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Biomedical subjects

Izge Gunal

Publications and source records attributed to Izge Gunal.

At least 19 recordsLinked to original sources
PubMed2007

Gait assessment in patients with thrust plate prosthesis and intramedullary stemmed prosthesis implanted to each hip.

INTRODUCTION: There has not been any study regarding comparative gait analysis in patients with intramedullary stemmed prosthesis (ISP) and thrust plate prosthesis (TPP) implanted to each hip. PATIENTS AND METHODS: Four patients (three females and one male) who had undergone operation due to coxarthrosis were selected. The mean age was 60.5 (37-78) years. TPP and ISP had been implanted to the left and right hip, respectively, in three patients, and one patient received TPP to the right and ISP to the left hip. Gait was analyzed with a BTS Elite System consisting six cameras and two Kistler force plates using Helen Hayes marker set to assess the gait parameters. The clinical outcome was also evaluated according to Harris hip score (HHS). RESULTS: The average HHS was 95.0 (82-100) points after a mean follow-up of 45.0 (30-50) months for TPP and 94.5 (80-100) points after a follow-up of 60.0 (14-122) months for ISP. Neither of the HHS scores and follow-up time nor gait parameters obtained from the TPP-implanted side were statistically different when compared to those of the ISP-implanted side. CONCLUSION: TPP and ISP as the implants with their own biomechanical specifications did not produce any remarkable difference in gait.

Adult↗
PubMed2006

Thrust plate prosthesis for osteonecrosis of the femoral head: short-term results of 15 patients followed 2-6 years.

BACKGROUND: The thrust plate prosthesis is an implant with a metaphyseal fixation at the proximal femur that transmits the load forces of the hip onto the femoral neck. METHODS: In this prospective study, 15 patients (8 women, 7 men) with 19 cementless thrust plate prostheses because of femoral head necrosis were examined. A clinical and radiologic evaluation was performed preoperatively, at 3, 6, 12, 18, and 24 months postoperatively, and every year thereafter. The mean follow-up period was 44 (range, 24-72) months. The average age at the time of surgery was 49 (27-70) years. The pathogenesis of femoral head necrosis included alcoholism (6 joints of 3 cases), Gaucher disease (1 joint of 1 case), Sheehan syndrome (2 joints of 1 case), and idiopathic (10 joints of 10 cases). RESULTS: The Harris hip score increased from 53 (range, 15-71) to 97 (92-100) points on the final evaluation. Although mean preoperative hip flexion and abduction were 78 degrees (45 degrees -110 degrees ) and 24 degrees (10 degrees -45 degrees ), respectively, these increased to 114 degrees (75 degrees -125 degrees ) and 47 degrees (45 degrees -50 degrees ) 12 months after surgery and remained stable up to the latest follow-up. None of the patients displayed mechanical problems, and revision was not necessary in any case. CONCLUSIONS: The thrust plate prosthesis shows midterm results comparable to those of the cementless stemmed prosthesis and supplies advantages, especially for younger patients with femoral head necrosis, because of its metaphyseal bone-preserving fixation.

Adult↗
PubMed2006

Beta-blockers increase bone mineral density.

UNLABELLED: Authors of animal studies suggest that beta-blockers stimulate bone formation and inhibit bone resorption. On the other hand, data in humans are limited and conflicting results exist in literature. We conducted a prospective case-control study in order to investigate the effects of beta-blockers on bone mineral density in the elderly population. None of the patients were receiving anti-resorptive medicine. Bone mineral density of 50 beta-blocker users was significantly greater at all measured skeletal sites compared with 100 nonusers. Bone mineral density for total hip and spine (beta-blocker users and nonusers) were, 0.85 +/- 0.13, 0.80 +/- 0.11 and 0.90 +/- 0.15, 0.83 +/- 0.12, respectively. Our results suggest that use of beta-blockers is associated with an increase in bone mineral density. LEVEL OF EVIDENCE: Therapeutic study, LEVEL III (case control study). See the Guidelines for Authors for a complete description of the levels of evidence.

Absorptiometry, Photon↗
PubMed2006

Burden of osteoporosis.

