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Öğe Adolescent pelvic chondrosarcoma, surgical treatment, and unusual reconstruction with pedestal conic cup (LUMIC®) A case report(Turkish Joint Diseases Foundation, 2020) Colak, Tahsin Sami; Kekec, Ahmet FevziAn 18-year-old male patient was diagnosed pelvic chondrosarcoma histopathologically. Hip joint involvement was detected. No metastasis or neurovascular invasion was seen. Type I+II pelvic resection and hip reconstruction were planned with pedestal cup (LUMIC (R)) and proximal femur tumor prosthesis. Surgery was performed in lateral decubitus position with extensive triradiate incision. Pelvic wide resection was performed. At the second year of follow-up, implant failure was detected and patient was revised with same pedestal cup. Axial stability was supported by a 1.5 screw and connector from 1.5 vertebrae to LUMIC (R) prosthesis. Except the implant failure. no oncological complication or infection was observed during the final 36th month follow-up.Öğe Does the pre-operative neutrophil-lymphocyte ratio have a predictive value in detecting infection in type 3 open tibia diaphysis fractures?(Turkish Assoc Trauma Emergency Surgery, 2022) Colak, Tahsin Sami; Kekec, Ahmet FevziBACKGROUND: This retrospective study was aimed to investigate whether the pre-operative neutrophil-lymphocyte (N/L) ratio has a predictive value in terms of evaluating the development of infection in patients with type 3 open fractures of the tibia diaphysis. METHODS: A total of 72 patients with type 3 open tibia fractures who consulted to the emergency service at the Necmettin Erbakan University Meram Faculty of Medicine, during the period between 2015 and 2020 were retrospectively examined. A total of 39 patients who underwent external fixator in the first treatment were included in the study. The information pertaining to the patients such as the patient demographic data, type of injury, wound cultures, and N/L rates during the pre-operative period were recorded. Patients were divided into two groups based on the presence of infection: Group 1 (12 patients) consisted of patients who had infection, and Group 2 (27 patients) consisted of patients who had no infection. RESULTS: 34 (87.2%) of the patients were male and 5 (12.8%) were women. The mean age of these patients was 43.18??18.67 (19???80). Infection was detected in 12 (30.8%) out of 39 patients. Of these patients, 9 (75%) were monomicrobial, and 3 (25%) were polymicrobial. The most common mechanism of the injury was gunshot injury in 16 (41%) of all patients. However, there was no significant difference between the groups in terms of mechanism of injury (p=0.445). When all patients were examined in terms of N/L rates and presence of infection, there was no significant difference between Group 1 and Group 2 (p=0.976). CONCLUSION: Although N/L ratio of the blood in the pre-operative period has a predictive value for chronic diseases, we believe that it has no predictive value for detecting infection in patients with type 3 acute open tibia fractures.Öğe Does the pre-operative neutrophil-lymphocyte ratio have a predictive value in detecting infection in type 3 open tibia diaphysis fractures?(Turkish Assoc Trauma Emergency Surgery, 2022) Colak, Tahsin Sami; Kekec, Ahmet FevziBACKGROUND: This retrospective study was aimed to investigate whether the pre-operative neutrophil-lymphocyte (N/L) ratio has a predictive value in terms of evaluating the development of infection in patients with type 3 open fractures of the tibia diaphysis. METHODS: A total of 72 patients with type 3 open tibia fractures who consulted to the emergency service at the Necmettin Erbakan University Meram Faculty of Medicine, during the period between 2015 and 2020 were retrospectively examined. A total of 39 patients who underwent external fixator in the first treatment were included in the study. The information pertaining to the patients such as the patient demographic data, type of injury, wound cultures, and N/L rates during the pre-operative period were recorded. Patients were divided into two groups based on the presence of infection: Group 1 (12 patients) consisted of patients who had infection, and Group 2 (27 patients) consisted of patients who had no infection. RESULTS: 34 (87.2%) of the patients were male and 5 (12.8%) were women. The mean age of these patients was 43.18??18.67 (19???80). Infection was detected in 12 (30.8%) out of 39 patients. Of these patients, 9 (75%) were monomicrobial, and 3 (25%) were polymicrobial. The most common mechanism of the injury was gunshot injury in 16 (41%) of all patients. However, there was no significant difference between the groups in terms of mechanism of injury (p=0.445). When all patients were examined in terms of N/L rates and presence of infection, there was no significant difference between Group 1 and Group 2 (p=0.976). CONCLUSION: Although N/L ratio of the blood in the pre-operative period has a predictive value for chronic diseases, we believe that it has no predictive value for detecting infection in patients with type 3 acute open tibia fractures.