Murat Cinar

Baskent University, Engüri, Ankara, Turkey

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Publications (6)7.05 Total impact

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    ABSTRACT: An unusual case of a double-level isthmic spondylolisthesis of the lumbar spine in a 38-year-old female was described. The patient had been suffering from low back pain for 8 years and did not respond to conservative treatment. Her medical examination revealed that grade II isthmic spondylolisthesis was present both at L-4 to L-5 and at L-5 to S-1. The patient was managed by surgical treatment. After the reduction of lysthesis with posterior instrumentation, posterior lumbar interbody fusion (PLIF) technique was performed for double level. At a recent follow-up, 1 year after the surgery, the symptoms of the patient were completely resolved, reduction was preserved, and fusion was achieved. PLIF with posterior instrumentation and reduction seems to be a convenient treatment option in the treatment for double-level spondylolisthesis.
    European Journal of Orthopaedic Surgery & Traumatology 11/2012; 22(1). · 0.18 Impact Factor
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    ABSTRACT: In this study, we aimed to compare of kyphoplasty versus transpedicular polymethylmethacrylate (PMMA) augmentation biomechanically in the revision of the failed pedicle screw in osteoporotic lumbar spine. Bone mineral density (BMD) of lumbar vertebrae collected from four bovines were measured. Each vertebra was decalcified with hydrochloric acid solution to obtain osteoporotic specimens. Primary polyaxial pedicle screws were inserted into the pedicles and pulled out until they failed. The pullout strength results of all specimens were recorded. Revision pedicle screws were randomly inserted into the same pedicles by either pedicle hole PMMA augmented (group 1) or kyphoplasty (Xvoid™) PMMA augmented pedicle screws (group 2). The pullout strength results of all specimens were re-recorded. The mean BMD significantly decreased from 1.686 ± 227.9 g/cm(2) to 1.432 ± 157.1 g/cm(2) following decalcification (p<0.001). In group 1, the mean pullout strength of primary screws significantly decreased from 3443 ± 1086 N/m(2) to 2088 ± 924 N/m(2) following pedicle screw augmentation (p=0.006). In group 2, the mean pullout strength of primary screws decreased from 3702 ± 1063 N/m(2) to 3664 ± 1057 N/m(2) following kyphoplasty augmentation (p=0.934). Pedicle screw augmentation group achieved significantly lower pullout strength values than kyphoplasty pedicle hole augmentation group (p=0.002). Although pedicle hole PMMA augmentation is the gold standard for the failed screws in an osteoporotic bone, kyphoplasty augmented pedicle screw seems to be more effective method increasing the pullout strength.
    Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 08/2012; 23(2):106-10.
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    ABSTRACT: To prevent amputation, achieving successfull ankle artrodesis in diabetic Charcot arthropaty patients is very important. As a salvage procedure, we have used a 95-degree-angled blade plate via a posterior approach to achieve tibiocalcaneal arthrodesis. Between 2006 and 2008, four diabetic patients with hindfoot Charcot arthropathy underwent talectomy and tibiocalcaneal arthrodesis with an AO 95-degree-angled blade plate via a posterior approach. Two of the patients were male and two were female. The average age was 63 (range, 53 to 70) years. The mean duration of diabetes was 9 (range, 5 to 20) years. All the patients were on hemodialysis. Three of four patients had undergone previous surgeries. The average followup period was 24 (range, 12 to 35) months. Clinical and radiographic fusion was present by 5 (range, 3 to 6) months in three of four patients. In the other patient, a stable fibrous ankylosis was achieved. Clinical outcomes were excellent in three patients, and good in one patient. The performance of tibiocalcaneal arthrodesis with the use of blade plate with a posterior approach was a safe and successful surgical method for the treatment of Charcot ankle.
    Foot & Ankle International 06/2010; 31(6):511-6. · 1.47 Impact Factor
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    ABSTRACT: The clinical results of arthroscopic capsular release for frozen shoulder in diabetic (group 1) and idiopathic (group 2) patients were compared. Surgery was performed on 28 shoulders of 26 patients (24 women, 2 men) with frozen shoulder unresponsive to conservative treatment. The mean age was 50 (range 40-65). A total of 14 patients were included in group 1, and 12 were in group 2. The average duration of complaints was 10 and 7 months in groups 1 and 2, respectively. The evaluation of shoulder functions was made according to the University of California, Los Angeles (UCLA) and Constant Scoring Systems. Duration of complete pain relief and for regaining range of motion (ROM) after surgery were also noted in their final follow-up examination. The mean follow-up period was 48.5 and 60.2 months in group 1 and group 2, respectively. There was