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Öğe Arthroscopic fixation with intra-articular button for tibial intercondylar eminence fractures in skeletally immature patients(Lippincott Williams & Wilkins, 2016) Memişoğlu, Kaya; Müezzinoğlu, Ümit Sefa; Atmaca, Halil; Sarman, Hakan; Kesemenli, Cumhur CevdetThe aim of this study was to describe our experiences with arthroscopy-guided intra-articular button fixation in the treatment of displaced tibial eminence fractures in skeletally immature children. Eleven adolescent patients with an average age of 12.2 years were treated arthroscopically between January 2005 and February 2007. At follow-up evaluation at 69 months, we did not find any instability. Only minimal differences were found in the functional outcomes (Lysholm and International Knee Documentation Committee scores: 95.7 and 94.3, respectively). None of the patients had a leg-length discrepancy defined at the time of the final follow-up. The advantages of this technique are as follows: (a) it is a simple and reliable arthroscopic technique with a direct view, (b) the fixation is stable, (c) there is no need to remove the implant, (d) minimal physeal interruption in a pediatric skeletally immature population, and (e) no additional arthroscopic portal.Öğe Comparison of semi-invasive "internal splinting" and open suturing techniques in achilles tendon rupture surgery(Elsevier Science Inc, 2016) Sarman, Hakan; Müezzinoğlu, Ümit Sefa; Memişoğlu, Kaya; Aydın, Adem; Atmaca, HalilThe goal of the present study was to evaluate the semi-invasive "internal splinting" (SIIS) method for repair of Achilles tendon rupture relative to open repair with Krakow sutures. Efficacy was evaluated based on the clinical and functional outcomes, postoperative magnetic resonance imaging measurements, isokinetic results, and surgical complication rates. Functional measurements included the Thermann and American Orthopaedic Foot and Ankle Society (AOFAS) ankle scores, bilateral ankle dorsiflexion, and plantar flexion measurements. Magnetic resonance imaging was used to compare the bilateral length and thickness of each Achilles tendon. The isokinetic outcomes were evaluated using a Biodex System 3 dynamometer. Of the 45 patients meeting the inclusion criteria, 24 were treated by SIIS and 21 by the open Krackow suture technique. The mean follow-up time for all patients was 43.7 (range 6 to 116) months. In the SIIS group, patients returned to normal daily activities after 7.2 (range 6 to 8) weeks compared with 14.3 (range 12 to 15) weeks in the open surgery group. The AOFAS ankle scores were 93.5 (range 82 to 100) points in the open repair group and 96.2 (range 86 to 100) points in the SIIS group. The Thermann scores were 80.4 (range 53 to 91) points for the open repair group and 87.9 (range 81 to 100) points for the SIIS method. The mean Achilles length on the operated side measured using magnetic resonance imaging was 175.06 (range 110 to 224) mm and 177.76 (range 149 to 214) mm for the open surgery and SIIS groups, respectively. Sensory impairment in the territory of the sural nerve was identified in 1 patient immediately after SIIS surgery, although this defect had completely resolved within 12 months. SIIS yielded better outcomes relative to the open surgery group according to the isokinetic measurements. Taken together, these data indicate the SIIS method for Achilles tendon ruptures performed better in terms of both functional and objective outcomes compared with open surgery. (C) 2016 by the American College of Foot and Ankle Surgeons. All rights reserved.Öğe Effect of surgical and natural menopause on proximal femur morphometry in obese women(Elsevier Gmbh, 2020) Meyvacı, Seda Sertel; Bamaç, Belgin; Duran, Bülent; Çolak, Tuncay; Memişoğlu, KayaThe purpose of this study is to determine whether there are differences in proximal femur parameters of women subjected to menopause surgically or naturally. In this study, 10 parameters belonging to proximal femur of a total of 60 women cases of whom 30 had a mean age of 55.53 +/- 4.57 years; body mass index, 33.06 +/- 4.21 kg/m(2); menopause age, 48.10 +/- 5.92; and menopause years, 7.50 +/- 4.58; and who were subjected to natural menopause; and 30 women whose mean age was 56.10 +/- 6.87 years; body mass index, 33.33 +/- 3.76 kg/m(2) ; menopause age, 48.00 +/- 4.64 years and menopause year, 8.10 +/- 7.29; who were subjected to surgical menopause, and who did not use hormone replacement, were examined by radiography. Their anthropometric measurements, body compositions, blood hormone analyses (FSH, LH, estradiol, progesterone) and bone mineral densities (femur neck, femur total, lumbar t-score) were evaluated. It was found that there was no difference between surgical and natural menopause with respect to proximal femur parameters (p > 0.05). It was also found that FSH levels were high in the surgical menopause group and there were significant differences between the groups (p < 0.040). No significant difference was found even though bone mineral density t-score tests were lower in the surgical menopause group (p > 0.05). It was found that the difference in low bone mineral density level and high FSH values in the surgical menopause group do not have a relationship with proximal femur morphometry. It was determined that even though the women did not have ovaries, there was no difference between surgical menopause women and natural menopause women with respect to proximal femur morphometry. (C) 2019 Elsevier GmbH. All rights reserved.Öğe A new isometric quadriceps-strengthening exercise using EMG-biofeedback(E-Century Publishing Corp, 2014) Kesemenli, Cumhur Cevdet; Sarman, Hakan; Baran, Tuncay; Memişoğlu, Kaya; Binbir, Ismail; Işık, Cengiz; Boyraz, İsmail; Koç, BünyaminA new isometric contraction quadriceps-strengthening exercise was developed to restore the quadriceps strength lost after knee surgery more rapidly. This study evaluated the results of this new method. Patients were taught to perform the isometric quadriceps-strengthening exercise in the unaffected knee in the supine position, and then they performed it in the affected knee. First, patients were taught the classical isometric quadriceps-strengthening exercise, and then they were taught our new alternative method: "pull the patella superiorly tightly and hold the leg in the same position for 10 seconds". Afterward, the quadriceps contraction was evaluated using a non-invasive Myomed 932 EMG-biofeedback device (Enraf-Nonius, The Netherlands) with gel-containing 48 mm electrodes (Turklab, The Turkey) placed on both knees. The isometric quadriceps-strengthening exercise performed using our new method had stronger contraction than the classical method (P < 0.01). The new method involving pulling the patella superiorly appears to be a better choice, which can be applied easily, leading to better patient compliance and greater quadriceps force after arthroscopic and other knee surgeries.Öğe Vacuum-assisted closure for skin necrosis after revision total knee arthroplasty(Wiley, 2016) Sarman, Hakan; Müezzinoğlu, Ümit Sefa; Memişoğlu, Kaya; Baran, TuncayAlthough skin necrosis following total knee arthroplasty or revision total knee arthroplasty is rare, it may cause severe complications. Skin changes begin with superficial infections and may result in removal of the prosthesis. Treatment of skin necrosis is an important factor, which determines the prognosis of the prosthesis. Several techniques have been defined for sufficient closure. In this article, we present the case of a patient who was treated for skin necrosis that developed after knee revision arthroplasty, using serial debridement, convergence sutures and an intermittent vacuum-assisted closure device (KCI Inc., San Antonio, TX).