Öğe Effectiveness of gonarthrosis treatment via intra-articular injections of linear vs. cross-linked hyaluronic acids(Turkish Joint Diseases Foundation, 2023) Yilmaz, Selcuk; Kurt, Mehmet; Kekec, Ahmet Fevzi; Yildirim, AhmetObjectives: The study aimed to compare the outcomes of single-dose cross-linked hyaluronic acid and the linear regimen of three doses of HA knee injections among patients with gonarthrosis.Patients and methods: This single-center, retrospective study was conducted with 60 patients (47 females, 13 males; mean age: 57.9 +/- 4.29 years; range, 50 to 65 years) with Kellgren-Lawrence Grade 2 or 3 gonarthrosis between February 2020 and February 2022. Patients were either subjected to intra-articular cross-linked hyaluronic acid (n=30) or linear hyaluronic acid (n=30) injection treatments. Comprehensive assessments of the patients were conducted prior to the injections, as well as at three and six months after injection. The two injection groups were compared regarding the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score.Results: Both injections showed a statistically significant improvement from baseline in both WOMAC and Oxford Knee Score at three and six months (p<0.001). There was no notable distinction in the alteration of WOMAC knee scores between the two injection types. However, a notable discrepancy was observed in the elevation of Oxford Knee Score among patients who received cross-linked knee injections compared to those who underwent linear hyaluronic acid knee injections, signifying a significant increase in the former group (p<0.001).Conclusion: The advantage of a single-dose administration of cross-linked HA knee injections, as opposed to the three-dose regimen required for linear hyaluronic acid, translates into reduced time and cost for the injection process. Moreover, this approach minimizes injection-associated discomfort for patients due to the singular dose administration.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 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 Is there a predictive value of the preoperative neutrophil-lymnhocyte ratio in terms of intensive care need in geriatric patients who underwent pertrochanteric fracture surgery?(Turkish Assoc Trauma Emergency Surgery, 2022) Kekec, Ahmet Fevzi; Colak, Tahsin SamiBACKGROUND: Pertrochanteric fractures are serious health problem with an ever-increasing prevalence in elderly population. Potential post-operative intensive care need leads to delays in the timing of surgery due to the referral of patients to better equipped hospitals as well as the inability to arrange a reserved intensive care bed. The purpose of this study is to investigate whether pre-operative neutrophil-lymphocyte ratio (NLR) has predictive value in terms of post-operative intensive care need in geriatric patients who underwent surgery following pertrochanteric fractures. METHODS: total of 535 patients aged 65 years and above with hip fractures who presented to the emergency service between 2017 and 2020 were retrospectively screened. Out of 535 patients, 317 patients who met the inclusion and exclusion criteria were included in the study. The screened patient population was divided into two groups as those followed in the post-operative intensive care unit (ICU) and those followed in the orthopedic ward. RESULTS: There were 190 patients (59.9%) who were followed in the orthopedic ward postoperatively and 127 (40.1%) patients followed in the ICU postoperatively. While the mean pre-operative NLR value of all patients was 6.57, the mean pre-operative NLR of the patients who were followed up postoperatively in the orthopedic ward was 5.85, and the mean NLR of those who were followed up in the ICU was 7.65. It was found that the admission NLR values of the ICU group patients were significantly higher compared to those of the orthopedic ward group (p<0.001) and also the cutoff value of NLR was calculated as 6.14. CONCLUSION: We believe that this objective, simple, cost-effective, and rapid marker can be used in combination with other parameters to predict ICU need to prevent surgical delays due to the lack of a reserved intensive care bed in the ASA 3 geriatric patient group with pertrochanteric fractures, whose intensive care need cannot be clarified, thereby reducing mortality and morbidity.