26 results on '"Harun R. Gungor"'
Search Results
2. Strain Ratio Measurements of Patellar and Achilles Tendons With Different Reference Regions in Healthy Volunteers
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Nusret Ök, Semih Akkaya, Nuray Akkaya, Harun R. Gungor, and Kadir Agladioglu
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Male ,elastography ,Acoustics and Ultrasonics ,Patellar Tendon ,Strain (injury) ,Tissue elasticity ,Fat pad ,Strain ratio ,030218 nuclear medicine & medical imaging ,Tendons ,human experiment ,Sonoelastography ,0302 clinical medicine ,Reference Values ,middle aged ,Healthy volunteers ,Ultrasonics ,Achilles Tendon/*physiology ,Adipose Tissue/physiology ,Adolescent ,Adult ,Aged ,Female ,Healthy Volunteers ,Humans ,Middle Aged ,Patellar Ligament/*physiology ,Ultrasonography/*methods ,Young Adult ,Ultrasonography ,Orthodontics ,Achilles tendon ,physician ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,ultrasound ,adult ,Ultrasound ,article ,musculoskeletal system ,adipose tissue ,Tendon ,aged ,female ,medicine.anatomical_structure ,rigidity ,Adipose Tissue ,patellar ligament ,young adult ,Medical imaging ,subcutaneous tissue ,Elastography ,Subcutaneous tissue ,musculoskeletal diseases ,Achilles tendons ,achilles tendon ,Biophysics ,volunteer ,Achilles Tendon ,03 medical and health sciences ,Patellar Ligament ,medicine ,Strain ratios ,controlled study ,Radiology, Nuclear Medicine and imaging ,human ,normal human ,procedures ,030203 arthritis & rheumatology ,business.industry ,echography ,reference value ,medicine.disease ,physiology ,infrapatellar fat pad ,business - Abstract
Strain ratio measurements of tendons vary because of the reference tissue selection. The main purpose of this study is to highlight, in detail, the numeric variability attributable to the use of various reference materials on strain ratio measurements of patellar and Achilles tendons. Measurements were performed at the proximal, middle and distal thirds of the patellar and Achilles tendons on the dominant site of healthy volunteers. A total of 3 references were used: the Hoffa's fat pad for the patellar tendon, the Kager's fat pad for the Achilles tendon, subcutaneous tissue and Aquaflex gel pads (Parker Laboratories, Fairfield, NJ, USA) for both tendons. Although the same methods were used by the same physician for each tendon site on repeated measurements, strain ratio values had numeric variability with various reference materials in each measurement. Therefore, comparison of numeric strain ratio results of various studies with various reference materials could confuse the clinical interpretations of these numeric data, and, using a reference material with standard stiffness like Aquaflex ultrasound gel pads, should be considered by verifying these results with further studies. © 2019 World Federation for Ultrasound in Medicine & Biology
- Published
- 2019
3. Use of a Spacer Block Tool for Assessment of Joint Line Position during Revision Total Knee Arthroplasty
- Author
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Harun R. Gungor and Nusret Ök
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Male ,Reoperation ,medicine.medical_specialty ,Knee Joint ,Radiography ,Block (permutation group theory) ,Condyle ,joint line ,Adductor Tubercle ,Joint line ,Computer software ,Contralateral knee ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Knee ,Femur ,revision total knee arthroplasty ,Arthroplasty, Replacement, Knee ,fibular head ,business.industry ,spacer block ,Surgery ,Reliable Landmark ,Restoration ,Elevation ,Level ,Female ,business ,Epicondyle ,Knee Prosthesis ,medial epicondyle ,Revision total knee arthroplasty - Abstract
There is a tendency of orthopaedic surgeons to elevate joint line (JL) in revision total knee arthroplasty (RTKA). Here, we ascertain the use of the spacer block tool (SBT) to determine JL more accurately for less experienced RTKA surgeons. To perform more precise restoration of JL, an SBT with markers was developed and produced using computer software and three-dimensional printers. The study was planned prospectively to include patients who received either condylar constrained or rotating hinge RTKA between January 2016 and December 2019. To determine JL, distance from fibular head (FH), adductor tubercle (AT), and medial epicondyle (ME) were measured on contralateral knee preoperative radiographs and on operated knee postoperative radiographs. Patients were randomized and grouped according to the technique of JL reconstruction. In Group 1, conventional methods by evaluating aforementioned landmarks and preoperative contralateral knee measurements were used to determine JL, whereas in Group 2, the SBT was used. The main outcome measure was the JL change in revised knee postoperatively in contrast to contralateral knee to compare effective restoration of JL between the groups. Twenty-five patients in Group 1 (3 males, 22 females, 72 years, body mass index [BMI] 32.04 ± 4.45) and 20 patients (7 males, 13 females, 74 years, BMI 30.12 ± 5.02) in Group 2 were included in the study. JL measurements for the whole group were FH-JL = 18.3 ± 3.8 mm, AT-JL = 45.8 ± 4.6 mm, and ME-JL = 27.1 ± 2.8 mm preoperatively, and FH-JL = 20.7 ± 4.2 mm, AT-JL = 43.4 ± 5.2 mm, and ME-JL = 24.7 ± 3.1 mm postoperatively. JL level differences in reference to FH, AT, and ME in Group 1 were 3.6 ± 3.1, 3.6 ± 3.5, and 3.4 ± 3.1 mm, respectively, and in Group 2 were 1.0 ± .0.9, 1.3 ± 1.3, and 1.1 ± 1.3 mm, respectively. There were statistically significant differences between the two groups in JL changes referenced to all of the specific landmarks (p
- Published
- 2021
4. Does mini-midvastus approach have an advantageous effect on rapid recovery protocols over medial parapatellar approach in total knee arthroplasty?
- Author
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Nihal Büker, Harun R. Gungor, Raziye Şavkın, Gökhan Bayrak, and Hakan Zora
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Male ,Knee Joint ,medicine.medical_treatment ,Osteoarthritis ,Hematocrit ,Fast-track protocol ,law.invention ,Quadriceps Muscle ,Hemoglobins ,midvastus approach ,parapatellar approach ,rapid ,Randomized controlled trial ,law ,Orthopedics and Sports Medicine ,Single-Blind Method ,Postoperative Period ,Prospective Studies ,Range of Motion, Articular ,Prospective cohort study ,Arthroplasty, Replacement, Knee ,Pain Measurement ,Aged, 80 and over ,Pain, Postoperative ,medicine.diagnostic_test ,rapid recovery protocol ,Rehabilitation ,Middle Aged ,Osteoarthritis, Knee ,Anesthesia ,Female ,Original Article ,Range of motion ,Enhanced Recovery After Surgery ,WOMAC ,Visual analogue scale ,Operative Time ,total knee arthroplasty ,recovery protocol ,medicine ,Humans ,Muscle Strength ,Aged ,business.industry ,Length of Stay ,medicine.disease ,Arthroplasty ,Quality of Life ,Surgery ,business - Abstract
Objectives: This study aims to compare the effects of mini-midvastus (MMV) versus medial parapatellar (MPP) approach on rapid recovery protocols during total knee arthroplasty (TKA)., Patients and methods: This prospective, randomized, single-blinded study was performed in 54 patients (4 males, 50 females; mean age 64.1 +/- 6.4 years) diagnosed as primary knee osteoarthritis and planned for unilateral TKA between May 2018 and March 2019. Patients were randomly assigned as MMV (1 male, 26 females; mean age 65 +/- 6.4 years) and MPP (3 males, 24 females; mean age 63.2 +/- 6.3 years) groups. Rapid recovery TKA protocol and discharge criteria were assembled and all patients were evaluated preoperatively, and at postoperative first and third months. Length of hospital stay (LOS) was recorded for all patients. Hemoglobin and hematocrit values, radiologic assessment of alignment, knee range of motion (ROM), quadriceps muscle strength, visual analog scale (VAS), 30-sec chair-stand test, stair-climb test, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Short Form-36 (SF-36) were used for evaluations by blinded observers., Results: There was no significant difference in demographic variables between two groups. Operative time in MMV Group (78.1 +/- 2.7 min) was significantly longer than the MPP Group (65.9 +/- 2.6 min) (p0.05). In terms of quadriceps muscle strength gain, we could not find any difference between groups in pre- and postoperative difference of changes (p>0.05)., Conclusion: With the use of contemporary rapid recovery protocols during TKA, MMV approach had no superiority over MPP approach when quadriceps muscle strength, LOS, pain, function, and quality of life were assessed. Longer operative time in the MMV approach compared to MPP approach may be considered as a disadvantage.
