Browsing by Author "Simsek, Ekin Kaya"

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Can Platelet-Rich Plasma Be As Effective As Corticosteroids in the Treatment of Frozen Shoulder in Rats? Experimental Animal Study
(2023) Azarabadi, Javid Mohammadzadeh; Vahidfar, Shahla; Simsek, Ekin Kaya; Simsek, Duygu Turkbey; 0000-0003-2393-3535; JWO-8929-2024
Aim: Frozen shoulder is an important health problem that causes significant socio-economic losses as it affects daily life. Its etiopathogenesis has not been fully elucidated. A long recovery period leads to new searches for treatment. In the treatment of frozen shoulder, corticosteroids (CS) and platelet-rich plasma (PRP) are applied, among other options. The aim of this study is to compare the effectiveness of CS and PRP in frozen shoulder. Material and Methods: A secondary frozen shoulder model was created in rats. At the end of the eight-week waiting period, the shoulder joint was released. The rats, divided into three groups, were injected intraarticularly with saline in the first group, CS in the second group, and PRP in the third group. After a two-week waiting period, the shoulder joint range of motion of the sacrificed rats was measured. The joint capsule was evaluated histologically for synovial inflammation, type 3 collagen, capillary proliferation, subscapular bursa adhesion and fibrosis. Result: CS and PRP application did not affect the range of motion of the joint. A significant increase in synovial inflammation a decrease in fibrosis, type 3 collagen deposition, subscapular bursa adhesion were revealed. It was observed that vascular proliferation did not change. Discussion: CS and PRP treatment yielded similar results in the frozen shoulder animal model. While both of these treatments do not affect the range of motion of the joint, they reverse the pathological changes in a frozen shoulder.
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.
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.
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.
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.
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.