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    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.
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    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.
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    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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    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, Fatih
    BackgroundDopamine 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.
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    Effect of potential risk factors on renal functions in simultaneous bilateral total knee arthroplasty
    (Frontiers Media Sa, 2024) Akar, Bedrettin; Ugur, Fatih; Yucel, Mucahid Osman; Aytug, Ferhan
    Objective This retrospective study investigated the risk factors leading to a decrease in Renal glomerular filtration rate (eGFR) and the development of acute kidney injury (AKI) during the early postoperative period in patients undergoing simultaneous bilateral total knee arthroplasty (SBTKA).Methods SBTKA was performed on 862 patients between 2014 and 2021 in a single center, by a single surgeon. The risk factors affecting the development of AKI were analyzed by monitoring the changes in pre-and postoperative serum creatinine (Scr) levels and eGFR values. RIFLE criteria were used to evaluate the kidney functions of the patients, who were followed up for an average of 6 months.Results While there was no decrease in eGFR or AKI in 818 patients postoperatively, eGFR decreased and AKI of different stages developed in 44 patients, according to the RIFLE criteria. Of the 44 patients with AKI, 31 had Risk, 9 had Injury, 3 had Failure, and one had Loss of kidney function. Two patients with American Society of Anaesthesiologists (ASA) class IV died due to deepening of postoperative renal dysfunction.Conclusion We found that the direct risk factors in SBTKA in terms of eGFR decrease and AKI development include long operation time, increased need for blood transfusion, and diabetic nephropathy, while increased body mass index (BMI) is an indirect risk factor. When planning for a SBTKA, we presume that a thorough analysis of these factors will decrease AKI risk.
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    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, Mucahit
    Background/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.