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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 564 - 564
1 Dec 2013
Eren UE Tuzun HY Yildiz C Akyildiz F Ozkan H Ozturk K Tunay S
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Arthroplasty is a successfulsurgical procedure which provides returning daily activities by relieving pain, correcting deformity, and regaining the loss of ROM which is caused by many diseases such as degenerative arthritis when conservative and other surgical techniques fail to achieve. Successful outcomes depend on many variables at arthroplasty. Proper indication, careful selection of patient, adequate surgical technique and postoperative rehabilitation plays a major role.

Despite successful outcomes achieved at arthroplasty, undesired complications can be frustrating for the patient and the surgeon. These complications can be minimized by careful preoperative planning, meticulous surgical procedure and rigorius postoperative care.

Infection is the most frequent and most effective complication on outcomes after arthroplasty. Because of that, risk factors for infection must be researched carefully and minimized preoperatively. Antibiotic prophylaxis is routinely suggested before the surgery. Using routine irrigation as well as the standard surgical technique is effective for decreasing postoperative infection rates. Antibiotic impregenated cement is used especially at revision arthroplasties and should be used at primary surgery at high risk groups.

In this study we evaluated 19 patients which admitted to Gulhane Military Academy of Medicine, Department of Orthopedics and Traumatology betwen 2007 and 2012. 5 patients had total hip arthroplasty (26.32%), 11 patients had total knee arthroplasty (57.89%) and 3 patients had hip hemiarthroplasty after femoral neck fractures. 14 of the patiens were female (73.68%) and 5 were (26,32%). Mean age was 69.74 (53–83). Primary surgery was held at our institution at 14 of the patients and 5 patients were referred from other instutitions because of their complaints.6 of the knees were right-sided and 5 of them was left-sided. 3 of the totap hips were left-sided and 2 of them was right-sided. 1 of the hip hemiarthroplasties were left-sided and 2 of them was right-sided. 42.11%of the patients were treated medically and 47.37%were treated with two staged surgery. 42.11%of the surgically treated group were healed completely and 5.26%of the patients passed away due to other comorbidities. Wound debridement was applied 10.53%of the patients which were admitted at early phase and resection arthroplasty was applied 5.26%of these patients because of the lack of response to medical and surgical debridement.

With these results, patients with infected prosthesis can present with many different symptoms and infection risk must always be considered. It must be remembered that the onset time of infection is very important during diagnosis and treatment. Follow ups and treatment protocols must be standardized by clinics as algorithms. During the treatment the surgeon must be in close contact with infectious diseases and microbiology departments. Especially by new developing techniques during the recent years, spesific agents of the infection can be determined and spesific antibiotics can be used for the treatment.


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 470 - 470
1 Dec 2013
Tatar O Tuzun HY Ozturk K Eyi YE Ozkan H Yurttas Y Yildiz C Tunay S Basbozkurt M
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Developmental hip displasia (DHD) still presents as an important problem in our country. Latency in diagnosis and inaccurate treatment causes seconder osteoarthritis in young adults and elder patients. Variable reconstructive surgical procedures as proximal femoral and acetabular osteotomies can be performed, but the most satisfactory functional results are achieved by total hip arthroplasty (THA). In this study, we analyzed the results of the cementless total hip arthroplasties performed in coxarthrosis secondary to developmental hip displasia. Between January 2006 and October 2009, 53 patients diagnosed with hip osteoarthritis secondary to DHD, whom performed 59 total hip arthroplasties in GATA Orthopaedics and Traumatology Clinic were included in the study. 10 of the patients were male (%19), and 43 of them were female (%81). Age of the patients varied between 29 and 78 years and the mean age was 48,7. In 23 patients (%44), THA procedure was performed at the right hip and in 24 patients (%45) at the left hip. 6 patients operadted bilaterally. All patients were followed up 8–38 months (mean 20, 6 months) with clinical and radiological evaluation. The hospitalization period varied between 7–14 days, mean 8,3 days. Posterolateral incision was used at all of the patients. Totally 10 (%17) complications were observed. 5 (%8,5) of them was intraoperative and 5(%8,5) was postoperative. Patients evaluated preoperatively and postoperatively with modified Harris Hip Score. While preoperative mean Harris score was 39,1, the postoperative mean score measured as 90,3. The results were excellent in 52 cases (%88,1), and very good in 7 cases (%11,9). Appropriate implementation of cementless total hip prosthesis in patients with hip osteoarthritis secondary to DHD, who have good bone quality and surgical indicaton; clinical and radiological short term results were satisfactory.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_II | Pages 278 - 279
1 May 2010
Kurklu M Yildiz C Caferov A Serdar M Karaçalioglu Ö Deveci S Köse Ö Basbozkurt M
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Objective: The aim of this experimental study was to evaluate the effects of alpha-tocopherol on new bone formation by distraction osteogenesis.

Materials and Methods: Tirthy New Zealand white rabbits were randomly divided into 2 groups. Bone lengthening was performed in the right tibia through distraction osteogenesis at a rate of 0,5 mm/day for 20 days with circular external fixator (CEF). While the experimental group rabbits were administered i.m. 20mg/kg alpha tocopherol daily starting at the first day of study lasting for 20 days, control group rabbits did not receive any corresponding treatment. Radiographic examination were performed at 20th, 30th and 40th days. Scintigraphic evaluation for osteoblastic activity was at 5th and 20th day of the study. Serum total antioxidant capacity (TAC) was measured at first day and 20th day of the study. All animals were sacrificed at the end of the consolidation period of 40 days. The right tibia of all animals were removed and evaluated by histopathologic examination. Results were compared between groups and statistically analysed. A p value less than 0.05 is considered as significant in 95% confidence interval.

Results: At the 20th day, radiologic scores were statistically similar in both groups. However, at the 30th and 40th days, experimental group demonstrated statistically significant high radiologic scores and visible callus formation, maturation and remodelling. Scintigraphic baseline study at 5th day of study showed statistically similar osteoblastic activity in both groups. However, at the 20th day osteoblastic activity was significantly higher in experimental group. Serum TAC values were also significantly higher in experimental group at 20th day. At necropsy, experimental group rabbits got statistically significant high scores in histopathologic examination and showed the formation of mature bone.

Conclusions: Results of this study showed that alpha-tocopherol had beneficial effects on new bone formation by distraction osteogenesis. Administration of supplemental alpha tocopherol in patients treated with distarction osteogenesis may shorthen the framing time and increase the quality of regenerated bone.


The Journal of Bone & Joint Surgery British Volume
Vol. 82-B, Issue 3 | Pages 462 - 462
1 Apr 2000
ATESALP S YILDIZ C