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Öğe A new method of calculating the rotation angle in pediatric forearm fractures using direct radiographs(Ios Press, 2017) Kömür, Baran Heval; Durmuş, Tahir Mutlu; Mutlu, Serhat; Güler, Olcay; Mutlu, Harun; Yücel, BülentBACKGROUND: The aim of this study was to measure the rotational angle defect between fracture ends in paediatric forearm diaphyseal fractures on radiographs. METHODS: Evaluations were performed on 78 paediatric patients who presented at the emergency department with a diaphyseal forearm fracture during 2013-2014. Thirty-two patients who underwent conservative treatment and had < 10 degrees of angulation and translation of not more than half the bone diameter after application of a plaster cast were included in the study. A rotational formula was used with diameter values to determine changes. The degree of rotation of both ends of the fracture line and the forearm rotational defect of the fracture line were calculated. FINDINGS: Fractures included an isolated radius in 16 cases, an isolated ulna in four cases, and both bones in 12 cases. The mean lateral angular (LAT-theta) value was 26.13 +/- 5.93 degrees on the proximal fracture end, and the distal mean LAT-theta was 30.29 +/- 6.24 degrees (p = 0.037). The mean proximal anteroposterior angular (AP-theta) value was 26.83 +/- 5.75 degrees, and the distal mean AP-theta was 30.58 +/- 7.27 degrees (p = 0.008). A significant correlation was detected between the AP-Delta and LAT-Delta measurements (p = 0.883). INTERPRETATION: The rotational defect was mathematically calculated directly from radiographs using a rotational measurement formula.Öğe An evaluation of partial matrix excision with winograd method for the surgical treatment of ıngrown toenails(2014) Güler, Olcay; Mahiroğulları, Mahir; Mutlu, Serhat; Çerçi, Halis; Şeker, Ali; Mutlu, HarunObjective: The most frequent nail pathology of the hallux is the ingrown toenail. In our study, we evaluated Winograd s partial matrix excision method as a treatment for unilateral ingrown hallux toenail. Methods: Winograd s partial toenail excision was performed on 239 patients (127 males, 112 females; mean age 37.4 years) with an ingrown toenail. Primary patient complaints included a painful hallux toenail, discharge, nail deformation, and difficulty walking. According to the Heifetz staging system, there were 62 patients evaluated as Stage l, 96 as Stage ll, and 81 as Stage lll. A total of 174 (74%) patients had discharge from infection. In infected cases, an antibiotic was administered until inflammatory signs and discharged ceased, at which time surgical treatment was performed. Patients duration to return to daily living and work, recurrence ratio, satisfaction, and cosmetic issues were evaluated. The mean follow-up time was 27 months (range: 14-45 months). Results: Patients returned to daily living in 10-15 days (mean 11.3) and to work in 8.7 days (range: 6-13 days). A total of 230 patients (96.3%) were satisfied with the procedure, and 231 patients (96.6%) were satisfied with the cosmetic results. Nine patients were dissatisfied with the surgical outcome, and eight patients who experienced recurrence were dissatisfied with the cosmetic results. None of the patients experienced deep tissue infections or neurovascular complications. Conclusion: Winograd s partial matrix excision method is a beneficial surgical procedure for ingrown toenail, resulting in low recurrence and high satisfaction rates.Öğe An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm(Turkısh Assoc Orthopaedıcs Traumatology, 2014) Mutlu, Serhat; Güler, Olcay; Uçar, Adem Kalyoncu; Mahiroğulları, MahirWe report a case of a pseudoaneurysm of the medial circumflex femoral artery that presented 4 months following cementless left total hip arthroplasty (THA). A successful embolization was achieved using super-selective catheterization and coil embolization. Arterial complications associated with THA are remarkably rare. Endovascular techniques have been shown to be effective and are considered a valid alternative to conventional surgery.