Browsing by Author "Haberal, Bahtiyar"

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Analysis of Risk Factors for Ultrasonographic Graf Type IIa (-) Hips in Developmental Dysplasia: A Hospital-Based Case-Control Study with Follow-Up Outcomes
(2021) Haberal, Bahtiyar; Sahin, Orcun; Tuncay, Ismail Cengiz; 0000-0002-1668-6997; 0000-0002-6035-6258; W-9080-2019; AAF-4032-2021
Objective: To examine the association of Graf type IIa(-) hips with maternal and infant risk factors in newborns and to evaluate the follow-up outcomes. Materials and Methods: Two different risk analyses were performed. In the first analysis, Graf type I hips were grouped as "controls," and Graf type II were grouped as "cases." In the second analysis, all the Graf type I and Type IIa(+) hips were grouped as "controls," and all Graf type IIa (-) hips were considered as "cases." Maternal age, presence of consanguinity, pregnancy, and smoking were considered as maternal risk factors. Sex, birth weight, gestational age, associated congenital anomalies, and family history were considered as infant risk factors. Further, we determined the risk factors for Graf type IIa and type IIa (-) hips. Results: The study population included 73 cases (11.4%) and 569 controls (88.6%), including 322 (50.2%) male and 320 (49.8%) female infants. Graf type IIa hips revealed significant differences for gestational age (>42 wk), birthweight (>3500 g), and maternal age (<= 20 y). At follow-up, all Graf type IIa(+) hips became Graf type I mature hips. In contrast, three Graf type IIa(-) hips (3/12, 25%) required additional treatment. Conclusion: Significant risk factors for Graf type IIa(-) hips were female sex, gestational age of >42 wk, and birthweight of >3500 g. Almost one-quarter of Graf type IIa (-) hips may require additional treatment. Thus, significant risk factors for Graf type IIa(-)should be remembered in clinical practice.
Biomechanical Comparison of Polymethylmethacrylate Augmentation Methods in Failed Pedicle Screw Revision
(2021) Haberal, Bahtiyar; Temiz, Abdulaziz; Tuncay, Ismail Cengiz; 0000-0002-1668-6997; 34374983; W-9080-2019
AIM: To compare biomechanical results between different polymethylmethacrylate (PMMA) augmentation methods on failed lumbar pedicle screw models of animal vertebrae. MATERIAL and METHODS: Thirty lumbar vertebrae were harvested from six calves, and their bone mineral density was measured. 60 Polyaxial pedicle screws were inserted to all vertebrae. Pull-out tests were performed to all specimens on an Instron machine. The specimens were randomly divided into four groups. The same screws used in primary screwing process were labeled and used in revision. Screws in the first group were augmented by injecting PMMA into the failed screw hole with a syringe; screws in the second group by inserting bone graft and roll-shaped PMMA, screws in the third group by inserting bone graft and injecting PMMA with a syringe; and the fourth group by inserting bone graft and injecting PMMA through a fenestrated pedicle screw. The pull-out strength (POS) results of all specimens were recorded and compared with statistical analyses. RESULTS: The mean BMD of the vertebrae was 1.31 +/- 0.225 g/cm2 and no significant difference was found between the groups (p>0.05). The mean POS of the primary screws in the first, second, third, and fourth groups were 2166,5 N/m2, 2183,5 N/m2, 2508,5 N/m2, and 2005c N/m2 respectively. After the augmentation, the mean POS in the first, second, third and fourth groups were 3839 N/m2, 2874 N/m2, 2929 N/m2 and 3826 N/m2 respectively. No statistical difference was found between the groups in post-revision POS values (p>0.05). CONCLUSION: There was no significant statistical difference found in POS between the augmentation methods.
