Person: UÇAN, VAHDET
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Publication 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 Use of cement combined grafting in upper and lower extremity benign bone tumors(2020-01-01T00:00:00Z) Pulatkan, Anil; Ucan, Vandet; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, Volkan; UÇAN, VAHDET; TOKDEMİR, SEVİL; ELMALI, NURZAT; GÜRKAN, VOLKANObjectives: This study aims to investigate the effectivity of cement combined demineralized bone matrix (DBM) treatment on new bone formation in the cortical window as well as to evaluate the effect of new bone formation on functional outcomes. Patients and methods: Thirty-two benign bone tumor patients (15 males, 17 females; median age 38 years; range, 12 to 68 years), who were treated with cement combined DBM between February 2010 and December 2014, were evaluated retrospectively. Patient characteristics were recorded as age, gender, tumor localization, histological diagnosis, Enneking stage, tumor size, size of the cortical window, usage of prophylactic fixation, time to return to work, Musculoskeletal Tumor Society (MSTS) functional score, tumor relapse, and new bone formation on the cortical window in the computed tomography scans after one year of surgery. Results: Median tumor volume was 17.2 cm 3 (range, 2.8 to 139.6 cm 3 ), median area of the cortical window was 8.3 cm 2 (range, 1.6 to 28.4 cm 2 ), and median postoperative one-year MSTS score was 84.5 (range, 66 to 97). MSTS scores were significantly worse with the usage of prophylactic fixation (p<0.001). There was a statistically significant difference between the usage of prophylactic fixation and cortical window size (p=0.013). There was a low-level negative correlation in terms of age and bone formation on the cortical window (p=0.046, r= -0.356) and mid -level negative correlation between cortical window size and functional scores (p=0.001, r= -0.577). Conclusion: Application of cement combined with DBM procedure is an effective, alternative, and biological treatment in bone tumors that provides immediate stability and stimulates new bone formation on the cortical window.Publication Comparison of Small-diameter-hole and Traditional Microfracture in Cartilage Repair and the Effect of Adding a Hyaluronic Acid-based Acellular Matrix Scaffold: An Animal Study(2021-03-01T00:00:00Z) UÇAN, VAHDET; YILDIZ, FATİH; ELMADAĞ, Nuh Mehmet; UZER, GÖKÇER; GÜZEL, YUNUS; TOK, OLGU ENİS; Mukaddes, E.; UÇAN, VAHDET; YILDIZ, FATİH; ELMADAĞ, NUH MEHMET; UZER, GÖKÇER; TOK, OLGU ENİS; EŞREFOĞLU, MUKADDESObjective: Since, there is no standardized technique for the treatment of focal cartilage defects that can recreate original cartilage tissue; researchers continue to explore and evaluate various treatment modalities. This study compared post-operatke healing of cartilage defects after treatment with small-diameter-hole microfracture (SDHM) technique with that of traditional microfracture technique. The effects of the hole density and augmentation with hyaluronic acid-based acellular matrix (HA-based AM) on cartilage healing were also investigated. Methods: Articular cartilage defects measuring 5 mm in diameter and 3 mm in depth were created in each femoral trochlear groove of 21 New Zealand rabbits. Rabbits were assigned to seven groups comprising six knees each. The rabbits were sacrificed 12 weeks later, and the regenerated cartilage was harvested for histological evaluation using the Wakitani scoring system. Results: All defects were filled with regenerated tissue macroscopically. Group I (14; range 10-14 points) had significantly higher Wakitani score than in groups VI (6; range 1-11 points) and VII (5; range 3-10 points) (p=0.043 and p=0.016, respectively). No significant differences were observed among the other groups. Augmentation with HA-based AM did not contribute to cartilage healing. Conclusion: Improved cartilage healing was observed with increasing SDHM density than with traditional microfracture technique. SDHM combined with HA-based AM implantation did not improve the quality of the regenerated cartilage.Publication Comparison of Arthrodesis, Resurfacing Hemiarthroplasty, and Total Joint Replacement in the Treatment of Advanced Hallux Rigidus(2013-09-01T00:00:00Z) ERDIL, Mehmet; Elmadag, NUH MEHMET; POLAT, Gokhan; TUNCER, Nejat; Bilsel, Kerem; Ucan, Vandet; Erkocak, Omer Faruk; SEN, Cengiz; ELMADAĞ, NUH MEHMET; BİLSEL, İSMAIL KEREM; UÇAN, VAHDETThe purpose of the present study was to compare the functional results of arthrodesis, resurfacing hemiarthroplasty, and total joint replacement in hallux rigidus. The data from patients treated from 2006 to 2010 for advanced stage hallux rigidus were retrospectively reviewed. A total of 38 patients who had at least 2 years (range 24 to 66 months, mean 31.1) of follow-up were included in the present study. Of the 38 patients, 12 were included in the total joint replacement group (group A), 14 in the resurfacing hemiarthroplasty group (group B), and 12 in the arthrodesis group (group C). At