- Published
- 2020
5. Evaluation of overactive bladder and nocturia as a risk factor for hip fracture in climacteric women: a matched pair case control study
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Aysun Karabulut, Harun R. Gungor, Ömer Demirtaş, Nusret Ök, Serap Simavli, and Ali Ersin Zumrutbas
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very elderly ,030232 urology & nephrology ,urologic and male genital diseases ,Severity of Illness Index ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,comparative study ,Aged, 80 and over ,clinical article ,Hip fracture ,Obstetrics and Gynecology ,climacterium ,medical history ,humanities ,female genital diseases and pregnancy complications ,female ,priority journal ,risk factor ,Overactive bladder ,hip fracture ,disease severity ,Nocturia ,medicine.symptom ,Climacteric ,prospective study ,structured questionnaire ,medicine.medical_specialty ,quality of life assessment ,Urology ,complication ,psychology ,Article ,climacteric ,03 medical and health sciences ,evaluation study ,Severity of illness ,medicine ,Humans ,controlled study ,human ,Risk factor ,Aged ,Hip Fractures ,Urinary Bladder, Overactive ,business.industry ,questionnaire ,Case-control study ,case control study ,medicine.disease ,age ,Case-Control Studies ,business - Abstract
The aim of this study was to investigate whether overactive bladder (OAB) influences hip fractures in climacteric women by comparing the frequency of OAB and nocturia symptoms in patients with hip fractures and their age-matched controls in pre-fracture period. A total of 30 climacteric patients with a history of hip fracture were compared to a control group of 51 women in terms of OAB, nocturia and nocturia-QoL. A questionnaire composed of structured questions and Turkish validated versions of the specific questionnaires for OAB, OAB-Quality of Life (OAB-q) and nocturia-QoL was directed to the two groups. We did not detect statistically relevant differences between the groups for the presence or severity of OAB and OAB-q (p >.05). However, Nocturia-QoL was worse in the group with hip fracture (p =.022). Overactive bladder has no contribution to the overall risk of hip fracture, whereas, the severity of nocturia seems to play a role as a risk factor in the formation of hip fracture.Impact statementWhat is already known on this subject: Hip fracture is associated with high morbidity, mortality and the cost. Prevention of hip fracture is a high priority for the patients, physicians and the public health. Several studies and consensus opinions have investigated the risk factors for the hip fractures. What the results of this study add: Although urinary symptoms were not evaluated in previous studies as a risk factor, desire of urination makes people stand up and move to their toilet, and may put them in a hurry if it is sudden and uncontrollable one. Therefore, we hypothesised that overactive bladder (OAB) and nocturia may be a risk factor in the formation of hip fractures. Our study showed that Nocturia Quality of Life is worse in patients with the hip fracture. Therefore, overactive bladder may not have a role on the overall risk of hip fracture, but the severity of nocturia seems as a risk factor in the fracture process. What the implications are of these findings for clinical practice and/or further research: The getting up from the bed would probably be harder than getting up from a chair in elderly, and life style modifications such as illumination bedroom and organisation of living place may be helpful to minimise the risks. © 2017 Informa UK Limited, trading as Taylor & Francis Group.
- Published
- 2017
6. Investigation of the functional status of patients with unicondylar knee prosthesis
- Author
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Harun R. Gungor, Raziye Şavkın, Gökhan Bayrak, Nihal Büker, and Nusret Ök
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Orthodontics ,Rheumatology ,business.industry ,Biomedical Engineering ,Medicine ,Orthopedics and Sports Medicine ,Unicondylar knee prosthesis ,Functional status ,business - Abstract
Not Available
- Published
- 2019
7. Impact of early loading on fracture healing with intramedullary nailing
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Harun R. Gungor, Bekir Alper Kılıç, Nadir Aydemir, Fahir Demirkan, Nihal Büker, Mehmet Yücens, Cagdas Yorukoglu, and Nusret Ök
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Gynecology ,medicine.medical_specialty ,business.industry ,010102 general mathematics ,01 natural sciences ,Tıp ,Tibia cisim kırıkları,Kilitli intramedüller çivileme,Yük verme ,03 medical and health sciences ,0302 clinical medicine ,Tibia fracture,Locked intramedullery nail,loading ,Medicine ,030212 general & internal medicine ,0101 mathematics ,business ,General Environmental Science - Abstract
Giriş:Tibia cisim kırıkları, ortopedi ve travmatoloji pratiğinde en sık görülen kırıktiplerinden biridir. Bu çalışmada tibia cisim kırıkları tedavisinde kilitliintramedüller çivi uygulanan hastaların klinik sonuçlarının ve fonksiyoneldurumlarının değerlendirilmesi ve yük verme ile kaynama zamanınınkarşılaştırılması amaçlanmıştır.Yöntem:Çalışmaya 18-73 yaş arası, tibia cisim kırığı nedeni ile intramedüllerfiksasyon uygulanmış olan 44 hasta dahil edildi. Çalışmamızda sonuçlar, Johnerve Wruhs Kriterlerine göre ve Karlstum-Olerud kriterlerine göre kaydedildi.Radyolojik olarak iyileşme, radyografilerde hastanın desteksiz olarak yükverebileceği düzeyde kallus formasyonu ve/veya kırık hattının kaybolması olarakdeğerlendirildi. Klinik iyileşme ise hastanın ağrısız tam yük verebilmesi vegünlük aktivitelerine dönebilmesi olarak değerlendirildi.Bulgular:Hastaların yaş ortalaması 38,7±14,9 (17-73) yıl idi. 44 hastadan Hastaların 16’sında ( %36,4) tibia 1/3 orta cisim kırığı, 25’ inde (%56,8) tibia 1/3 distalkırık, 3’ ünde ise ( %6,8) ise tibia 1/3 proksimal kırığı görüldü. Hastalarınortalama kaynama süresi 11,36±3,8 (6-20) hafta olarak gözlendi.Karlstrom-Olerud'un fiziksel fonksiyonel değerlendirme skalasına göre ; 21hasta (%47,7) mükemmel, 14 hasta (%31,8)iyi, 1 hasta (%2,3) tatmin edici, 8hasta ( %18,2 ) ise orta olarak kaydedildi ve hiç kötü sonuç yoktu. Johner-Wrushkriterlerine göre 32 hastada (%72,7) mükemmel, 12 hastada ise %27,3 iyi olarak değerlendirildi. Takipsürecinde bütün kırıkların kaynadığı gözlendi.Sonuç:Hastalar Johner-Wrush Kriterlerine göre mükemmel ve iyi skora sahiptiler. Karlstrom-Olerud'un fiziksel fonksiyoneldeğerlendirme skalasına göre ise hiçbir hasta kötü skora sahip değildi. Genç,erken ağırlık aktaran ve çivi korteks mesafesi 2mm’den az olan hastalardakaynama süresi kısalmaktadır., Introduction: Tibialdiaphyseal fractures are one of the most common types of fractures in practiseof the orthopedics and traumatology. In this study, clinical results of thepatients with diaphyseal fractures of the tibia which have been treated withlocking intramedullary nailing tecnique and the weight bearing time and uniontime has been evaluated. Method: Patients who appliedto our hospital with tibial diaphyseal fractures were evaluatedretrospectively. 43 patients wereincluded in the study. Karlstrom-Olerud, Johner and Wruhs score were used toevaluate clinical results. Radiologic improvement was assessed as loss ofcallus formation and / or fracture line at the level that the patient couldload without support on radiographs. Clinical improvement was assessed as thepatient was able to give full pain relief and return to daily activities.Results: Mean duration ofunion was 11.36 ± 3.8 (6-20) weeks. According to Karlstrom-Olerud 21 patients(47,7%) has received a full grade of 36, 14 patients (31,8%) have beenevaluated as good with a grade between 33 and 35, 1 patient (2,3%) wassatisfactory with a grade in the range 30-32 and 8 patients were in the range27-29 and they are evaluated as fair. Non of the patients were evaluated aspoor.Conclusion: Patients have anexcellent and good score according to the Johner-Wrush criteria. According toKarlstrom-Olerud's physical functional assessment scale, no patient had a badscar. Younger, early-weight-bearing patients with a nail cortex distance ofless than 2mm, the duration of union is shortening.