The Correlation Between Knee Osteoarthritis and the ABO Blood Group System in A Turkish Population
(2021) Yaradilmis, Yuksel Ugur; Haberal, Bahtiyar; Demirkale, Ismail; Altay, Murat; 0000-0002-1668-6997; W-9080-2019
Aim: This study aimed to determine the validity of the relationship between primary knee osteoarthritis and the ABO blood group system in the Turkish population and whether ABO group system could be a risk factor for early-onset knee osteoarthritis or revision surgery. Material and Methods: A retrospective examination of the data of 2752 patients who underwent knee arthroplasty surgery in our clinic between 2011 and 2019 was carried out. A total of 2436 primary knee osteoarthritis (PKO) patients underwent total knee arthroplasty (TKA) surgery and 206 patients underwent revision knee arthroplasty (RKA). A control group was formed of 22350 individuals aged >40 years from the same geographical region. The frequency of the ABO subgroups (A, B, O, AB) was compared between the primary knee osteoarthritis group and the control group. In addition, ABO subgroups (A, B, O, AB) were determined in the group of patients aged <65 with knee osteoarthritis (early-onset knee osteoarthritis) or revision group. Results: In the PKO group, the female to male ratio was 8:1, and the mean age was 67.2 +/- 8 years. The most significant relationship between blood groups and osteoarthritis was found in Group A (p=0.001). Group AB had a significant but low relationship (p=0.002). However, no statistically significant difference was found between age <65 years and >65 years of age (p=0.642). In comparison with the PKO group and RKA, Group A in the revision group was seen at a statistically significantly higher rate (p=0.043). Discussion: Group A blood group was found to be associated with both primary knee osteoarthritis and revision knee arthroplasty.
Could radial extracorporeal shock wave therapy have an effect on wound healing in clinical practice by creating genotoxic damage? An in-vitro study in mouse fibroblasts
(2021) Simsek, Ekin Kaya; Haberal, Bahtiyar; Kasap, Yesim Korkmaz; Yurtcu, Erkan; 0000-0003-3438-1633; 0000-0002-1668-6997; 34842098; AAV-8821-2021; W-9080-2019
Objectives: This study aims to evaluate wound healing effects of in vitro radial extracorporeal shock wave (rESW) application on mouse fibroblasts and whether the cytotoxic effect of extracorporeal shock wave (ESW) was due to a possible genotoxic effect. Patients and methods: After creating an in vitro wound healing model in L929 mouse fibroblast culture, fibroblasts were stimulated with a frequency of 3 Hz, and 100, 250, 500, 1,000 and 1,500 pulses shock waves were applied. Energy flux densities ranging from 0.01 to 0.23 mJ/mm2 (14.3 MPa) at a constant pressure level of 0.5 and 1 bar were applied. Wound healing, cell viability, and genotoxicity were evaluated at 24 and 48 h. Results: All shot numbers for both pressures significantly reduced cell viability (p<0.05). For both 0.5 and 1 bar pressures, in both intervals, the rate of wound healing decreased, regardless of the number of shots (p<0.05). In vitro genotoxic damage was detected at both 0.5 and 1 bar pressures, in both time intervals, regardless of the number of shots. The genotoxic damage increased from 24 h to 48 h. Conclusion: The study results suggest that, when ESWT is applied in this in vitro experimental setup, cell viability decreases and wound healing is delayed under all conditions. Furthermore, genotoxic damage can be prevented by using shots below 1,000 pulses. Therefore, while investigating the therapeutic effect of ESW therapy in vitro, the upper limit for the number of shots should be 1,000 pulses.
Does an infra pectineal plate alone provide adequate fixation in anterior column posterior hemitransverse acetabular fractures? A comparative biomechanical study
(2022) Simsek, Ekin Kaya; Haberal, Bahtiyar; Mahmuti, Ates; Balcik, Bedi Cenk; Demirors, Huseyin; 0000-0002-1668-6997; 35920432; W-9080-2019
BACKGROUND: The purpose of this study is to compare biomechanical properties of suprapectineal (SP) plate fixation, infrapectineal (IP) plate fixation, and both SP and IP plate fixation in anterior column posterior hemitransverse (ACPHT) fractures of the acetabulum using posterior and anterior column screws. METHODS: In 21 hard plastic left hemipelvis models, ACPHT fractures of the acetabulum were created, and in three different fixation groups, the methods were compared: Group 1: SP plating using a 3.5 mm reconstruction plate and cortical screw fixation, Group 2: Infrapectineal plating using 3.5 mm reconstruction plate and cortical screws combined with posterior and anterior column screws, and Group 3: Combined fixation with SP and IP plating using 3.5 mm reconstruction plates and cortical screws. Maximum load to failure (strength) of these three groups was compared between groups. RESULTS: The mean maximum load of failure for three groups was 2921 N, 2018 N, and 3658 N, respectively. When strength was compared considering the force that causing implant failure, it was determined that the strongest fixation was achieved when SP and IP fixation method were applied together, followed by SP only fixation and IP fixation supported by anterior and posterior column screws, respectively. CONCLUSIONS: The combined application of SP and IP fixation provides the most stable fixation of the ACPHT acetabular fractures, and IP fixation does not provide comparable biomechanical stability despite reinforcement with three-column screws placed away from the plate. Although IP fixation supported by anterior and posterior column screws with the limited combined approach is less invasive approach for patients, SP fixation should be included in the surgical treatment method to ensure adequate stability.
