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Öğe 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, MehmetObjectives: 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.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 Effects of Drone Brood Homogenate on Wound Healing: An Experimental Study on Rats(Wiley, 2025) Arican, Mehmet; Kekecoglu, Meral; Turhan, Yalcin; Caprazli, Tugce; Gamsizkan, Mehmet; Karaduman, Zekeriya OkanBackground Wound healing is one of the most interesting topics in orthopaedic surgery, and there are many studies on the factors and mechanisms affecting this process. Objectives To evaluated the macroscopic and histopathological results of drone larvae homogenate (DLH) on wound healing in a full-thickness wound model. Methods Thirty male wistar rats (6-8 weeks, 250 +/- 50 g) were used. A uniform circular full-thickness wound of approximately 18.44 +/- 1.45 (control), 19.02 +/- 1.24 (silverdin), 19.37 +/- 1.28 (DLH) mm2 was excised on the back of each rat. They were divided into control (n: 10), silverdin (n: 10) and DLH (n: 10) groups. DLH, collected from the beehive for 3-7 days in late spring and ready for use after homogenization and lyophilization. Two mL of physiological saline, silver sulfadiazine 1% and DLH were applied to the control, silverdin and DLH groups, respectively, and a thin layer that completely covered the wound, and repeated every 2 days for all groups for 14 days. The condition of the lesions was observed every 2 days and the amount of contraction and granulation tissue formed in the lesion was recorded. The lesioned areas was examined histopathologically. Results There was no statistically significant difference in lymphocyte, fibroblast, scar thickness, polymorphonuclear leukocyte (PMNL), minivascular density (CD34) and transforming growth factor-beta 1 (TGF-beta 1) among the control, silverdin and DLH groups (p = 0.771, 0.434, 0.07, 0.396). The scar density of the DLH group was found to be higher than the control and silverdin groups (p = 0.003). The average wound diameter of the control group (6.87 +/- 0.93 mm2) on the 10th day was found to be higher than the silverdin (4.39 +/- 1.15 mm2) and DLH groups (4.16 +/- 0.55 mm2) (p = 0.0001). Conclusions DLH has a positive effect on wound healing, especially by ensuring early wound contraction and wound scar formation.Öğe The Effects of Phenyramidol and Diclofenac Treatment on Fracture Healing in Rats(Korean Orthopaedic Assoc, 2024) Celik, Mucahit; Karaduman, Zekeriya Okan; Turhan, Yalcin; Arican, Mehmet; Gamsizkan, Mehmet; Saglam, Sonmez; Uludag, VeyselBackground: Fracture healing or nonunion refers to a process in which many factors interact. In this study, we aimed to evaluate the radiological, histological, and biomechanical effects of phenyramidol and diclofenac, which are frequently used to treat post-fracture ture pain worldwide, on fracture healing and nonunion in a rat femur fracture model. Methods: In this study, 72 male Wistar-Albino rats aged 2-3 months and weighing 250 +/- 30 g were divided into 4 main groups. The rats were divided into 12 subgroups according to the early, middle, and late periods. A fracture model was created in rat femurs, and surgical fixation was performed. Postoperative analgesic treatment protocols included phenyramidol, diclofenac, phenyramidol + diclofenac, and the control group. The rats were sacrificed on the fifteenth, thirtieth, and forty-fifth days and were evaluated radiologically, histopathologically, and biomechanically. Results: Scoring was conducted independently by 2 orthopedists not involved in the study. When the results were analyzed statistically, no statistically significant difference was observed between the fifteenth and thirtieth day radiology score values of the control, diclofenac, phenyramidol, and Phenyramidol + diclofenac groups (p > 0.05), but there was a statistically significant difference (p < 0.05) between the forty-fifth day radiology score values of the control, diclofenac, phenyramidol, and phenyramidol + diclofenac groups. Conclusions: Our study shows that the use of diclofenac or phenyramidol alone negatively affects postoperative fracture healing. However, this effect was less pronounced in the combined treatment group. Histologic examination revealed that neither treatment had a significant effect on healing. There were statistical differences in biomechanical and radiologic properties between the phenyramidol and diclofenac groups; in particular, the diclofenac group had lower biomechanical properties.