Browsing by Author "Tuncay, Ismail Cengiz"

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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.
Evaluation of Interobserver and Intraobserver Differences of Graf Method in Developmental Hip Dysplasia
(2023) Dogruel, Halil; Baymurat, Alim Can; Tuncay, Ismail Cengiz; Atalar, Hakan
Purpose: The aim of this study was to evaluate possible differences in hip ultrasonography (US) results between physicians working in different medical centers. Method: In this study, a total of 117 horizontal US images representing all sonographic types of developmental dysplasia of the hip (DDH) were utilized. Four experienced researchers independently measured the 117 US images at different times. The results obtained by each researcher were documented separately, including alpha and beta angles, Graf types. All of the collected data were analyzed statistically to assess for interobserver and intraobserver variability. Results: The study found that the average change between the alpha angles ranged from a minimum of 1 to a maximum of 4. The mean change between the beta angles was wider, ranging from a minimum of 1.8 to a maximum of 8.2. To evaluate the differences between the Graf hip typologies, paired groups were formed and Cohen's Kappa method was used. For the first group k= 0.661, for the second group k= 0.671, for the third group K= 0.647, for the fourth group k= 0, 718, k= 0.717 for the fifth group and k= 0.637 for the sixth group. Interobserver Kappa evaluation results (k=0.647) showed moderate and significant agreement. Conclusion: The results revealed a moderate to substantial level of agreement between the researchers. Based on these findings, it was concluded that the use of US for screening and follow-up of the Graf hip typing method should be performed by experienced professionals.
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.
Kinetic and Kinematics Parameters of Hip in Gait for a Congenital Longitudinal Tibial Deficiency with Orthoprosthesis and Transfemoral Prosthesis: A Case Study
(2021) Alsancak, Serap; Cuener, Senem; Tuncay, Ismail Cengiz
Introduction: Congenital longitudinal tibial deficiency is a rare condition. It is characterized by partial or complete absence of tibia with a relatively intact fibula. Its standard treatment is surgery and employing orthoprosthesis or prosthesis. However, the effects of gaits according to the types of prosthesis is barely known. Methods: Orthoprosthesis is offered to a 30-year-old man experiencing left-side congenital type 1 tibial hemimelia (classified as Jones type 1B) deficiency with thoracolumbar scoliosis and exhibiting a depressed shoulder as well as a stiff knee. He decided to have an amputation to wear a transfemoral (TF) prosthesis comprising a microprocessor-controlled knee. Results: Three-dimensional gait analyses and a 6-minute walk test were performed preoperatively and postoperatively with the orthoprosthesis and TF prosthesis. Furthermore, the kinematics of hip flexion/extension and pelvic anterior/posterior tilt range of the motion degree were increased using TF prosthesis. The result of the kinetics of the hip flexion/extension moment and hip power parameters were affected using the TF prosthesis. Conclusions: This case study suggests that the new prosthesis provides removable and adaptable component; further, it delivers a comfortable sitting experience because of its new socket design and knee joint flexion. Clinical Relevance: Patient satisfaction is better with TF prosthesis than with orthoprosthesis. TF prosthesis is more cosmetic than orthoprosthesis, provides a symmetrical gait pattern, decreases donning and doffing durations, and there is no uncomfortable protrusion when sitting (due to amputation of the foot and leg part).
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.
Platelet-rich plasma decreases fibroblastic activity and woven bone formation with no significant immunohistochemical effect on long-bone healing: An experimental animal study with radiological outcomes
(2018) Akgun, Rahmi Can; Canbeyli, İbrahim Deniz; Sahin, Orcun; Terzi, Aysen; Tuncay, Ismail Cengiz; 30295139
Purpose: This study aimed to analyze the immunohistochemical effect of platelet-rich plasma (PRP) on healing of long-bone fractures in terms of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF), the Ki-67 proliferation index, and radiological and histological analyses. Methods: Sixteen adult rabbits, whose right femoral diaphysis was fractured and fixed with Kirschner wires, were randomly divided into two groups, control and PRP (groups A and B, respectively). PRP was given to group B at 1 week postoperatively, and all animals were euthanized after 12 weeks. Radiographic evaluations were performed periodically. Cortical callus formation, chondroid and woven bone area percentages, osteoblastic and fibroblastic activities, and mature bone formation were examined. The depths of BMP-2 and VEGF staining were measured. The Ki-67 proliferation index was also calculated. Results: The mean radiological union score of group B was significantly higher than that of group A. There were also statistically significant differences between groups A and B in terms of cortical callus formation, woven bone area percentage, fibroblast proliferation, and mature bone formation. Group B had significantly more cortical callus and mature bone formation with less woven bone and fibroblast proliferation. Immunohistochemical analysis revealed no statistically significant difference between the groups in terms of BMP-2 and VEGF staining and the Ki-67 index. Conclusions: PRP had no effect on BMP-2 or VEGF levels with no increase in the Ki-67 proliferation index, although its application had a positive effect on bone healing by increasing callus and mature bone formation with decreased woven bone and fibroblast proliferation.
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.