Öğe Anterior glenohumeral instability: Classification of pathologies of anteroinferior labroligamentous structures using MR arthrography(Hindawi, 2013) Mutlu, Serhat; Mahiroğulları, Mahir; Güler, Olcay; Uçar, Bekir Yavuz; Mutlu, Harun; Sönmez, Güner; Mutlu, HakanWe examined labroligamentous structures in unstable anteroinferior glenohumeral joints using MR arthrography (MRA) to demonstrate that not all instabilities are Bankart lesions. We aimed to show that other surgical protocols besides classic Bankart repair are appropriate for labroligamentous lesions. The study included 35 patients (33 males and 2 females; mean age: 30.2; range: 18 to 57 years). MRA was performed in all patients. The lesions underlying patients’ instability such as Bankart, anterior labral periosteal sleeve avulsion (ALPSA), and Perthes lesions were diagnosed by two radiologists. MRA yielded 16 diagnoses of Bankart lesions, 5 of ALPSA lesions, and 14 of Perthes lesions. Albeit invasive, MRA seems to be a more reliable and accurate diagnostic imaging modality for the classification and treatment of instabilities compared to standard MRI.Öğe Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint(BioMed Central Ltd., 2017) Kuyucu, Ersin; Mutlu, Harun; Mutlu, Serhat; Gülenç, Barış; Erdil, MehmetBackground: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early-grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment. Methods: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter. Results: The patients had mean preoperative VPS (visual pain scale) and AOFAS (American Orthopedic Foot and Ankle Society)-Hallux scores of 8.14 ± 0.86 SD and 48.64 ± 4.27, respectively; the corresponding postoperative values of both scores were 1.86 ± 0.66 SD and 87.00 ± 3.70, respectively. Both VPS and AOFAS-Hallux scores changed significantly. Discussion: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment. Conclusions: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.Öğe Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint(BioMed Central Ltd., 2017) Kuyucu, Ersin; Mutlu, Harun; Mutlu, Serhat; Gülenç, Barış; Erdil, MehmetBackground: Although arthroscopic surgical treatment of the first metatarsophalangeal (MTP) joint involves painful sesamoid excision, synovectomy, debridement, and partial cheilectomy, no gold standard treatment technique has been defined in the literature for hallux rigidus and focal osteochondral lesions. This study aimed to assess the arthroscopic treatment for early grade focal osteochondral lesions of the first MTP joint and to determine the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in a group of patients who failed conservative treatment.Methods: This prospective study included 14 patients with hallux rigidus and focal osteochondral lesions of the first MTP joint who underwent surgery in 2014 and were followed on a regular basis thereafter.Results: The patients had mean preoperative VPS (visual pain score) and AOFAS (American Orthopedic Foot and ankle Society)-Hallux scores of 8.14 +/- 0.86 SD and 48.64 +/- 4.27, respectively; the corresponding postoperative values of both scores were 1.86 +/- 0.66 SD and 87.00 +/- 3.70. Both VPS and AOFAS-Hallux scores changed significantly.Discussion: In this prospective study, we explored the impact of arthroscopic microhole drill surgery on foot function and activities of daily living in patients with focal osteochondral lesions of the first MTP joint. Our results showed significant improvements in VPS and AOFAS scores with this treatment.Conclusions: An arthroscopic microhole drill technique can be used with impressive functional scores and without any complications in patients who failed conservative therapy for hallux rigidus with focal chondral injury.Öğe Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint (vol 12, 68, 2017)(BMC, 2019) Kuyucu, Ersin; Mutlu, Harun; Mutlu, Serhat; Gülenç, Barış; Erdil, MehmetThis article [2] was published twice [1] due to a production error. The original article [1] should be considered the version of record and used for citation purposes. The publisher apologizes to the authors and readers for the error and any inconvenience caused.