- Published
- 2019
8. Real-time elastography of patellar tendon in patients with auto-graft bone–tendon–bone anterior cruciate ligament reconstruction
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Nusret Ök, Kadir Agladioglu, Levent Özçakar, Nuray Akkaya, Semih Akkaya, and Harun R. Gungor
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Male ,demography ,elastography ,Anterior cruciate ligament reconstruction ,clinical evaluation ,real time elastography ,medicine.medical_treatment ,bone graft ,Strain (injury) ,postoperative period ,Bone-Patellar Tendon-Bone Grafting ,Strain ratio ,0302 clinical medicine ,Medicine ,Orthopedics and Sports Medicine ,clinical article ,030222 orthopedics ,Lysholm Knee Score ,medicine.diagnostic_test ,Ultrasound ,operation duration ,General Medicine ,musculoskeletal system ,Tendon ,anterior cruciate ligament injury ,female ,medicine.anatomical_structure ,priority journal ,Elasticity Imaging Techniques ,pain severity ,Anterior cruciate ligament ,Adult ,musculoskeletal diseases ,medicine.medical_specialty ,diagnostic imaging ,Lysholm score ,Patellar tendon ,Transplantation, Autologous ,Article ,smoking ,03 medical and health sciences ,Patellar Ligament ,follow up ,Humans ,controlled study ,human ,bone patellar tendon bone graft ,autotransplantation ,Anterior Cruciate Ligament Reconstruction ,business.industry ,disease association ,Magnetic resonance imaging ,030229 sport sciences ,medicine.disease ,body mass ,Surgery ,tendon graft ,Orthopedic surgery ,adverse effects ,business ,human activities ,Follow-Up Studies - Abstract
Introduction: Patellar tendon donor site has been previously evaluated in patients with auto-graft bone–tendon–bone (BTB) anterior cruciate ligament (ACL) reconstruction using either magnetic resonance imaging or B mode ultrasound. However, donor site patellar tendon strain ratio—reflecting structural features—has not been studied with US elastography. Here, we ascertain real-time elastography properties of patellar tendon donor site and clinical relevance of these properties in patients with auto-graft BTB ACL reconstruction in the postoperative period. Methods: Patients who underwent ACL reconstruction using BTB autograft were evaluated. Demographic, operative and clinical data (severity of pain, Lysholm Knee score, sit to stand test, packages/year for smoking amount) were noted. Patellar tendons of the operated knees were evaluated by ultrasound (length and thickness) and sonoelastography (strain ratio). The healthy knees of the patients constituted the control group. Results: Eighteen patients (17 M, 1 F; mean age 30.9 ± 7 years) were evaluated. Mean postoperative follow-up period was 22.1 ± 2.6 (range 18–26) months. Patellar tendons were shorter and thicker on the operated side when compared with the contralateral side (both p = 0.001). Patellar tendon strain ratios of the operated side were lower than the contralateral side (harder tendon on operated side). While there was no correlation between strain ratios and clinical variables (age, BMI, postoperative time, severity of pain, Lysholm score, all p values > 0.05), significant negative correlations were detected between strain ratios of proximal, middle and distal thirds of operated side and amount of smoking (p = 0.008, r = −0.607, p = 0.009, r = −0.598, p = 0.023, r = −0.533, respectively). Conclusion: Patellar tendons on the operated sides seemed to thicken and shorten with decreased strain ratios at the donor side compared to the healthy side at an average of 2-year follow-up in patients with ACL reconstruction using BTB autograft, and amount of smoking had negative relationship with strain ratio of donor patellar tendon. © 2016, Springer-Verlag Berlin Heidelberg.
- Published
- 2016
9. Chronic Exposure to Static Magnetic Fields from Magnetic Resonance Imaging Devices Deserves Screening for Osteoporosis and Vitamin D Levels: A Rat Model
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Gülçin Abban Mete, Cagdas Yorukoglu, Nazan Keskin, Emin Oğuzhan Oğuz, Aygun Yorukoglu, Esat Kiter, Semih Akkaya, Harun R. Gungor, and Nusret Ök
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Male ,Pathology ,osteology ,Health, Toxicology and Mutagenesis ,Osteoporosis ,lcsh:Medicine ,magnetic field ,radiation exposure ,vitamin D ,Wistar rat ,Bone tissue ,bone ,Random Allocation ,magnetic resonance imaging ,rat ,animal ,phosphorus ,nuclear magnetic resonance imaging ,TUNEL assay ,medicine.diagnostic_test ,rodent ,vitamin ,apoptosis ,Magnetic Resonance Imaging ,alkaline phosphatase bone isoenzyme ,medicine.anatomical_structure ,bioassay ,nuclear magnetic resonance scanner ,trabecular bone ,medicine.medical_specialty ,vitamin D deficiency ,animal experiment ,osteocyte ,chronic exposure ,randomization ,Article ,animal tissue ,long term exposure ,histology ,evaluation study ,cortical thickness (bone) ,medicine ,Vitamin D and neurology ,biochemistry ,Animals ,controlled study ,Rats, Wistar ,Static magnetic field ,Centimeter ,calcium ,nonhuman ,Rattus ,business.industry ,imaging method ,lcsh:R ,Public Health, Environmental and Occupational Health ,Magnetic resonance imaging ,medicine.disease ,Magnetostatics ,osteoporosis ,Chronic exposure ,Rats ,Magnetic Fields ,adverse effects ,business ,Nuclear medicine ,metabolism - Abstract
Technicians often receive chronic magnetic exposures from magnetic resonance imaging (MRI) devices, mainly due to static magnetic fields (SMFs). Here, we ascertain the biological effects of chronic exposure to SMFs from MRI devices on the bone quality using rats exposed to SMFs in MRI examining rooms. Eighteen Wistar albino male rats were randomly assigned to SMF exposure (A), sham (B), and control (C) groups. Group A rats were positioned within 50 centimeters of the bore of the magnet of 1.5 T MRI machine during the nighttime for 8 weeks. We collected blood samples for biochemical analysis, and bone tissue samples for electron microscopic and histological analysis. The mean vitamin D level in Group A was lower than in the other groups (p = 0.002). The mean cortical thickness, the mean trabecular wall thickness, and number of trabeculae per 1 mm2 were significantly lower in Group A (p = 0.003). TUNEL assay revealed that apoptosis of osteocytes were significantly greater in Group A than the other groups (p = 0.005). The effect of SMFs in chronic exposure is related to movement within the magnetic field that induces low-frequency fields within the tissues. These fields can exceed the exposure limits necessary to deteriorate bone microstructure and vitamin D metabolism. © 2015 by the authors; licensee MDPI, Basel, Switzerland.