Dynamic and Stabilometric Analysis After Syndesmosis Injuries A Comparative Study
(2020) Taskesen, Anil; Okkaoglu, Mustafa Caner; Demirkale, Ismail; Haberal, Bahtiyar; Yaradilmis, Ugur; Altay, Murat; 0000-0002-1668-6997; W-9080-2019
Background: Distal tibiofibular syndesmosis contributes to dynamic stability of the ankle joint and thereby affects gait cycle. The purpose of this study was to evaluate the grade of syndesmosis injury on plantar pressure distribution and dynamic parameters of the foot. Methods: Grade of syndesmosis injury was determined by preoperative plain radiographic evaluation, intraoperative hook test, or external rotation stress test under fluoroscopic examination, and two groups were created: group 1, patients with grade III syndesmosis injury (n = 17); and group 2, patients with grade II syndesmosis injury (n = 10). At the last visit, radiologic and clinical assessment using the Foot and Ankle Outcome Score was performed. Dynamic and stabilometric analysis was carried out at least 1 year after surgery. Results: The mean age of the patients was 48.9 years (range, 17-80 years), and the mean follow-up was 16 months (range, 12-24 months). No statistically significant difference was noted between two groups regarding Foot and Ankle Outcome Score. The comparison of stabilometric and dynamic analysis revealed no significant difference between grade II and grade III injuries (P>.05). However, comparison of the data of patients with grade III syndesmosis injury between injured and healthy feet showed a significant difference for dynamic maximum and mean pressures (P = .035 and P = .49, respectively). Conclusions: Syndesmosis injury does not affect stance phase but affects the gait cycle by generating increased pressures on the uninjured foot and decreased pressures on the injured foot. With the help of pedobarography, processing suitable orthopedic insoles for the injured foot and interceptive measures for overloading of the normal foot may prevent later consequences of ankle trauma.
Effects of Orthopedic Instruments Breakage During Surgery: A Minimum Five-Year Follow-Up
(2021) Haberal, Bahtiyar; Beyaz, Salih; 0000-0002-1668-6997; 0000-0002-5788-5116; W-9080-2019; K-8820-2019
Aim: The present study aims to investigate the the long-term effect of metallic orthopedic instruments that were broken and not removed during surgery on the health status of patients. Material and Methods: Radiographs of 12,601 patients (5765 females and 6836 males; mean age: 48.9 years; range: 0-105) who underwent orthopedic surgery in our clinic between January 2009 and January 2015 were screened. Thirty-six patients (13 females and 23 males; mean age: 45.3 years; range: 12-82) with metallic instruments, broken and not removed during surgery, were included in the study and minimum five-year follow-up radiographs of the patients were examined. Results: The rate of orthopedic instrument breakage during surgery was 0.28%. This was 0.64% in trauma cases and 0.08% in elective surgery cases. The broken instrument was a Kirschner wire (K-wire) in 16 (44.4%) cases, a screw in 14 (38.9%), and a drill bit in 6 (16.6%). The rate of instrument breakage was 7.44 times higher in trauma cases than in elective surgery cases, which was statistically significant (p = 0.001). Only 1 patient required reoperation for the broken instrument 7 years later. No surgical notes regarding broken implants were identified in patient files. Discussion: Instruments that are broken and not removed during surgery do not cause any complication if they are entirely within the bone. Nevertheless, any instance of instrument breakage should be documented, and the patient should be informed about the condition and followed closely.