Öğe Comparison of extracorporeal shock wave therapy in acute and chronic lateral epicondylitis(Turkish Association of Orthopaedics and Traumatology, 2015) Köksal, İsmet; Güler, Olcay; Mahiroğulları, Mahir; Mutlu, Serhat; Çakmak, Selami; Akşahin, Ertu?rulObjective: The aim of this study is to evaluate and compare the results of extracorporeal shock wave therapy (ESWT) in the treatment of acute (<3 months) lateral epicondylitis (LE) and chronic (>6 months) LE groups. Methods: Fifty-four patients who were diagnosed with LE and treated with BTL-5000 SWT Power (BTL Türkiye Medikal Cihazlar, Ankara, Turkey) ESWT were included in the study. Twenty-four patients who had symptoms for <3 months were defined as the acute LE group (Group A), and 30 patients who had symptoms for >6 months were defined as the chronic LE group (Group B). All cases were evaluated pretherapy and at Weeks 2, 12, and 24 posttherapy according to pain while resting, pain while stretching, pain when pressed, pain while lifting chair, pain while working, nighttime pain on LE zone. Results: Almost all values in both Group A and Group B were significantly improved at Weeks 2, 12, and 24 compared to the baseline values. Conclusion: ESWT is equally effective in the treatment of acute LE and chronic LE. In addition, the current data suggest the progression of LE cases from acute phase to chronic phase may be prevented by treatment with ESWT.Öğe Comparison of MRI results of grafts obtained by unilateral anterior cruciate ligament reconstruction either using anteromedial portal only or transtibial method with contralateral healthy knee: Tibial tunnel or graft insertion?(SAGE Publications Ltd, 2014) Güler, Olcay; Mahiroğulları, Mahir; Mutlu, Serhat; Çerçi, Mehmet Halis; Şeker, Ali; Çakmak, SelamiObjectives: Our aim is to compare graft angles and tibial tunnel insertion in patients undergone single bundle ligament reconstruction using anatomical anteromedial (AM) and transtibial (TT) method with the contralateral healthy knee by using MR imaging. And to investigate correlation of this evaluation with functional results. Methods: We investigated 96 knees of 48 patients undergone anterior cruciate ligament (ACL) reconstruction with AM or TT method. 23 of 48 patients were operated with AM method. These patients were named as Group A. 25 patients were operated with TT method and named as group B. MRI was taken for both knees in each group postoperatively at the mean 10.47 (9-15) and 11.72 (9-17) months, respectively. Angle between ACL graft and anatomical axis of tibia in coronal and sagittal plane, [Sagittal ACL graft angle (SAGA), Frontal ACL graft angle (FAGA)], middle insertion point on tibial articular surface, [Sagittal ACL middle point (SGMP), Frontal ACL tibial tunnel middle point (FTMP), and Sagittal ACL tibial tunnel middle point(STMP)] was assessed by three orthopaedic surgeons. Values in both groups, inter observer, values between operated and healthy knees and differences between two groups were statistically evaluated. Functional scores between operated and healthy knees were evaluated with the Lysholm scoring system. Results: Inter observer results were statistically significant in group A between operated and healthy knees for 1st and 2nd observers in SAGA values and for 1st and 3rd, and 2nd and 3rd observers in FAGA values (p<0.05). In group B there was statistically significant difference in SAGA values for 1st and 2nd, and for 2nd and 3rd observers and in FTMP values for 1st and 3rd, and 2nd and 3rd observers (p<0.05). Statistically significant difference was detected between SAGA, FAGA and SGMP values of operated and healthy knees of A and B groups in all three observers’ evaluation (p<0.05). No statistically significant difference was detected between STMP values of operated knees and SGMP values of healthy knees in both groups (p>0.05). Statistically significant difference was detected between SAGA and FAGA values of operated knees in both groups (p<0.05). There was statistically significant difference in Lysholm scores between group A and B (p<0.05). Nonetheless there was no statistically significant difference between the Lysholm scores of operated knees in A and B groups (p>0.05). Conclusion: ACL reconstruction surgery with TT and AM methods do not provide anatomical reconstruction in Sagittal plane. Moreover, functional results were not as good as contralateral healthy knees. Although tibial tunnel was in anatomical position in both TT and AM methods, the posterior insertion of graft is thought to be the result of anterior placement of interference screw.