Öğe Is there a predictive value of the preoperative neutrophil-lymnhocyte ratio in terms of intensive care need in geriatric patients who underwent pertrochanteric fracture surgery?(Turkish Assoc Trauma Emergency Surgery, 2022) Kekec, Ahmet Fevzi; Colak, Tahsin SamiBACKGROUND: Pertrochanteric fractures are serious health problem with an ever-increasing prevalence in elderly population. Potential post-operative intensive care need leads to delays in the timing of surgery due to the referral of patients to better equipped hospitals as well as the inability to arrange a reserved intensive care bed. The purpose of this study is to investigate whether pre-operative neutrophil-lymphocyte ratio (NLR) has predictive value in terms of post-operative intensive care need in geriatric patients who underwent surgery following pertrochanteric fractures. METHODS: total of 535 patients aged 65 years and above with hip fractures who presented to the emergency service between 2017 and 2020 were retrospectively screened. Out of 535 patients, 317 patients who met the inclusion and exclusion criteria were included in the study. The screened patient population was divided into two groups as those followed in the post-operative intensive care unit (ICU) and those followed in the orthopedic ward. RESULTS: There were 190 patients (59.9%) who were followed in the orthopedic ward postoperatively and 127 (40.1%) patients followed in the ICU postoperatively. While the mean pre-operative NLR value of all patients was 6.57, the mean pre-operative NLR of the patients who were followed up postoperatively in the orthopedic ward was 5.85, and the mean NLR of those who were followed up in the ICU was 7.65. It was found that the admission NLR values of the ICU group patients were significantly higher compared to those of the orthopedic ward group (p<0.001) and also the cutoff value of NLR was calculated as 6.14. CONCLUSION: We believe that this objective, simple, cost-effective, and rapid marker can be used in combination with other parameters to predict ICU need to prevent surgical delays due to the lack of a reserved intensive care bed in the ASA 3 geriatric patient group with pertrochanteric fractures, whose intensive care need cannot be clarified, thereby reducing mortality and morbidity.Öğe Is vitamin D level related to bilateral lateral epicondylitis?(Bayrakol Medical Publisher, 2023) Yaka, Haluk; Yilmaz, Cumali; Ruzgar, Hasan; Colak, Tahsin Sami; Kekec, Ahmet Fevzi; Ozer, MustafaAim: This study aimed to examine the relationship between unilateral lateral epicondylitis (ULE), bilateral lateral epicondylitis (BLE), and vitamin D levels. Material and Methods: Between January 2016 and January 2021, 112 ULE patients (67 men, 45 women, mean age 45.55 +/- 10.75 years), 90 BLE patients (47 men, 43 women, mean age 44.93 +/- 9.76 years), and 134 patients determined as the control group (47 men, 43 women, mean age 44.93 +/- 9.76 years) were included in the study. The three groups were compared in terms of vitamin D levels. Results: The mean vitamin D level was 24.87 +/- 8.45 ng/ml in the control group, 16.67 +/- 8.08 ng/ml in the ULE group, and 12.2 +/- 5.71ng/ml in the BLE group. There was a significant difference in vitamin D levels between the control and ULE group, the control and BLE group, and the ULE and BLE group (p<0.001, p<0.001, p=0.014, respectively). Discussion: Vitamin D levels of patients with bilateral lateral epicondylitis were significantly lower than those with unilateral lateral epicondylitis. This study shows that low vitamin D may be one of the etiological factors of lateral epicondylitis and may cause bilateral lateral epicondylitis at lower values.