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ABSTRACT: In this study, we aimed to compare basal metabolic rate and body composition in patients with femoral neck fractures and controls.
Sixty-eight consecutive patients with femoral neck fractures (36 males, 32 females; mean age 73.9 ± 7.1 years, range 65 to 93 years) and 71 controls (33 males 38 females; mean age 72.1 ± 5.9 years; range 65 to 90 years) were prospectively analyzed. The controls were matched with the patients in terms of sex, age, and body mass index. The findings were assessed by bioelectrical impedance analysis (BIA).
The phase angle, body capacitance, resistance, reactance, body cell mass, lean body mass, basal metabolic rate, and intracellular water values of the patients were found to be significantly lower, compared to the controls. Extracellular mass, fat mass, extracellular mass/body cell mass and extracellular water levels were significantly higher in the patients, compared to the controls. There was no significant difference between the patient and control group in terms of the total body weight/lean body mass ratio.
Although it is not clear whether these physiological changes are an exact cause of a predisposition for simple falls, the assessment of basal metabolic rate and body composition by BIA may be a useful adjunctive tool for the evaluation of physiological changes in the routine health screening of elderly people.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 08/2012; 23(2):77-81.
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ABSTRACT: The aim of this study was to investigate serum paraoxonase-1 (PON1) activity and oxidative/anti-oxidative status in knee osteoarthritis (OA), and evaluate their relationship using radiological and clinical parameters.
The study population comprised 127 patients with knee OA and 107 healthy volunteers. Patients with knee OA were divided into four subgroups according to the Kellgren-Lawrence (K&L) grading scale. In addition, each patient was clinically evaluated by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Serum PON1 activity was measured spectrophotometrically. Oxidative status was assessed by measuring serum lipid hydroperoxide (LOOH) and total oxidant status (TOS). Anti-oxidative status was assessed by measuring serum free sulfydryl groups (-SH = total thiol) and total antioxidant capacity (TAC). Oxidative stress index (OSI) was calculated. Lipid parameters were determined by routine laboratory methods.
Serum PON1 activity was significantly lower in the knee OA group compared to the control group (p < 0.001), whereas serum LOOH, TOS, and OSI levels of the knee OA group were significantly higher than those of the controls (p < 0.001 for all). However, TAC and -SH levels did not differ between the two groups (p > 0.05). The lowest and highest mean serum PON1 activities were detected in patients with grades 4 and 1, respectively (ANOVA p < 0.001). In multiple regression analysis, WOMAC score was independently associated with serum PON1 activity (β = -0.248, p = 0.027).
Decreased serum PON1 activity and elevated LOOH, TOS, and OSI levels may be associated with knee OA, and serum PON1 activity may be a useful adjunctive indicator of the severity of knee OA for follow-up.
Scandinavian journal of clinical and laboratory investigation 05/2012; 72(5):433-9. · 1.38 Impact Factor
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ABSTRACT: The aim of this study was to examine the changes in the lumbar intervertebral area after extracorporeal shockwave therapy (ESWT) at different energy levels in a rabbit model using magnetic resonance imaging (MRI) and histopathological evaluation.
The study included 30 male New Zealand white rabbits divided randomly into five groups: Groups A and C received 1,000 shockwave impulses at an intensity of 14 kV, Groups B and D received 1,000 impulses at 21 kV, and Group E was a sham group. Side effects such as subcutaneous and paravertebral soft-tissue injuries were evaluated using MRI one day after ESWT administration. Neovascularization, edema and fibroblast activity in the intervertebral area were evaluated histopathologically.
No change was observed in any group on MRI. Histopathologically, Groups A and C showed no change, whereas Groups B and D showed edema, fibroblast activity and significant neovascularization at the intervertebral end-plate (p<0.05).
Our findings indicate that ESWT caused dose-dependent changes in the intervertebral end-plate. This study constitutes a preliminary evaluation of shockwave therapy to the intervertebral area in an animal model. High-dose ESWT may stimulate angiogenesis at cartilage end-plates in rabbits.
acta orthopaedica et traumatologica turcica 01/2012; 46(6):449-54. · 0.34 Impact Factor
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ABSTRACT: The aim of this study was to compare bone healing in pelvic osteotomy patients with osteotomy gaps filled with a femoral segment resected (FSR) graft with bone healing in patients with an iliac tricortical autograft (ITA) in treatment of developmental dysplasia of the hip. Sixty-three hips were treated using FSR grafts. Sixty-one hips were treated using ITA. The mean operation time and blood loss were significantly reduced in the FSR graft group, but graft union time was extended in the FSR graft group compared with that in the ITA group. The FSR graft was found to be safe and effective in treatment of developmental dysplasia of the hip and serves as an advantageous alternative to ITA.
Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 12/2011; 21(3):200-5. · 0.66 Impact Factor
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ABSTRACT: Intramedullary Ender nailing in intertrochanteric fractures was very popular in the past. However, this method has fallen in favor over time, due to complications. The purpose of this study was to evaluate results with this method and possible ways to prevent these complications, including the use of unilateral fixators to support the Ender nails.
This technique (Ender nailing and external fixator) was used in 39 patients (17 M/22 F, mean age: 71.4 years). The preoperative mean American Society of Anesthesiologists (ASA) score was 1.84 (range: 1-4) for all the patients. AO/OTA classification of fractures was used. In our surgery, we used an external fixator to support the intramedullary nails. All patients were evaluated with Parker-Palmer mobility score and with the Harris hip score.
The follow-up period was 29.2 months (20-56). Two patients experienced nail migration in the knees, two patients had varus deformation with a reduction in length of 2 cm, and seven patients developed pin-track infection. The average Harris score and Parker-Palmer score of the 14 patients who presented for their last follow-up examination were 64 and 6.8, respectively.
This method demonstrated several advantages, in that it allows the patient to put weight on the extremity after a shorter period of time and enables the fracture to heal rapidly without any serious complications.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 09/2011; 17(5):407-12. · 0.33 Impact Factor
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ABSTRACT: A total of 38 children (49 hips) were retrospectively investigated to assess the efficacy and safety of one-stage treatment of developmental dysplasia of the hip (DDH) in untreated children from two to five years of age. Our method consisted of open reduction, Salter innominate osteotomy, femoral shortening and derotation osteotomy. The patients were distributed into two groups according to the age at which they were operated: Group I included 19 patients aged < 3 years (24 hips) and Group II included 19 patients aged > or = 3 years (25 hips). Mean follow-up was 5.08 years for Group I and 5.76 years for group II. Clinical and radiological assessment at final followup showed that the outcome was not significantly different between the two groups. Furthermore, after this follow-up period, the rates of avascular necrosis were similar. Children with DDH between two and five years of age were treated successfully with one-stage treatment.
Acta orthopaedica Belgica 08/2011; 77(4):464-71. · 0.40 Impact Factor
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ABSTRACT: The purpose of this study is to compare retrospectively intraoperative fluoroscopy time and clinical-radiological results in pediatric femoral shaft fractures treated with titanium elastic nailing (TEN), with a mini-open "blind-hand" technique versus closed reduction. The study included 87 children (18 girls and 69 boys) who underwent surgical treatment with TEN for femoral shaft fractures. Patients were divided into two groups. Group 1 included 42 patients (mean age : 83 +/- 2.7 years) treated with a mini-open "blind-ha nd" technique (a 2-3 cm lateral incision at the level of the fracture ; reduction achieved with one or two fingers, without visualization of the fracture). Group 2 consisted of 45 patients (mean age: 8.8 +/- 2.6 years) treated with a closed reduction technique. Duration of surgery and intraoperative fluoroscopy time were recorded in both groups. Clinical and radiologic results were assessed using the TEN scoring system after mean follow-up periods of 213 +/- 5.8 months and 193 +/- 5.6 months in group 1 and group 2, respectively. Mean duration of surgery was 31.7 +/- 7.6 and 52.1 +/- 14.4 minutes, and mean fluoroscopy time 32.9 +/- 22.1 and 75.1 +/- 31.5 seconds in group 1 and group 2, respectively. Both surgical and fluoroscopy time were significantly longer in group 2 (p < 0.001). There was no significant difference between the two groups in terms of clinical and radiological results. All fractures healed with solid union, and there was no complication that was expected to cause permanent disability. Although successful clinical and radiological results were obtained with both techniques, duration of surgery and intraoperative fluoroscopy time were significantly higher in the closed reduction group 2. We suggest the "blind-hand" technique as an alternative to closed reduction to prevent extensive intraoperative radiation exposure and to decrease the length of the surgical procedure.
Acta orthopaedica Belgica 04/2011; 77(2):211-7. · 0.40 Impact Factor
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ABSTRACT: In this prospective study, we aimed to find out whether there is a change in the ultrasonographic features of the radial and ulnar nerves as well as clinical outcomes after traditional and lateral percutaneous cross-wiring of the supracondylar humerus fractures in children. Twenty-nine consecutive children with completely displaced Gartland type III supracondylar humerus fractures were treated with the traditional (group T) or lateral (group L) cross-wiring technique. Our findings showed that ultrasonographic features of the radial nerve were not changed in both groups but the ulnar nerve movement was reduced, and the diameter of major axis of the ulnar nerve during elbow flexion was larger (P=0.040) than in elbow extension in the traditional cross-wiring technique but not in the lateral cross-wiring technique. Lateral cross-wiring technique does not change the ultrasonographic features of the radial and ulnar nerves, and provides satisfactory results.
Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 03/2011; 20(5):334-40. · 0.66 Impact Factor
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ABSTRACT: We aimed to find out that whether collagen turnover is altered in the context of Legg-Calve-Perthes disease (LCPD) by evaluating serum prolidase activity. We also investigated the correlation between collagen turnover and oxidative-antioxidative status in LCPD. Plasma prolidase activity, total oxidant status (TOS), total antioxidant capacity, and oxidative stress index (OSI) were determined for 39 patients with LCPD and 40 healthy controls. Serum prolidase activity, TOS, and OSI were higher, but TAC was lower in patients with LCPD compared with controls. Prolidase activity was positively correlated with TOS and OSI levels. Serum prolidase activity is significantly associated with LCPD.
Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 02/2011; 20(4):222-6. · 0.66 Impact Factor
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ABSTRACT: Anterior knee pain continues to be an important problem following total knee arthroplasty (TKA). The aim of this study was to present the early results of patelloplasty with patellar decompression to relieve anterior knee pain in patients who undergo TKA.
We prospectively reviewed 49 knees from 46 patients (35 females, 11 males; mean age: 69.2 years; range: 54 to 82 years) who underwent TKA between January 2004 and December 2008. Decompression and patelloplasty were performed in patients in whom Grade 3 and 4 chondropathy was detected during operation according to the Outerbridge classification. All knees were rated according to the Knee Society Knee and Function Scores, before surgery and during the final follow-up. The patella score was evaluated according to a specific patellofemoral pain questionnaire used by Feller, and the mean knee range of motion was measured preoperatively and postoperatively. Additionally, a patient satisfaction questionnaire used by Levitsky was performed during the final follow-up exam. The mean follow-up period was 41.1 (range: 24 to 68) months.
The mean preoperative and final follow-up knee scores were 48.6 ± 8.8 and 87.70 ± 9.3, and function scores were 48.4 ± 10.4 and 81.4 ± 12.6, respectively. The mean preoperative patellar score was 18.1 ± 3.5, and the final follow-up patellar score was 25.7 ± 2.8. The mean patellar scores were significantly greater in knees with Grade 3 chondropathy compared to Grade 4 chondropathy (26.47 ± 2.38 and 24.29 ± 3.19, respectively). Postoperative anterior knee pain was present in four knees (8.2%). The mean preoperative knee range of motion was 85.1 ± 12.7, and the final follow-up knee range of motion was 117.0 ± 9.8. Patients were "extremely" or "very" satisfied with 93.8% of their operative outcomes on their knees.
Patellar decompression with patelloplasty in TKA is an option for the reduction of anterior knee pain, but there is a lack of significant evidence in the literature, demonstrating that this method is superior to patellar resurfacing and patellar retention.
acta orthopaedica et traumatologica turcica 01/2011; 45(6):425-30. · 0.34 Impact Factor
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ABSTRACT: This study aimed to evaluate the effect of an anterior versus posterior surgical approach for bipolar hemiarthroplasty on postoperative functional results of patients treated for femoral neck fractures.
Among the 196 patients over the age of 65 treated with cemented bipolar prosthesis for femoral neck fracture in our clinic between May 2000 and November 2008, 76 patients who followed up for at least one-year were retrospectively evaluated. The average follow-up period was 18.7 months (range 12 to 40 months). All fractures were Garden's type III or IV. The patients were divided into two groups according the surgical approach: posterior in 52 patients (Group 1; 25 males, 27 females; mean age 73.8 years; range 65 to 88 years) and anterior in 24 patients (Group 2; 14 males, 10 females; mean age 71.4 years; range 67 to 94 years). Cement was applied by hand in 62 cases and with a cement gun in 14 cases.
Mean Harris scores were 84.7±10.3 in group 1 and 85.8±7.1 in group 2. According to the Harris scoring system, the results were very good in 26 cases; good in 40 cases; fair in six cases; and poor in four cases. While early dislocation was observed in 9.6% of patients with the posterior approach, it was not observed in any patients treated with the anterior approach. There was no significant difference with regard to functional scores or early dislocations between group 1 compared to group 2 (p>0.05).