Evaluation of quality and reliability of YouTube videos on spondylolisthesis
(2020) Yaradilmis, Yuksel Ugur; Evren, Ali Teoman; Okkaoglu, Mustafa Caner; Ozturk, Ozkan; Haberal, Bahtiyar; Ozdemir, Mahmut; 0000-0002-1668-6997; W-9080-2019
Background: YouTube is the most popular and the largest video portal and is a source of information in all areas. In our study, we aim to investigate the quality of videos on spondylolisthesis in the YouTube video portal and to detail the parameters for low-quality videos. Material and methods: A search was made by using keyword "spondylolisthesis" on the YouTube search portal. 50 most watched videos were included in the study. The duration of the videos, view counts, like counts, dislike counts, number of comments, the date the video was published, and the video's release time were noted. Popularity of the video is determined by Video Power Index (VPI) and video quality is evaluated with DISCERN (Quality Criteria for Consumer Health Information), JAMA (Journal of the American Medical Association), and Global Quality Score (GQS) scoring systems. Video content was categorized as physician and non-physician, video length, release date, view count, daily view count, VPI, comments/year. The relationship between the groups and video quality was evaluated. Results: Video uploaders consist of 27 physicians (54%), 7 health channels, 6 physiotherapists, 4 patients, 4 hospital channels, 1 chiropractic, 1 fitness coach. The mean JAMA score was 2.7 +/- 0.6 (1-4), the mean DISCERN score was 35 +/- 11.1 (16-64) and the mean GQS score was 2.84 +/- 1.05. DISCERN, JAMA, and GQS scores correlate among themselves. In linear regression analysis, there was a significant difference between the duration of the videos, the view counts and the video quality scores (DISCERN and JAMA) (p < 0.05), no significant difference was observed between the daily view counts, like counts, dislike counts, VPI and comment count (p > 0.05). Conclusion: The video quality of videos on Spondylolisthesis on YouTube was found to be low. Especially videos by non-physician uploaders, short videos, most viewed videos were found to have low quality.
Impact of radial extracorporeal shock wave therapy in post-laminectomy epidural fibrosis in a rat model
(2021) Haberal, Bahtiyar; Simsek, Ekin Kaya; Akpinar, Koray; Simsek, Duygu Turkbey; Sahinturk, Fikret; https://orcid.org/0000-0002-1668-6997; https://orcid.org/0000-0003-3438-1633; https://orcid.org/0000-0002-0471-3177; 33463432; W-9080-2019; AAV-8821-2021; AAI-7972-2021
Objectives: This study aims to investigate the effect of radial extracorporeal shock wave therapy (rESWT) treatment in the prevention of epidural fibrosis after laminectomy in rats. Materials and methods: Eighteen 16-month-old male Sprague-Dawley rats weighing 300 g were used in this experimental study between November 2019 and February 2020. The rats were randomly divided into two groups as the control group (L3-L4 total laminectomy without any treatment) and the study group (L3-L4 total laminectomy plus rESWT). The rats were sacrificed at the postoperative sixth week and the lumbar spine was excised en bloc, fixed, and decalcified. Sections were stained with hematoxylin-eosin to evaluate epidural fibrosis, acute inflammation, chronic inflammation, and vascular proliferation. Results: The median value and standard deviations were obtained based on histological examinations. Accordingly, epidural fibrosis decreased significantly in the study group compared to the control group. There was no statistically significant difference between the groups in terms of acute and chronic inflammation response and vascular proliferation. Conclusion: The rESWT application immediately after surgery is effective in preventing epidural fibrosis after laminectomy in rats.
