one of the most frequently used methods in the clinic. The most important step in this treatment method is the stabilization of fibrin clot Tranexamic acid (TA) is an antifibrinolytic agent commonly used in orthopedic surgery in recent years. This study evaluated the effect of local TA application on healing of experimentally induced osteochondral defects on rabbits. Methods: This paper contains an animal in vivo data and histological outcomes on the effect of TA. Eighteen New Zealand white rabbits were treated unilaterally and cylindrical defects having a width of 4 mm and depth of 5 mm were created in the weight-bearing surfaces of the medial and lateral condyles of the right femur. They were divided into two groups, as group 1 study and group 2 control groups, respectively. One milliliter (ml) of TA was injected into the knee joints of the subjects in group 1. All animals were sacrificed for the extraction of the femur condyles for histologic study at the fourth and eighth weeks after surgery. Histological evaluations were performed by Brittberg and O'Driscoll scores to all samples. Data were organized in a Standard Statistical Package System v.22 software package (SPSS/PC Inc., Chicago, IL) and reported as mean and median (min-max). Repeated measures ANOVA test was used to compare groups and condyle effects together for each week. p values below 0.05 were considered as statistically significant. Results: Samples were taken in the fourth and eighth weeks. The regularity of the surface in group 1 was smoother, and the tissue stability was more robust. Mean Brittberg scores in both weeks were statistically higher in group 1 when compared with group 2. In the microscopic evaluation, it was observed that the regeneration of subchondral and cartilage tissues were more rapid and organized in group 1, and the mean O' Driscoll scores in both weeks were statistically higher in group 1. Conclusions: Application of TA improves the healing time and tissue stability in osteochondral defects which are implanted a-cellular scaffold after microfracture and should be applicable to humans for the treatment of osteochondral defects.Öğe Short-Term Results of Patients Undergoing Arthroscopic Subacromial Decompression and Acromioplasty(2021) Kaya, Yasin Emre; Ayanoğlu, TacettinAim: The aim of this study is to evaluate the arthroscopic surgery results of cases with isolated subacromialimpingement syndrome (SIS) that do not respond to conservative treatment.Material and Methods: 44 patients who had arthroscopic subacromial decompression and acromiplasty due to SISbetween 2015 and 2018, were retrospectively analyzed. Patients with isolated subacromial impingement syndrome whodid not respond to conservative treatment including drugs, physiotherapy, exercises and subacromial steroid injectionswere included. For the patients, preoperative and postoperative The American Shoulder and Elbow Surgeons Shoulder(ASES) Scores were measured.Results: Forty-four patients with a mean follow-up of 26.4 months (ranging from 24 to 35 months; SD: 7.3) and a meanage of 51.4 (ranging from 39 to 55; SD: 6.96) were reached. Thirty (68%) of the patients were female and fourteen(32%) were male. There were no significant differences between groups according to the age, sex, and follow-up time(p>0.50). There were type 3 acromion in total of 7 patients and type 2 acromion in 18 patients. The overall meanpreperative ASES score was 38.8 (ranging from 36.6 to 41.8). And, the mean postoperaive ASES score was 84.9(ranging from 76.2 to 88.3).Conclusion: The short-term clinical results of subacromial decompression and acromioplasty in patients who do notrespond to conservative treatment has successfull results that support literature knowledge.