- Published
- 2015
10. Obliteration of Intercondylar Notch Mimicking Flexion-Extension Gap Imbalance in a Cruciate Retaining Total Knee Arthroplasty
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Semih Akkaya, Esat Kiter, Harun R. Gungor, Nusret Ök, and Cagdas Yorukoglu
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musculoskeletal diseases ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Total knee arthroplasty ,Soft tissue ,Case Report ,General Medicine ,musculoskeletal system ,Cruciate retaining ,Prosthesis ,Surgery ,lcsh:RD701-811 ,medicine.anatomical_structure ,lcsh:Orthopedic surgery ,Posterior cruciate ligament ,medicine ,Implant ,business ,Range of motion ,Balance (ability) - Abstract
Following total knee arthroplasty (TKA), the most frequent cause of extension deficit and limitation of range of motion in early postoperative period is related to improper tensioning of soft tissues and failure to balance extension and flexion gaps. If a cruciate retaining (CR) prosthesis is the planned implant, then attention should be given to balancing the posterior cruciate ligament (PCL), and any factor that alters this balance may also cause deterioration of knee balance in postoperative period. Here, we report on an unusual case referred from another hospital because of continuous pain and restriction of knee motion in early postoperative period following CR-designed TKA that was initially thought to be due to flexion-extension imbalance. However, during the revision procedure, extruded cement to the intercondylar notch was found to be both mechanically blocking terminal extension and limiting flexion by possible mechanism of irritation of the synovial nerve endings around the stretched anterior fibers of PCL during flexion. This case was successfully treated by removal of extruded cement from intercondylar notch to decompress PCL, polyethylene exchange, and secondary patellar resurfacing.
- Published
- 2015
11. Effects of weighted and un-weighted pendulum exercises on ultrasonographic acromiohumeral distance in patients with subacromial impingement syndrome
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Fusun Sahin, Nilgün Şimşir Atalay, Harun R. Gungor, Gökçe Yaşar, Nuray Akkaya, and Semih Akkaya
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Male ,pendulum exercise ,shoulder ,medicine.medical_treatment ,acromiohumeral distance ,joint function ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Pain assessment ,middle aged ,pain assessment ,Medicine ,Orthopedics and Sports Medicine ,subacromial impingement syndrome ,Range of Motion, Articular ,pathophysiology ,Pain Measurement ,Ultrasonography ,030222 orthopedics ,clinical article ,Rehabilitation ,adult ,Pendulum ,Middle Aged ,ultrasound scanner ,Exercise Therapy ,medicine.anatomical_structure ,female ,Treatment Outcome ,priority journal ,Shoulder Impingement Syndrome ,health program ,pain severity ,Female ,joint characteristics and functions ,Acromion ,shoulder impingement syndrome ,Adult ,medicine.medical_specialty ,Shoulder ,weight lifting ,diagnostic imaging ,codman exercises ,abduction ,Physical Therapy, Sports Therapy and Rehabilitation ,Article ,03 medical and health sciences ,Humans ,In patient ,controlled study ,human ,procedures ,Kinesiotherapy ,kinesiotherapy ,single blind procedure ,030203 arthritis & rheumatology ,business.industry ,echography ,treatment response ,therapy effect ,randomized controlled trial ,physiology ,Physical therapy ,pendulum exercises ,business ,musculoskeletal system parameters - Abstract
BACKGROUND: Although functional results of combined rehabilitation programs are reported, there have been no reports studying the effects of solo pendulum exercises on ultrasonographic measurements of acromiohumeral distance (AHD). OBJECTIVE: To investigate the effects of weighted and un-weighted pendulum exercises on ultrasonographic AHD and clinical symptoms in patients with subacromial impingement syndrome. METHODS: Patients with subacromial impingement syndrome were randomized to performing weighted (1.5 kilograms hand held dumbbell, N = 18) or un-weighted (free of weight, N = 16) pendulum exercises for 4 weeks, 3 sessions/day. Exercises were repeated for each direction of shoulder motion in each session (ten minutes). Clinical situation was evaluated by Constant score and Shoulder Pain Disability Index (SPADI). Ultrasonographic measurements of AHD at 0°, 30° and 60° shoulder abduction were performed. All clinical and ultrasonographic evaluations were performed at the beginning of the exercise program and at end of 4 weeks of exercise program. RESULTS: Thirty-four patients (23 females, 11 males; mean age 41.7 ± 8.9 years) were evaluated. Significant clinical improvements were detected in both exercise groups between pre and post-treatment evaluations (p < 0.05). There was no significant difference for pre and post-treatment AHD measurements at 0°, 30°, and 60° shoulder abduction between groups (p > 0.05). There was no significant difference for pre and post-treatment narrowing of AHD (narrowing of 0°'30°, and 0°'60°) between groups (p > 0.05). CONCLUSION: While significant clinical improvements were achieved with both weighted and un-weighted solo pendulum exercises, no significant difference was detected for ultrasonographic AHD measurements between exercise groups. © 2017 IOS Press and the authors. All rights reserved.