the last follow-up visit, the functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scale, visual analog scale (VAS), and metatarsophalangeal range of motion. Significant improvements were seen in the AOFAS-HMI score, with a decrease in the VAS score in all 3 groups. According to the AOFAS-HMI score, no significant difference was found between groups A and B. However, in group C, the AOFAS-HMI scores were significantly lower than in the other groups owing to the lack of motion. According to the final VAS scores, no significant difference was found between groups A and B; however, the VAS score had decreased significantly more in group C than in the other groups. No major complications occurred in any of the 3 groups. After 2 years of follow-up, all the groups had good functional outcomes. Although arthrodesis is still the most reliable procedure, implant arthroplasty is also a good alternative for advanced stage hallux rigidus. (C) 2013 by the American College of Foot and Ankle Surgeons. All rights reserved.Publication Comparison of 3 Cell-Free Matrix Scaffolds Used to Treat Osteochondral Lesions in a Rabbit Model.(2022-03-30T00:00:00Z) Ucan, Vahdet; Pulatkan, Anil; Yilmaz, Bengi; Tahmasebifar, Aydin; Tok, Olgu Enis; Tuncay, Ibrahim; Elmali, Nurzat; Ozturk, Burak Yagmur; Uzer, GÖKÇER; UÇAN, VAHDET; TUNCAY, İBRAHİM; UZER, GÖKÇERPublication Comparison of Single and Double Incision Repair Techniques in Distal Biceps Tendon Rupture(2022-08-01T00:00:00Z) KAPICIOĞLU, Mehmet; Pulatkan, Anil; UÇAN, VAHDET; TEZGEL, OKAN; Bilsel, Kerem; KAPICIOĞLU, MEHMET; UÇAN, VAHDET; TEZGEL, OKAN; BİLSEL, İSMAIL KEREMObjective: The purpose of this study was to compare the complications and functional outcomes of single versus doubleincision repair techniques for the treatment of distal biceps brachii tendon rupture Methods: Between 2012 and 2018, patients with distal biceps brachii tendon rupture who were treated with a single or doubleincision repair technique were included in this retrospective study. Range of motion (ROM) and Mayo elbow performance scores (MEPS) were evaluated. Results: Seventeen patients with a mean age of 45.6±6.4 years (range: 34-58 years) who underwent single (n=9) and double (n=8) incision techniques were included in this study. The mean followup was 33±10.5 months (range: 24-62 months). Preoperative and postoperative ROM and MEPS were similar between two groups (p>0.05). In the single incision repair technique group, 3 patients had lateral antebrachial cutaneous nerve (LACN) palsy and 1 patient was re-operated due to re-rupture. In the double incision repair technique group, 1 patient had posterior interosseous nerve (PIN) palsy and 1 patient had hematoma that did not require surgical drainage. No significant differences were detected in terms of complications (p=0.62). Conclusion: Good functional results were obtained after both single and double incision techniques for the treatment of distal biceps brachii tendon rupture. Both single and double incision techniques were reliable however LACN was at risk in single incision technique and PIN in double incision technique.Publication Sık Yapılan Ortopedik Ameliyatlar ve Rehabilitasyon Yaklaşımları(2021-01-01T00:00:00Z) Elmalı, Nurzat; ELMALI, NURZAT; UÇAN, VAHDETPublication Do Techniques for Hill-Sachs Remplissage Matter in Terms of Functional and Radiological Outcomes?(2021-06-01T00:00:00Z) Pulatkan, Anil; KAPICIOĞLU, Mehmet; UÇAN, VAHDET; Masai, Mustafa Ngeiywo; Ozdemir, Bulent; Akpinar, Sercan; Bilsel, Kerem; KAPICIOĞLU, MEHMET; UÇAN, VAHDET; BİLSEL, İSMAIL KEREMBackground: Different techniques are used for the remplissage procedure, including the double-pulley and mattress suture techniques. Both techniques have shown good results; however, it is unclear if one technique is superior. Hypothesis: The remplissage procedure using the double-pulley technique with 2 anchors would have superior functional and radiological outcomes compared with the mattress suture technique with a single anchor. Study Design: Cohort study; Level of evidence, 3. Methods: This study included patients with anterior shoulder instability who were treated using arthroscopic Bankart repair combined with remplissage between 2012 and 2017. A structured questionnaire was used to gather information on the following metrics: Instability Severity Index Score, hyperlaxity, Sugaya index, presence of a Hill-Sachs defect, number of dislocations before surgery, sports participation, radiological measurement of the Hill-Sachs lesion, postoperative range of motion in both shoulders, Rowe score, Walch-Duplay score, American Shoulder and Elbow Surgeons score, and Filling Index Score of Remplissage grade according to magnetic resonance imaging scans at the last follow-up. Results: There were 41 patients included with a mean age of 30 +/- 7 years who underwent the Hill-Sachs remplissage procedure using the double-pulley technique with 2 anchors (n = 21; group DA) or the mattress suture technique with a single anchor (n = 20; group SA). At the final