Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Clinical characteristics of avascular necrosis in patients with Behcet disease: a case series and literature review(2019) Atas, Nuh; Bitik, Berivan; Varan, Ozkan; Babaoglu, Hakan; Tufan, Abdurrahman; Haznedaroglu, Seminur; Goker, Berna; Ozturk, Mehmet Akif; 30560445Avascular necrosis (AVN), also known as osteonecrosis, is characterized by death of the osteocytes due to inadequate blood supply caused by various mechanisms. The hip is the most common affected joint followed by knee. Incidence of AVN in rheumatic diseases is variable and high corticosteroid (CS) therapy is a known major risk factor for development of AVN. Data on the AVN in Behcet disease (BD) are limited. The purpose of this study is to examine the clinical and treatment characteristics of BD patients with diagnosis of AVN. Retrospective medical records of 337 BD patients were reviewed. Nine BD patients with AVN were detected. The clinical data of these patients with AVN have been reviewed. All patients had MRI of the symptomatic joints compatible with AVN. All of the nine patients who were diagnosed with AVN were male. Median duration of BD was 7years. Median time between diagnosis of BD and detection of AVN was 3years (1-16years). Multiple joints were involved in seven patients. Six patients had bilateral knee AVN. Six patients had vascular BD. The median time interval between initial CS dose and AVN development was 24months (range=2-100). The median highest daily CS dose was 64mg/day (range=32-80) and median cumulative CS dose prior to AVN was 18g. All of patients had intravenous pulse steroids. CS treatment, smoking and vascular involvement may predispose to AVN in patients with BD. According to this cohort, AVN in BD frequently tended to be in the knee joint and bilateral.Item Intractable pain following core decompression caused by salmonella septic arthritis(2016) Beyaz, Salih; Guler, Umit Ozgr; Cinar, Bekir Murat; Bolat, Filiz Aka; 0000-0002-7906-5039; 0000-0002-5375-635X; 0000-0002-5788-5116; 0000-0002-5788-5116; AAL-4474-2021; O-7590-2017; K-8820-2019; M-2609-2013Glucocorticoids (GC), often used in the treatment of diseases caused by autoimmune mechanisms, are the most common nontraumatic causative factor of femoral head avascular necrosis (FHAN). FHAN is, in turn, the most common cause leading to orthopedic surgery in patients using GCs. As GCs suppress the immune system, patients experience increased susceptibility to infections, including FHAN, which has a similar clinical manifestation with septic arthritis. In rare cases, septic arthritis may be caused by salmonella in patients using GCs. Core decompression is the gold standard in the treatment of early stage FHAN. We report a 28-year-old male patient with multiple sclerosis (MS) presenting with the complaints of hip pain. The patient had been treated with two megadoses of steroids. FHAN was considered due to X-ray and MRI findings. The patient underwent core decompression (CD) and salmonella bacteria growth was found in the hip puncture culture. Avascular necrosis associated with septic arthritis was determined. The patient was re-operated and irrigation and debridement for synovial tissues were performed two days following the first operation. While the association of septic arthritis with causative Salmonella and FHAN is rare except in sickle cell patients, septic arthritis must be considered and ruled out in patients who have previously undergone CD and did not show expected relief in early stage FHAN.Item 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; 30376800Objectives: 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.