Biomedical subjects

Ali Biçimoğlu

Publications and source records attributed to Ali Biçimoğlu.

At least 19 recordsLinked to original sources

PubMed2006

[Cementless total hip arthroplasty in patients with avascular necrosis of the femoral head].

OBJECTIVES: We assessed the results of cementless total hip arthroplasty in patients with late-stage avascular necrosis of the femoral head. METHODS: Unilateral cementless total hip replacement was performed in 25 patients (19 males, 6 females; mean age 39.6 years; range 26 to 56 years) with avascular necrosis of the femoral head. A cementless acetabular cup with screws was used for the acetabulum with a cementless femoral component. Functional results were evaluated according to the Harris hip score. Radiographically, acetabular and femoral components were evaluated according to the criteria of Lins et al. and Engh et al., respectively. Heterotopic ossification was assessed according to the criteria of Brooker et al. The mean follow-up was 63.9 months (range 48 to 94 months). RESULTS: The mean Harris hip score increased from 41.5 (range 33 to 52) to 87.1 (range 74 to 96) after the treatment (p<0.001). No radiographic loosening was detected in 22 patients (88%). Radiolucent lines were observed in one acetabular and two femoral components, but no secondary interventions were performed as the patients were asymptomatic. Heterotopic ossification was observed in 13 patients, which was grade 1 in eight patients, grade 2 in two patients, and grade 3 in three patients. CONCLUSION: In general, patients who undergo total hip arthroplasty for avascular necrosis of the femoral head are younger and more active compared to those with osteoarthritis, showing a high likelihood of future revision procedures. Our results favor cementless applications as a more appropriate alternative in this patient group.

Adult↗

PubMed2005

Comparison of plasma endothelin levels between osteoporotic, osteopenic and normal subjects.

BACKGROUND: It has been demonstrated that endothelins (ET) have significant roles in bone remodeling, metabolism and physiopathology of several bone diseases. We aimed to investigate if there was any difference between the plasma ET levels of osteoporotic patients and normals. METHODS: 86 patients (70 women and 16 men) with a mean age of 62.6 (ranges: 51-90) years were included in this study. Patients were divided into groups of osteoporosis, osteopenia and normal regarding reported T scores of DEXA evaluation according to the suggestions of World Health Organization. According to these criteria 19, 43 and 24 were normal, osteopenic and osteoporotic respectively. Then total plasma level of ET was measured in all patients with monoclonal antibody based sandwich immunoassay (EIA) method. One-way analysis of variance test was used to compare endothelin values between normals, osteopenics and osteoporotics. RESULTS: Endothelin total plasma level in patients was a mean of 98.36 +/- 63.96, 100.92 +/- 47.2 and 99.56 +/- 56.6 pg/ml in osteoporotic, osteopenic and normal groups respectively. The difference between groups was not significant (p > 0.05). CONCLUSION: No significant differences in plasma ET levels among three groups of study participants could be detected in this study.

Aged↗

PubMed2005

Bilateral patellar tendon rupture in a child: a case report.

Patellar tendon rupture in children is very rare. When it occurs, patellar tendon is usually ruptured either from the upper end as a sleeve fracture of the patella or from lower end as an avulsion fracture of the tibial tuberosity. In this report, we present the case of an otherwise healthy 9-years-old boy who had subsequent bilateral patellar tendon ruptures through the midparts, which has not been published previously in the literature. Treatment was performed with primary end-to-end repair, reinforcement with cerclage wires and fresh-frozen achilles tendon augmentation for both sides.

Achilles Tendon↗

PubMed2005

Simultaneous rupture of the quadriceps tendon and contralateral patellar tendon in a patient with chronic renal failure.

Simultaneous quadriceps and patellar tendon rupture is rare. Mechanical factors and coexisting systemic and local factors are taken into consideration in the pathogenesis of these ruptures. In patients with some chronic systemic diseases, simultaneous rupture can occur spontaneously or with minor traumas. We present a case of simultaneous quadriceps and patellar tendon rupture in a 21-year-old man with chronic renal failure in this report. He was treated surgically by osseotendinous repair with suture anchors and supplemental cerclage wire fixation on both sides. He regained his normal knee joint functions 18 months after the operation.

Adult↗

PubMed2005

Gait characteristics of patients with bilateral club feet following posteromedial release procedure.

