Browsing by Author "Ozalay, Metin"

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Comparision of PFN and INTERTAN nail for unstable intertrochanteric femoral fracture in mobile patients
(2019) Kochai, Alauddin; Uysal, Mustafa; Ozalay, Metin; Cinar, Bekir Murat; Battal, Vahid; Avci, Mustafa Cagri
Objectives: The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. Intramedullary nails with different varieties of design offer good options in treatment. The aim of this study was to compare two intramedullary nails in different design and reveal the differences by evaluating radiological parameters of patients with unstable intertrochanteric femoral fracture in mobile patients. Material and Method: PFN and INTERTAN nails in two groups were compared overall in 63 patients. Reduction quality and the differences on varus collapse and neck shortening of femur by measuring radiological parameters on early and late postoperative X-rays were examined. Results: Similar radiological results were found between PFN and INTERTAN nails. Reduction quality of fractures was similar between groups. There was a significant difference only in the varus collapse degrees between groups (p<0,001) but no difference in neck shortening. The results revealed that INTERTAN has better resistance to occur varus collapse and the same prevention for neck shortening. Conclusion: Implant design is the one of major factors that may affect the results. INTERTAN nail made a difference in varus collapse of the neck but not in neck shortening. The results of this study have shown that the nail with two adjacent lag screws provides slightly better fixation properties preventing varus collapse than the nail with two separate lag screws. INTERTAN and PFN are currently good options in the treatment of unstable intertrochanteric femoral fractures and sustain enough stability during healing period in mobile patients.
Comparison of Clinical and Radiological Parameters with Two Different Surgical Methods for Anterior Cruciate Ligament Reconstruction
(2020) Ciloglu, Osman; Cicek, Hakan; Yilmaz, Ahmet; Ozalay, Metin; Soker, Gokhan; Leblebici, Berrin; 0000-0002-6241-268X; 32392610; AAM-3220-2021
This study compared the clinical and radiological findings of nonanatomic transtibial (TT) technique with intraspongious fixation and anatomical anteromedial portal (AMP) technique with extracortical button implant in anterior cruciate ligament (ACL) reconstruction. A total of 54 patients with isolated ACL rupture were included in this prospective study. The patients who had the intraspongious fixation by nonanatomical TT technique were allocated to Group 1 (n = 27). The patients with extracortical fixation by anatomical AMP technique were placed in Group 2 (n = 27). The clinical scores of the patients were evaluated with the International Knee Documentation Committee Evaluation Form, Tegner activity score, and Lysholm II Functional Scoring. The tibial and femoral tunnels were evaluated with three-dimensional computed tomography. The kinematic examinations were performed with a Biodex System 3 Pro isokinetic dynamometer. There was no significant difference between the groups in terms of demographic data (p > 0.05). The postoperative clinical scores improved significantly in both the groups compared with the preoperative levels (p = 0.001), but there was no significant difference in the postoperative clinical scores between the groups (p > 0.05). In the extension and flexion of 60 to 180 degrees/s, the peak torque and the peak torque/body weight values of the repaired knee to intact knee ratios showed significant differences in favor of Group 2 (p = 0.001). In both the groups, no significant difference was found between the mean extent of the tunnel enlargement (p > 0.05). The mean tunnel height was significantly greater in Group 1 (45% +/- 9.86 vs. 34.11% +/- 10.0%) (p = 0.001). When the localization of the tunnel enlargements (proximal-middle-distal) was examined, a significant difference was found between the groups (p = 0.001). Although the AMP technique, which is a more anatomic reconstruction, had an advantage with regard to tunnel enlargement and the isokinetic muscle studies, there was no difference between the two techniques in terms of the clinical results.
Effect of PLIF and TLIF on sagittal spinopelvic balance of patients with degenerative spondylolisthesis
(2018) Ozalay, Metin; Uysal, Mustafa; Derincek, Alihan; Kochai, Alauddin; Turker, Mehmet; 29705297
Objective: The aim of this study was to evaluate the effects of PLIF and TLIF on sagittal spinopelvic balance and to compare radiological results of two surgical procedures with regard to spinopelvic parameters. Methods: Thirty-five patients (34 female and 1 male; mean age: 52.29 +/- 13.08 (range: 35-75)) with degenerative spondylolisthesis cases were included in the study. Patients were divided into two groups according to surgical technique: PLIF and TLIF. The level and the severity of listhesis according to Meyerding classification were assessed and spinopelvic parameters including sacral slope, pelvic tilt, pelvic incidence (PI), lumbar lordosis, and segmental lumbar lordosis were measured on digital X-rays. All preoperative and postoperative parameters and the results were compared between two groups. Results: The age distribution was similar in both groups (p = 0.825) and there was no difference between the mean PI of the groups (p = 0.616). In 15 patients, spondylolisthesis level were at the L5-S1 level (PLIF: 8, TLIF: 7), in 16 patients at the L4-L5 level (PLIF: 6, TLIF: 10) and in 4 patients at the L3-L4 level (PLIF: 2, TLIF: 2). According to Meyerding classification, before the operation, the sliding grades were 0 in 4 patients, 1 in 21 patients, 2 in 7 patients, and 3 in 3 patients. The grades changed into 0 in 28 patients, 1 in 5 patients, and 2 in 2 patients after surgery. There were no differences in the grade of listhesis between PLIF and TLIF groups preoperatively (p = 0.190) and postoperatively (p = 0.208). In both groups, the spondylolisthesis-related deformities of patients were significantly corrected after surgery (p < 0.001). Conclusion: PLIF and TLIF techniques have similar radiological results in restoring the sagittal spinopelvic balance in patients with degenerative spondylolisthesis. Both techniques are good options to achieve reduction and fusion in patients with degenerative spondylolisthesis, but have no advantage over each other for restoring spinopelvic balance. (C) 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.
