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Öğe The challenging battle of mankind against COVID-19 outbreak: Is this global international biological catastrophe the beginning of a new era?(Sage Publications Ltd, 2020) Doral, Mahmut Nedim; Bilge, Onur[Abstract Not Availabe]Öğe The epidemiology of adult fractures according to the AO/OTA fracture classification(Turkish Assoc Trauma Emergency Surgery, 2022) Bilge, Onur; Dundar, Zerrin Defne; Atilgan, Numan; Yaka, Haluk; Kekec, Ahmet Fevzi; Karaguven, Dogac; Doral, Mahmut NedimBACKGROUND: The epidemiology of adult fractures has been changing timely, in a multifactorial fashion. The aim of this study was to put forward a recent 5-year epidemiological analysis of adult fractures, according to the current AO/OTA fracture classification, in the current decade of action for road safety. METHODS: 5324 adult patients who were diagnosed with at least one fracture related with orthopedics and traumatology in a level-one trauma center were included in this retrospective, epidemiological descriptive study. The patients were grouped according to their ages as; 18-35, 36-55, 56-69, and >= 70. The fractures were examined according to the AO/OTA classification. RESULTS: 5865 fractures were present in 5324 patients. The mean age of the patients was 48.6 +/- 21.5. The number of patients according to the age groups was as follows; 1947 (36.6%), 1636 (30.7%), 881 (16.5%), and 860 (16.2%), respectively. The most frequent three fractures according to the AO/OTA fracture classification were; 7 (hand 19.6%), 23 (distal forearm, 12.1%), and 8 (foot, 11.8%). About 54.4% and 45.4% of the patients were treated non-surgically and surgically, respectively. About 0.2% of the patients preferred an alternative treatment. Overall mortality rate was 0.4%. CONCLUSION: To the best of our knowledge, this study represents the first analysis of adult fractures according to the AO/OTA classification, over a 5-year period. As a future prospect, further multi-centric epidemiological studies are warranted to constitute a sustainable action plan for the prevention of major traumas.Öğe The epidemiology of adult fractures according to the AO/OTA fracture classification(Turkish Assoc Trauma Emergency Surgery, 2022) Bilge, Onur; Dundar, Zerrin Defne; Atilgan, Numan; Yaka, Haluk; Kekec, Ahmet Fevzi; Karaguven, Dogac; Doral, Mahmut NedimBACKGROUND: The epidemiology of adult fractures has been changing timely, in a multifactorial fashion. The aim of this study was to put forward a recent 5-year epidemiological analysis of adult fractures, according to the current AO/OTA fracture classification, in the current decade of action for road safety. METHODS: 5324 adult patients who were diagnosed with at least one fracture related with orthopedics and traumatology in a level-one trauma center were included in this retrospective, epidemiological descriptive study. The patients were grouped according to their ages as; 18-35, 36-55, 56-69, and >= 70. The fractures were examined according to the AO/OTA classification. RESULTS: 5865 fractures were present in 5324 patients. The mean age of the patients was 48.6 +/- 21.5. The number of patients according to the age groups was as follows; 1947 (36.6%), 1636 (30.7%), 881 (16.5%), and 860 (16.2%), respectively. The most frequent three fractures according to the AO/OTA fracture classification were; 7 (hand 19.6%), 23 (distal forearm, 12.1%), and 8 (foot, 11.8%). About 54.4% and 45.4% of the patients were treated non-surgically and surgically, respectively. About 0.2% of the patients preferred an alternative treatment. Overall mortality rate was 0.4%. CONCLUSION: To the best of our knowledge, this study represents the first analysis of adult fractures according to the AO/OTA classification, over a 5-year period. As a future prospect, further multi-centric epidemiological studies are warranted to constitute a sustainable action plan for the prevention of major traumas.Öğe Focal anatomic resurfacing implantation for bilateral humeral and femoral heads' avascular necrosis in a patient with Hodgkin's lymphoma and literature review(Elsevier Sci Ltd, 2015) Bilge, Onur; Doral, Mahmut Nedim; Miniaci, AnthonyINTRODUCTION: The femoral and humeral heads are among the most common sites of osteonecrosis. The aims of this case report was to report three years' results for sequential treatment of bilateral, concomitant involvement of humeral and femoral heads with focal anatomic resurfacing implantation in a single patient with Hodgkin's lymphoma and to review the relevant literature, which is relatively scarce. PRESENTATION OF CASE: We present a 48-year-old male patient with concomitant, bilateral femoral and humeral head avascular necrosis. He was diagnosed as Hodgkin's