UNLABELLED: The number of the people with osteoporosis increases as the population ages. Increasing numbers of patients with osteoporotic fractures may have a serious economic impact on society and on the quality of life of the patient. We review some literature and provide expert opinion on the burden of osteoporosis. Awareness among clinicians and health care professionals on osteoporosis should be increased to overcome the burden of the disease. Although most of the osteoporotic fractures are treated by orthopaedic surgeons, many patients with these problems are not diagnosed appropriately and treated for probable osteoporosis. Appropriate diagnosis of the disease is essential to prevent osteoporotic fractures and related mortality and morbidity. Indirect costs and sociologic and psychological impact of fractures should be evaluated together with the direct costs of the disease. LEVEL OF EVIDENCE: Economic and decision analysis, level V (expert opinion). See the Guidelines for Authors for a complete description of the levels of evidence.

Absorptiometry, Photon↗
PubMed2005

The effects of non-selective and cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs on heterotopic ossification in rats.

BACKGROUND: Review of the literature revealed several experimental studies on the effects of selective COX-2 inhibitors on fracture healing, but no reports were encountered regarding the effects of these compounds on experimental heterotopic bone formation, so the present study was conducted. MATERIAL/METHODS: Thirty adult male Wistar rats were divided into three groups of ten animals each. Tibial and femoral bones were collected from the rats, cleaned and demineralized, and diaphyseal parts were implanted in muscle pouches created in the right gluteal region, one into each rat. Group 1 received DFU (5,5-dimethyl-3-(3-fluorophenyl)-4-(4-methylsulphonyl)phenyl-2(5H)-furanone), a highly selective COX-2 inhibitor, at a dose of 1.1 mg/kg/day. Group 2 received 2 mg/kg/day of indomethacin. The drugs were administered by oral gavage with 0.5% methyl cellulose as a delivery vehicle for eleven days, beginning on the first postoperative day. Group 3 received only methyl cellulose. RESULTS: Thirty days after the implantation of the demineralized bone matrix, 6/10 of DFU-treated, 9/9 of the indomethacin-treated, and 8/9 of the control rats displayed new bone formation. CONCLUSIONS: The results of this study suggest that no form of non-steroidal anti-inflammatory drug has inhibitory effects on heterotopic bone formation in rats. In our opinion, bone formation is a quite complex process that requires several events and is regulated by several factors, so further investigations other than those using non-steroidal anti-inflammatory drugs are required.

Animals↗
PubMed2005

Intra-articular hyaluranic acid compared with progressive knee exercises in osteoarthritis of the knee: a prospective randomized trial with long-term follow-up.

The goal of this study was to determine whether hyaluronic acid (HA) or progressive knee exercises (PE) can improve functional parameters in patients with osteoarthritis (OA) of the knee. In a prospective clinical trial 200 knees (105 patients) with radiographic Kellgren Lawrence grade III OA were randomized and received either three intra-articular injections of hyaluronic acid (Hylan G-F 20) at one-week intervals or PE for 6 weeks. Patients were evaluated by use of the Hospital for Special Surgery (HSS) Knee Score and followed-up for 18 months. Total HSS score for HA and PE patients improved from 62.6 +/- 13.8 to 88.8 +/- 11.1 and from 65.4 +/- 12.3 to 88.3 +/- 9.1, respectively, at the end of the trial (P < 0.01). There were no statistically significant differences between the groups. Twenty-one patients of the HA group were excluded from the study because they had received another form of therapy. All patients in the PE group completed the trial. The patients who dropped out had also significant improvement from 57.0 +/- 12.9 to 76.7 +/- 11.9 (P < 0.01). This prospective randomized trial confirmed that both HA injections and PE result in functional improvement. HA injections also increase the levels of satisfaction of the OA patients.

Adjuvants, Immunologic↗
PubMed2005

No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees. A study in rabbits.

BACKGROUND: Although promising results have been reported, on the use of joint distraction in osteoarthrotic joints, the mechanism behind the effects has not yet been expland. MATERIAL AND METHODS: 24 rabbits were randomly divided into 4 groups and osteoarthrosis was induced by papain injection. The first group served as control and the others were treated by simple external fixation (group 2), articulated distraction (group 3) or nonarticulated distraction (group 4). RESULTS: Histologically, there was no significant difference between the first, the second and the third groups. However, osteoarthrosis increased in group 4. INTERPRETATION: We conclude that joint distraction has no beneficial effect on the osteoarthrotic cartilage in papain-induced osteoarthrosis, and nonarticulated distraction worsens the results.