In this study we intended to evaluate the gait characteristics of children who had bilateral operated clubfeet, and to compare the results with gait parameters of children without clubfeet or lower extremity abnormalities. Fifteen children with bilateral plantigrade and asymptomatic clubfeet, operated bilaterally with posteromedial release method, were included in group P. Means+/-SD of age and follow-up time were 8.5+/-2.6 years (range, 4-14 years) and 7.7+/-2.8 years (range, 3-10 years), respectively. Age, sex, height-and weight-matched 24 children without clubfeet or lower extremity abnormalities were included in the control group (group C). Three-dimensional computerized gait analysis was performed for all subjects, and time-distance, kinematic and kinetic gait characteristics of the groups were compared. Time-distance characteristics of the groups were identical. Ankle plantar flexion angles, plantar flexor moment and generated power were significantly decreased in group P (P<0.05). Knee hyperextension during midstance was observed in 17 of 30 (57%) knees in the P group. Kinetic analysis revealed excessive knee valgus and flexion moments, as well as decreased second peak values of vertical ground reaction forces for group P. This study shows that even successfully operated, plantigrade and clinically asymptomatic children with bilateral clubfeet have significant gait deviations involving all lower limb joints. Future studies are needed to investigate the accountable factors of gait deviations and possible long-term musculoskeletal morbidity of operated children with bilateral clubfeet.

Adolescent↗

PubMed2005

[Treatment of humeral pseudarthroses by open reduction and internal fixation].

OBJECTIVES: The effectiveness of open reduction and plate fixation combined with autogenous bone grafting was assessed in the treatment of humeral diaphysis pseudarthrosis. METHODS: Twenty-four patients (16 men, 8 women; mean age 44 years; range 28 to 64 years) were operated on for humeral pseudarthrosis. Of these, 16 patients and eight patients had had previous surgical and conservative treatments, respectively. Surgery was performed after a mean of 10.8 months (range 7 to 21 months) following the initial treatments. Preoperatively, none of the patients had infected nonunion, a bone defect greater than 4 cm, and radial nerve injury. Treatment included open reduction and plate fixation combined with autogenous bone grafting. The plate was secured with at least four screws (8 cortices) both proximally and distally. The mean follow-up was 40 months (range 28 to 60 months). The range of motion of the shoulder and elbow was evaluated according to the criteria by Rommens et al. Functional evaluations were made according to the criteria by Stewart and Hundley. RESULTS: Union was achieved in all the patients after a mean of 19 weeks (range 14 to 26 weeks). Shoulder range of motion was excellent in all the patients. Elbow range of motion was excellent in 22 patients and moderate in two patients. Functional results were excellent in 20 patients and good in four patients. Deep infection, nonunion, malunion, implant failure, or permanent nerve injury did not occur in any of the patients. Two patients had transient radial nerve palsy. CONCLUSION: Treatment with open reduction and plate fixation combined with autogenous bone grafting is a safe and effective option in humeral pseudarthroses, particularly in cases without infection, bony defect, and deformity requiring correction.

Adult↗

PubMed2004

Magnetic resonance arthrographic evaluation of syndesmotic diastasis in ankle fractures.

INTRODUCTION: We examined whether magnetic resonance arthrography (MRA) contributes to the diagnosis of syndesmotic complex disruption in ankle fractures. Patients suffering syndesmotic diastasis according to conventional radiographic criteria were evaluated by MRI and MRA. MATERIAL AND METHODS: Fifteen patients (15 ankles) with Denis-Weber type B and C fractures and were suspected of having syndesmotic diastasis considering tibiofibular clear space and tibiofibular overlap measurements in conventional radiographs were prospectively evaluated by MRI and MRA methods. Syndesmotic diastasis was diagnosed by radiographic, MRI, and MRA findings and by intraoperative observation and assessment criteria. Differences between MRI and MRA findings were tested statistically. Conventional radiography, MRI, and MRA results were analyzed by two independent observers, and interobserver concordance was also assessed. RESULTS: In 15 patients regarded to have syndesmotic diastasis on conventional radiography the diagnosis was confirmed in 8 (53.3%) with MRI and 12 (80%) with MRA. Following overall assessment 13 of 15 patients (86.6%) were determined to have diastasis. There were statistically significant differences in diagnosis after MRI and after MRA. There was interobserver concordance in conventional radiographic, MRA assessments, and in assessments for anterior and posterior tibiofibular ligaments separately in MRI. CONCLUSIONS: These results suggest that conventional radiography and MRI is not sufficient in assessing syndesmotic disruption, and that MRA can make an important contribution to diagnosis in ankle fractures.

Adult↗

PubMed2004

Mechanoreceptor evaluation of hip joint capsule and ligamentum capitis femoris in developmental hip dysplasia: a preliminary study.

