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Öğe Does Total Knee Arthroplasty Positively Affect Body Static-Dynamic Balance and Fall Risk Parameters in Patients With Satisfactory Functional Scores?(Springernature, 2022) Davut, Serkan; Huzmeli, Irem; Hallaceli, Hasan; Kalacı, AydınerObjectiveThe aim of this study was to determine the balance problems and risk of falling by using digital or computerized methods in patients who underwent total knee arthroplasty (TKA) and have satisfactory functional scores in the early postoperative period.MethodologyA total of 31 participants (24 women, seven men; mean age: 61.93 +/- 10.75 years; range: 49-82 years) who underwent unilateral TKA were included. The fall risk was evaluated using the time up-and-go (TUG) test and computerized platforms. Patient-reported pain, stiffness, and physical functional outcome measures [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score (OKS)] and posture (New York Posture Rating Chart) were evaluated.ResultsBased on the WOMAC scores, there was a significant impact on self-reported pain (p`0.001), function (p=0.001), and stiffness (p=0.001) between preoperative and postoperative results. The OKS (p=0.006) and the TUG score (p=0.004) improved significantly, but the posture scores remained the same after the surgery. There was a statistically significant difference between the preoperative and third-month postoperative test results of the stabilometric test, bipedal opened eye, bipedal closed eye, monopedal right, and monopedal left foot static balance tests (p`0.05). However, the disequilibrium and equilibrium dynamic balance values remained unchanged three months after TKA.ConclusionsSatisfactory functional scores according to WOMAC or OKS were achieved in the early postoperative period. However, posture and dynamic balance problems related to falling risk continued to persist in the same period. Although the TUG test results were statistically significant, they also showed fall risk values. Fall risk and postural problems should be analyzed objectively using computerized methods. Early rehabilitation programs after TKA in elderly individuals should be designed accordingly and close attention must be paid to fall risks.Öğe Effect of distal locking type on radiological results of proximal femoral nails used in the surgical treatment of hip fractures(Cukurova Univ, Fac Medicine, 2022) Davut, SerkanPurpose: The aim of our study is to obtain data that will shed light on the effect of the distal locking type of proximal femoral nails (PFN) on fracture healing, causes of general complications, especially those in the distal of the nails, and reduction of possible complication rates. Materials and Methods: Patients who underwent surgery with the diagnosis of trochanteric hip fracture between 01.01.2015 and 01.01.2020 and completed the second year follow-up time were examined from the medical records. Patients were grouped first according to AO/OTA subtypes (Three groups as AO A1, A2 and A3), then grouped according to distal locking type (Two groups as group 1: dynamic, group 2: static distal locking with 2 screws). The fracture type, healing status, fracture healing time, complication rates and reoperation because of complication development data were evaluated. Results: 339 patients enrolled in the study [189 women, 150 men, mean age: 76.24 (60-102) years]. The overall complication rate was 15.6%. AO A3 type fractures had long fracture healing times in each distal locking group compared to the other fracture sub-types. AO A3 type fractures had more frequent complication rates than the other subtype groups. AO A3 type fractures in group 2 had higher overall complication rates than in group 1. There was a significant correlation between group 1 and lag screw cut-out complication occurrence in females and between group 2 and pseudoarthrosis occurrence in males. In addition, there was a statistically significant relationship between the AO fracture sub-type and total rate of complication occurrence, AO A2 fracture type and lag screw cut-out complication occurrence and AO A3 fracture type and pseudoarthrosis complication occurrence. Conclusion: Patients with AO/OTA 31 A3 type fractures with static distal locking have a longer fracture healing time and a higher complication rate compared to dynamic locking. However, dynamic or static distal locking is not associated with other implant-related complications, especially those in the distal to the tip of PFN's.Öğe Endoscopy-assisted distal locking of an intramedullary nail: A new experimental technique to reduce radiation exposure during distal locking of the intramedullary nails(Turkish Joint Diseases Foundation, 2021) Davut, Serkan; Dogramaci, YunusObjectives: In this study, we aimed to introduce a new technique in which distal locking step was easier and safer for orthopedic trauma surgeons involving in the treatment of long bone fractures using an intranail endoscopic visualization and illumination method. Materials and methods: A total of 20 fresh bovine hind limbs derived from healthy adults and killed for sale were dissected to obtain tibial bones. Two equal groups including 10 samples in each were prepared. We applied a standard nailing process in both groups: the study group (n=10) was locked by the new technique, intranail endoscopic illumination