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    Atypical femur fractures associated with bisphosphonates treatment: Retrospective single-center study
    (2019) Haberal, Bahtiyar; Kaya Simsek, Ekin; Cetin, Can
    Aim: Osteoporosis is a very common condition caused by an imbalance between bone production and resorption. The first-line treatment of osteoporosis and the most commonly prescribed medication group is bisphosphonates. In recent years, several researches have reported that atypical femur fractures are seen following long term bisphosphonate usage. However, time of usage is not clearly defined yet. Our purpose of this study was to unveil the correlation between long term bisphosphonate usage and atypical femur fractures.Material and Methods: Patients with a history of bisphosphonates treatment with atypical femur fracture were retrospectively analyzed. The collected data included patient demographics, the presence of trauma or history of the fracture, concomitant medical diagnoses, and history of bisphosphonates usage, type of bisphosphonates used, concomitant fractures, and other complications related to atypical femur fractures, mortalities.Results: Twenty-two patients were included. All patients were female, and the mean age was 79.36±8.71 (mean ± SD) years. Sixteen patients were taking alendronate for an average of 6.81±2.74 (mean ± SD) years while six patients were taking ibandronate sustained atypical femur fractures in a shorter time average of 4.66±1.49 (mean ±SD) years. Atypical femur fractures are started to be diagnosed after 3 years of usage with having peak numbers in forth year.Conclusion: Our study supports correlation between long term bisphosphonates usage and atypical femur fractures as reported in several studies. In the use of long-term bisphosphonates more than 3 years, care should be taken for atypical femur fractures, with investigating prodromal symptoms and performing radiological imaging.
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    Do patellar degeneration and obesity have an impact on anterior knee pain in total knee arthroplasty without patellar resurfacing?
    (2020) Haberal, Bahtiyar; Kaya Simsek, Ekin; Sahin, Orcun; Ersozlu, Salim
    Aim: Purpose of this study was to determine clinical and radiological outcomes of total knee arthroplasty (TKA), and analyze correlation between the degree of the patellar degeneration and anterior knee pain. Materials and Methods: We identified all patients at our institution underwent TKA between January 2009 and March 2011. Patients were classified into two groups according to Outherbridge classification system. The effect of patellar resurfacing on clinical and radiological outcomes was evaluated. Results: A total of 326 patients were included in the present study. The female to male ratio was 254/72. The preoperative, early postoperative and last follow-up range of motion, Knee Society Score and functional scores were similar between groups (p=0.707, p=0.241, p=0.123, p=0.864, p=0.212, p=0.320, p=0.966, p=0.117, p=0.232, respectively). Patient satisfaction rates were similar between groups at last follow-up (p=0.127). Conclusion: In the present study there is no significant relationship between the severity of the patellar cartilage defect and clinical/ radiological outcomes at long-term follow-up. Therefore, we do not suggest resurfacing the patella in the surgical treatment of knee osteoarthritis to decrease knee pain and improve knee functionality.