In Vivo Study of The Role of Hyaluronic Acid, N-Acetyl Cysteine, and Deproteinized Calf Serum on Injury-Induced Cartilage Degeneration
(2023) Ozdemir, Mahmut; Birinci, Baris; Haberal, Bahtiyar; Atilgan, Alev Ok; Demirkale, Ismail; https://orcid.org/0000-0003-2674-9549; https://orcid.org/0000-0002-1668-6997; https://orcid.org/0000-0001-8595-8880; 36700278; HOH-2091-2023; W-9080-2019; AAK-3333-2021
Objectives: The aim of this study was to compare the effects of hyaluronic acid ( HA), N-acetyl cysteine ( NAC), and deproteinized calf serum on cartilage healing after the creation of traumatic cartilage injury in a rat model. Materials and methods: A total of 48 rats, each weighing an average of 350 g, were randomly separated into four groups of 12. An osteochondral defect was created, 2-mm-wide and 3-mm deep in each rat. Injections were made to the knees of the rats as saline solution in Group 1, deproteinized calf serum in Group 2, NAC in Group 3, and HA in Group 4. At the end of 12 weeks, all rats were sacrificed and tissues were evaluated histologically. Results: The HA group had a better cell morphology, tissue morphology, surface architecture, and vascularity than the other groups (p < 0.001). Matrix staining, chondrocyte clustering, and the assessment scores of the mid, deep, superficial zones, and overall were higher in the HA group than in the other groups (p < 0.001). The NAC showed a better tissue morphology, cell morphology, and vascularity than the control group (p= 0.003, p < 0.001, and p < 0.001, respectively). Conclusion: Hyaluronic acid was the most effective agent in cartilage healing compared to NAC and deproteinized calf serum. In addition, the NAC was more effective compared to the control group.
Is simple decompression enough for the treatment of idiopathic cubital tunnel syndrome: A prosoective comparative study analyzing the outcomes of simple decompression versus partial medial epicondylectomy
(2020) Sahin, Orcun; Haberal, Bahtiyar; Sahin, Mehmet Sukru; Demirors, Huseyin; Kuru, Ilhami; Tuncay, Ismail Cengiz; 0000-0002-2457-0935; 0000-0001-5856-8895; 0000-0001-7677-8423; 0000-0002-1268-1451; 0000-0002-6035-6258; 0000-0002-1668-6997; 32962585; AAJ-5273-2021; AAF-3988-2021; AAJ-9972-2021; AAJ-4341-2021; AAF-4032-2021; W-9080-2019
Objectives: This study aims to compare the clinical and functional outcomes of simple in-situ decompression and partial medial epicondylectomy for the treatment of idiopathic cubital tunnel syndrome (CuTS). Patients and methods: Between March 2014 and December 2016, 71 patients (31 males. 40 females: mean age 46.7 years: range. 38 to 62 years) with CuTS scheduled to undergo simple in-situ decompression (group 1) or partial medial epicondylectomy (group 2) were prospectively reviewed. All patients were analyzed with clinical examination (Tinel sign. Froment's and Wartenberg's signs, elbow flexion test, subluxation), and McGowan scores before and after surgery. Final outcomes were reviewed with Wilson and Krout grading system. Results: There was no significant difference between the study groups in regard to Wilson and Krout grading and McGowan scores postoperatively. Group 1 had significantly better grip and key pinch strength values compared to group 2 at the final follow-up control. Conclusion: In-situ decompression and partial medial epicondylectomy represent efficient and safe methods for the treatment of idiopathic CuTS. When their efficiency is compared. in-situ decompression had better grip and key pinch strength values and more excellent outcomes compared to partial medial epicondylectomy.
Lack of association between MMP13 (rs3819089), ADAM12 (rs3740199-rs1871054) and ADAMTS14 (rs4747096) genotypes and advanced-stage knee osteoarthritis
(2021) Haberal, Bahtiyar; Simsek, Ekin Kaya; Cebi, Hatice Pinar Baysan; Tuc, Ozer; Verdi, Hasibe; Atac, Fatma Belgin; 0000-0002-1668-6997; 0000-0002-9141-9987; 0000-0002-2228-6893; 0000-0003-0591-009X; 34145804; W-9080-2019
Objectives: The aim of this study was to investigate the relationship between MMP13 rs3819089, ADAM12 rs3740199 and rs1871054, and ADAMTS14 rs4747096 genotypes in patients with radiologically diagnosed knee osteoarthritis (OA). Patients and methods: A total of 300 patients (68 males, 232 females; mean age: 61.6 years; range, 25 to 89 years) who were admitted to the orthopedics and traumatology clinic and diagnosed with knee OA according to the 2000 American College of Rheumatology (ACR) criteria between October 2018 and March 2019 were prospectively analyzed. Patients with Grades III-IV OA according to the KellgrenLawrence (K-L) grading system were included in the patient group (n=150) and those without radiological features of knee OA (K-L Grades I-II) were included in the control group (n=150) voluntarily. The presence of single nucleotide polymorphisms (SNPs) in the targeted genes in both groups was assessed by real-time polymerase chain reaction in the peripheral blood sample. Results: The most common nucleotides in both the control and patient groups were CG for rs3740199 and CT for rs1871054 in the ADAM12 gene, and the most common nucleotides in alleles were GG for MMP13 rs3819089 and AA for ADAMTS14 rs4747096. No statistically significant relationship was detected between the gene polymorphisms and advanced OA. Conclusion: The study results suggest that ADAM12 rs3740199 and rs1871054, MMP13 rs3819089, and ADAMTS14 rs4747096 polymorphisms have no relationship with knee OA susceptibility in the Turkish population. However, as this is the first study to investigate the relationship between the SNPs of ADAM12, ADAMTS14, and MMP13 genes and the development of OA in the Turkish population, it would contribute to our understanding of the molecular bases of OA.