Öğe Evaluation of Clinical, Radiological and Functional Outcomes of Surgically Treated Ankle Fractures(Duzce Univ, Fac Medicine, 2022) Guler, Cemal; Karaduman, Zekeriya Okan; Orhan, Safak; Turhan, Yalcin; Arican, Mehmet; Turhal, Ozan; Orhan, ZaferObjective: The ankle is an important joint in the walking function of the body. Surgical treatment is required in cases where displaced and unstable fractures and joint compatibility cannot be achieved by conservative methods. The main goal of surgical treatment is to restore the anatomical position of the talus within the ankle for a normal tibiotalar joint relationship. Methods: 73 patients who were admitted to our outpatient clinics between January 2006 and October 2015, who were diagnosed with ankle fracture and underwent surgical treatment, were retrospectively evaluated and compared with the intact ankle. Results: Of the patients who had surgery; Bimalleol fracture in 34 (46.58%), trimalleol fracture in 8 (10.96%), lateral malleolar fracture in 14 (19.18%), medial malleolar fracture in 13 (17.81%), with posterior malleolar fracture in 1 ankle dislocation (1.37%) and 1 had posterior malleolar fracture with medial malleolus fracture (1.37%). According to the Lauge Hansen classification, the most common type of SER (Supination External Rotation) fracture (14 cases) (19.18%), followed by the second most common PER (Pronation External Rotation) fracture type (14 cases) (19.18%). According to the Danis -Weber classification, Type C (21 cases) (52.50%) was the most common and Type B (14 cases) (35.00%) was the second most common. When the union time was analyzed according to the fracture type, no statistically significant difference was observed (p=0.064). Conclusions: If surgical treatment is applied in ankle fractures the length of the fibula should be ensured, rigid internal fixation should be made with the aim of anatomical reduction of the joint surface, and ankle movements should be started early.Öğe 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, VeyselPurpose 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.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 Investıgatıon of the effects of treatment with enoxaparın sodıum and hyperbarıc oxygen therapy on the recovery of rats wıth achılles tendon rupture(Bmc, 2024) Aytekin, Cafer Erman; Turhan, Yalcin; Karaduman, Zekeriya Okan; Arican, Mehmet; Saglam, Sonmez; Coskun, Sinem Kantarcioglu; Uludag, VeyselPurpose In this study, we aimed to investigate the effects of hyperbaric oxygen therapy and enoxaparin sodium, which are known to accelerate bone tissue healing as well as tendon and soft tissue healing, on the healing of Achilles tendon rupture. Methods Thirty-six rats were used in the present study. All rats were divided into groups of nine. The groups were the enoxaparin sodium group, enoxaparin sodium and hyperbaric oxygen group, hyperbaric oxygen group and control group. After 21 days, the process was completed, and the rats were sacrificed. Achilles tendon samples were evaluated histopathologically. Results The groups were compared according to the results of statistical analysis based on the histopathological data. There was no significant difference between the groups in terms of acute inflammation (p = 0.785) or chronic inflammation (p = 0.827) scores, but there were significant differences in neovascularization (p = 0.009), proliferation (p < 0.001) and fibrosis (p = 0.006) scores. Conclusion Our study showed that the use of enoxaparin sodium and hyperbaric oxygen had a positive effect on the healing of the Achilles tendon. Based on these results, we believe that the use of enoxaparin sodium and hyperbaric oxygen therapy after Achilles tendon rupture will be beneficial for healing and preventing complications.Öğe Management preferences of orthopedic surgeons in developmental dysplasia of the hip under 1 year of age in Türkiye: Results of a nationwide cross-sectional survey(Turkish Assoc Orthopaedics Traumatology, 2023) Cetin, Baki Volkan; Bakircioglu, Sancar; Ciftci, Sadettin; Soylemez, Mehmet Salih; Erkus, Serkan; Turhan, Yalcin; Camurcu, Ismet YalkinObjective: This study aimed to evaluate the diagnosis and treatment preferences of orthopedic surgeons in developmental dysplasia of the hip (DDH) cases under the age of 1 in Turkiye with a higher incidence of DDH, estimated to be around 5-15 per 1000 live births. Methods: This was a nationwide cross-sectional survey. A link for the online survey, including 16 multiple-choice questions, was sent to the email group of the National Orthopedic Society. Results: Among 233 filled -out surveys, 211 met the inclusion criteria. Half of the participants had experience of <10 years as orthopedic surgeons, managed <25% of pediatric patients in daily practice, and treated <25 DDH cases per year before walking age. Ninety-seven percent used more than one method, hip ultrasound the most common, for exact diagnosis of DDH under 6 months. Pavlik harness was the most commonly preferred brace, but the use of Tubingen orthosis increased among experienced surgeons. The uppermost age limit for bracing was higher in surgeons dealing with more pediatric patients and treating more DDH cases. Dislocated hips and hips requiring closed/open reduction were more commonly referred to other surgeons by less experienced surgeons in terms of years, number of pediatric patients, and treated DDH cases per year. The lowest age limit for intervention under general anesthesia was lower in surgeons treating >25 DDH cases per year. Over one-third used both anterior and medial approach open reduction, but a trend to anterior open reduction alone was more evident in surgeons treating >50 DDH cases per year. More experienced surgeons were more prone to check the intraoperative reduction with postoperative computed tomography or magnetic resonance imaging. Diagnosis and treatment ages of DDH cases did not significantly change during the coronavirus disease 2019 pandemic. Conclusion: Management preferences of orthopedic surgeons in DDH before walking age primarily depend on the rate of pediatric patients in daily practice and the number of treated DDH cases per year.