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Öğe Assessment of hip development in the early period in patients who underwent dega osteotomy due to developmental dysplasia of the hip(2017) Sarikaya, Baran; Sipahioglu, Serkan; Bekin Sarikaya, Zeynep; Bozkurt, Celal; Levent, Ali; Yapti, Metin; Altay, Mehmet Akif; Isikan, Ugur ErdemObjective: To examine hip development in a patient who underwent Dega osteotomy due to developmental dysplasia of the hip (DDH) by means of radiography. Materials and Methods: Dega osteotomy was performed on 43 hips (7 were bilateral) of 36 patients with DDH. In preoperative and final follow-up; the acetabular index (AI), acetabular depth ratio (ADR) and Wiberg's center-edge angle (CEA) were measured in anteroposterior pelvic radiographs. Hips were classified in accordance with Tönnis classification system. Radiological findings were evaluated in accordance with Severin classification system. Avascular necrosis (AVN) of the hips were evaluated according to Kalamchi-MacEwen classification system. Results: The mean age was 87 months (48-130 months), mean follow-up period was 30.5 months (15-62 months). The mean preoperative and final follow-up values of AI were 43° (28°to 60°) and 19° (6° to 34°), respectively. The mean preoperative and final follow-up values of ADR were detected as 14 (8 to 24) and 26 (18 to 42), respectively.The mean CEA was found as 38° (18° to 61°) at the final follow-up. Of the hips, 37 were Tönnis type 4 and 6 were Type 3. Totally 10 hips had AVN; of those, 6 were Type 1, 2 were Type 2 and 2 were Type 3 hips. According to Severin classification, 11 hips were Type 1a, 3 were Type 1b, 22 were Type 2a, 5 were Type 2b and 2 were Type 3. Conclusion: In patients who underwent Dega osteotomy, hip development can be detected radiographically with satisfactory levels.Öğe Clinical Effects of Platelet-Rich Plasma and Hyaluronic Acid as an Additional Therapy for Talar Osteochondral Lesions Treated with Microfracture Surgery: A Prospective Randomized Clinical Trial(Sage Publications Inc, 2015) Gormeli, Gokay; Karakaplan, Mustafa; Gormeli, Cemile Ayse; Sarikaya, Baran; Elmali, Nurzat; Ersoy, YukselBackground: Osteochondral ankle injuries commonly affect the dome of the talus, and these injuries are a common cause of athletic disability. Various treatment options are available for these injuries including intra-articular hyaluronic acid (HA) and platelet-rich plasma (PRP) injections. The purpose of this study was to compare the effects of HA and PRP as adjunct therapies after arthroscopic microfracture in osteochondral lesions (OCLs) of the talus. Methods: In this prospective, randomized blinded study, 40 patients with talar OCLs in their ankle joints were treated with arthroscopic debridement and a microfracture technique. Thirteen randomly selected patients received PRP, 14 patients received HA, and the remaining 13 patients received saline as a control group. The participants were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) and visual analog pain scale (VAS) scores after a 15.3-month (range, 11-25 months) follow-up. Results: Postoperatively, all the groups exhibited significantly increased AOFAS scores and decreased VAS scores compared with their preoperative results (P < .005). The AOFAS scores were significantly increased in the PRP group versus the HA and control groups (P < .005), although the increased AOFAS scores in the HA group versus the control group were also significant (P < .005). Similar to the AOFAS scores, the decrease in the VAS scores was significantly lower in the PRP group versus the HA and control groups (P < .005). In addition, the HA group had significantly lower VAS scores than the control group (P < .005). Conclusion: Both PRP and HA injections improved the clinical outcomes of patients who underwent operation for talar OCLs in the midterm period and can be used as adjunct therapies for these patients. Because a single dose of PRP provided better results, we recommend PRP as the primary adjunct treatment option in the talar OCL postoperative period. Level of Evidence: Level I, prospective randomized study.Öğe Comparison of percutaneous pinning with Kirschner wires and internal fixation with anatomical proximal humeral plates for proximal humeral fractures(2018) Bozkurt, Celal; Sarikaya, Baran; Sipahioglu, Serkan; Ergun, Murat; Altay, Mehmet Akif; Isikan, Erdem UgurAim: The treatment of proximal humeral fractures is a controversial issue. The aim of this study was to compare clinically and radiologically the results of two surgical treatment methods for proximal humeral fractures. Material and Methods: Between January 2010 and January 2016, 32 consecutive patients with a diagnosis of displaced proximal humeral fracture who underwent surgical treatment were evaluated retrospectively. The fractures were classified as two-, three-, and four-part fractures according to the Neer system. Sixteen patients were treated with closed-reduction percutaneous pinning and 16 patients were treated with open-reduction internal fixation with proximal humerus anatomical plates. The results were compared clinically using the Constant-Murley shoulder outcome score (CS) and radiologically with direct roentgenograms. Results: The CSs of the Kirschner wire (K-wire) and plate groups did not differ significantly (P = 0.696). The mean CS values were 76.56 ± 19.11 for the K-wire group and 73.56 ± 15.91 for the plate group. No case of avascular necrosis (AVN) and three cases of partial loss of reduction occurred in the K-wire group. In the plate group, two cases of AVN and no case of loss of reduction occurred. All fractures in both groups healed, with no need for revision surgery in either group. Conclusion: The clinical and radiological results of the plate and K-wire groups were similar. Percutaneous fixation has the advantage of minimal invasiveness, which lowers the rate of complications. Closed reduction with K-wire application is a good alternative, especially for two- and three-part fractures of the proximal humeral surgical neck.