The mid-term effects on quality of life and foot functions following pilon fracture
(2020) Yaradilmis, Yuksel Ugur; Okkaoglu, Mustafa Caner; Kilic, Alparslan; Haberal, Bahtiyar; Demirkale, Ismail; Altay, Murat; 0000-0002-1668-6997; 32946104; W-9080-2019
BACKGROUND: Although pilon fractures are uncommon, they are of importance to orthopaedic surgeons because of the difficulty of treatment. Poor outcomes and high complication rates are seen despite various surgical methods. This study aims to examine the changes affecting the quality of life and foot functions in patients applied with open reduction and internal fixation (ORIF) for a pilon fracture. METHODS: In this study, a total of 45 patients treated with ORIF for a pilon fracture in our clinic between January 2010 and December 2016 were evaluated with AOFAS and SF-12 in a total of 10 categories according to demographic data, fracture classification and surgical technique. In addition to functional values, patient records were examined regarding complications, including infection, soft-tissue defect, malalignment, non-union, arthrosis and Sudeck atrophy. In patients with AOFAS <85 and low SF-12 scores, variables were examined and the relationship with complications was evaluated. RESULTS: The mean follow-up period was 3.7 years (range 2 to 7). The AOFAS value was determined to fall to <85 when the Ruedi Allgower classification increased (p=0.010), when AO classification increased (p=0.020), when there was a concomitant lateral malleolar fracture (p=0.028), and when the status was non-anatomic according to the Ovadia Bell criteria (p=0.031). The SF-12 PCS value was observed to decrease when the Ruedi Allgower classification increased ( p=0.018) and when the status was non-anatomic according to the Ovadia Bell criteria (p=0.012). A correlation was determined between the SF-12 PCS and the AOFAS values (p=0.000). CONCLUSION: The reasons for the failure of ORIF in tibia pilon fractures were found to be Ruedi 3 classification, concomitant lateral malleolar fracture, and non-anatomic surgical reduction. Failure in foot functions has a direct effect on quality of life in both the short and mid term.
Outcomes for core decompression with multiple drilling of the osteonecrosis of the femoral head in patients with solid organ transplantation
(2018) Haberal, Bahtiyar; Sahin, Orcun; Simsek, Ekin Kaya; Mahmuti, Ates; Tuncay, Ismail Cengiz; 30376800
Objectives: This study aims to investigate the clinical and radiological outcomes of core decompression surgery performed with multiple drilling in solid organ transplantation patients with osteonecrosis of femoral head (ONFH) and evaluate the effectiveness of this procedure in regard to duration of corticosteroid use and stage of osteonecrosis. Patients and methods: A total of 22 solid organ transplantation (kidney, liver or heart) patients (14 males, 8 females; mean age 43.3 years; range. 23 to 67 years) who were scheduled to undergo core decompression surgery with multiple drilling for ONFH were evaluated. Patients' Harris hip scores (HHSs) and radiographic data including Association Research Circulation Osseous (ARCO) staging and Kerboul grading were retrospectively reviewed at pre- and postoperative controls. Results: Patients were followed-up for mean 34.3 months (range, 12 to 76 months). Two patients (9.09%) were performed total hip arthroplasty. These two patients' Kerboul grade was 3. There was no statistically significant relationship between preoperation and postoperative final control in terms of ARCO staging. There was no statistically significant difference between pre- and postoperative HHSs. Conclusion: Although multiple drilling is a safe and minimally invasive surgery, its effect is limited, particularly in solid organ transplantation patients with ONFH due to long-term corticosteroid use. Therefore, solid organ transplantation patients should be closely monitored in terms of ONFH development.