Öğe Mid-term outcomes of hemipelvic allograft reconstruction after pelvic bone tumor resections(Turkish Joint Diseases Foundation, 2022) Kekec, Ahmet Fevzi; Gungor, Bedii SafakObjectives: This study aims to evaluate survival of patients and implants, functions, and morbidity of surgical technique of reconstruction with a fresh-frozen massive pelvic allograft following a pelvic resection. Patients and methods: Between January 2009 and December 2016, a total of 19 patients (12 males, 7 females; mean age: 35.8 +/- 14.4 years; range, 10 to 53 years) who underwent reconstruction with fresh-frozen massive allograft after internal hemipelvectomy were retrospectively analyzed. Patients. age, sex, resection types, histopathology and grades, surgical margins, operative times, intraoperative blood loss, complications experienced during their treatment (infection, dislocation, implant failure, nonunion, local recurrence and metastasis), neoadjuvant and adjuvant therapies they received, and functional scores were revelaed and analyzed in 10 years period. Results: According to the Enneking and Dunham classification, two (10%) patients had type I resection only, six (32%) had type I-II, one (5%) had a type II resection, one (5%) had type II-III resection, three (16%) had type I-II-III resection, one (5%) had type I-IV resection, and five (26%) had type I-II-IV resection. The resection involved the acetabulum (type II) in all, but three patients. Several complications were seen in 12 patients, although seven patients had no complication. Pelvic resections had a high mortality rate in patients with malignant tumors and reconstruction with massive allograft had a high morbidity rate with susceptibility to many complications. Prolonged surgical time was found to be directly related to blood loss. Deep infection significantly worsened functional results. Conclusion: Despite the high complication rates seen in pelvic resections, massive pelvic allografts represent a valid option for reconstruction after resection of pelvic tumors, but due to the associated morbidity, patients should be carefully selected.Öğe Mid-term results of autologous matrix-induced chondrogenesis surgery with or without scaffolds for arthroscopic treatment of deep talus osteochondral lesions: A comparative study(Turkish Joint Diseases Foundation, 2023) Kekec, Ahmet Fevzi; Yildirim, AhmetObjectives: This study aims to investigate the effectiveness of arthroscopic autologous matrix-induced chondrogenesis (AMIC) procedure with or without polyglycolic acid-hyaluronic acid ( PGA-HA)-based cell-free scaffold (CFS) in Bristol E4 and E5 osteochondral lesion of the talus (OLT) ranging between 1.5 and 3 cm(2). Patients and methods: Between March 2018 and March 2021, a total of 47 patients with OLTs (29 males, 18 females; mean age: 22.8 +/- 2.3 years; range, 18 to 65 years) were retrospectively analyzed. The patients were divided into two groups based on the procedures applied. Patients in the first group (Group 1, n= 23) underwent the AMIC procedure alone (curettage, microfracture, and grafting), while patients in the second group (Group 2, n=24) underwent AMIC procedure with PGA-HA-based CFS. The localization of the lesions was evaluated. All OLTs were diagnosed with preoperative radiography and magnetic resonance imaging ( MRI). During the preoperative period, lesion stages were evaluated based on the Bristol staging system, and the postoperative results were evaluated based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system. Results: The mean follow- up was 36.2 +/- 5.6 months. In the early period, the three-month functional scores were comparable between the groups. While a significant increase was observed in the American Orthopaedic Foot and Ankle Society (AOFAS) scores from the mean preoperative of 62.71 +/- 4.44 points to the postoperative of 86.00 +/- 6.58 points in Group 1, a significant increase in the AOFAS score was observed from 65.28 +/- 7.91 points to 95.42 +/- 4.41 points in Group 2 at 12-month follow-up (p= 0.016, p=0.011, respectively). The functional scores tended to progress after 12 months. Radiologically, a complete defect filling was observed in a mean of 10.5 +/- 2.7 months. No graft hypertrophy was recorded in any patients. The AOFAS and MOCART scores in Group 2 were found to be statistically significantly higher than that in Group 1 (p= 0.034 for AOFAS 1/AOFAS 2 and p=0.006 for MOCART 1/MOCART 2). Overall, there was a positive, but weak, significant correlation between the final AOFAS scores and MOCART scores (r= 0.347, p<0.001). Conclusion: Arthroscopic AMIC procedure in deep OLTs between 1.5 cm(2) and 3 cm(2) can yield a statistically significant improvement both clinically and radiologically; however, the use of a PGA-HA-based CFS in addition to this procedure can improve the clinical and radiological recovery.