Person: UZER, GÖKÇER
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Publication Open Access Superior Mesenteric Artery Syndrome due to a Vertebral Hemangioma and Postpartum Osteoporosis following Treatment.(2015-01-01) Elmadag, M; GÜZEL, Y; UZER, GÖKÇER; TUNCAY, İBRAHİM; ELMADAĞ, NUH MEHMET; UZER, GÖKÇER; TUNCAY, İBRAHİMIn pregnancy, advanced vertebral hemangiomas may be seen, and these require treatment. The case reported here is of a 35-yearold female in the 32nd week of pregnancy who was admitted to the orthopaedics clinic with a history of backache and difficulty walking. A burst fracture of L1 associated with a vertebral hemangioma was identified with an L3 compression fracture secondary to osteoporosis. The local kyphosis angle between T12 and L2 was 27∘ . Kyphotic deformity was corrected and postoperatively, the measured T12–L2 local kyphotic angle was 9∘ . Twelve hours postoperatively, oral nutrition was allowed, but she developed nausea and vomiting and twenty-four hours postoperatively, an electrolyte imbalance developed. Postoperatively, the patient was diagnosed with superior mesenteric artery syndrome. To the best of our knowledge, this is the first reported case of superior mesenteric artery syndrome, which occurred following the correction of a kyphotic deformity that had developed secondary to an advanced hemangioma in pregnancyPublication Open Access Reply to Letter to Editor: Safety of one-stage bilateral total knee arthroplasty-one-surgeon sequential vs. two surgeons simultaneous: a randomized controlled study(2020-08-01T00:00:00Z) Gungoren, Nurdan; UZER, GÖKÇER; ALIYEV, ORKHAN; YILDIZ, FATİH; ELMALI, NURZAT; TUNCAY, İBRAHİM; UZER, GÖKÇER; ALIYEV, ORKHAN; YILDIZ, FATİH; GÜNGÖREN, NURDAN; ELMALI, NURZAT; TUNCAY, İBRAHİMPublication Open Access Onlay fibula autografting technique and its comparison with cortical allograft for the reconstruction of periprosthetic bone defects around the femur(2020-11-01T00:00:00Z) TUNCAY, İBRAHİM; Tozun, Remzi; ALIYEV, ORKHAN; Dikmen, Goksel; UZER, GÖKÇER; ÖZDEN, Vahit Emre; YILDIZ, FATİH; TUNCAY, İBRAHİM; ALIYEV, ORKHAN; UZER, GÖKÇER; YILDIZ, FATİHBackground Bone defect around the femur related to revisions or periprosthetic fractures (PFF) is an issue. We present a bone defect reconstruction technique in femoral revisions and/or PFF using fibula autograft and compared our radiological and clinical results to that of allograft. Methods A total of 53 patients who underwent revision hip arthroplasty and/or PFF fixation with the use of cortical fibula autograft (FG group) or cortical allograft (CG group) were evaluated. After exclusions, 20 patients who had minimum two years of follow-up were investigated for each group, for their radiological and clinical outcomes. Results In FG and CG groups, the median ages were 69.5(44-90) and 62(38-88) years, follow-ups were 59(28-72) and 120(48-216) months, defect lengths were seven (1-10) and ten (1-17) cm, and grafts lengths were 16.5(10-30) and 20(12-37) cm, respectively. The rate of graft incorporation was 90% in each group and median time to incorporations were seven (4-12) and 12(6-24) months (p < 0.001), and graft resorption (moderate and severe) rates were 10% and 25% (p = 0.41), respectively. Median Harris Hip (77.6 vs 78.0), WOMAC (23.2 vs 22), SF-12 physical (50.0 vs 46.1), and SF-12 mental (53.8 vs 52.5) scores were similar between the groups, respectively. Kaplan-Meier survivorship analyses revealed an estimated mean survival of 100% at six years in FG group and 90% at 14 years in CG group. Conclusion In the reconstruction of periprosthetic bone defects after femoral revision or PPF, onlay cortical fibula autografts provide comparable clinical and radiological outcomes to allografts. Its incorporation is faster, it is cost-effective and easy to obtain without apparent morbidity.Publication Open Access Cytotoxicity of a new antimicrobial coating for surgical screws: an in vivo study(2017-01-01) Guzel, Yunus; Elmadag, Mehmet; Uzer, GÖKÇER; Yildiz, FATİH; Bilsel, Kerem; Tuncay, Ibrahim; ELMADAĞ, NUH MEHMET; UZER, GÖKÇER; YILDIZ, FATİH; BİLSEL, İSMAIL KEREM; TUNCAY, İBRAHİMhe risk of surgery-related infection is a persistent problem in orthopaedics and infections involving implants are particularly difficult to treat. This study explored the responses of bone and soft tissue to antimicrobialcoated screws. We investigated whether such screws, which have never been used to fix bony tissues, would result in a cytotoxic effect. We hypothesised that the coated screws would not be toxic to the bone and that the likelihood of infection would be reduced since bacteria are not able to grow on these screws. METHODS Titanium screws were inserted into the left supracondylar femoral regions of 16 rabbits. The screws were either uncoated (control group, n = 8) or coated with a polyvinylpyrrolidone-polyurethane interpolymer with tertiary amine functional groups (experimental group, n = 8). At Week 