Öğe Management preferences of orthopedic surgeons in rickets patients in Turkey: Results of a nationwide survey(Public Library Science, 2025) Turhan, Banu; Yasar, Niyazi Erdem; Sungur, Mehmet Ali; Turhan, Yalcin; Bekmez, SenolAim Rickets remains a significant health issue, particularly in developing countries. This study evaluated the management preferences of orthopedic surgeons in Turkey regarding rickets and analyzed these approaches from a pediatric endocrinology perspective. Methods An online survey was developed based on a comprehensive literature review and previous similar studies. The survey link was distributed via email to members of the Turkish Orthopedic and Traumatology Association and the Pediatric Orthopedics Association. The questionnaire included 14 multiple-choice items addressing sociodemographic characteristics and the general approach to the diagnosis and treatment of rickets. Prior to dissemination, the survey was reviewed by 13 board-certified orthopedic surgeons from various institutions to ensure clarity and content validity. Results Of the 257 respondents, 198 met the inclusion criteria and were included in the analysis. Orthopedic surgeons with more than 10 years of experience (n = 111,56.1%) were significantly less likely to refer rickets patients to a pediatric endocrinologist (p = 0.009) and more likely to recommend oral or intramuscular 25-OH-vitamin D3 ampoule treatment rather than oral drops or capsules (p < 0.001). Surgeons who saw fewer than 25% pediatric patients in daily practice (n = 110,55.6%) were more inclined to refer patients without ordering diagnostic tests or initiating treatment (p = 0.011). The presence of a pediatric endocrinologist within the same institution (n = 96,48.5%) was also associated with increased referral rates without preliminary testing or treatment (p = 0.003/p = 0.002, respectively). Physicians who encountered at least one rickets patient per week (n = 78,39.4%) demonstrated better knowledge of normal serum 25-OH-vitamin D3 levels (p = 0.042) and were significantly less likely to refer patients to a pediatric endocrinologist (p < 0.001). Conclusion Management approaches to rickets among orthopedic and traumatology specialists in Turkey vary significantly depending on clinical experience, practice setting, and access to a pediatric endocrinologist. To prevent both undertreatment and unnecessary referrals, newly diagnosed rickets patients in orthopedic clinics should be appropriately evaluated and referred when necessary. Establishing a standardized diagnostic and referral algorithm based on international guidelines and incorporating it into orthopedic training programs is strongly recommended.Öğe A Pregnant Woman with Multi-Fragmented Giant Cell Tumor of Tendon Sheath A Rare Anatomical Location(Amer Podiatric Med Assoc, 2020) Arican, Mehmet; Turhan, YalcinGiant cell tumor of the tendon sheath (GCTTS) in the foot is a rare pathology and is involved in the differential diagnosis of soft-tissue tumors of the foot and ankle. Although it can affect any age group, GCTTS mainly occurs at the 3rd and 5th decade and is more common in females. Histopathologic examination is a major definitive method for diagnosis, although physical examination and radiologic imaging are helpful in reaching a diagnosis preoperatively. Many treatment options exist but marginal excision is the most commonly used treatment. We describe the case of a 26-year-old pregnant woman with a multi-fragmented mass extending from the first web space to the plantar aspect of the metatarsophalangeal joint (MTP) of the left great toe associated with flexor hallucis longus tendon after trauma. She had pain that worsened with activity and wearing shoes. After pregnancy, a marginal excision with dorsal longitudinal incision in the first web space was performed under spinal anesthesia. The lesion was diagnosed as a localized type tenosynovial giant cell tumor. At the last follow-up appointment in the 23rd month, the patient was doing well and there was no recurrence of the lesion. GCSST should be considered in the differential diagnosis of plantar masses of foot. Although, GCTTS is frequently seen in females, it has not been previously reported in a pregnant woman with an extremely rare condition after trauma.