lymphoma in 1984. He had bilateral groin and shoulder pain, lasting for three years and aggravated by joint motions. Radiological evaluations demonstrated bilateral focal osteonecrosis of femoral heads and humeral heads, respectively. Despite conservative treatment, he did not obtain any symptomatic relief. Following the common decision, he was treated with sequential implantations with the HemiCAP device for both bilateral pathologies, by a single surgeon and standard surgical approaches. Neither intraoperative nor postoperative complication was encountered. After the follow-up period of 36 months after the last surgery, he was symptomless and with normal range of motion for all four joints. DISCUSSION: The bilateral, concomitant involvement of humeral and femoral head in the setting of avascular necrosis is relatively rare. Moreover, the optimal treatment method at earlier stages, in young patients has not been established yet. CONCLUSION: This study is the first report to present the three-years' clinical result of a single, relevant case, who was treated with sequential focal anatomic resurfacing implantations (HemiCAP) in four aforementioned joints. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of IJS Publishing Group Ltd.Öğe The initial analysis of pediatric fractures according to the AO/OTA fracture classification and mechanisms of injuries(Turkish Assoc Trauma Emergency Surgery, 2022) Bilge, Onur; Kekec, Ahmet Fevzi; Atilgan, Numan; Yaka, Haluk; Dundar, Zerrin Defne; Karaguven, Dogac; Doral, Mahmut NedimBACKGROUND: The epidemiology of pediatric fractures has been changing timely, in a multifactorial fashion. The aim of this study was to put forward a recent 5-year epidemiological analysis of pediatric fractures, according to the current AO/OTA fracture classifi-cation, in the current decade of action for road safety.METHODS: A total of 3261 pediatric patients who were diagnosed with at least one fracture related with orthopedics and trau-matology in a level-one trauma center were included in this retrospective and epidemiological descriptive study. The patients were grouped according to their ages as follows; <2, 2-5.9, 6-9.9, and 10-17.9. The fractures were examined according to the AO/OTA classification. RESULTS: A total of 3396 fractures were present in 3261 patients. The mean age of the patients was 9.8 +/- 4.6 (1-17). The number of patients according to the age groups was as follows; 28 (0.008%), 735 (22.53%), 863 (26.47%), and 1635 (50.99%), respectively. The most frequent three fractures according to the AO/OTA fracture classification were; 23 (radius/ulna distal 22.9%), 13 (humerus distal, 13.3%), and 7 (hand/carpal, 12%). About 68.8% and 31.2% of the patients were treated non-surgically and surgically, respectively. Overall mortality rate was 0.1%.CONCLUSION: To the best of our knowledge, this study represents the first analysis of pediatric fractures according to the AO/ OTA classification, over a 5-year period. As a future prospect, further multicentric epidemiological studies are warranted to constitute a sustainable action plan for the prevention of major traumas.Öğe The initial analysis of pediatric fractures according to the AO/OTA fracture classification and mechanisms of injuries(Turkish Assoc Trauma Emergency Surgery, 2022) Bilge, Onur; Kekec, Ahmet Fevzi; Atilgan, Numan; Yaka, Haluk; Dundar, Zerrin Defne; Karaguven, Dogac; Doral, Mahmut NedimBACKGROUND: The epidemiology of pediatric fractures has been changing timely, in a multifactorial fashion. The aim of this study was to put forward a recent 5-year epidemiological analysis of pediatric fractures, according to the current AO/OTA fracture classifi-cation, in the current decade of action for road safety.METHODS: A total of 3261 pediatric patients who were diagnosed with at least one fracture related with orthopedics and trau-matology in a level-one trauma center were included in this retrospective and epidemiological descriptive study. The patients were grouped according to their ages as follows; <2, 2-5.9, 6-9.9, and 10-17.9. The fractures were examined according to the AO/OTA classification. RESULTS: A total of 3396 fractures were present in 3261 patients. The mean age of the patients was 9.8 +/- 4.6 (1-17). The number of patients according to the age groups was as follows; 28 (0.008%), 735 (22.53%), 863 (26.47%), and 1635 (50.99%), respectively. The most frequent three fractures according to the AO/OTA fracture classification were; 23 (radius/ulna distal 22.9%), 13 (humerus distal, 13.3%), and 7 (hand/carpal, 12%). About 68.8% and 31.2% of the patients were treated non-surgically and surgically, respectively. Overall mortality rate was 0.1%.CONCLUSION: To the best of our knowledge, this study represents the first analysis of pediatric fractures according to the AO/ OTA classification, over a 5-year period. As a future prospect, further multicentric epidemiological studies are warranted to constitute a sustainable action plan for the prevention of major traumas.