We aimed to determine if there are mechanoreceptors in the hip joint capsule and ligamentum capitis femoris (LCF) of patients with developmental dysplasia of the hip (DDH). We took capsule and LCF biopsies from 20 hips of 20 patients who were operated on because of DDH. The mean age was 10.2 months (range 6-20 months) at the time of surgery. There were 12 girls and eight boys. Teratologic and secondary hip dislocations were not included in this study. Full thickness, 0.5 x 0.5 cm anterior capsule and LCF portions were taken for biopsy specimen. Specimens were stained with hemotoxylin eosin and examined immunohistochemically using monoclonal antibody against S-100 protein. In both analyses no mechanoreceptor was found in any samples of capsule or LCF. In this preliminary study we could not find mechanoreceptors in the local anterior joint capsule and LCF of the hip in children with DDH. We think that additional studies are necessary in order to understand the mechanoreceptor characteristics of the hip joint in children not only with DDH but also in children with healthy hips.

Biopsy, Needle↗

PubMed2004

[The effects of arthrographically detected femoral head lateralization and soft tissue interposition during closed reduction of developmental dislocation of the hip on mid-term results].

OBJECTIVES: In a prospective, non-randomized evaluation of patients who underwent surgery under general anesthesia for developmental dislocation of the hip (DDH) at or below 18 months of age, we assessed the mid-term effects of arthrographically documented femoral head lateralization and soft tissue interposition under the acetabular labrum during reduction without opening the hip joint capsule. METHODS: The study included 31 unstable hips of 21 children (mean age 12 months; range 4 to 18 months). After the iliopsoas and adductor longus tendons were sectioned by a medial approach, hip joint arthrography was performed. According to the criteria of Tönnis, all the patients had grade 2 arthrographic reduction and the hip joint capsule was left intact. The mean follow-up was 6.5 years (range 3 to 9.5 years). RESULTS: Avascular necrosis of the femoral head (AVN), redislocation, and secondary operation were seen in 42%, 19%, and 29%, respectively. The physeal plate was involved in nearly half of the hips with AVN. The occurrence of AVN was less in hips treated at the age of below one year. Complications were more frequent in cases in which more than one intraarticular soft tissue obstacles had been documented by arthrography. Avascular necrosis and redislocation were more commonly encountered in hips in which the medial pool size of contrast material exceeded 7 mm than those with sizes between 3 to 7 mm. CONCLUSION: Our mid-term complication rates suggest that the hip joint capsule be opened in order to achieve an anatomical reduction through eliminating intraarticular obstacles when arthrography shows lateralization of the femoral head, soft tissue interposition, and medial pooling of the contrast material following closed reduction of DDH.

Arthrography↗

PubMed2004

[The efficacy of non-operative treatment of burst fractures of the thoracolumbar vertebrae].

OBJECTIVES: We evaluated the efficacy of non-operative treatment of thoracolumbar burst fractures. METHODS: The study included 26 patients (19 males, 7 females; mean age 36 years; range 18 to 67 years) who underwent conservative treatment for single-level thoracolumbar fractures without posterior column involvement. None of the patients had neurologic deficits and canal encroachment was 50% or less in all fractures. Functional results were evaluated with the use of Denis' pain and work scales. Relationships were sought between functional results and follow-up time, progression in kyphosis angle, residual kyphosis, and residual canal stenosis, and between radiologic parameters. RESULTS: Functional results were excellent or good in 65.3%, and poor in 7.7%. Three patients required surgery because of pain. Final follow-up evaluations showed a significant progression in the mean Cobb angle (p<0.001) and a significant remodelization in the mean canal encroachment (p<0.001). No significant correlations were found between progression in kyphosis, residual kyphosis, residual canal stenosis, and functional results (p>0.05). The mean initial Cobb angle was correlated with the mean initial canal encroachment (p<0.05). There was also a correlation between the initial canal encroachment and final remodelization (p<0.001). CONCLUSION: Although non-operative management of thoracolumbar fractures has considerable efficacy, it may yield poor results in a small percentage of patients, some of whom require surgery because of pain. Thus, further prospective, randomized, and comparative studies with longer follow-up periods are required to define prognostic factors that may predict poor results following non-operative treatment.

Adolescent↗

PubMed2004

[Recurrent traumatic hip dislocation in a child].

Recurrent traumatic hip dislocation is rarely seen in childhood. We presented a case of traumatic hip dislocation which was treated by conservative methods. A two-year-old girl was treated with closed reduction and a hip spica cast for posterior traumatic dislocation in the right hip. Two years later, a recurrent dislocation occurred following a minor trauma on the same side. She was again treated with closed reduction and immobilization with a hip spica cast for three weeks followed by a three-week load bearing restriction. Early follow-up examinations showed an increased internal rotation of the hip compared to the left side, suggesting increased posterior capsular laxity. It then disappeared on her final follow-up at age six and magnetic resonance imaging showed no evidence for avascular necrosis or capsular laxity. She was asymptomatic and her physical examination was within normal limits. Of note, several members in her family had developmental dysplasia of the hip.

