Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Removal of an Epidural Catheter Without Discontinuation of Dual Antiplatelet Therapy in A Patient with Postoperative Urgent Coronary Stenting(2016) Tuncali, Bahattin; Boya, Hakan; https://orcid.org/0000-0002-7898-2943; https://orcid.org/0000-0001-6110-4004; 26256721; AAJ-7840-2021; W-7391-2019Item Caudal Block Combined with Propofol Infusion Using Laryngeal Mask Airway in A Spontaneously Ventilating Child with Merosin-Positive Occidental Type Congenital Muscular Dystrophy(2016) Tuncali, Bahattin; Boya, Hakan; Arac, Sukru; 0000-0002-7898-2943; 0000-0001-6110-4004; 27290974; AAJ-7840-2021; W-7391-2019Item A Novel Hybrid Type (Custom-Made Plus Off-The-Shelf) Total Femoral PROSTALAC(2016) Arac, Suleyman Sukru; Boya, Hakan; 0000-0001-6110-4004; 27174065; W-7391-2019Introduction: Treatment of periprosthetic joint infection following revision-Total Hip Arthroplasty is more problematic when there is poor bone quality and severe bone loss. Migration of revision prosthesis with a long stem to the knee joint in infected cases makes treatment more complex. In these cases, total femoral replacement is the only treatment option and eradication of infection is mandatory before the replacement. In 2-staged reconstruction treatment, there is a need for a PROSTALAC to replace the whole femur. Methods: We describe here a novel hybrid type (custom-made plus off-the-shelf) total femoral PROSTALAC for cases in need of whole femoral bone and femoral component removal for the treatment of periprosthetic joint infection in total hip arthroplasty. Result: Both sides of the PROSTALAC have anatomical joint surfaces, so the articulation with the acetabulum proximally is expected to be more stable. The off-the-shelf anatomic joint surface of the PROSTALAC distally allows articulation compatible with a proximal tibial off-the-shelf spacer. Conclusions: This simple hybrid-type total femoral PROSTALAC can be adjusted to femoral length, has anatomical joint surfaces that produce a more stable articulation, and can articulate with an off-the-shelf proximal tibial spacer.Item Proximal Tibiofibular Joint Pain Versus Peroneal Nerve Dysfunction: Clinical Results of Closed-Wedge High Tibial Osteotomy Performed with Proximal Tibiofibular Joint Disruption(2017) Ozcan, Ozal; Eroglu, Mehmet; Boya, Hakan; Kaya, Yilmaz; https://orcid.org/0000-0001-6110-4004; 26971107; W-7391-2019Closed-wedge high tibial osteotomy (CW-HTO) requires shortening of the fibula or the fibular head or disruption of the proximal tibiofibular joint (PTFJ). However, no study has evaluated the proximal tibiofibular joint after the osteotomy. The aim of this study was to investigate the fate of the PTFJ after CW-HTO applied with using PTFJ disruption method. This prospective study included 22 knees of 20 patients who underwent CW-HTO. The mean age of the patients was 50 +/- 4 years, and the mean follow-up period was 27.5 +/- 14.3 months (12-46 months). The grade of gonarthrosis (Ahlback's classification), tibiofemoral alignment and tibial slope angles were measured on radiographs pre- and post-operatively. During the surgery, the PTFJ capsule was released meticulously so as not to injure the peroneal nerve. Tenderness over the PTFJ was recorded preoperatively and at the last follow-up. No patient had tenderness or pain over PTFJ preoperatively. On the follow-up examinations, tenderness with compression was detected in nine knees with dorsiflexion, in ten with plantar flexion and in nine with neutral position of the ankle, respectively. None of the patients had peroneal nerve injury (including hypesthesia and mild weakness) post-operatively. However, while 11 knees were pain free in all positions of the ankle, seven knees had tenderness over PTFJ both in dorsiflexion and in plantar flexion. CW-HTO using PTFJ disruption provides good clinical results in terms of medial knee pain and corrects the alignment sufficiently while avoiding peroneal nerve injury. However, the results of this study indicated that this technique might result in painful PTFJs. Thus, the surgeon should consider a possibly painful PTFJ, which can be a cause of chronic lateral knee pain when performing this technique.Item Obese patients require higher, but not high pneumatic tourniquet inflation pressures using a novel technique during total knee arthroplasty(2018) Tuncali, Bahatin; Boya, Hakan; Kayhan, Zeynep; Arac, Sukru; 0000-0003-0579-1115; 0000-0002-7898-2943; 0000-0001-6110-4004; 29526158; AAJ-4623-2021; AAJ-7840-2021; AAJ-7840-2021Objectives: This study aims to investigate the effect of obesity on pneumatic tourniquet inflation pressures determined with a novel formula during total knee arthroplasty (TKA). Patients and methods: Data of 208 patients (19 males, 199 females; mean age 69.8 years; range, 53 to 84 years) who were performed TKA between January 2013 and December 2016 were evaluated prospectively. Patients were divided into two groups as non-obese (body mass index [BMI] <= 30.0 kg/m(2)) and obese (BMI > 30.0 kg/m(2)) according to BMI. Tourniquet inflation pressures were set using arterial occlusion pressure (AOP) estimation method and adding 20 mmHg of safety margin to AOP value. All patients were assessed intra-and postoperatively with outcome measures such as systolic blood pressure, AOP, tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion. Results: The study included 118 and 90 lower extremity operations in obese and non-obese groups, respectively. Compared to non-obese group; extremity circumference, initial and maximal systolic blood pressures, AOP values, initial and maximal tourniquet pressures were higher in obese group. The performance of the tourniquet was assessed as "excellent" and "good" at almost all stages of the surgical procedure in all patients in both groups. No complication occurred intra-or postoperatively. Conclusion: Compared to non-obese patients, higher tourniquet inflation pressure is required in obese patients during TKA due to their wider extremity circumference and higher systolic blood pressure profile.