Öğe Radiologic and histopathologic effects of favipiravir and hydroxychloroquine on fracture healing in rats(Springer, 2024) Tekce, Giray; Arican, Mehmet; Karaduman, Zekeriya Okan; Turhan, Yalcin; Saglam, Sonmez; Yucel, Muecahid Osman; Coskun, Sinem KantarciogluFracture healing is a process in which many factors interact. In addition to many treatments, physical and biological therapy methods that affect different steps of this process, there are many biological and chemical agents that cause fracture union delay. Although the number of studies on fracture healing is increasing day by day, the mechanism of fracture healing, which is not fully understood, still attracts the attention of all researchers. In this study, we aimed to investigate the effects of favipiravir and hydroxychloroquine used in the treatment of COVID-19. In this study, 48 male Wistar rats weighing 300 +/- 50 g were used. Each group was divided into eight subgroups of six rats each to be sacrificed at the 2nd and 4th weeks and evaluated radiologically and histologically. Favipiravir (group 1), hydroxychloroquine (group 2), favipiravir + hydroxychloroquine (group 3), and random control (group 4) were used. A statistically significant difference was observed between the 15th day histological scoring averages of the groups (p < 0.05). Although there was no statistically significant difference between the 15th day radiological score distributions of the groups (p > 0.05), we obtained different results in terms of complete bone union distributions and radiological images of the fracture line. Although favipiravir has a negative effect on fracture union in the early period, favipiravir may have a positive effect on fracture union in the late period. We did not find any effect of hydroxychloroquine on fracture union.Öğe Systemic tranexamic acid promotes bone healing in a rat model of femur fracture(Turkish Joint Diseases Foundation, 2020) Karaduman, Zekeriya Okan; Arican, Mehmet; Turhan, Yalcin; Turhal, Ozan; Orhan, Zafer; Gamsizkan, MehmetObjectives: This study aims to investigate the effect of tranexamic acid (TXA) on the union of closed femoral fractures using radiological and histological methods in an experimental rat model. Materials and methods: This experimental study was conducted between June 2017 and February 2018. Closed femoral fractures were created in 36 male Wistar albino rats (age: three months [range. 2.5-3.5 months]. weighing 200 grams [range. 180-220 grams]). Half of the animals randomly divided into two groups were administered intravenous single dose of TXA (30 mg/kg). whereas the animals in the control group did not receive any medication. The animals in the two groups were randomly divided into three groups with six animals each and cervical dislocation was performed at days 15, 30, and 45, and radiological and histopathological healing scores were compared. Results: When the mean radiological scores of the TXA and control groups were compared. a statistically significant difference was found in favor of the TXA group at day 15 (p=0.019). but no significant difference was found in the mean scores on days 30 and 45 (p=0.138 and p=0.269. respectively). Histopathological examination also showed a statistically significant difference between the 15-day mean score values in favor of the TXA group (p=0.017). Conclusion: The use of systemic TXA accelerates early bone formation and fracture healing.Öğe Topical or intravenous administration of tranexamic acid accelerates wound healing(Turkish Joint Diseases Foundation, 2024) Saglam, Sonmez; Orhan, Zafer; Arican, Mehmet; Turhan, Yalcin; Karaduman, Zekeriya Okan; Tekce, Yildiray; Yucel, Muecahid OsmanObjectives: In this study, we aimed to investigate the morphological and histological effects of tranexamic acid (TA) on wound healing in a rat wound model.Materials and methods: A total of 24 adult mal e Wistar Albino rats were used in this study. All rats were simple randomly divided into three groups including eight rats in each group. A full-thickness skin defect was created on the back of the rats in all groups. Serum physiological (2 mL) was instilled saline drops after wound formation (control group). Wound was created and topical TA (0.12 to 0.15 mL [30 mg/kg]) was applied (local group). Intravenous TA (0.12 to 0.15 mL [30 mg/kg]) was applied intravenously before the wound was created (intravenous group). The wound diameters of the groups were photographed and measured on Days 0, 3, 7, 10, 14 and, at the end of Day 14, the rats were sacrificed and their histopathological results and wound diameters were compared.Results: Fibroblast count values of the control group were found to be significantly lower than the local group (p=0.002), and no significant difference was observed between the local and intravenous groups (p>0.05). The collagen density (%) values of the control group were found to be significantly higher than the local and intravenous groups (p=0.016 and p=0.044). Wound diameter values of the control group on Day 10 day were found to be significantly higher than the local and intravenous groups (p=0.001). In addition, the wound diameter values of the control group on Day 14 were found to be significantly higher than the local and intravenous groups (p=0.001 and p=0.0001). The wound diameter changes of the control group on Days 0-10 were found to be significantly lower than the local and intravenous groups (p=0.001). In addition, the wound diameter changes of the control group on Days 0-14 were found to be lower than those of the local and intravenous groups (p=0.001 and p=0.0001).Conclusion: The use of local or intravenous TA may have positive effects on the fibroblast count and wound contraction in a rat wound model.