Öğe Peritoneum and omentum are natural reservoirs for chondrocytes of osteochondral autografts: A comparative animal study(2016) Büyükdoğan, Kadir; Doral, Mahmut Nedim; Bilge, Onur; Turhan, Egemen; Huri, Gazi; Sargon, Mustafa FevziObjective: The purpose of this study was to investigate the effects of the omentum, peritoneum, paratenon and skeletal muscle on the proliferation of the cartilage tissue using rabbit model as an in vivo culture medium. Methods: 6 months old forty-five New Zealand rabbits were randomized into omentum, peritoneum, muscle, and Achilles paratenon groups. Standard sized osteochondral grafts were harvested from right knees and immediately placed into the specified tissues. Control group was fresh cartilage at the end of follow-up. After five months, samples were collected and evaluated macroscopically by measuring their dimensions (vertical ¼ D1, horizontal ¼ D2, and depth ¼ D3) and volumes, and histologically by counting the chondrocyte number using camera lucida method. Results: Macroscopically, increase in mean values for D1 and D2 dimensions of specimens from paratenon and omentum compared to pretransplant dimensions was statistically significant (p < 0.05). Although, volume measurements were higher in omentum and peritoneum group compared to pretransplant dimensions, increase was not significant (p > 0.05). Histologically, mean chondrocyte count was 14.0 ± 0.6 in fresh articular cartilage. Mean chondrocyte counts were 14.4 ± 0.9 in omentum group, 15.4 ± 1.0 in peritoneum group, 9.7 ± 1.3 in muscle group and 9.2 ± 0.4 in Achilles paratenon group respectively. However, mean chondrocyte counts were higher in samples of omentum and peritoneum group compared to fresh articular cartilage, increase was not statistically significant (p > 0.05). Discussion: Transplantation of the cartilage grafts into mesothelium enhanced the chondrocyte counts and volumes compared with the pretransplant measurements. Mesothelium may have the potential to be used as an in vivo culture medium for osteochondral tissue growth.Öğe Return to sport rate following sports trauma-related delayed bucket-handle meniscus repair with concomitant ACL reconstruction(Turkish Assoc Trauma Emergency Surgery, 2022) Basal, Ozgur; Aslan, Talip Teoman; Deniz, Hande Guney; Bilge, Onur; Doral, Mahmut NedimBACKGROUND: Return to sports rate of chronic meniscus repair concurrent with Anterior Cruciate Ligament (ACL) reconstruction remains unclear, especially there is no well-defined return to sports criteria for evaluation. The purpose of this retrospective study was to determine the success rate of chronic locked bucket-handle meniscal tear (BHMT) repair with concomitant ACL reconstruction. METHODS: This study includes 51 chronic ACL injury patients with a locked meniscal tear of at least 6 weeks who underwent surgery. All cases were treated with arthroscopic BHMT repair and ACL reconstruction between 2017 and 2020. Patient demographics, chronicity, pre-operative, and intraoperative surgical variables which associated with return to sports were defined. BHMT was repaired with an all-in-side meniscus repair and/or combined repair procedure first, then an anatomic outside-in ACL reconstruction using a suspension device for femoral fixation was performed. Patients underwent same rehabilitation program with the goal of returning to sport at approximately 4-8 months. A modified return-to-sport criterion was performed in this study. RESULTS: Fifty-one patients with an average age of 27.4 (range 18-48) years were included in the study. The average time elapsed from the occurrence of locked knee symptoms to surgery was 10.5 +/- 4.4 weeks. The mean follow-up time was 25.3 +/- 4.5 months. Significant improvement was observed in all patient-reported outcomes from baseline to the final follow-up. The mean modified Lysholm knee score increased from 45.5 points to 91.5 at the final follow-up (p<0.001). The 43 out of 51 patients (84.3%) were return to their recreational activities (amateur sports). The mean time to return to sport was 5.9 +/- 0.8 (5-8) months. CONCLUSION: Majority of the patients who underwent ACL reconstruction with BHMT repair return to their pre-operative activity levels in 8 months. All neglected BHMTs with concomitant chronic ACL rupture should be repaired in a single-stage surgery if the half plane-concave shape of the menisci has been preserved regardless of the delay in time to surgery.