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    Comparison of two different total joint replacement and arthrodesis treatments for advanced hallux rigidus: Short-term functional outcomes
    (2019) Dulgeroglu, Turan Cihan
    Aim: Hallux rigidus is osteoarthritis of the big toe and is a clinical tableau with progressive pain and movement loss. This study aims to present the clinical outcomes of patients with grade 3 and 4 hallux rigidus unresponsive to conservative treatment who had arthroplasty with two different metallic implants or arthrodesis and to compare the outcomes of these treatments.Material and Method: Forty patients with arthroplasty or arthrodesis surgery due to hallux rigidus performed by a single surgeon from 2013 to 2018 were retrospectively compared in terms of AOFAS, VAS and ROM measurements and functional scores.Results: When the clinical outcomes of patients with arthroplasty are compared, there was no statistically significant difference observed. When the arthrodesis group is compared with the arthroplasty groups, separately and combined, there was no statistically significant differences observed in terms of functional scores.Conclusion: Total joint arthroplasty performed on the big toe offers patients the possibility of a painless metatarsalphalangeal joint (MTPJ) without movement limitations or high complication rates. Arthrodesis is still the most reliable surgical salvage procedure; however, it should be chosen for use as a salvage procedure for stage hallux rigidus that is advanced in terms of function, as with other joints in the musculoskeletal system.Keywords: Arthroplasty; hallux rigidus; metatarsophalangeal joint; surgical treatment; joint functions.
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    Constrained liner use of developing dislocation after total hip arthroplasty: Short-term results
    (2019) Dulgeroglu, Turan Cihan
    Aim: Today total hip arthroplasty is one of the surgical procedures with the most satisfying data. In spite of all these good outcomes, difficult and upsetting complications for patient and surgeon may be encountered after total hip arthroplasty. Constrained liner were developed to reduce the risk for primary total hip arthroplasty patients with cognitive function disorder before surgery and patients with re-dislocation risks. The aim of this retrospective study is to present the clinical outcomes of freedom constrained lıner systems in patients developing dislocation after total hip arthroplasty. Material and Methods: The aim of our study was to present clinical outcomes of fifteen consecutive surgical procedures with freedom anti-luxation revision system (Biomet, Warsaw, IN, USA) from March 2014 to December 2018. Patients were assessed with Harris hip score, Oxford score and Charnley score and early period complications and satisfaction outcomes were evaluated. Results: Only one of the fifteen patients developed complications of intraoperative femur shaft fracture. According to postoperative data of early period outcomes, postoperative Harris hip score and Oxford scores were observed to have significant amelioration. No deep or superficial wound site complications developed. Neurovascular injury complications were not observed in patients. Conclusion: In conclusion, patients with hip arthroplasty procedure with the constrained implant used in our study obtained satisfactory results.
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    Long anatomical femoral stem reduces stress concentrations on femurs with lateral bowing deformity: A finite element analysis
    (2019) Demirkiran, Nihat Demirhan; Erduran, Mehmet; Dulgeroglu, Turan Cihan
    Aim: Femoral morphology varies widely among different ages and sexes. Lateral bowing is a variance of the femur described in elderly females from Asian race. This bowing deformity is usually underestimated in patient evaluation and planning the most suitable treatment. In this study we aimed to evaluate the stress distribution around femoral prosthesis in femurs with lateral bowing deformity, using a finite-element (FE) method. The main objective of our study was to compare stress concentrations around five different stem models.Material and Methods: A lateral femoral bowing deformity model was obtained from the post-operative CT data of a 69-year-old woman, using a software (3D-Slicer). Straight and anatomical femoral stem models with different lengths are designed on the model of von Mises stress concentrations of five different stem models are evaluated.Results: The long anatomic stem did not lead to excessive stress concentrations on any area of the femur and a uniform stress distribution was obtained. The maximum von Mises stress for long anatomical stem (29,197 MPa) was lower than any other model. Highest stress concentrations were observed in medium straight stems (43,147 MPa).Conclusion: For patients with a lateral bowing deformity, longer anatomical femoral stems may overcome the excessive stress shielding, providing stress distribution over a wider region of the femur.Keywords: Femoral Lateral Bowing; Finite Element; Anatomical Stem; Hip Arthroplasty.