Animals↗
PubMed2005

Assessing the results of thrust plate prosthesis: a comparison of four different rating systems.

OBJECTIVE: To evaluate four rating systems designed to assess patients following provision of a thrust plate prosthesis. SUBJECTS: Sixty-one patients undergoing total hip replacement with thrust plate prosthesis. DESIGN: Patients were evaluated preoperatively and six months postoperatively by four different hip rating systems (Harris, Iowa, Charnley and Merle d'Aubigne), both on a categorical and on a numerical basis. SETTING: Department of orthopaedics and traumatology in a university hospital. MAIN OUTCOME MEASURES: Patients were evaluated by four rating systems preoperatively and postoperatively either on a categorical or a numerical basis. RESULTS: All patients showed significant improvement after surgery in all rating systems. Although preoperative categorical evaluation revealed that the strongest correlation was between Charnley and Merle d'Aubigne scores (r = 0.876), numerical comparison of the rating systems showed strong correlation among all systems, both pre- and postoperatively. Responsiveness analysis revealed larger effect size for the Iowa and Harris hip scores. CONCLUSIONS: Our results suggest that hip rating systems should be compared numerically rather than by categorical evaluation and that the Iowa and Harris hip scores are more convenient in evaluating thrust plate prosthesis patients because they have larger effect sizes without floor and ceiling effects.

Adult↗
PubMed2005

Medium-term results of thrust plate prostheses for osteoarthritis of the hip.

We retrospectively evaluated the results of 61 patients (67 hips) who underwent total hip arthroplasty using the thrust plate prosthesis (TPP) for osteoarthritis of the hip joint. All patients were followed-up at least two years (mean: 37.2 months). Mean preoperative Harris hip score improved from 45.8 (SD: 13.5) to 94.9 (SD: 5.4) points postoperatively. Revision was performed in five cases. Medium-term results of TPP are promising.

Adult↗
PubMed2004

Does scapular elevation accompany glenohumeral abduction in healthy subjects?

INTRODUCTION: Although it is used in clinical practice, there are no data concerning scapular elevation during glenohumeral abduction. MATERIALS AND METHODS: Scapular elevation of 30 healthy volunteers in supine and sitting positions were measured at 90-180 deg of glenohumeral abduction by two examiners. In addition, radiographs of the ten subjects were taken in supine position at 0-180 deg of glenohumeral abduction, and the scapular elevation measurements were repeated. Also, the movements of five anatomical landmarks (acromioclavicular joint, center of glenoid cavity, scapular notch, angulus superior and inferior) were measured with regard to transverse and vertical axes. RESULTS: The values obtained for scapular elevation during 90, 120, 150, and 180 deg of glenohumeral abduction were (mean and SD) 26.63 and 3.96, 31.77 and 4.36, 35.97 and 5.15, 40.10 and 5.18 deg, respectively. There were no significant differences with regard to side, gender, and position of the subject. No correlation was found between the clinical and radiological measurements. Movements of certain points did not reveal progressive upward motion. CONCLUSION: There is no scapular elevation but rather rotation during glenohumeral joint abduction. Normal values given in the present study can be used in clinical examinations.

Acromioclavicular Joint↗
PubMed2004

Trans-metatarsal amputation as a complication of child sexual abuse.

A case of chronic physical abuse and acute sexual abuse via anal penetration complicated with disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and subsequent bilateral trans-metatarsal amputation is reported. A 13-year-old male presented with old cigarette burns on his chest and acute anal laceration. Four days after laceration repair, he developed DIC and ARDS. The child had to undergo bilateral trans-metatarsal amputation. Due to the systemic defects of the child protection system in Turkey, sexual and physical abuse were recognized by medical personnel 45 days after admission, child protective services never got involved, and prosecution failed to punish the perpetrator(s) of this extreme victimization. This is the only reported case of bilateral trans-metatarsal amputation due to sexual abuse complicated with DIC and ARDS. Social and medico-legal management of sexual abuse is suboptimal in Turkey. Within that context, professionals should be trained on how to recognize, assess, diagnose and manage victims of child abuse and neglect.

Adolescent↗
PubMed2004

The frequency of visits by the physiotherapist of patients receiving home-based exercise therapy for knee osteoarthritis.