Öğe Outcomes of Planned Marginal and Wide Resection of Sarcomas Associated with Major Vascular Structures in Extremities(Springer India, 2022) Kekec, Ahmet Fevzi; Gunaydin, Ilknur; Ozturk, Recep; Gungor, Bedii SafakBone and soft tissue sarcomas of lower and upper extremities may sometimes be in close contact with neurovascular structures. In such cases, it is controversial that whether en bloc resection and vascular reconstruction to reach wider surgical margins or planned marginal resection with the help of adjuvant therapies should be preferred. This study aimed to determine surgical and oncological outcomes of planned marginal and wide resection of extremity sarcomas that are associated with major vascular structures in the extremities. The collected database of 54 patients treated by the same orthopedic and vascular surgeon for primary or locally recurrent soft and bone tissue sarcoma of extremities was retrospectively reviewed. Eligible subjects for this study were patients diagnosed with upper and lower extremity soft and bone tissue sarcomas that encased a maximum of 50% of the circumference of the major vascular structures, requiring limb-sparing resection. When microscopic positive (19 patients, 33.9%) and negative cases' (35 patients, 66.1%) surgical margins were compared, local recurrence, metastasis, amputation, and tumor type (soft/bone) parameters showed no statistically significant difference. When metastatic and non-metastatic patients were compared, it was shown that bone tumors metastasized more than soft tissue tumors (p = 0.001). However, there was no difference between metastasis and amputation, histopathology, grade, nerve involvement, surgical margins, or local recurrences. The mean survival was 1460.6 +/- 137.4 days, and the 6-year mortality was 87.5%. Anesthetic and surgical complication rates may be higher since en bloc resection surgeries of large tumors with vascular reconstructions take a very long time. Therefore, we suggest marginal resection with sub-adventitial dissection in those locations and wide resection at other areas according to the surgeon's experiences about safe margin with the contribution of radiotherapy.Öğe Peripheral nerve blocks in a patient with suspected COVID-19 infection(Elsevier Science Inc, 2020) Kilicaslan, Alper; Kekec, Ahmet Fevzi; Eren, Ayse Seda; Uzun, Sema Tuncer[Abstract Not Availabe]Öğe Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats(Turkish Joint Diseases Foundation, 2020) Korucu, Ismail Hakki; Kekec, Ahmet Fevzi; Arslan, Abdullah; Oltulu, Pembe; Korucu, Emine Nedime; Ozer, MustafaObjectives: This study aims to investigate the effects of hyperbaric oxygen (HBO) therapy and platelet-rich plasma (PRP) on the regeneration of osteochondral defects of the rats, and the synergistic effect of this combined treatment. Materials and methods: This randomized, controlled, and interventional animal study was conducted between May 2014 and August 2014 Osteochondral regeneration was evaluated in four treatment groups (control, PRP, HBO, and HBO+PRP groups) at the 30 th day after iatrogenic injury. Thirty-two female Wistar albino rats (weighing 248-305 g) underwent arthrotomy and osteochondral surgery on left knees. The regenerations of defects were then examined histologically by the modified version of O'Driscoll score. Results: Groups that were treated with either HBO or PRP alone regenerated significantly better than the control group (p=0.01), while no significant difference was found between the HBO- and PRP-treated groups (p 0.05). The defects in group 4 (treated with both HBO and PRP) regenerated significantly better than the control group, the HBO-treated group alone, and the PRP-treated group alone (p=0.01). Conclusion: The results of this study showed a synergistic effect of HBO and PRP on knee cartilage regeneration. However, the possible underlying mechanisms should be the subject of future researches. The aggregation and activation of growth factors released from platelets whose activation is increased in the hyperbaric environment may explain this effect. This may result in a better regeneration than the effect of PRP or HBO alone.Öğe Sacral erector spinae plane block provides effective postoperative analgesia for pelvic and sacral fracture surgery(Elsevier Science Inc, 2020) Kilicaslan, Alper; Aydin, Ali; Kekec, Ahmet Fevzi; Ahiskalioglu, Ali[Abstract Not Availabe]