Öğe Comparison of quadriceps muscle volume after unilateral total knee arthroplasty with and without tourniquet use(Springer, 2016) Güler, Olcay; Mahiroğulları, Mahir; İşyar, Mehmet; Pişkin, Ahmet; Yalçın, Sercan; Mutlu, Serhat; Şahin, BünyaminDetermination of the effect of tourniquet use in total knee arthroplasty (TKA) on thigh and quadriceps muscle volume using magnetic resonance imaging (MRI). A total of 148 knees of 74 patients (mean age 66.5 +/- 4.8 years; female/male, 62/12) with bilateral primary varus gonarthrosis underwent unilateral TKA with a tourniquet (Group A, n = 35) or without a tourniquet (Group B, n = 39). The total thigh volume and connective, bone, and muscle tissue volumes were stereologically measured on preoperative and postoperative MRI. The Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were calculated to evaluate functional outcomes. After TKA, the knees of patients in Group A exhibited a significant decrease in all tissue measurements, except bone tissue volume; however, the knees of patients in Group B exhibited no significant difference in tissue measurements. Although no difference was found between the operated and contralateral non-operated thighs (4076.9 and 4073.4 cm(3), respectively) in Group B postoperatively at 1 month (p > 0.05), the operated thighs had lost 20 % of its volume in Group A postoperatively at 1 month (p < 0.001). A significant difference was found in all tissue measurements, except the connective and bone tissue volumes of the thigh between the operated and contralateral non-operated knees in Group A. No significant difference was identified between the operated and contralateral non-operated knees in Group B. The total WOMAC score was significantly higher, and the total KSS was significantly lower in Group A than in Group B during the postoperative follow-up period of 1-6 months (p < 0.001 for all) but not 12 months (n.s.). Tourniquet use in TKA decreases the thigh and quadriceps muscle volumes and postoperatively delays the recovery of knee function. Therefore, caution should be exercised for tourniquet use during TKA in daily clinical practice and using alternative methods for tourniquet application in preventing intraoperative blood loss. III.Öğe Comparison of screw fixation with elastic fixation methods in the treatment of syndesmosis injuries in ankle fractures(Elsevier, 2015) Seyhan, Mustafa; Dönmez, Ferdi; Mahiroğulları, Mahir; Çakmak, Selami; Mutlu, Serhat; Güler, Olcay17 patients with ankle syndesmosic injury were treated with a 4.5 mm single cortical screw fixation (passage of screw 4 cortices) and 15 patients were treated with single-level elastic fixation material. All patients were evaluated according to the AOFAS ankle and posterior foot scale at the third, sixth and twelfth months after the fixation. The ankle range of movement was recorded together with the healthy side. The Student's t test was used for statistical comparisons. No statistical significant difference was observed between the AOFAS scores (p > 0.05). The range of dorsiflexion and plantar flexion motion of the elastic fixation group at the 6th and 12th months were significantly better compared to the screw fixation group (p < 0.01). Elastic fixation is as functional as screw fixation in the treatment of ankle syndesmosis injuries. The unnecessary need of a second surgical intervention for removal of the fixation material is another advantageous aspect of this method of fixation.Öğe Comparison of short-term results of intraarticular platelet-rich plasma (PRP) and hyaluronic acid treatments in early-stage gonarthrosis patients(Springer-Verlag, 2015) Güler, Olcay; Mutlu, Serhat; İşyar, Mehmet; Şeker, Ali; Kayaalp, Mahmut Enes; Mahiroğulları, MahirThe present study aimed to compare short-term clinical outcomes between intraarticular platelet-rich plasma (PRP) and hyaluronic acid (HA) treatments in early-stage gonarthrosis patients. Data of gonarthrosis patients, who were stage 1 or stage 2 according to Kellgren–Lawrence classification and underwent intraarticular PRP or HA treatment, were obtained retrospectively. The patients received treatment for three times at one-week intervals (intraarticular PRP or HA). They were evaluated using the Knee Society’s Knee Scoring System (KSS) and the visual analog scale (VAS) scoring system before treatment and at the second and sixth months of treatment. The study included 132 patients (mean age, 55.06 ± 8.41 years). Sixty-three patients (86 knees) were in the HA group and 69 patients (89 knees) were in the PRP group. Changes in KSS and VAS scores over time and the differences between the treatment groups in terms of changes in KSS and VAS scores over time were significant. In conclusion, PRP appears to be an appropriate option for intraarticular treatment in patients with early-stage knee osteoarthritis.