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Biomedical subjects

Vasfi Karatosun

Publications and source records attributed to Vasfi Karatosun.

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↗
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

ABility to rise independently from a chair during 6-month follow-up after unilateral and bilateral total knee replacement.

OBJECTIVE: The purpose of this study was to compare extensor mechanism function using a sit-to-stand test in patients undergoing uni- and bilateral total knee replacement, with a 6-month follow-up. DESIGN: Prospective controlled study. PATIENTS: The series included 72 patients with total knee replacement (unilateral 32 patients, bilateral 40 patients). METHODS: All patients were evaluated pre-operatively by the physiotherapist and then at 2-weekly intervals during the postoperative 6 months using Hospital for Special Surgery knee score, and range of motion. Extensor mechanism function was evaluated at the same time points using a sit-to-stand test. RESULTS: At the end of study, there was no difference between the groups in their knee range of motion and Hospital for Special Surgery scores (p>0.05). There was a significant difference between the groups in their chair rising ability (p<0.05). At 2 weeks, 22% of patients in the group with unilateral total knee replacement and 20% of patients in the group with bilateral total knee replacement could rise independently. However, there was significant difference in favour of unilateral total knee replacement at 4, 6, 8 and 10 weeks. At 10 weeks, all patients in the group with unilateral total knee replacement and at 6 months all patients in the group with bilateral total knee replacement could rise independently. CONCLUSION: We conclude that patients with unilateral total knee replacement gain independence earlier than patients with bilateral total knee replacement. However, for patients with bilateral total knee replacement eventually to gain independence, they should be prepared for a longer rehabilitation programme.

Aged↗
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

The reliability of hip scoring systems for total hip arthroplasty candidates: assessment by physical therapists.

OBJECTIVE: Hip rating systems have been widely used in assessing severity of hip dysfunction but no uniform method has emerged. The current study was performed to determine the interobserver reliability of five different hip scores on patients with coxarthrosis. DESIGN: Test reliability among physical therapists for five commonly used hip scores. SUBJECTS: Thirty-five patients (48 hips) who had coxarthrosis and who were candidates for total hip arthroplasty were included in the study. METHODS: Patients were evaluated preoperatively by three physical therapists using five different hip rating systems; the Harris Hip Score, the Iowa Hip Score, the Charnley Hip Score, the Merle d'Aubigne Hip Score and the American Academy of Orthopaedic Surgeons' Hip Score. RESULTS: The average age of the patients was 58.8 +/- 2.2 years (range 28-76 years). For all scores, an excellent interobserver reliability between the physical therapists were found (kappa = 0.77-0.95). The best correlation between first and second observer was on Harris Hip Score (kappa = 0.91), between second and third was on Merle d'Aubigne Hip Score (kappa = 0.95) and between first and third was on Iowa Hip Score (kappa = 0.87). CONCLUSION: There was an excellent interobserver reliability for all hip scores between the physical therapists, suggesting that all these hip scores are suitable for use by physical therapists.

Adult↗
PubMed2005

[Total dislodgement of the femoral component following cemented total knee arthroplasty: a case report].

Total dislodgement of the components, which is the most severe form of loosening, has hitherto been unreported following total knee arthroplasty. An eighty-four-year-old woman presented with complaints of pain and sensation of insecurity of her right knee after cemented total knee arthroplasty. On physical examination, a clunk was elicited during movements of the knee; however, radiographs appeared normal except for a separated fragment of the medial femoral condyle. Further examination with varus and valgus stress tests under fluoroscopic control showed dislodgement of the femoral component, which was only apparent on stress radiographs. She underwent revision cemented total knee arthroplasty and her complaints disappeared completely within a follow-up period of three years. This case illustrates the need for stress radiographs when standard radiographs are normal in the face of a high suspicion of loosening.

Aged↗
PubMed2005

[A case of acute colonic pseudo-obstruction following total hip arthroplasty].

Acute colonic pseudo-obstruction or Ogilvie syndrome refers to the occurrence of colonic obstruction without the presence of any mechanical cause. A 71-year-old male patient developed abdominal distension, nausea, vomiting, and pain on the second postoperative day of total hip arthroplasty. Radiographs showed bowel dilatation. Oral intake was immediately ceased and nasogastric decompression was performed, after which all the symptoms and signs disappeared within four days. This syndrome should be borne in mind following major orthopedic interventions and be diagnosed and treated without delay.

Acute Disease↗
PubMed2005

[Biomechanical analysis of load transmission characteristics of limited carpal fusions used to treat Kienböck's disease].

OBJECTIVES: Although limited carpal fusions used in the treatment of Kienböck's disease are thought to act by decreasing the loads on the lunate, biomechanical studies show that capitohamate fusion acts oppositely to what is expected. This experimental study was designed to resolve this paradox. METHODS: In a biomechanical cadaveric study, load transmissions at the radioulnacarpal joint were investigated under 140 and 210 newtons of load with three wrist postures, namely, neutral, ulnar and radial deviations, in five intact wrists and after scaphotrapeziotrapezoid, capitohamate, and scaphocapitate fusions. RESULTS: Under 140 newtons of load, the loads imposed to the lunate decreased following scaphotrapeziotrapezoid and scaphocapitate fusions, but increased after capitohamate fusion. However, when the load was increased to 210 newtons, there were no differences between intact wrists and limited carpal fusions in respect to the loads exerted on the lunate. In all the situations, the lunate was subjected to a significantly greater load in ulnar deviation. CONCLUSION: These results suggest that limited carpal fusions do not alter load transmission characteristics of the wrist joint under 210 newtons of load. The etiology of the Kienböck's disease seems to be related to an overload in ulnar deviation and the beneficial effect of limited carpal fusions seems to be associated with restricted ulnar deviation of the wrist rather than load transmission characteristics.

Arthrodesis↗
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

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↗