- Published
- 2016
12. Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength
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Ali Kitiş, Harun R. Gungor, Kadir Agladioglu, Semih Akkaya, Fahir Demirkan, Nusret Ök, and Nuran Sabir Akkoyunlu
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Male ,Handgrip ,Acoustics and Ultrasonics ,correlation analysis ,medical staff ,030230 surgery ,hemispheric dominance ,dynamometry ,Functional Laterality ,human experiment ,0302 clinical medicine ,middle aged ,Pinch Strength ,Pronator quadratus muscle ,Volunteer ,Handedness ,Dominance (genetics) ,Ultrasonography ,Cross sectional area ,030222 orthopedics ,Radiological and Ultrasound Technology ,Hand Strength ,adult ,right handedness ,Anatomy ,Middle Aged ,female ,medicine.anatomical_structure ,body height ,young adult ,Female ,echograph ,Adult ,diagnostic imaging ,volunteer ,Article ,body weight ,03 medical and health sciences ,Young Adult ,Atrophy ,image analysis ,Hand strength ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,human ,normal human ,procedures ,Flinders Handedness Survey ,skeletal muscle ,muscle thickness ,Muscle, Skeletal ,hand grip ,business.industry ,Significant difference ,echography ,arm muscle ,medicine.disease ,Hand ,body mass ,Sagittal plane ,age ,grip strength ,physiology ,functional assessment ,left handedness ,business ,Nuclear medicine - Abstract
Aims: We ascertained effects of hand dominance in both right and left-handed volunteers on the thickness and cross sectional area (CSA) of pronator quadratus (PQ) muscle as measured by the axial and sagittal views of ultrasound imaging. Secondly, we also aimed to document the extent of the relationship between the PQ measurements and handgrip. Materials and methods: Healthy adults from the volunteer medical staff were included in the study. Handedness was assessed via The Flinders Handedness survey. The sonographic appearance of the PQ was evaluated on sagittal and axial images for both hands. CSA of PQ muscle was digitally drawn and calculated on the axial plane. Handgrip was measured by using adjustable-handle dynamometer. Results: Eighty-nine healthy volunteers were included (54 right and 35 left-handed). Significant difference was detected between dominant and non-dominant hands in CSA and muscle thickness in both right and left-handed volunteers (p
- Published
- 2016
13. Sonoelastographic evaluation of the distal femoral cartilage in patients with anterior cruciate ligament reconstruction
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Levent Özçakar, Semih Akkaya, Harun R. Gungor, Nusret Ök, Nuray Akkaya, Kadir Agladioglu, and Fiziksel Tıp ve Rehabilitasyon
- Subjects
Male ,elastography ,Anterior cruciate ligament reconstruction ,patient satisfaction ,Knee Joint ,medicine.medical_treatment ,Distal femoral cartilage ,Sonoelastography ,knee ,Strain (injury) ,Strain ratio ,surgery ,0302 clinical medicine ,Postoperative Complications ,hamstring ,Medicine ,Orthopedics and Sports Medicine ,muscle training ,Anterior Cruciate Ligament ,cartilage ,pathophysiology ,injuries ,030222 orthopedics ,Lysholm Knee Score ,clinical article ,ultrasound ,adult ,Rehabilitation ,Ultrasound ,Femur Head ,femoral head ,musculoskeletal system ,medicine.anatomical_structure ,female ,Treatment Outcome ,Elasticity Imaging Techniques ,patella ligament ,Joint Instability ,Anterior cruciate ligament ,Lysholm score ,03 medical and health sciences ,follow up ,Humans ,human ,procedures ,Anterior Cruciate Ligament Reconstruction ,business.industry ,Anterior Cruciate Ligament Injuries ,Cartilage ,echography ,030229 sport sciences ,medicine.disease ,thickness ,Orthopedics ,tendon graft ,Ortopedi ,muscle strength ,adverse effects ,Surgery ,femur ,pathology ,business ,Nuclear medicine ,human activities ,Follow-Up Studies - Abstract
Objectives: This study aims to evaluate sonoelastographic properties of the distal femoral cartilage in patients with anterior cruciate ligament (ACL) reconstruction. Patients and methods: Demographic characteristics and operative data of 28 patients (27 males, 1 female; mean age 31.7 +/- 7.1 years; range 22 to 48 years) with unilateral ACL reconstruction were evaluated. Reconstruction was performed with patellar tendon graft in 22 patients (78.6%) and hamstring tendon graft in six patients (21.4%). Lysholm knee score was used for functional evaluation and chair stand test was used for lower extremity strength. Medial, intercondylar, and lateral distal femoral cartilage thicknesses of operated knees and healthy knees were measured with B-mode ultrasound, while strain ratios were measured with real time sonoelastography. Results: Postoperative mean follow-up duration was 20.4 +/- 9.8 months. Mean Lysholm knee and patient satisfaction scores were 88.0 +/- 8.5 and 8.2 +/- 1.8, respectively. Cartilage thicknesses were similar between operated and healthy knees (all p>0.05). Sonoelastographic strain ratio of medial distal femoral cartilage in operated knees was significantly higher (softer cartilage) (p=0.026). There was a negative correlation between strain ratio difference of medial cartilage of operated knees and lower extremity muscle strength (p=0.009, r=-0.487). Conclusion: While there was no difference for cartilage thickness between operated and healthy knees in B-mode ultrasound evaluation, detection of sonoelastographic strain ratio changes in medial distal femoral cartilage on the operated sides may indicate early structural changes following ACL reconstruction. Further studies are required to highlight the clinical effects of this relationship between the changes in cartilage structure and sonoelastography features.
- Published
- 2016
14. The effects of smoking on ultrasonographic thickness and elastosonographic strain ratio measurements of distal femoral cartilage
- Author
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Levent Özçakar, Nusret Ök, Nuray Akkaya, Semih Akkaya, Harun R. Gungor, Kadir Agladioglu, and Fiziksel Tıp ve Rehabilitasyon
- Subjects
Cartilage, Articular ,Male ,elastography ,adverse outcome ,Knee Joint ,osteology ,Health, Toxicology and Mutagenesis ,correlation analysis ,lcsh:Medicine ,knee ,Strain (injury) ,Osteoarthritis ,Tegner activity score ,bone ,030218 nuclear medicine & medical imaging ,tobacco consumption ,0302 clinical medicine ,Sonoelastography ,intrarater reliability ,middle aged ,image quality ,Femur ,cartilage ,pathophysiology ,distal femur ,smoking ,ultrasound ,sonoelastography ,adult ,Ultrasound ,Smoking ,real time echography ,Anatomy ,Osteoarthritis, Knee ,Femoral cartilage ,lateral distal femoral cartilage ,ultrasound scanner ,Healthy Volunteers ,medicine.anatomical_structure ,female ,young adult ,Elasticity Imaging Techniques ,medicine.symptom ,distal femoral cartilage ,bone structure ,Adolescent ,intercondylar distal femoral cartilage ,smoking habit ,medial distal femoral cartilage ,Asymptomatic ,Article ,03 medical and health sciences ,image analysis ,cartilage thickness ,medicine ,cross-sectional study ,Humans ,controlled study ,articular cartilage ,human ,normal human ,030203 arthritis & rheumatology ,business.industry ,Cartilage ,lcsh:R ,imaging method ,Public Health, Environmental and Occupational Health ,medicine.disease ,Distal femur ,Cross-Sectional Studies ,cartilage strain ratio ,adverse effects ,pathology ,business ,musculoskeletal system parameters - Abstract
Although adverse effects of smoking on bone health are all well known, data on how smoking interacts with cartilage structure in otherwise healthy individuals remains conflicting. Here, we ascertain the effects of cigarette smoking on sonoelastographic properties of distal femoral cartilage in asymptomatic adults. Demographic characteristics and smoking habits (packets/year) of healthy volunteers were recorded. Medial, intercondylar, and lateral distal femoral cartilage thicknesses and strain ratios on the dominant extremity were measured with ultrasonography (US) and real time US elastography. A total of 88 subjects (71 M, 17 F; aged 18–56 years, N = 43 smokers and N = 45 nonsmokers) were evaluated. Mean amount of cigarette smoking was 10.3 ± 8.9 (1–45) packets/year. Medial, intercondylar and lateral cartilage were thicker in smokers than nonsmokers (p = 0.002, p = 0.017, and p = 0.004, respectively). Medial distal femoral cartilage strain ratio was lower in smokers (p = 0.003). The amount of smoking was positively correlated with cartilage thicknesses and negatively correlated with medial cartilage strain ratios (p < 0.05). Femoral cartilage is thicker in smokers but has less strain ratio representing harder cartilage on the medial side. Future studies are needed to understand how these structural changes in the knee cartilage should be interpreted with regard to the development of knee osteoarthritis in smokers. © 2016 by the authors; licensee MDPI, Basel, Switzerland.