Öğe Concomitantly intra-articular fracture of proximal condylar second and third proximal phalanges: A rare case report(Elsevier, 2016) Kömür, Baran; Güler, Olcay; Mutlu, Serhat; Yılmaz, Barış; Yücel, Bülent; Mutlu Duymuş, TahirINTRODUCTION: A rare case of proximal phalange fractures has been presented in this study. PRESENTATION OF CASE: A 29-year-old male patient from Turkey was admitted to the orthopedics and traumatology clinic with a complaint of left hand pain, which had persisted for 10 days. He described a rotationaltrauma that had occurred right after hitting his hand on the wheel of a car as a result of an in-car traffic accident 10 days ago. Radiological work-ups were requested. In the anteroposterior (AP) graph of the case in which the fracture line could not be observed in the oblique graph, unicondylar fractures in the proximal section of the second and third proximal phalanges have been observed. Surgical treatment was not planned because 10 days had passed since the trauma. In the control graphs taken after 3 weeks, healing at the fracture site was observed, and he was referred to physiotherapy after the removal of the splint. A good result was observed after physiotherapy. DISCUSSION: Because of the extension of tendons is important over the bone, the goal of the treatment is not only to heal the fracture, but also to preserve the sliding mechanism of these tendons. Regarding to lack of soft tissue trauma, favored joint movements after the healing of the fracture can be achieved more easily with conservative treatment; however, the fracture must be closely followed up. CONCLUSION: Condylar fractures of proximal phalanges those nondisplaced can be conservatively treated with closed methods.Öğe Distal oblique metatarsal osteotomy for hallux valgus deformity: A clinical analysis(Elsevier Science Inc, 2017) Güler, Olcay; Yılmaz, Barış; Mutlu, Serhat; Çerçi, Mehmet Halis; Heybeli, NurettinWe compared the outcomes of the distal oblique metatarsal (DOM) osteotomy, which is parallel to the articulation surface of the proximal phalanx, with those of the chevron osteotomy and evaluated whether displacement and shortening of the first metatarsal have any effect on the incidence of metatarsalgia and patient satisfaction. Patients treated with the DOM osteotomy (n = 30) or distal chevron osteotomy (n = 31) were evaluated retrospectively. The chevron and DOM osteotomies both provided significant improvement in the first intermetatarsal angle (p <.001), hallux valgus angle (p <.001), distal metatarsal articular angle (p <.001), range of first metatarsophalangeal joint motion (p <.001), American Orthopaedic Foot and Ankle Society score (p <.001), and sesamoid position (p <.001), without any significant differences between the 2 groups. Patient satisfaction and metatarsalgia also were not different between the study groups. The DOM osteotomy group had higher plantar displacement (0.1 +/- 0.1 mm versus 1.0 +/- 0.1 mm; p <.001) and absolute shortening of the first metatarsal (1.0 +/- 0.4 mm versus 6.8 +/- 1.0 mm; p <.001). In conclusion, the DOM osteotomy is an alternative treatment method for mild and moderate hallux valgus.Öğe Efficacy of periarticular injection applied trough knee other than posterior capsule in simultaneous bilateral total knee arthroplasty(Reed Elsevier India, 2015) Güler, Olcay; Mutlu, Serhat; İşyar, Mehmet; Mutlu, Harun; Bülbül, Ahmet Murat; Mahiroğulları, MahirBackground: We aimed to evaluate periarticular multimodal drug injection (PMDI) in bilateral total knee arthroplasty. Methods: In 154 knees of 77 patients, PMDI was administered intraoperatively through the regions other than posterior capsule to one knee; other knee was control. Results: Drug-injected knees had lower visual analog scale scores and higher passive range of motion postoperatively (p < 0.05). The active straight leg raise was higher in drug-injected knees (47 [61%] vs 19 [24.7%], p < 0.001). Conclusions: PMDI is a safe and effective method of early postoperative pain management in total knee arthroplasty when applied through regions other than posterior capsule.