Öğe A comparison of the measurements with biochemical markers of bone turnover and bone mineral density in the assessment of the efficiency of osteoporosis treatment(Turkish Joint Diseases Foundation, 2013) Ataoglu, M. Baybars; Atik, O. Sahap; Gul, Orkun; Sarikaya, Baran; Gormeli, Gokay; Ozturk, Burak Yagmur; Ozgurol, BarisObjectives: This study aims to compare the measurements using biochemical markers of bone turnover and bone mineral density (BMD) in the assessment of the efficiency of osteoporosis treatment. Patients and methods: Between March 2006 and December 2008, 166 patients with osteoporosis in our clinic were included. Patients who were out of contact due to death or other reasons during follow-up were excluded. We compared the measurements of urinary biochemical markers of bone turnover using cross-linked N-telopeptide (Ntx) values and BMD in 60 patients (49 females, 11 males; mean age: 65.7 years; range: 42 to 87 years) with osteoporosis who were treatment-naive and completed study. Results: Twenty-nine (48.3%) of the patients received surgical treatment, while 31 (51.7%) received conservative therapy. Urine NTx values of the patients decreased 38.82% at three months; 51.99% at six months and 66.41% at 12 months. Lumbar vertebra BMD increased by 20.7% and femur neck BMD increased by 11.9% at the end of the first year. Conclusion: Urine NTx values respond to osteoporosis treatment faster than BMD measurements; thereby it may be suitable to use this parameter for the monitorization of the treatment efficiency.Öğe Evaluation of short-term clinical outcomes of subacromial impingement patients with performed arthroscopic subacromial decompression(2017) Sarikaya, BaranAim: In this study, it was aimed to evaluate short-term clinical outcomes of arthroscopic subacromial decompression procedure which was performed on patients who had subacromial impingement syndrome and did not respond to conservative treatment. Material ans Methods: Patients who did not have any shoulder disorder including rotator cuff rupture or capsulolabral pathologies, but subacromial impingement syndrome were evaluated retrospectively. The patients were evaluated clinically according to the Constant-Murley scoring system and visual analog scale (VAS). Active and passive ranges of motion of the joint of the patients were evaluated both preoperatively and at the final follow-up. Results: A total of 64 patients were evaluated. Of the patients; 22 were male and 42 were female and 54 (29-77) was determined to be the mean age. Mean follow-up duration was 17.4 months (7-25 months). The preoperative mean Constant-Murley score was 52 (36- 79), whereas it was determined to be a mean of 79 (48-98) at the final follow-up. VAS was determined to be 7.2 (5-9) preoperatively, whereas it was determined to be 2 (0-5) at the final follow-up. Statistically significant differences were determined for both scoring systems at the final follow-up compared with the preoperative period (p<0.001). Conclusion: Satisfactory short-term outcomes may be acquired after arthroscopic subacromial decompression procedure which is performed due to subacromial impingement syndrome for patients who do not respond to conservative treatment.Öğe Outcomes of arthroscopic debridement and microfracture for osteochondral lesions of the talus(2017) Bozkurt, Celal; Sarikaya, Baran; Sipahioglu, Serkan; Altay, Mehmet Akif; Isikan, Ugur ErdemAim: Osteochondral Lesions of the Talus (OLT) is a common pathology in orthopedic injuries. Recently arthroscopic microfracture treatment is widely used as a simple technique with clinically satisfactory outcomes. The present study aimed to reveal the outcomes of arthroscopic OLT treatment and determine the appropriate patient group. Material and Methods: 21 patients who underwent arthroscopic debridement and microfracture for OLT were evaluated retrospectively between March 2015 and May 2016. The clinical assessment was performed by using The American Orthopaedic Foot & Ankle Society (AOFAS) and Visual Analog Scale (VAS) prior to the surgery and at the final follow up. Results: The mean diameter of lesions were measured as 1.1 cm² (0.7-1.7) arthroscopically. The mean age of the patients was 35 (18-55) years. Lesions were located at the medial side in 17 patients and lateral side in 4 patients. The mean value of preop AOFAS score was 65.4±7.3 (55-78) and it was 86.6 ± 8.3 (68-100) at the final follow up. VAS scores of the patients were 6.7±1.2 (5-9) prior to the surgery and 2.2±1.3 (0-5) at the final follow up. Conclusion: Arthroscopic treatment of OLTs is a beneficial technique with low complication rate in broad range of patients. Patient’s age and lesion size are guideway in patients requiring arthroscopic treatment. As the age and lesion size increase, surgical treatment becomes less beneficial.