- Published
- 2016
15. Comment on: Measurement of the knee joint line in Turkish population
- Author
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Kadir Agladioglu, Nusret Ök, and Harun R. Gungor
- Subjects
musculoskeletal diseases ,Turkish population ,medicine.medical_specialty ,business.industry ,General Medicine ,musculoskeletal system ,Article ,Surgery ,lcsh:RD701-811 ,Orthopedics ,Physical medicine and rehabilitation ,lcsh:Orthopedic surgery ,Joint line ,Knee ,joint line ,interepicondylar distance ,adductor tubercle ,Medicine ,Orthopedics and Sports Medicine ,Knee joint line ,business - Abstract
To the Editor,We read with interest the article entitled “Measurement of the knee joint line in Turkish population” by Gürbüz et al in Vol. 49, No 1 (2015) of your journal.1 We congratulate them for their inspiring work.The authors measured femoral width, the distance from the apex of the fibular head to joint line and the distance from the adductor tubercle to the joint line to determine the knee joint line level relative to these landmarks and correlation of relative distance of joint line level to the femoral width. However, the study itself has some methodological drawbacks;A total of 117 knees were included in the study, but the number of the patients was 108. That means 9 patients were recorded twice considering right and left knee measurements. This is not appropriate from the statistical point of view since joint line levels relative to specific landmarks for individual persons are not expected to be different in each knee. Therefore, to our knowledge, all the studies in the literature cover only one leg for this type of morphometric studies; otherwise, bilateral measurements should be evaluated in separate groups. 2-5To ensure images representative of normal anatomy, patients with preexisting radiologic evidence of arthritis in their knees should be excluded from the study.2-5 However, exclusion criteria of the authors did not cover knee osteoarthritis that definitely might alter joint level measurements due to erosions of subchondral bone as it is seen on Fig 1 in original article (knee with Kellgren-Lawrance grade 3 osteoarthritis and possible valgus deformity). In addition, the patella in the figure showing the knee joint is not centered that was supposed to be one of the criteria of the study.Statistical analysis results given in the article are very preliminary to understand relationship between variables in details. For instance, just by reporting R2 value for linear regression analysis, we could estimate what percentage of the variability in the dependent variable (adductor tubercle joint line level-AJD) is explained by the independent variable (femoral width-FW). DOI: 10.3944/AOTT.2015.15.0214This abstract belongs to the un-edited version of the article and is only for informative purposes. Published version may differ from the current version.
- Published
- 2016
16. Preoperative and postoperative serial assessments of postural balance and fall risk in patients with arthroscopic anterior cruciate ligament reconstruction
- Author
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Nihal Büker, Cagdas Yorukoglu, Harun R. Gungor, Oğuzhan Gökalp, Semih Akkaya, Nusret Ök, and Nuray Akkaya
- Subjects
Male ,Anterior cruciate ligament reconstruction ,medicine.medical_treatment ,clinical evaluation ,Poison control ,high risk patient ,functional status ,postoperative period ,surgery ,Arthroscopy ,0302 clinical medicine ,computer program ,Postural Balance ,statistics and numerical data ,Orthopedics and Sports Medicine ,prevention and control ,body equilibrium ,Anterior Cruciate Ligament ,pathophysiology ,030222 orthopedics ,clinical article ,adult ,Rehabilitation ,falling ,risk assessment ,Fall risk ,oscillation ,preoperative evaluation ,medicine.anatomical_structure ,anterior cruciate ligament injury ,female ,Treatment Outcome ,priority journal ,Preoperative Period ,young adult ,prospective study ,medicine.medical_specialty ,velocity ,reconstruction ,Anterior cruciate ligament ,fall risk ,Physical Therapy, Sports Therapy and Rehabilitation ,Article ,range of motion ,03 medical and health sciences ,stabilography ,medicine ,follow up ,Humans ,In patient ,human ,procedures ,outcome assessment ,Mechanical instability ,Balance (ability) ,bone patellar tendon bone graft ,stabilograph ,Anterior Cruciate Ligament Reconstruction ,business.industry ,030229 sport sciences ,Surgery ,physiology ,Accidental Falls ,business ,Follow-Up Studies - Abstract
BACKGROUND: Impaired postural balance due to somatosensory data loss with mechanical instability has been shown in patients with ACL deficiency. OBJECTIVE: To assess postural balance in patients with ACL insufficiency prior to surgery and following reconstruction with serial evaluations. METHODS: Thirty patients (mean age of 27.7 ± 6.7 years) who underwent arthroscopic reconstruction of ACL with bonepatellar tendon-bone autograft were examined for clinical and functional variables at preoperative day and postoperative 12th week. Posturographic analysis were performed by using Tetrax Interactive Balance System (Sunlight Medical Ltd, Israel) at preoperative day, at 4th, 8th, and 12th weeks following reconstruction. Data computed by posturographic software by the considerations of the oscillation velocities of body sways is fall risk as a numeric value (0-100, lower values indicate better condition). RESULTS: All of the patients (mean age of 27.7 ± 6.7 years) had significant improvements for clinical, functional evaluations and fall risk (p < 0.05). Mean fall risk was within high-risk category (59.9 ± 22.8) preoperatively. The highest fall risk was detected at postoperative 4th week. Patients had high fall risk at 8th week similar to preoperative value. Mean fall risk decreased to low level risk at 12th week. Preoperative symptom duration had relationships with preoperative fall risk and postoperative improvement of fall risk (p = 0.001, r = -0.632, p = 0.001, r = -0.870, respectively). The improvement of fall risk was higher in patients with symptoms shorter than 6 months (p = 0.001). CONCLUSIONS: According to these results, mean fall risk of patients with ACL insufficiency was within high risk category preoperatively, and fall risk improves after surgical reconstruction, but as the duration of complaints lengthens especially longer than 6 months, the improvement of fall risk decreases following reconstruction. © 2016 - IOS Press and the authors. All rights reserved.
- Published
- 2016
17. Effects of cigarette smoking on elastographic strain ratio measurements of patellar and achilles tendons
- Author
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Levent Özçakar, Semih Akkaya, Harun R. Gungor, Nusret Ök, Nuray Akkaya, and Kadir Agladioglu
- Subjects
Ultrasound elastography ,Male ,elastography ,Future studies ,Patellar Tendon ,Strain (injury) ,Demographic characteristics ,030218 nuclear medicine & medical imaging ,Tendons ,0302 clinical medicine ,pathophysiology ,Ultrasonography ,030222 orthopedics ,Achilles tendon ,Negative correlation ,Musculoskeletal system ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Ultrasonic imaging ,musculoskeletal system ,Ultrasonic applications ,medicine.anatomical_structure ,female ,Musculoskeletal ultrasound ,Elasticity Imaging Techniques ,Elastography ,Medical imaging ,musculoskeletal diseases ,Adult ,medicine.medical_specialty ,Achilles tendons ,diagnostic imaging ,achilles tendon ,smoking ,03 medical and health sciences ,Cigarette smoking ,Patellar Ligament ,medicine ,Analytical studies ,Humans ,Radiology, Nuclear Medicine and imaging ,human ,business.industry ,case control study ,medicine.disease ,Patellar tendon ,Surgery ,Sonography ,Case-Control Studies ,Nuclear medicine ,business ,Body mass index - Abstract
Objectives - The aim of this study was to explore the sonographic and elastographic properties of patellar and Achilles tendons in smoking and nonsmoking otherwise healthy adults. Methods - We conducted a level 3 case-control analytical study. Smoking and nonsmoking volunteers (>18 years) without musculoskeletal system disorders were included in the study. Demographic characteristics and smoking habits (pack-years) were recorded. Proximal, middle, and distal third thicknesses of the patellar and Achilles tendons were measured by B-mode sonography. Strain ratio measurements of the same regions were measured by real-time ultrasound elastography. Results - A total of 69 participants (57 male and 12 female; mean age ± SD, 35.5 ± 7.8 years) were evaluated in the study. Smoking (n = 35) and nonsmoking (n = 34) groups had no significant differences in terms of age, body mass index, sex, and activity level (all P > .05). Proximal, middle, and distal thirds of the patellar and Achilles tendons were significantly thinner in the smoking group (all P < .05). Furthermore, strain ratio measurements in the same regions were significantly lower in the smoking group (all P < .05). Patellar tendon thicknesses and strain ratios had negative correlations with the smoking amount (all P < .05). Conclusions - Thickness and strain ratio measurements of patellar and Achilles tendons were reduced (thinner and harder tendons) in smokers. Clinical implications of these morphologic and elastographic changes should be investigated in future studies. © 2016 by the American Institute of Ultrasound in Medicine.