Öğe Eksternal fiksatör ile tedavi ettiğimiz eklem içi distal radius kırıklarının sonuçları(Istanbul Medeniyet University, 2014) Güler, Olcay; Mutlu, Serhat; Uygur, Esat; Mutlu, Harun; Mutlu, BurcuRadius distal kırıklarının kapalı redüksiyon eksternal fiksasyon yöntemi ile tedavi sonuçlarının klinik ve radyolojik olarak değerlendirilmesini amaçladığımız bu çalışmada Şubat 2008- Ekim 2011 tarihleri arasında tedavi edilen 17 radius distal kırığı değerlendirildi. AO sınıflamasına göre 6 kırık tip C, 11 kırık ise tip B idi. Tüm kırıklar kapalı redüksiyon eksternal fiksatör ile tedavi edildi ve ortalama 25 ay (12-46 ay) takip edildi. Fonksiyonel değerlendirmede Gartland ve Werley skorlamasının Sarmiento modifikasyonu, radyolojik değerlendirmelerde ise Modifiye Sarmiento skorlaması kullanıldı. Güncel yaşam aktivite değerlendirilmesinde DASH skorlama sistemi kullanıldı. Radyolojik ölçümlerin sonucuna göre yapılan anatomik değerlendirmede 11 kırık (% 64) kusursuz, 4 kırık (% 24) iyi, 2 kırık (% 12) orta-kötü olarak tespit edildi. Radyolojik değerlendirmede orta-kötü sonuçları olan 2 olgunun biri C1 diğeri de C2 tipi kırıklar idi. Gartland ve Wesley skorlaması Sarmiento modifikasyonuna göre 9 olgu çok iyi, 5 olgu iyi, 2 olgu orta, 1 olgu kötü olarak değerlendirildi. Güncel yaşam aktivite değerlendirmelerinde DASH skorlama sistemine göre ortalama değer 8.57 idi. Toplam 4 (% 23) olguda Refleks Sempatik Distrofi ve 8 (% 47) olguda yüzeyel çivi dibi infeksiyonu gelişti. Radius distal uç kırıklarının tedavisinde eksternal fiksatör yöntemi, klinik ve radyolojik sonuçları açısından uygun olgularda iyi bir tedavi seçeneğidir.Öğe Evaluation of results of conservative therapy in patients with transient osteoporosis of hip(ARSMB-KVBMG, 2015) Güler, Olcay; İşyar, Mehmet; Mahiroğulları, Mahir; Özyürek, Selahattin; Çakmak, Selami; Mutlu, SerhatThe present study aimed to review the general characteristics of 18 cases diagnosed with transient osteoporosis of the hip (TOH) in our hospital within a 3-year period and to present their follow-up results after conservative treatment. A retrospective evaluation was made of the treatment and results of followup of TOH cases using physical examination and laboratory findings, hip radiographs and magnetic resonance imaging (MRI) and Harris Hip Scores (HHS). The mean duration of complaints of 6 females (mean age, 34.3 ± 4.3 years) and 12 males (mean age, 40.7 ± 10.5 years) was 6.1 ± 2.7 weeks before the treatment. Three female patients had a history of giving birth by cesarean delivery. None of the patients had any history of trauma. MRI revealed increased intensity in T2 sequences and decreased intensity in T1 sequences in the proximal aspect of the femur. None of the patients had subchondral collapse or intra-articular effusion. For 3 female patients who were breastfeeding, no medical therapy was given, but only hyperbaric oxygen (HBO) therapy and forearm crutches. As standard management, the other patients were prevented from weight-bearing with the use of forearm crutches and medical therapy of diclofenac sodium, acetylsalicylic acid, and risedronate sodium was administered and additional HBO therapy. Clinical and radiological improvements were observed in all patients. None of the patients had avascular necrosis (AVN) of the femoral head. There was no record of therapy-related complications. While HHS was 55.6 ± 7.8 before the treatment, it increased to 88.8 ± 5.8 in the 3rd month and to 96.0 ± 1.8 in the 6th month after the treatment. This change in score over time was found to be significant.Öğe Evaluation of the short-term outcomes of platelet-rich plasma intraarticular injections for treating patients with early stage gonarthrosis(Anatolian Journal of Clinical Investigation, 2015) Güler, Olcay; Mahiroğulları, Mahir; Dönmez, Ferdi; Mutlu, Serhat; Çakmak, Selami; Mutlu, HarunThe aim of this study was to evaluate the short-term clinical outcomes of intra-articular platelet-rich plasma (PRP) treatment and to evaluate the increase in functional activity and quality of life in patients with early stage gonarthrosis. We planned our study retrospectively. Eighty-six patients (54 females and 32 males) with 108 knees (54 right and 54 left) who had pain and swelling for > 4 months due to all grades of knee osteoarthritis according to the Kellgren–Lawrence grading scale were evaluated. Our patients were homogenous in terms of age and body mass index. Three intra-articular PRP injections were administered once per week, and the patients were clinically evaluated prospectively before treatment and at 2 and 6 months after treatment with the visual analogue scale (VAS), the Knee Society Score (KSS), and the Short Form-36 (SF-36). No major complications due to treatment were observed. Seventeen patients had transient swelling and pain for 2 days. Significant improvements on the VAS, KSS and SF-36 scores were obtained at the 2- and 6-month followups (p < 0.05). The VAS, KSS, and SF-36 scores improved significantly at the 6-month evaluation compared to those at the month 2 follow up. We believe that intra-articular PRP treatment is effective during the early stage of gonarthrosis and increases the quality of life and functional activity of recipients.