Casts, Surgical↗

PubMed2004

[The results of intramedullary fixation with titanium elastic nails in children with femoral fractures].

OBJECTIVES: We evaluated clinical and radiologic results of intramedullary fixation with titanium elastic nails (TEN) in children with femoral fractures. METHODS: The study included 35 femoral fractures of 34 patients (20 boys, 14 girls; mean age 8.3 years; range 5 to 14 years) who were treated by intramedullary fixation with TEN. The results were evaluated according to the scoring system proposed by Flynn et al. Time to union and residual angulations were assessed on anteroposterior and mediolateral radiographs. Femoral anteversion angles and limb lengths were measured in comparison with the normal side by computed tomography (CT) in 14 patients and the results were compared using the Wilcoxon test. The mean follow-up period was 28 months (range 4 to 48 months). RESULTS: According to the criteria by Flynn et al., the results were excellent in 25 fractures (71.4%), successful in nine fractures (25.7%), and poor in one fracture (2.9%). The mean time to union was 7.4 weeks (range 5 to 12 weeks). Mediolateral and anteroposterior radiographs showed an angulation of 10 degrees or less in three fractures and of 8 degrees in one fracture, respectively. Limb length discrepancy of less than 2 cm was detected in seven patients (20.6%). Femoral anteversion angles measured by CT revealed significant retroversions on the fractured sides (p<0.01). CONCLUSION: Intramedullary fixation with TEN may be the preferred method for the treatment of femoral fractures in children aged 5 to 15 years. However, residual rotation detected by CT seems to be a technical challenge to be improved.

Adolescent↗

PubMed2003

[Cementless total hip replacement in patients with high total dislocation: the results of femoral shortening by subtrochanteric segmental resection].

OBJECTIVES: We evaluated the results of femoral shortening by subtrochanteric segmental resection in patients who underwent total hip replacement (THR) for high total dislocation of the hip. METHODS: We performed THR in 19 hips of 16 patients (15 females, 1 male; mean age 41 years; range 22 to 55 years) with high total dislocation of the hip. All the patients had severe hip pain. In all cases, femoral shortening by subtrochanteric segmental resection and an anatomical reconstruction of the acetabulum were performed with the use of cementless femoral components and cementless acetabular components with screws, respectively. The Harris hip scoring system was used for functional assessments. Radiologic assessments were based on the DeLee and Charnley criteria for the acetabular component, and on the Gruen zones and the Engh criteria for the femoral component. The mean follow-up period was 44 months (range 22 to 79 months). RESULTS: Union was achieved in all cases in a mean of 14 weeks (range 11 to 15 weeks). The mean leg length discrepancy decreased from 4 cm to 1.5 cm postoperatively. A positive Trendelenburg sign was found in 13 patients and four patients before and after surgery, respectively. The mean Harris hip score improved from 37 to 83 postoperatively. None of the patients developed deep infection, dislocation, sciatic nerve palsy, or nonunion at the osteotomy site. No clinical and radiologic signs of loosening were observed and no revisions were required. CONCLUSION: Femoral shortening with subtrochanteric segmental resection in THR is a safe technique in patients with high total dislocation of the hip, leading to satisfactory functional results.

Acetabulum↗

PubMed2003

[The results of acetabular shelf procedures in Legg-Calve-Perthes disease].

OBJECTIVES: We evaluated the results of acetabular shelf procedures performed for the treatment of Legg-Calve-Perthes (LCP) disease. METHODS: The study included 14 patients (17 hips) with LCP disease, who were treated with acetabular shelf operation. The mean ages at the time of diagnosis, operations, and final examinations were 7 years (range 5 to 9 years), 8 years (range 6 to 10 years), and 12 years (range 10 to 16 years), respectively. The mean follow-up was five years (range 3 to 9 years). Before surgery, all patients had Catterall 3-4 hips, and at least two risk factors were identified. On pre- and postoperative anteroposterior and lateral radiograms, the Mose sphericity indices and CE angles were measured. In addition, the presence of hinge abduction was evaluated by dynamic arthrography preoperatively, and on direct radiograms and clinically during final examinations. The hips were graded according to a modified Stulberg classification on final direct radiograms. Clinical evaluation was made with the use of the Iowa hip scores. RESULTS: The Mose measurements did not yield significant improvement on anteroposterior radiograms (p>0.05), whereas postoperative improvement was significant on lateral views (p<0.05). Improvement in CE angles was also statistically significant (p<0.001). According to the Stulberg classification, 10 hips (58.8%) (Stulberg 1-2) were successful, three hips (17.6%) (Stulberg 3) were discussible, and four hips (23.5%) (Stulberg 4-5) were failures. Of four failures, three patients were at the age of 9 years or above. The final Iowa hip scores ranged from 65 to 99 (mean 88.2). Hinge abduction disappeared postoperatively in seven hips (7/13, 53.8%). CONCLUSION: Acetabular shelf operation following dynamic arthrography may be an alternative treatment option for hips with hinge abduction in LCP disease; however, it does not alter the natural course of the disease as the age increases.