Based on our results, bipolar prothesis is an appropriate and effective treatment option for patients with femoral neck fracture to obtain early return to daily activity. The surgical approach does not affect the functional results. Although not statistically significant, it was concluded that the anterior approach is more reliable for early dislocation.
Eklem hastalıkları ve cerrahisi = Joint diseases & related surgery. 12/2010; 21(3):136-41.
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ABSTRACT: Congenital fibrosarcoma is a rare, malignant, soft-tissue tumor in infants and the pediatric age group. The clinical behavior of congenital fibrosarcoma is more favorable, and metastatic spread is rare, but local recurrence is a common problem. The patient was a 1-year-old girl at the time of operation, and there was a giant mass in the posterior region of the right leg. A wide surgical excision was performed and histological findings showed the diagnosis of congenital fibrosarcoma. After one and a half years, femoral supracondylar amputation was performed because of the recurrence of the local tumor.
Journal of pediatric orthopaedics. Part B / European Paediatric Orthopaedic Society, Pediatric Orthopaedic Society of North America 07/2010; 19(4):348-52. · 0.66 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the early results of total knee arthroplasty (TKA) performed through the midvastus approach.
This retrospective study included 48 knees of 42 patients (29 females, 13 males; mean age 69 years; range 54 to 82 years) who underwent TKA for grade 4 knee osteoarthritis. All TKA operations were performed by the same orthopedic surgeon through the midvastus approach. Preoperatively, 40 patients (95.2%) had primary osteoarthritis, and two patients (4.8%) had rheumatoid arthritis. In all cases, a posterior stabilized cemented prosthesis with a fixed insert was used. Patellar resurfacing was performed in seven knees (14.6%). All the knees were rated according to the Knee Society knee and function scores before surgery and at the final follow-up. Postoperative radiographic evaluations were performed on anteroposterior and lateral radiographs according to the Knee Society TKA Roentgenographic Evaluation and Scoring System. The mean follow-up period was 26 months (range 12 to 49 months).
The mean knee score significantly improved from 49.0+/-9.3 preoperatively to 87.5+/-9.9 postoperatively (p=0.000). The corresponding increase in the knee function score was from 48.8+/-9.9 to 79.6+/-14.0 (p=0.000). The mean increases in the knee and function scores were 38.5 and 30.8 points, respectively. The knee and function scores were excellent or good in 46 knees (95.8%) and 42 knees (87.5%), respectively. The mean knee flexion significantly increased by 28.6 degrees , from 84.3+/-14.7 degrees preoperatively to 112.9+/-11.9 degrees postoperatively (p=0.000). Among patients with bilateral osteoarthritis, the knee function scores were significantly higher in patients who had undergone bilateral versus unilateral TKA (90.0+/-11.5 and 78.8+/-10.8, respectively; p=0.007). None of the patients had patellar tracking abnormality intraoperatively; thus, there was no need for lateral retinacular release. Postoperative clinical and radiographic assessments showed no signs of instability or loosing. Clinical and radiographic loosening of the patella and osteolysis were not observed in patients who had undergone patellar replacement. No changes were observed in the tracking and position of the protheses. Neurovascular injury did not occur. One patient who developed early infection of the knee that required a two-stage revision was assessed as failure.
In our study, lateral retinacular release was not needed due to achievement of proper patellar tracking in TKA operations with the midvastus approach, and satisfactory clinical and radiographic results were obtained.
acta orthopaedica et traumatologica turcica 01/2010; 44(1):36-41. · 0.34 Impact Factor
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ABSTRACT: ZET Amaç: Bu çalışmada amacımız artroskopik diz cerrahisi uygulanan hastalarda eklem içi lokal anestezik uygula-masının ameliyat sonrası ağrıya ve hasta memnuniyetine etkisini araştırmaktır. Gereç ve yöntem: Çalışmaya artroskopik diz cerrahisi yapılan 18-45 yaş arası 64 hasta dahil edildi. Operasyon sonunda diz eklemi içine Grup B hastalarında %0.5 bu-pivakain (20 ml, 100 mg) ve Grup K hastalarında serum fizyolojik (20 ml) uygulandıktan 10 dk sonra her 2 grupta da eklem içi serum fizyolojik ile yıkanarak aspire edildi. Hastaların ameliyat sonrası VAS değerleri ve ek analjezik ihtiyaçları kaydedildi. Bulgular: Grupların ameliyat sonrası VAS değerleri kar-şılaştırıldığında ilk 8 saatte anlamlı fark görülürken 12. ve 24. saatlerde anlamlı fark bulunmadı. Ek analjezik ihtiyacı ise Grup B'de anlamlı derecede az bulundu.