guidance and intranail visualization assistance locking technique and the control group (n=10) was locked by the classical free-hand fluoroscopic guidance technique. We measured the surgical period time and the radiation exposure time required for the distal locking in both groups. Results: The radiation exposure time was statistically significantly lower in the study group compared to the control group. Also, the time period required for distal locking in the study group were statistically significantly lower than the control group. With the use of the intranail endoscopic illumination guidance and visualization assistance technique, the median period time required for the distal locking procedure reduced from 477.5 to 223.5 sec (p<0.001). The median time for radiation exposure dramatically reduced from 13.5 to 2 sec (p<0.001). The median attempt number reduced from 6.5 to 2 times (p<0.001). Conclusion: This experimental study indicates that the endoscopic illumination and intranail visualization assistance technique can reduce the radiation exposure time and the period time required for distal locking compared to the free-handÖğe Evaluation of the relationship between the anatomical characteristics of the vastus medialis obliquus muscle and the patella chondral lesion occurrence(Turkish Joint Diseases Foundation, 2024) Davut, Serkan; Dogramaci, YunusObjectives: The study aims to investigate the relationship between the vastus medialis obliquus (VMO) muscle distal insertion features and patellar chondral lesion presence. Patients and methods: This cross-sectional study included a total of 100 patients (18 males, 82 females, mean age 67.2 +/- 7.1 years; range, 50 to 86 years) who underwent total knee arthroplasty (TKA). Radiological assessments, including merchant view and standing orthoroentgenograms, were conducted. The current osteoarthritis stage, varus angle, quadriceps angle (Q angle), patella -patellar tendon angle (P -PT angle), congruence angle, and sulcus angle were calculated. The VMO tendon length, muscle fiber angle, tendon insertion width measurements, and patellar chondral lesion localization data were obtained intraoperatively. Grouping was done according to the distal insertion width of the VMO tendon to the medial edge of the patella. The medial rim of the patella was divided into three equal -sized sectors. The first group (Group 1, n=31) consisted of patients who had an insertion from the quadriceps tendon into the upper one-third of the patella. The second group (Group 1, n=48) consisted of patients with a distal insertion expanding into the middle one-third of the patella. The third group (Group 3, n=21) consisted of patients who had a distal insertion extending into the distal third region of the medial patella margin. The patella joint surface was divided into sectors, and the presence and location of cartilage lesions were noted in detail. Results: The mean tendon insertion width rate was 45.99 +/- 16.886% (range, 16.7 to 83.3%). The mean muscle fiber insertion angle was 51.85 +/- 11.67 degrees (range, 20 degrees to 80 degrees). The mean tendon length was 12.45 +/- 3.289 (range, 4 to 20) mm. There was no significant difference between the mean age, weight, height, body mass index, BMI, fiber angle, tendon length, varus angle, Q angle, sulcus angle, and congruence angle data among the groups. In terms of the P -PT angle, Groups 1 and 2 had a significant relationship (p=0.008). No relationship was found between the mean fiber insertion angle, mean tendon length, or the presence of chondral lesions. There was a statistically significant difference among the groups regarding the presence of chondral lesions. The highest percentage of chondral lesion frequency was observed in Group 3 (95.24%), followed by Group 1 (90.3%) and Group 2 (89.6%), respectively. Compared to the other two groups, Group 3 had a higher average ratio of lesion areas per patient. Conclusion: Our study results demonstrate that the formation and localization of the patellar chondral lesions are affected by the insertion width type of the VMO muscle into the patella. Group 2 -type insertion is associated with a lower lesion frequency rate than Groups 1 and 3.Öğe Immediate Effect of Kinesiology Tape on Functionality, Static and Dynamic Balance, Exercise Capacity, and Posture in Users of High-Heeled Shoes(Amer Podiatric Med Assoc, 2023) Huzmeli, Irem; Sari, Zubeyir; Hallaceli, Hasan; Gokcek, Ozden; Davut, SerkanBackground: Using high-heeled shoes in daily life affects the stability of walking, body posture, and functionality. We aimed to determine the immediate effect of kinesiology taping (KT) on functionality, static and dynamic balance, exercise capacity, and posture in young women using high-heeled shoes.Methods: Thirty-seven women who wore high-heeled shoes (mean +/- SD age, 20.32 +/- 1.37 years) were divided into control (n = 20) and study (n = 17) groups. Both limbs of study group participants were taped medially, laterally, and dorsally with KT; no application was made to the control group. Balance (TecnoBody postural line), functionality (vertical jump and functional reach tests), exercise capacity (6-Minute Walk Test), and human body posture (New York Posture Rating Chart) were assessed.Results: Median use of high-heeled shoes was 8 hours daily, 5 days weekly, and 3 years