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Öğe Does platelet-rich plasma have a favorable effect in the early stages of steroid-associated femoral head osteonecrosis in a rabbit model?(Turkish Joint Diseases Foundation, 2017) Karakaplan, Mustafa; Gulabi, Deniz; Topgul, Haldun; Elmali, NurzatObjectives: This study aims to investigate the effect of platelet-rich plasma (PRP) on femoral head osteonecrosis and compare it with bone marrow injection and core decompression. Materials and methods: A total of 30 healthy, adult, male New Zealand white rabbits (mean weight 2.25 +/- 0.15 kg; range 2.0 to 2.5 kg) were used in the study. To create experimental osteonecrosis in all rabbits, 40 mg/kg methylprednisolone acetate was applied intramuscularly. Rabbits were randomly allocated into three groups with 10 rabbits in each: drilling group, PRP group, and bone marrow group. The non-drilled hips of the drilling group were identified as the control group. Results: Rate of necrotic bone was lower in the PRP group compared to other groups. Highest rate of necrotic bone was detected in the control group. New bone formation rate was higher in the PRP group compared to other groups. Lowest new bone formation rate was determined in the control group. Inflammatory reaction rate was higher in the PRP group compared to other groups. Conclusion: Platelet-rich plasma injection may play a positive role in the treatment of steroid-associated osteonecrosis in a rabbit model.Öğe Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction(Derman Medical Publ, 2015) Pepele, Demet; Karakaplan, Mustafa; Elmali, Nurzat; Topgul, Haldun; Ozen, MetehanAim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months). Patients' scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85%) A (excellent) and B (good) group and 3 patients took place as C (adequate) group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large numbers in order to determine improving clinical outcome, preventing degeneration and restoring the knee biomechanics better.Öğe Removing the ring stuck on finger with a high speed motor: a case report(Bayrakol Medical Publisher, 2019) Ceylan, M. Fethi; Topgul, HaldunA considerable number of patients apply to the emergency departments with rings, made of different alloys and in different shapes, stuck on their fingers. Sticking is a condition that must be removed as soon as possible because it may cause a serious problem that can lead up to the necrosis in the finger. Many methods have been described in the literature for removing the stuck rings. In this report, we presented a case where a ring made of a thick and hard metal alloy that causes sticking and infection in the finger, was removed with a diamond tip high-speed motor used In spinal surgery unlike conventional methods, and the patient was treated without any sequel.Öğe Vascular pedicled iliac bone grafting is effective in patients with an early stage of femoral head avascular necrosis(Turkish Joint Diseases Foundation, 2014) Elmali, Nurzat; Ertem, Kadir; Karakaplan, Mustafa; Pepele, Demet; Daggez, Cihat; Topgul, HaldunObjectives: This study aims to evaluate clinical and radiological findings of a series of patients with avascular necrosis of the femur head (ANFH) treated by core decompression and vascular pedicled iliac crest grafting. Patients and methods: This retrospective study included 26 hips of 22 patients (14 males, 8 females; mean age 36 years; range 16 to 48 years) with ANFH using the vascularized iliac bone grafting between March 2003 and July 2010 in our clinic. The main predisposing factor was steroid use in 13 patients. All patients were assessed clinically according to the Harris hip score and by radiographs by the Association Internationale de Recherche sur la Circulation Osseuse (ARCO) staging system. Results: The mean follow-up was 36 (range 14 to 62) months. Eleven hips (42%) had stage II and 15 hips (58%) had stage III ANFH. The mean Harris scores increased from 52 (range 31 to 63) to 82.8 (range 62 to 90) after surgery. Based on clinical outcomes, 18 hips (69%) were presented as excellent and good, while eight hips presented fair and poor. According to the ARCO staging system, satisfactory results were provided in 17 (65%) of the 26 hips. Two of four hips at preoperatively stage II progressed to stage III, two other hips to stage IV. Five hips at stage III preoperatively progressed to stage IV and these hips had to undergo hip replacement. Conclusion: Our results suggest that core decompression and the vascular pedicled iliac bone grafting are effective in early stages of ANFH.