Persistent infection of Mycobacterium tuberculosis in a patient with Behcet's disease after rotator cuff repair surgery: A case report
(2021) Haberal, Bahtiyar; Simsek, Duygu Turkbey; Kuru, Ilhami; 0000-0002-1668-6997; 34842115; W-9080-2019
Tuberculosis (TB) infection is a common health problem in low socioeconomic populations in developing countries. Osteoarticular TB is a disease that rarely occurs outside the vertebral column and is often diagnosed late or misdiagnosed, particularly in non-weight bearing joints. A 51-year-old female patient with Behcet's disease presented with shoulder TB following rotator cuff repair surgery, leading to joint resection as a result of recurrent infections with no reproduction in culture samples due to delayed diagnosis. Surgical excision was proposed for the treatment of draining a mass with a sinus tract opening into the joint on the anterior aspect of the right shoulder. A diagnosis was able to be reached after 13 operations, based on the presence of TB bacilli in the pathological examination of the samples. In conclusion, TB should be considered in the absence of reproduction in culture samples taken during persistent post-surgical infections.
Tam kat kıkırdak hasarlarının pedikülü ve serbest sinoviya grefti ile tedavisi: hayvan modelinde karşılaştırılmalı çalışma
(Başkent Üniversitesi Tıp Fakültesi, 2015) Haberal, Bahtiyar; Şahin, Orçun
Eklem kıkırdak hasarına bağlı olarak ortaya çıkan osteoartrit dünyada en sık görülen kas-iskelet sistemi hastalığı olup önemli bir sağlık sorunudur. Osteoartrit bir kere oluştuktan sonra ciddi tedavi maliyetlerine sebep olduğu için araştırmacılar dejeneratif kalıcı değişiklikler oluşmadan önleyici tedavi yöntemlerine yönelmişlerdir. Bu amaçla birçok yöntem denenmiştir ve günümüzde bu konu yoğun olarak çalışılmaktadır. Bizim bu çalışmadaki amacımız, tavşan modelinde oluşturulan travmatik eklem kıkırdak defektlerinin onarımında pediküllü ve serbest sinoviya grefti uygulamalarını birbirleriyle ve kontrol grubuyla karşılaştırarak iyileşme üzerine etkilerini histolojik olarak değerlendirmektir. Bu amaçla beyaz Yeni Zellanda cinsi 24 adet tavşan kullanıldı. 24 tavşan 2 eşit gruba ayrılarak defekt oluşturulduktan sonra bir grupta sağ dizlere pediküllü sinoviya grefti, diğer grupta serbest sinoviya grefti uygulandı. Sol dizler kontrol grubunu oluşturdu. Her iki gruptan 6 adet tavşan 4 hafta, 6 adet tavşan 8 hafta boyunca takip edildikten sonra sakrifikasyon gerçekleştirildi ve histolojik inceleme yapıldı. Sonuç olarak, kontrol dizlerle işlem yapılan dizler karşılaştırıldığı zaman hem pediküllü hem de serbest sinoviya greftinin kıkırdak dokuyu anlamlı olarak iyileştirildiği gösterilmiştir; ancak pediküllü greft yapılan grupta bu ilişki istatistiksel olarak daha anlamlı bulunmuştur. Her iki grupta 4. hafta sonuçları istatistiksel olarak anlamlı çıkarken, 8. hafta sonuçları istatistiksel olarak anlamlı bulunmamıştır. Osteoarthritis due to articular cartilage defects is the most common muculoskeletal disease in the world. As serious treatment costs may occur once osteoarthritis ensues, researchers began to prefer preventive treatments in order to reduce these costs. Various methods have been tested for his purpose and this is still a current intriguing research area. The aim of this study is to evaluate the effect of pedunculated synovial grafts and free synovial grafts histologically in the repair of traumatic articular cartilage defects created in a rabbit model. For this purpose twenty four New Zealand white rabbits were divided into two groups of 12 rabbits each. After inducing cartilage defects into the medial condyles, pedunculated synovial grafts were transplanted to the right knees in the first group. In the second group free synovial grafts were applied to the right knees. Left knees formed the control group. At the fourth and eighth weeks, 6 rabbits from each group were sacrificed. The samples were examined histologically. As a result, when control knees were compared with grafts, it was seen that both pedunculated and free synovial grafts had repaired the defective cartilage tissue. This association was found to be more statistically significant in the pedunculated synovial graft group. While the results from the fourth week were statistically significant for both of the study groups, this significance was not observed at the eight week.