- Published
- 2016
18. What if the silent disease comes with the reality? Comment on: Prevalence of bone mineral density testing and osteoporosis management following low-and high-energy fractures
- Author
-
Nusret Ök and Harun R. Gungor
- Subjects
Male ,medicine.medical_specialty ,Pediatrics ,High energy ,silent disease,reality,Prevalence ,Osteoporosis ,Disease ,Fractures, Bone ,Absorptiometry, Photon ,Bone Density ,Health Care Sciences and Services ,medicine ,Humans ,Orthopedics and Sports Medicine ,Vitamin D ,Sağlık Bilimleri ve Hizmetleri ,Bone mineral ,Diphosphonates ,business.industry ,General Medicine ,Calcium Compounds ,medicine.disease ,Physical therapy ,Surgery ,Female ,business - Abstract
We read with interest the article entitled “Prevalence of bone mineral density testing and osteoporosis management following low- and high-energy fractures” by Angthong et al. in Vol. 47, No 5 (2013) of your journal. [1] We congratulate them for their inspiring work. However, the study itself has some methodological drawbacks, and contains false interpretations of results that lead to misunderstanding: 1. Inclusion of both low- and high-energy fracture patients to test probability of DEXA examination renders the criteria inconsistent., Bu makale, yukarıda künyesi belirtilmiş olan makalenin yazarlar tarafından gönderilen çevirisidir. Sağlanan içeriğin, orijinal makale ile uyumluluğunun tüm sorumluluğu yazarlara aittir
- Published
- 2015
19. Osteochondral mosaicplasty along with osteochondroplasty of the femoral head in femoroacetabular impingement: A case report
- Author
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Adem Çatak, Nusret Ök, Esat Kiter, and Harun R. Gungor
- Subjects
Osteochondroma ,Cartilage, Articular ,medicine.medical_specialty ,orthopedic surgery ,complication ,Femoracetabular Impingement ,Cam type impingement ,Femoral head ,Young Adult ,medicine ,case report ,Hip Dislocation ,Humans ,Transplantation, Homologous ,Orthopedics and Sports Medicine ,articular cartilage ,Orthopedic Procedures ,human ,procedures ,nuclear magnetic resonance imaging ,Range of Motion, Articular ,Femoroacetabular impingement ,pathophysiology ,Femoral neck ,Mosaicplasty ,Hip ,Acetabular labrum ,business.industry ,Rehabilitation ,Femur Head ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Transplantation ,medicine.anatomical_structure ,allotransplantation ,female ,Treatment Outcome ,Debridement ,Ortopedi ,pathology ,business ,Range of motion ,Osteochondral lesion ,joint characteristics and functions - Abstract
Although femoroacetabular impingement (FAI) syndrome is included in the etiology of lesions involving the acetabular labrum and acetabular cartilage, it is one of many possible reasons behind osteochondral lesions in the femoral head. Herein, we present clinical findings and outcomes of two cases with osteochondral defects and cam type impingement of femoral head. Both cases underwent autologous osteochondral mosaicplasty along with femoral osteochondroplasty following controlled hip dislocation. Harris hip scores improved significantly postoperatively and magnetic resonance imaging showed an adequate graft union and formation of a healthy chondral surface at the final assessment. Autologous osteochondral mosaicplasty of parafoveal region defects and femoral neck osteochondroplasty combination may be an effective treatment method for young patients with FAI syndrome. In addition, we believe that cam type impingement may also have a role in the etiology of parafoveal osteochondral lesions.
- Published
- 2015
20. Clarification of terminology: sonographic appearance of the pronator quadratus muscle in healthy volunteers
- Author
-
Harun R. Gungor and Kadir Agladioglu
- Subjects
Male ,Wrist Joint ,Radiological and Ultrasound Technology ,business.industry ,Pronator quadratus muscle ,Anatomy ,Terminology ,Healthy volunteers ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,business ,Muscle, Skeletal ,Ultrasonography - Published
- 2014
21. Significance of asymmetrical posteromedial and posterolateral femoral condylar chamfer cuts in total knee arthroplasty
- Author
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Harun R. Gungor, Nusret Ök, Esat Kiter, Semih Akkaya, and Kadir Agladioglu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Chamfer ,Rotation ,Knee Joint ,medicine.medical_treatment ,retrospective study ,Total knee arthroplasty ,knee ,knee arthroplasty ,Condyle ,Posterior offset ,surgery ,Young Adult ,medicine ,Humans ,Orthopedics and Sports Medicine ,human ,procedures ,Femur ,nuclear magnetic resonance imaging ,Arthroplasty, Replacement, Knee ,Alignment ,Retrospective Studies ,Orthodontics ,medicine.diagnostic_test ,business.industry ,theoretical model ,Magnetic resonance imaging ,Arthroplasty, Replacement, Knee/*methods ,Female ,Femur/*surgery ,Knee Joint/*surgery ,Magnetic Resonance Imaging ,Models, Theoretical ,Arthroplasty ,female ,Orthopedic surgery ,Calipers ,Surgery ,business ,MRI - Abstract
Purpose: Orthopedic surgeons remove more bone from the posteromedial femoral condyle than the posterolateral condyle to achieve the desired femoral component rotation. Here, the correlation between the asymmetry of chamfer cuts and femoral component rotation in total knee arthroplasty was determined., Methods: A model was built to simulate anterior chamfer cuts performed during total knee arthroplasty to measure posterior condylar offset. Right knee axial magnetic resonance imaging slices were examined from 280 consecutive patients (142 men, 138 women; mean age 31.4 ± 6.6 years). The anatomic and surgical transepicondylar axes, as well as the posterior condylar joint line, were drawn. Differences in the posteromedial and posterolateral offsets and the femoral rotation angles relative to the posterior joint line were measured., Results: The mean surgical femoral rotation angle was 4.8° ± 1.2°, and the mean posterior condylar offset difference was 4.4 ± 1 mm, with a strong correlation (p, Conclusion: The accuracy of the applied technique intra-operatively can be verified by correlating the asymmetry of posterior chamfer cuts with the achieved femoral component rotation, as determined by measuring the thicknesses of posterior chamfer cuts with a caliper. Technical errors can also be minimized by confirming the association between the femoral component rotation—as predicted by the posterior condylar offset difference—and the preoperatively measured femoral rotation angle., Level of evidence: II. © 2014, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
- Published
- 2014
22. Are there any adverse effects of static magnetic field from magnetic resonance imaging devices on bone health of workers?