follow-up, there were no significant differences between the groups regarding the Instability Severity Index Score (P = .134), the Sugaya index (P = .538), sports participation (P = .41), the radiological measurement of the Hill-Sachs lesion (P = .803), or the Rowe score (P = .182). However, there were significant differences between the groups in the Walch-Duplay score (P = .012), American Shoulder and Elbow Surgeons score (P = .005), and Filling Index Score of Remplissage grade (P = .015), favoring group DA, as well as differences in external rotation in a neutral position (external rotation loss: 9 degrees +/- 3 degrees [group SA] vs 12 degrees +/- 3 degrees [group DA]; P = .003) and at 90 degrees of abduction (external rotation loss: 8 degrees +/- 3 degrees [group SA] vs 11 degrees +/- 3 degrees [group DA]; P = .006), favoring group SA. Conclusion: In the remplissage procedure, the double-pulley technique provided better filling of the lesion and improvement in functional scores, but external rotation was limited compared with the mattress suture technique.Publication Patellar height: an important parameter in knee MRI associated with tendinopathy, quadriceps fat pad edema (QFPE), anterior cruciate ligament mucoid degeneration (ACL-MD), and lateral cartilage damage(2024-01-01) Atay M.; TOPRAK H.; YILMAZ T. F.; Sari L.; Balsak S.; UÇAN V.; Mehdi E.; TOPRAK, HÜSEYİN; YILMAZ, TEMEL FATİH; SARI, LÜTFULLAH; BALSAK, SERDAR; UÇAN, VAHDETBackground: Some pathologies associated with abnormal patellar height have been reported in the literature. However, its relationship with some pathologies, such as anterior cruciate ligament mucoid degeneration (ACL-MD) and focal cartilage defect, has not been investigated. Purpose: To investigate the relationship between patellar height with patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and focal cartilage defect. Material and Methods: Magnetic resonance imaging of the knees of 261 patients were classified into three groups as normal, patella alta, and patella baja, and evaluated in terms of patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and focal cartilage defect. Results: There were 261 patients (140 men, 121 women; age range = 18–60 years; mean age = 30 ± 4.7 years). Of the 261 patients, 181 (69.3%) were normal, 56 (21.4%) were patella alta, and 24 were patella baja (9.1%). Patellar-quadriceps tendinopathy, quadriceps fat pad edema, and ACL-MD rates were significantly higher compared to the normal group (P <0.05). While a moderate positive correlation was found between patellar height shift and patellar-quadriceps tendinopathy and ACL-MD, there was a small correlation between patellar height shift and quadriceps fat pad edema. The rate of focal cartilage defect was significantly higher in the middle part of the lateral femoral condyle and lateral knee joint only in patella alta. Conclusion: The risk of patellar-quadriceps tendinopathy, quadriceps fat pad edema, ACL-MD, and lateral focal cartilage defect is higher in patients with alta-baja. The radiologist should evaluate these pathologies more carefully, especially subtle ones, in patients with abnormal patellar height.Publication Comparison of tapered-wedge short and standard-length femoral stems in single-stage bilateral direct anterior total hip arthroplasty(2021-08-01T00:00:00Z) UÇAN, VAHDET; EZİCİ, VOLKAN; ALIYEV, ORKHAN; UZER, GÖKÇER; TUNCAY, İBRAHİM; YILDIZ, FATİH; UÇAN, VAHDET; EZİCİ, VOLKAN; ALIYEV, ORKHAN; UZER, GÖKÇER; TUNCAY, İBRAHİM; YILDIZ, FATİHPurpose This study was performed to compare short and standard-length tapered-wedge-type femoral stems in single-stage bilateral total hip arthroplasty (THA) through a direct anterior approach (DAA). Materials and methods The patients were divided into two groups according to their femoral stem types as short tapered-wedge stem and standard-length tapered-wedge stem groups. Outcome parameters were the surgical time, estimated blood loss (EBL), length of stay (LOS), thigh pain, Harris Hip Score (HHS), and visual analog scale (VAS) score clinically, and canal fill ratio (CFR), coronal plan alignment of the stems, subsidence, and postoperative leg length difference (LLD), radiologically. Results The short-stem group and standard-length-stem group consisted of 20 patients (40 hips, mean age 52.0 +/- 14.1) and 22 patients (44 hips, mean age 49.4 +/- 11.9), respectively. There were no significant differences between the groups in terms of mean surgical times (p = 0.6), EBL (p = 0.2), LOS (p = 0.2), the rate of thigh pain (p = 0.4), improvements in HHS (p = 0.4) and VAS scores (p = 0.6), LLD (p = 0.3), amount of subsidence (p = 0.9), and varus or valgus misalignment (p = 0.7). The CFR at the level of the lesser trochanter was significantly higher in the short-stem group (0.79 +/- 0.1) than the standard-length-stem group (0.73 +/- 0.1) (p < 0.01). Conclusion In single-stage bilateral THA through DAA, short, tapered-wedge femoral stems provide similar radiographic and functional results to standard stems at short-term follow-up.