Öğe Giant lipoma of the back affecting quality of life(Elsevier, 2015) Güler, Olcay; Mutlu, Serhat; Mahiroğulları, MahirLipomas are benign tumours composed of adipose tissue. They may be localized in almost all body parts and may be in a giant form. Some of these giant lipomas may transform malignity and cause problems in daily living and detoriate quality of life. Mass localization also restrict body functions. In the present study, a 72-year-old man who presented with a mass enlarged in a time period of two years and because of this could not lie in the supine position, sit in an erect position and dress easily, go outside because of his physical appearance. With surgical treatment a 38 × 22 × 21 cm mass weighing 3575 g was successfully resected. Postoperative early phase complications did not occur. During 48 months of postoperative period, any recurrence was not detected and the patient was free of all his complaints. Cosmetic and functional results of the surgery and patient satisfaction were excellent. After surgery patient's quality of life was improved and restriction of body function was disappeared.Öğe Graft position in arthroscopic anterior cruciate ligament reconstruction: Anteromedial versus transtibial technique(Springer Verlag, 2016) Güler, Olcay; Mahiroğulları, Mahir; Mutlu, Serhat; Çerçi, Mehmet Halis; Şeker, Ali; Çakmak, SelamiIntroduction: When treating anterior cruciate ligament (ACL) injuries, the position of the ACL graft plays a key role in regaining postoperative knee function and physiologic kinematics. In this study, we aimed to compare graft angle, graft position in tibial tunnel, and tibial and femoral tunnel positions in patients operated with anteromedial (AM) and transtibial (TT) methods to those of contralateral healthy knees. Materials and methods: Forty-eight patients who underwent arthroscopic ACL reconstruction with ipsilateral hamstring tendon autograft were included. Of these, 23 and 25 were treated by AM and TT techniques, respectively. MRI was performed at 18.4 and 19.7 months postoperatively in AM and TT groups. Graft angles, graft positions in the tibial tunnel and alignment of tibial and femoral tunnels were noted and compared in these two groups. The sagittal graft insertion tibia midpoint distance (SGON) has been used for evaluation of graft position in tunnel. Results: Sagittal ACL graft angles in operated and healthy knees of AM patients were 57.78° and 46.80° (p < 0.01). With respect to TT patients, ACL graft angle was 58.87° and 70.04° on sagittal and frontal planes in operated knees versus 47.38° and 61.82° in healthy knees (p < 0.001). ACL graft angle was significantly different between the groups on both sagittal and frontal planes (p < 0.001). Sagittal graft insertion tibia midpoint distance ratio was 0.51 and 0.48 % in the operated and healthy knees of AM group (p < 0.001) and 0.51 and 0.48 % in TT group (p < 0.001). Sagittal tibial tunnel midpoint distance ratio did not differ from sagittal graft insertion tibia midpoint distance of healthy knees in either group. Femoral tunnel clock position was better in AM [right knee 10:19 o’clock-face position (310° ± 4°); left knee 1:40 (50° ± 3°)] compared with TT group [right knee 10:48 (324° ± 5°); left knee 1:04 (32° ± 4°)]. With respect to the sagittal plane, the anterior–posterior position of femoral tunnel was better in AM patients. Lysholm scores and range of motion of operated knees in the AM and TT groups showed no significant difference (p > 0.05). Conclusions: Precise reconstruction on sagittal plane cannot be obtained with either AM or TT technique. However, AM technique is superior to TT technique in terms of anatomical graft positioning. Posterior-placed grafts in tibial tunnel prevent ACL reconstruction, although tibial tunnel is drilled on sagittal plane.