in the study group versus 6 hours daily, 4 days weekly, and 4 years in the control group. Significance in functional reach distance was found within the control (P = .010) and study (P = .005) groups but not between the groups. Stabilometric monopedal right foot ellipse area (P = .016) and perimeter (P = .009); left foot ellipse area (P = .016), perimeter (P = .023), and front/back standard deviation (P = .018); and dynamic balance area gap percent-age (P = .030) were significant within the study group. Posture, vertical jump distance, exercise capacity, stabilometric test results, and bipedal closed-eye and opened-eye results were similar within and between groups (P > .05).Conclusions: Kinesiology taping has no immediate effect on exercise capacity, vertical jump function, posture, and bipedal static balance but can modulate functional reach function, static monopedal leg balance, and dynamic equilibrium. Further studies are recommended to investigate the additive effect of KT with high-heeled shoes and after 45 min, 24 hours, and 72 hours. (J Am Podiatr Med Assoc 113(4), 2023)Öğe Investigation of long-term fall prevalence after total knee arthroplasty in Hatay: A cross-sectional study(Ondokuz Mayis Universitesi, 2022) Davut, Serkan; Hallaçeli, Hasan; Hüzmeli, İremFalls and fractures caused by falls in the elderly affect their daily activities, creating fear of movement and alienating the individual from social participation. Fall related-injuries are some of the main afraid complications after total knee arthroplasty surgery. The aim of this study is to determine the incidence of falling and fear of movement in the long period (one year and more after surgery) in patients who had total knee arthroplasty surgery. Patients who had total knee arthroplasty surgery in Hatay Mustafa Kemal University Department of Orthopedics and Traumatology between 01.01.2016 and 01.10.2020 enrolled in the study. Demographic information was recorded from the patient file or asked to the patients/caregivers via telemedicine. The falls before the surgery, falls after the surgery within 3 months, within 3 to 6 months, within 6 to 12 months which caregiver/relative’s remember recorded via telemedicine. Fear of movement assessed with the Tampa Kinesiophobia Scale was asked. 149 Patients with, mean age 67.06±8.72 years, female (85.9%), mostly house wives (80.5%) was the cohort. Their education time (89.8 %) were less than 5 years, and the huge majority of the patients did not have exercise habits (83.2%). The fall rate before the surgery was (35.6%), after the surgery was (36.9%), within the first 3 months (6.7%), 3 to 6 months (6%) and 6 to 12 months (11.7%). 7. 4 % of our patients had a fall related-fractures including: 2 radius distal fractures (1.3%), 3 hip fractures (2%), 3 periprosthetic fractures (2%), 1 patella fracture (0. 7%) and 2 vertebral compression fractures (1.3%). Tampa Kinesiophobia Scale score was 41(38-44). There was a positive correlation between kinesiofobia and those who did not have exercise habits and those who fell preoperatively (r: 0.31, p:0.01). Some of TKA patients were falling and had fear of movement. New researches should be conducted about what is the reason that makes the patients posture and movement more stable or which mechanism alters the balance. In order to prevent complications that may occur due to falls, new studies, treatment modalities and rehabilitation programs focusing on the etiology of falling in the elderly individuals should be organized. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Treatment of secondary hip arthritis from shell fragment and gunshot injury in the Syrian civil war(Bmc, 2020) Ozden, Raif; Davut, Serkan; Dogramaci, Yunus; Kalacı, Aydıner; Duman, Ibrahim Gokhan; Uruc, VedatBackground In gunshot and shell fragment injuries to the hip joint, orthopedic intervention includes wound assessment and care, osteosynthesis of fractures, and avoiding of infection and osteoarthritis. Individuals injured in the Syrian civil war were frequently transferred to the authors' institution in neighboring city. Orthopedic trauma exposures were determined in approximately 30% of these patients. The aim of this study was to evaluate the outcomes of the patients with secondary hip arthritis due to prior gunshot and shell fragment (shrapnel) injuries who underwent primary total hip arthroplasty. Methods This retrospective study reviewed 26 patients (24 males, 2 females) who underwent hip arthroplasty due to prior gunshot and shell fragment injuries from November 2013 to January 2019. For all patients, the Harris Hip Score (HHS) was evaluated preoperatively and after surgery. Results Mean age was 31.5 (range, 19-48) years. The mean preoperative HHS was 52.95 points, and the mean postoperative HHS was 79.92 points at the final follow-up after surgery. Patients with shell fragment injuries to the hip joint had higher infection rates, but it is not statistically significant. Conclusions An anatomic reduction of the fracture may not be possible in these cases as a result of significant bone and/or cartilage loss. Total hip arthroplasty can be done after gunshot- and shell fragment-related posttraumatic arthritis. It is an effective treatment choice to reduce pain and improve function, but the surgeon must be very careful because of high rate of infection.