6, histological samples were obtained and examined. The presence of necrosis, fibrosis and inflammation in the bony tissue and the tissue surrounding the screws was recorded. RESULTS Live, cellular bone marrow was present in all the rabbits from the experimental group, but was replaced with connective tissue in four rabbits from the control group. Eight rabbits from the control group and two rabbits from the experimental group had necrosis in fatty bone marrow. Inflammation was observed in one rabbit from the experimental group and five rabbits from the control group. CONCLUSION Titanium surgical screws coated with polyvinylpyrrolidone-polyurethane interpolymer were associated with less necrosis than standard uncoated screws. The coated screws were also not associated with any cytotoxic side effect.Publication Open Access Comparison of Intravenous, Intra-articular, and Combined Tranexamic Acid Use in Primary Total Knee Arthroplasty without a Tourniquet and a Drain(2020-04-01T00:00:00Z) Binlaksar, Ruwais; Ali, Jotyar; UZER, GÖKÇER; YILDIZ, FATİH; UÇAN, VAHDET; TUNCAY, İBRAHİMObjective: We assessed the effect of tranexamic acid (TXA) route of administration on the estimated blood loss (EBL) in patients undergoing primary total knee arthroplasty (TKA) without tourniquet and drain use. Methods: One hundred fifty three patients who underwent primary TKA with use of TXA, between December 2012 and February 2016 were evaluated retrospectively. The patients were divided into three groups according to the route of TXA use: group I, 2 g of intravenous (IV; n=50); group II, 2 g of intraarticular (IA, n=50); and group III, 1 g of IV and 1 g IA combined use (n=53). We recorded the body mass indexes, the platelet counts, haemoglobin, haematocrit levels, prothrombin time, partial thromboplastin time, and international normalised ratio, preoperatively and at 1st and 7th days, postoperatively. EBL was calculated using Meunier's formula. Results: On the first day, the mean EBLs for groups I to III were 286.3 +/- 128.8 mL, 342.7 +/- 176.0 mL, and 379.7 +/- 228.9 mL, respectively (p=0.029 for group I vs. group III). On 7th day postoperatively, they were calculated as 823 +/- 619.3 mL, 1175.1 +/- 970.5 mL, and 1092.2 +/- 766.7 mL (p=0.073) During the first 90 days postoperatively, we did not see any symptomatic thromboembolic complications, delayed haemorrhage, or surgical site or periprosthetic infections. Conclusion: IV, IA or combined uses of TXA are effective and safe for reducing blood loss and transfusion requirements in primary TKA without a tourniquet and drain.Publication Open Access Comparison of Clinical Outcomes and Safety of Single-stage Bilateral and Unilateral Unicompartmental Knee Arthroplasty(2019-01-01T00:00:00Z) YILDIZ, FATİH; Erden, Tunay; UZER, GÖKÇER; TUNCAY, İBRAHİM; YILDIZ, FATİH; ERDEN, TUNAY; UZER, GÖKÇER; TUNCAY, İBRAHİMObjective To evaluate the effectiveness and safety of bilateral Oxford medial unicompartmental knee arthroplasty (UKA) in the patients under a single anesthetic procedure. Methods: Between October 2013 and December 2015, 225 knees of 181 (age 67.5 years) patients with at least two years of follow-up were evaluated. They were divided into two groups as unilateral group (group 1, n=137) and one stage simultaneous bilateral group (group 2, n=44) for the comparisons. The outcome parameters were femoral and tibial component positions measured on the full-length radiographs, clinical outcomes using Oxford Knee Score (OKS), International Knee Documentation Committee Score (IKDC), patient reported satisfaction and complications. Results: Between the groups, the mean follow-up periods (p=0.125), age (p=0.447), preoperative body mass index (p=0.288), OKS (p=0.314) and IKDC (p=0.127) scores were not significantly different. Postoperatively, the mean flexion of the femoral component (p=0.544), posterior slope (p=0.511), varus-valgus angulation of the tibial components (p=0.358) were statistically similar berwcen groups. Although the mcan varus-valgus angulation of the femoral components (p=0.033) was statistically different between groups, the difference was too small to make clinical significance. The mean postoperative OKS (p=0.272) and IKDC (p=0.106) were similar between the groups. In group 1, 21 (16.0%) patients reported excellent, 91 (69.5%) good and 4 (3.1%) moderate satisfaction. Fifteen (11.5%) patients reported non-satisfaction. In group 2, patients reported excellent satisfaction in 20 (24.4%) knees, good in 50 (61.0%) knees patients moderate in 2(2.4%) knees. Patients reported non-satisfaction in 10 (12.2%) knees (p>0.05). Eight (5.8%) complications in group 1 and, 3 (3.4%) complications in group 2 were observed. The number of complications was not statistically different between the groups (p=0.535). Conclusion: One-stage simultaneous bilateral Oxford medial UKA is a safe and effective method with acceptable complication rates compared to unilateral surgery.