Treatment of Full-Thickness Cartilage Defects with Pedunculated and Free Synovial Grafts: A Comparative Study in an Animal Model
(2020) Haberal, Bahtiyar; Sahin, Orcun; Terzi, Aysen; Simsek, Ekin Kaya; Mahmuti, Ates; Tuncay, Ismail Cengiz; 0000-0002-6035-6258; 0000-0001-5856-8895; 0000-0002-1668-6997; 32850038; AAF-4032-2021; AAF-3988-2021; W-9080-2019
Aims and Objectives The purpose of this study was to compare the potential effects of pedunculated and free synovial grafts in the repair of full-thickness articular cartilage defects on an animal model with histological and immunohistochemical analysis. Materials and Methods A comparative study in an animal model was performed with 24 rabbits, divided into two groups. Full-thickness cartilage defects were created bilaterally on the knees of all rabbits. Pedunculated and free synovial grafts were applied to the right knees of Group 1 and Group 2, respectively. Left knees were left as the control group. Six rabbits from each group were randomly selected for euthanasia 4 and 8 weeks postoperatively. All samples were examined histologically with a cartilage scoring system. For immunohistochemical analysis, the degree of collagen 2 staining was determined using a staging system. All data were statistically compared between the study groups with Student's t-test or Mann-Whitney U-test. The correlations between categorical variables were analyzed with Fisher's exact test and Chi-square test. Results In Group 1, the mean defect size had significantly decreased at 8 weeks postsurgery. It was also significantly smaller than that of Group 2. Both pedunculated and free synovial grafts had significantly better histological and immunohistochemical outcomes compared with the controls. Contrastingly, the results of comparison between the study groups (Group 1 vs. 2) at the 4th and 8th week were not statistically significant with regard to histological scores and immunohistochemical staining. Conclusion Synovial tissue, whether pedunculated or free, provided much better cartilage recovery compared with the control. It can be used as a mesenchymal stem cell (MSC) source, and synovium-derived MSCs have the chondrogenic potential for the in vivo treatment of full-thickness cartilage defects.
Use of Generalizability Theory Evaluating Comparative Reliability of the Scapholunate Interval Measurement With X-ray, CT, and US
(2023) Kuru, Cigdem Ayhan; Sezer, Rahime; Cetin, Can; Haberal, Bahtiyar; Yakut, Yavuz; Kuru, Ilhami; 0000-0003-3173-1757; 0000-0003-4613-1607; 0000-0002-1668-6997; 36604227; W-9080-2019
Rationale and Objectives: There is no universally accepted standard technique for measuring the scapholunate interval and no specific sources of measurement error have been identified. We aimed to establish a set of normal radiological criteria for the scapholunate interval that could be used in comparative studies of wrist pathology to determine interobserver reliability and to identify potential errors that might influence measurements.Materials and Methods: A total of 60 healthy volunteers participated in the study. Scapholunate interval was measured by three independent observers using X-ray, CT, and US in four positions, including neutral, fist, radial and ulnar deviation. Inter-observer reliability was tested using intraclass correlation coefficient. Generalizability theory was applied to evaluate specific sources of measurement error related to participant, observer, imaging modality and measurement position.Results: In neutral position, the scapholunate interval measured by X-ray, CT, and US was 3.1 mm, 3.5 mm and 3.5 mm respectively. The interval remained constant during fist and radial deviation but decreased during ulnar deviation. Correlation coefficients ranged from 0.874 to 0.907 for X-ray, 0.773-0.881 for CT and 0.964-0.979 for US. In the generalizability study, the participant x modality x position interaction accounted for the largest proportion of total variance (29%).Conclusion: X-ray, CT, and US are reliable modalities for measuring the scapholunate interval, with US having the highest reliability. Participant and position factors may independently contribute to measurement error. Therefore, standardized measurement positions are recommended to obtain reliable measurement results.