Although home-based physiotherapy (PT) has an important role in the management of knee osteoarthritis (OA), the optimal frequency of monitoring by the physiotherapist is not known. Ninety-six patients with bilateral Kellgren Lawrence grade 3 OA were divided into two groups. All patients received the same PT program but group 1 was monitored at 1, 2, 3, 6, 12 and 24 weeks, while group 2 was seen at 3 and 24 weeks. At the end of the study, both groups had improved their Hospital for Special Surgery score (P<0.05), and there was no statistically significant difference between the groups. We conclude that the frequency of visits for a home-based exercise program can be decreased without affecting the success of the therapy.

Adult↗
PubMed2004

Comparison of two different rehabilitation programmes for thrust plate prosthesis: a randomized controlled study.

OBJECTIVE: Weight bearing after total hip arthroplasty is postponed in order to prevent early loosening, but this negatively affects the rehabilitation programme. For the force transfer characteristics of thrust plate prosthesis (TPP), a new type of hip prosthesis used without cement is similar to the normal hip. We evaluated the possibilities of early weight bearing after TPP by comparing early partial with early full weight bearing. DESIGN: Randomized controlled study. SETTING: Department of orthopaedics and traumatology in a university hospital. SUBJECTS: Sixty hips of 51 patients who underwent total hip arthroplasty with TPP were randomly assigned into two groups. INTERVENTIONS: Both groups received accelerated rehabilitation programmes: group 1 with early partial weight bearing and group 2 with early full weight bearing. MAIN OUTCOME MEASURES: Patients were evaluated by a blind observer preoperatively, at three months after surgery by clinical (measurement of range of hip motion (universal goniometry), muscle strength (Manual Muscle Test), functional test (6-minute walk test), hip function (Harris Hip Scoring System)) and radiographical parameters and one year after surgery by clinical (Harris Hip Scoring System) and radiographical parameters. RESULTS: Group 2 performed transfer activities earlier, had more walking distance at the time of discharge and shorter hospital stay than group 1. At three months, Harris Hip Score, muscle strength, 6-minute walk test, and duration of crutch use were significantly (p < 0.05) in favour of group 2. None of the patients in either group showed signs of loosening one year after the operation. CONCLUSIONS: These results suggest that patients with TPP can tolerate an accelerated rehabilitation programme with early weight bearing and will gain the goals of rehabilitation earlier.

Arthroplasty, Replacement, Hip↗
PubMed2004

The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial.

OBJECTIVE: To investigate the effects of preoperative physical therapy for patients undergoing total hip replacement. DESIGN: Prospective randomized controlled study. SETTING: Department of Orthopaedics and Traumatology in a university hospital. SUBJECTS: Sixty patients with osteoarthritis of the hip scheduled to receive total hip replacement were randomly assigned into two groups. INTERVENTIONS: Subjects in the study group received preoperative physiotherapy designed to strengthen the muscles of the upper and lower limbs and to improve range of motion of the hip, beginning from eight weeks before the operation. These patients also received an educational programme about living with a prosthesis. The control group received no preoperative physiotherapy or educational programme. MAIN OUTCOME MEASURES: Patients were evaluated at baseline (study group only, eight weeks prior to operation), before surgery, at discharge, three months and two years postoperatively using Harris Hip Score, visual analogue scale and range at hip abduction. RESULTS: Although patients in the study group performed transfer activities earlier than the control group, there were no significant differences between the groups at discharge with regard to the improvement in Harris Hip Score (p < 0.48) and hip adduction (p < 0.97) and visual analogue scale at rest (p < 0.54) and activity (p < 0.89). At the latest follow-up (two years postoperatively) both groups had improved in Harris Hip Score, but rate of improvement between the groups was similar (p < 0.05). CONCLUSIONS: We conclude that the routine use of preoperative physiotherapy and education programme is not useful in total hip replacement surgery.

Arthroplasty, Replacement, Hip↗
PubMed2003

Disorders associated with osteopoikilosis: 5 different lesions in a family.

Although osteopoikilosis is generally considered an accidental finding, several developmental dysplasias coexisting with this disorder have been reported. However, all authors have mentioned only one coexisting finding, and most of them are case reports. We report a family in whom various members had osteopoikilosis with 5 different associated lesions. We suggest that osteopoikilosis is a bone manifestation of a generalized fibroproliferative or stenosing disease.

Adolescent↗