- Author
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Harun R. Gungor, Nusret Ök, Nuray Akkaya, and Semih Akkaya
- Subjects
Chronic exposure ,Adult ,Male ,medicine.medical_specialty ,colecalciferol ,analysis ,Statistics as Topic ,Parathyroid hormone ,magnetic field ,Bone health ,Magnetic resonance imaging ,Absorptiometry, Photon ,blood ,Bone Density ,photon absorptiometry ,Occupational Exposure ,Medicine ,Humans ,Orthopedics and Sports Medicine ,human ,procedures ,Vitamin D ,nuclear magnetic resonance imaging ,Adverse effect ,Volunteer ,Femoral neck ,Cholecalciferol ,Bone mineral ,calcium ,medicine.diagnostic_test ,business.industry ,Femur Neck ,Rehabilitation ,femoral neck ,methodology ,Alkaline Phosphatase ,medicine.anatomical_structure ,female ,Magnetic Fields ,statistics ,Research Design ,adverse effects ,Surgery ,Radiology ,business ,metabolism ,radiography - Abstract
Objectives: In this study, we aimed to evaluate the effects of static magnetic field (SMF) from magnetic resonance imaging (MRI) devices on the bone health of MRI workers. Materials and methods: Fourteen volunteer MRI technicians working with 1.5 Tesla MRI units at least for two years were included in the study. An age and sex-matched control group from indoor working 14 volunteer paramedical staff who were not exposed to SMF and met the identical criteria was formed. Dual-energy X-ray absorptiometry (DXA) scanning was performed in all participants. Parathyroid hormone, calcium, phosphorus, alkaline phosphatase, 25-hydroxyvitamin D3, and 1.25-dihydroxyvitamin D3 levels were measured. Results: The mean vertebral and femoral neck bone mineral content (BMC) and bone mineral density (BMD) as well as the mean 25-hydroxyvitamin D3 level of MRI technicians was found to be lower than the control group (p
- Published
- 2014
23. Orthopedic surgeons' view for the prevention of osteoporotic secondary fractures: A survey
- Author
-
Nusret Ök, Harun R. Gungor, Semih Akkaya, and Esat Kiter
- Subjects
medicine.medical_specialty ,Demographics ,Turkey ,Osteoporosis treatment ,recurrent disease ,Osteoporosis ,Statistical difference ,Traumatology ,Osteoporotic secondary fracture ,Osteoporotic fracture ,World health ,Absorptiometry, Photon ,Recurrence ,photon absorptiometry ,Surveys and Questionnaires ,Medicine ,Humans ,Orthopedics and Sports Medicine ,human ,Practice Patterns, Physicians' ,Academic career ,business.industry ,Dual-energy X-ray absorptiometry ,Hip Fractures ,questionnaire ,Rehabilitation ,medicine.disease ,osteoporosis ,clinical practice ,Orthopedics ,Orthopedic surgery ,Physical therapy ,Spinal Fractures ,Surgery ,Primary osteoporosis ,business ,Osteoporotic Fractures ,radiography - Abstract
Objectives: This study aims to investigate the tendencies related to assessment and treatment modalities administered to patients with osteoporotic fractures by orthopedics and traumatology specialists for the prevention of secondary fractures in our country. Materials and methods: A survey composed of 10 questions was applied in electronic environment to actively practicing 144 orthopedics and traumatology specialists to detect their demographics, protocol they administer for the diagnosis and follow-up of primary osteoporosis, and assessment and treatment modalities they administer for the prevention of secondary fractures. Categorical variables were compared statistically based on duration of specialization, affiliated institution, and academic career along with the descriptive results. Results: Use of the Fracture Risk Assessment Tool (FRAXTM) developed by World Health Organization is limited among orthopedics and traumatology specialists in our country (11%). There was no statistical difference between the groups (p>0.05). The rate of starting the appropriate treatment after hip and vertebral fractures due to osteoporosis was 21%. In addition, 46% of the physicians preferred to wait for the dual-energy X-ray absorptiometry results. Only academic career was statistically significantly different between the groups (p=0.043). Conclusion: In our country, majority of patients who present with osteoporotic hip and vertebra fractures are assessed and treated insufficiently for the prevention of secondary fractures. Supporting our results with clinical studies can accelerate the development of sufficient research and treatment programs for patients with osteoporotic fractures.
- Published
- 2014
24. Comment on ‘extension gap needs more than 1-mm laxity after implantation to avoid post-operative flexion contracture in total knee arthroplasty’
- Author
-
Harun R. Gungor and Nusret Ök
- Subjects
Flexion contracture ,030222 orthopedics ,medicine.medical_specialty ,business.industry ,Total knee arthroplasty ,030229 sport sciences ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Orthopedic surgery ,Medicine ,Orthopedics and Sports Medicine ,Post operative ,business - Published
- 2015
25. 'Outliers' in Osteoarthritic Knees Concerning Distal Femoral Valgus Angle and Femoral Rotation Angle
- Author
-
Nusret Ök, Kadir Agladioglu, and Harun R. Gungor
- Subjects
Orthodontics ,030222 orthopedics ,03 medical and health sciences ,Valgus ,0302 clinical medicine ,biology ,business.industry ,Medicine ,Orthopedics and Sports Medicine ,030229 sport sciences ,Femoral rotation ,biology.organism_classification ,business - Published
- 2016
26. Correlation Between Asymmetric Resection of Posterior Femoral Condyles and Femoral Component Rotation in Total Knee Arthroplasty
- Author
-
Kadir Agladioglu, Harun R. Gungor, Nusret Ök, Semih Akkaya, and Esat Kiter
- Subjects
Chamfer ,business.industry ,Total knee arthroplasty ,Medicine ,FEMORAL CONDYLE ,Orthopedics and Sports Medicine ,Mean age ,Anatomy ,Femoral component ,Rotation ,business ,Condyle ,Resection - Abstract
Objectives: Pertaining to peculiar designs of current knee prostheses, more bone is removed from posteromedial femoral condyle than posterolateral condyle to obtain desired femoral component rotation. The aim of our study was to evaluate whether there is a correlation between the asymmetry of the cuts and the femoral component rotation in total knee arthroplasty. Methods: We built a model to simulate anterior chamfer cut (ACC) performed during total knee arthroplasty for measuring posterior condylar offset (PCO). Right knee axial MRI slices of a total 290 consecutive patients (142 male, 138 female, and mean age 31.39 ± 6.6) were examined. A parallel line to surgical transepiphyseal axis was drawn, and placed at the deepest part of trochlear groove. Posteromedial and posterolateral condylar offsets were measured by drawing perpendicular lines to ACC beginning from the intersection points of both anteromedial and anterolateral cortices to posterior joint line (PJL), respectively. Differences between posteromedial and posterolateral PCO were calculated, and femoral rotation angles (FRA) relative to PJL were measured. Results: The mean surgical FRA was 4.76 ± 1.16 degrees and the mean PCO differencesss- was 4.35 ± 1.04 mm for the whole group and there was no statistically significant difference between genders. There was a strong correlation between surgical FRA and PCO difference (pConclusion: Correlation between the asymmetry of posterior chamfer cuts and achieved femoral component rotation can verify the accuracy of desired rotation, intraoperatively. However, further clinical investigations should be planned to test the results of our morphometric study.
- Published
- 2014
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