no significant difference between the two groups in terms of the postoperative duration of complete pain relief and that for regaining ROM (P > 0.05). The duration of complete pain relief was 2.6 and 2.5 months, and regaining of ROM was 1.6 and 1.5 months for groups 1 and 2, respectively. The postoperative UCLA and Constant scores had significant increases in both groups compared to the preoperative ones (P < 0.05). There was a significant difference between the groups in terms of Constant scores (P < 0.05) while there was no difference in terms of UCLA scores (P > 0.05). There was a statistically significant difference in shoulder abduction and internal rotation degrees between the groups (P < 0.05). The results of arthroscopic capsular release for frozen shoulder in diabetic patients had less good results in terms of range of motion and Constant-Score. There was no significant difference between the two groups in terms of the duration of pain relief and that of regaining the ROM.
    Archives of Orthopaedic and Trauma Surgery 06/2009; 130(3):401-6. · 1.36 Impact Factor
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    ABSTRACT: Biphasic calcium phosphate (BCP) has proved to be an effective bone substitute, but it's effectiveness and remodeling potential in open wedge high tibial osteotomy (OWHTO) has not been analyzed yet. This study sought to evaluate the bone healing and remodeling potentials of BCP granules using a radiographic rating system in biplanar OWHTO. Fifteen patients (15 knees) underwent biplanar OWHTO. Bone gaps were filled with BCP granules. For radiographic evaluation, remodeling was divided into four phases. Phase 1 was accepted as rounded osteotomy sites, with clear distinction between BCP and bone, phase 2 was accepted as whitened osteotomy sites, with distinction between BCP and bone still visible, phase 3 was accepted as distinction between BCP and bone not visible and cloudy bone formation and phase 4 was accepted as full reformation of BCP granules (4A-BCP visible, 4B-disappearence of BCP) with no sign of osteotomy. Bone union was confirmed with clinical (full weight bearing without pain) and radiographic evaluation (cortical bridging callus on radiographs and phase 3 or greater remodeling). The time to full remodeling and the starting point of the consolidation on anteroposterior radiographs were noted. Complications were also noted at each clinical follow-up. Mean follow-up was 27.2 months. The mean age was 55.8 years. At clinical follow-up, there were no wound healing problems, no loss of corrections, no infections, and no complications. All osteotomies successfully healed. According to the radiologic classification system, at the 6th week, 73.3% (11/15) of patients were in phase 1 and the remaining 26.7% (4/15) were in phase 2. At 12-month follow-up, 46.7 (7/15) of the patients were still in phase 3. After 2 years, all radiographs showed to be in phase 4A. Radiographic union was noted to progress from lateral to medial and finally central. BCP can be successfully used as a bone substitute. The radiographic remodeling and consolidation process of BCP was found to be different from that of beta-tricalcium phosphate. In our patients with more than 2 years of follow-up, BCP granules did not completely remodel. As a result, this clinical study demonstrated that calcium phosphate granules containing hydroxyapatite had a long period of "creeping substitution" that lasts longer than 2 years.
    Archives of Orthopaedic and Trauma Surgery 12/2008; 129(6):747-52. · 1.36 Impact Factor
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    ABSTRACT: The apoptotic bodies were observed aging in osteoarthritic cartilage and meniscus but there is still a lack of knowledge in the literature about the relationship between meniscal injury and apoptosis. The aim of this study is to investigate the apoptotic changes on meniscal tears caused by degeneration and trauma. Thirty-eight specimens of human meniscal tissues harvested from cadavers and patients were selected from groups below the age of 40. There were 14 normal meniscal tissues from cadavers in the control group. There were 24 meniscal tissues harvested from patients who had had arthroscopic operations for meniscal tear due to degeneration or trauma. The torn meniscal samples were divided into two groups according to their etiologies, either degenerative or traumatic. Apoptotic cells were investigated in each of the three groups in the histopathological examination. There was statistically significant difference among the groups according to apoptotic index (p < 0.01). The mean indexes of apoptosis in both groups of torn meniscus (group 2 = 0.497 and group 3 = 0.725) were significantly higher than that in the normal tissue (group 1 = 0.237) (p < 0.01) but the difference between groups 2 and 3 was not significant (p > 0.001). This study indicates that an increase in the amount of apoptosis appeared to have a close relationship with meniscal tear caused by either trauma or degenerative changes.
    Knee Surgery Sports Traumatology Arthroscopy 08/2008; 16(7):666-9. · 2.68 Impact Factor