Restoration of pull-out strength of the failed pedicle screw: biomechanical comparison of calcium sulfate vs polymethylmethacrylate augmentation
(2014) Guler, Umit Ozgur; Derincek, Alihan; Hersekli, Murat Ali; Ozalay, Metin; Cinar, Bekir Murat; Acaroglu, Emre
Objective: The aim of the present study was to compare calcium sulfate (CAS) and polymethylinethaaylate (PMMA) bone cements used for the augmentation of a failed pedicle screw with biomechanical pull-out strength (POS) testing. Methods: Thirty lumbar vertebrae were harvested from 6 calves and bone mineral densities (BMD) were measured. Primary polyaxial pedicle screws were randomly inserted and pulled out and the POSs of the specimen were recorded. For revision, specimens were randomly assigned to the CAS-augmented pedide screws group (Group 1) or PMMA-augmented pedicle screw group (Group 2). Pull-out tests were repeated to compare both groups. Results: Mean BMD of the specimens was 1.006 +/- 0.116 g/cm(2). There were no statistically significant differences between BMD results of the two groups (p=0.116). For Group 1, mean POS of primary screws was 2,441.3 +/- 936.4 N and was 2,499.5 +/- 1,425.1 N after CAS augmentation, demonstrating no statistically significant difference (p=0.865). In Group 2, mean POS of the primary screws was 2,876.6 +/- 926.6 N and significantly increased to 3,745.5 +/- 1,299.2 N after PMMA augmentation (p=0.047). There was also a significant difference in mean POS between the CAS and PMMA groups (p=0.026). Conclusion: Although CAS augmentation facilitates a revision screw POS as strong as that of primary screws, it is not as strong as PMMA augmentation.
Spinal Metastatic Disease Survival Analysis of 146 Patients and Evaluation of 4 Different Preoperative Scoring Systems
(2020) Derincek, Alihan; Guler, Umit O.; Uysal, Mustafa; Ozalay, Metin; 0000-0002-5375-635X; 31393277; AAJ-4844-2021; O-7590-2017
Study Design: This was a retrospective analysis. Objective: The objective of this study was to evaluate the predictive value of the 4 different scoring systems Tomita, Bauer modified, Tokuhashi revised, and Van der Linden and some parameters that are used in these scoring systems. Summary and Background Data: Prediction of the survival period before treatment for spinal metastasis is extremely important. A lot of scoring systems have been described to predict the survival periods and to select the ideal treatment modality in the literature. Materials and Methods: Retrospectively 146 patients with spinal metastasis were investigated between 2002 and 2011. The following parameters were analyzed: age, pathologic vertebra fracture, neurological deficit, visceral metastasis, diagnosis of primary tumor and its spinal metastasis interval, other skeletal metastasis, involved region of vertebra, and undergone spinal surgery. Patients were also scored by the 4 different scoring systems. The survival period was calculated from date of diagnosis of the spinal metastasis to the date of death or last follow-up (minimum: 12 mo). Cox regression, Kaplan-Meier survival test, and Cronbach alpha tests were performed for statistical analysis. Results: Median overall survival for all patients was 13 months (range: 1-68 mo). The primary tumor (P=0.015), existence of visceral metastasis (P=0.017), presence of pathologic vertebra fracture (P=0.009), and undergone spinal surgery (P=0.047) showed significant influence on survival. Each scoring system was reliable and concordant with the other scoring systems (Cronbach alpha=80%); however, after 2 years, Modified Bauer score appeared to be the most reliable system for predicting survival (Cronbach alpha=25%). Conclusions: According to this analysis, lung cancer, visceral metastasis, pathologic vertebra fracture, and undergone spinal surgery have shown a negative effect on survival. All 4 scoring systems were reliable for predicting survival of patients with spinal metastatic disease. However, modified Bauer scoring system seems to be more predictive after 2 years.