Öğe Return to sport rate following sports trauma-related delayed bucket-handle meniscus repair with concomitant ACL reconstruction(Turkish Assoc Trauma Emergency Surgery, 2022) Basal, Ozgur; Aslan, Talip Teoman; Deniz, Hande Guney; Bilge, Onur; Doral, Mahmut NedimBACKGROUND: Return to sports rate of chronic meniscus repair concurrent with Anterior Cruciate Ligament (ACL) reconstruction remains unclear, especially there is no well-defined return to sports criteria for evaluation. The purpose of this retrospective study was to determine the success rate of chronic locked bucket-handle meniscal tear (BHMT) repair with concomitant ACL reconstruction. METHODS: This study includes 51 chronic ACL injury patients with a locked meniscal tear of at least 6 weeks who underwent surgery. All cases were treated with arthroscopic BHMT repair and ACL reconstruction between 2017 and 2020. Patient demographics, chronicity, pre-operative, and intraoperative surgical variables which associated with return to sports were defined. BHMT was repaired with an all-in-side meniscus repair and/or combined repair procedure first, then an anatomic outside-in ACL reconstruction using a suspension device for femoral fixation was performed. Patients underwent same rehabilitation program with the goal of returning to sport at approximately 4-8 months. A modified return-to-sport criterion was performed in this study. RESULTS: Fifty-one patients with an average age of 27.4 (range 18-48) years were included in the study. The average time elapsed from the occurrence of locked knee symptoms to surgery was 10.5 +/- 4.4 weeks. The mean follow-up time was 25.3 +/- 4.5 months. Significant improvement was observed in all patient-reported outcomes from baseline to the final follow-up. The mean modified Lysholm knee score increased from 45.5 points to 91.5 at the final follow-up (p<0.001). The 43 out of 51 patients (84.3%) were return to their recreational activities (amateur sports). The mean time to return to sport was 5.9 +/- 0.8 (5-8) months. CONCLUSION: Majority of the patients who underwent ACL reconstruction with BHMT repair return to their pre-operative activity levels in 8 months. All neglected BHMTs with concomitant chronic ACL rupture should be repaired in a single-stage surgery if the half plane-concave shape of the menisci has been preserved regardless of the delay in time to surgery.Öğe Treatment of osteonecrosis of the femoral head with focal anatomic-resurfacing implantation (HemiCAP): preliminary results of an alternative option(Bmc, 2015) Bilge, Onur; Doral, Mahmut Nedim; Yel, Mustafa; Karalezli, Nazim; Miniaci, AnthonyBackground: The optimal treatment of osteonecrosis of the femoral head has not been established yet. The aim of this study was to report preliminary clinical results of focal anatomic-resurfacing implantation for the treatment of osteonecrosis of the femoral head. Methods: Five patients (four male, one female) with seven surgical procedures, ages between 37 and 52 with an average age of 45.2 (+/- 7.2), diagnosed as femoral head avascular necrosis and who were unresponsive to conservative management or had failed previous surgical treatments were treated with a focal anatomic femoral head resurfacing between the years 2011-2012 and were retrospectively reviewed. Five patients with at least two years of follow-up, one left hip, two right hips, and two patients with bilateral hip surgery were included in this review. After safe surgical dislocation of the hip, full exposure of the femoral head was established. A focal-resurfacing implant matching patient anatomy and femoral head curvature was performed accordingly. Neither intraoperative or postoperative complications nor revision ensued. Visual analogue scores and Harris Hip Scores were recorded both preoperatively and at postoperative 2 years for all seven surgeries. Results: The mean follow-up period was 26.6 +/- 3.8 months, with a range between 24-33 months. The mean visual analogue scores were 8.9 +/- 0.9 preoperatively and 2.3 +/- 1.0 postoperatively at year two (p = 0.017). Harris Hip Scores at postoperative follow-up were found to improve significantly from good to excellent scores (86.0 +/- 7.9), compared with preoperative poor scores (26.7 +/- 11.8) (p = 0.018). The clinical improvements in visual analogue scores (VAS) and Harris Hip Scores were also found to correlate with each other (p<0.05). Conclusions: In the present study, the alternative technique of focal anatomic hip resurfacing with HemiCAP (R) yielded preliminary successful results for the treatment of osteonecrosis of the femoral head. To the best of our knowledge, this is the first case series in the literature, reporting functional clinical results with the use of a focal anatomic-resurfacing implant for the treatment of focal femoral head osteonecrosis.