Acetabulum↗

PubMed2003

[Simultaneous asymmetric bilateral traumatic hip dislocation: a case report].

Asymmetric bilateral (one side anteriorly, the other posteriorly dislocated) traumatic hip dislocations are very rare. We present a 21-year-old male patient who had simultaneous anterior and posterior traumatic hip dislocations due to a car crash. He also suffered from a tarsometatarsal (Lisfranc's) fracture-dislocation. The patient underwent conservative treatment and was followed-up for 44 months. Final evaluations with Thompson and Epstein radiologic and clinical criteria showed an excellent result. To our knowledge, this is the first report of a case with asymmetric bilateral traumatic hip dislocations associated with Lisfranc's injury.

Accidents, Traffic↗

PubMed2003

[Osteoarticular tuberculosis].

Tuberculosis (Tbc) remains as a major public health problem in the world. Extrapulmonary Tbc is gaining importance and it accounts for approximately 15% of all new cases. Osteoarticular Tbc is an infrequent form of the disease, accounting for 1-5% of all cases. Joints are uncommon site of infection; therefore, peripheral Tbc is considered rare. Tbc arthritis are usually monoarticular but oligoarticular involvement are also reported. We presented here four cases with osteoarticular Tbc and reviewed the literature.

Adolescent↗

PubMed2002

Analysis of a radiographic assessment method of acetabular cover in developmental dysplasia of the hip.

The aim of this study was to analyse a radiographic assessment method of acetabular cover (Ogata et al.) in developmental dysplasia of the hip (DDH). Intraobserver and interobserver reliabilities of the method were found to be 'substantial' (agreement ratio 85%, kappa coefficient 0.76) and 'moderate' (agreement ratio 71%, kappa coefficient 0.54), respectively. The percentage of hips considered pathological was significantly higher following the use of the acetabular roof shape classification system (15%) than following the measurement of the centre-edge (CE) angle of Wiberg (3%) in the same hips ( p=0.000). The average CE angle of Ogata values of types 1&2, 3 and 4 acetabula were significantly different, whereas the CE angle of Wiberg ones were not. It was concluded that this classification system was a reliable and reproducible radiological indicator for reflecting the acetabular cover. A careful assessment is needed in types 3 and 4 acetabula, because the use of classical angle measurements on plain radiographs such as the CE angle of Wiberg may carry the risk of overestimation of the radiological hip anatomy in such hips.

Acetabulum↗

PubMed2002

[The results of plate fixation with the use of biological fixation principles and minimally invasive technique in femur fractures].

OBJECTIVES: We evaluated the clinical and radiologic results of patients treated by the minimally invasive technique and plate fixation in accordance with biological fixation principles for femoral fractures. METHODS: Biological fixation principles were used in the treatment of 24 patients (18 males, 6 females; mean age 32 years; range 18 to 56 years) with femoral fractures. Fractures were reduced by indirect reduction and the plate was forwarded through distal and proximal incisions over the periosteum without the need for incisions on the fracture line. Fixation of the plates was performed with the use of screws from distal and proximal incisions. The patients were allowed partial and full weight-bearing in a mean of 3.6 and 5 months, respectively. By means of monthly clinical and radiologic examinations, union was assessed by callus formation in the fracture line and painless weight-bearing. In addition, leg length discrepancy, rotation, angulation deformities, and knee and hip range of motions were determined. The mean follow-up was 2 years and 7 months (range 16 months to 4 years and 5 months). RESULTS: The mean union time was 4.6 months (range 4 to 11 months). Except for one patient (4%) with delayed union, all patients achieved union. No infections occurred related to the fracture site. CONCLUSION: Successful clinical and radiologic results can be obtained by biological methods of fixation in diaphyseal femur fractures with multiple fragments, segment formation, in multi-trauma patients with high Injury Severity Score and compromised pulmonary function, and in those having subtrochanteric or supracondylar fractures associated with high complication rates.

Adolescent↗