Scopus İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4809
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Item An investigation of consistency between posterior condylar axis+3 degree external rotation line and clinical transepicondylar axis line techniques in primary total knee arthroplasty(2014) Boya, Hakan; Ozcan, Ozai; Maralcan, GokhanObjectives: This study aims to investigate discrepancy between posterior condylar axis (PCA)+3 degree external rotation (ER) line and clinical transepicondylar axis (cTEA) line and consistency between the both techniques in primary total knee arthroplasty. Patients and methods: Thirty-six knees [Bilateral knees were operated simultaneously in 12 patients (50%)] in 24 patients [3 men (12.5%), 21 women (87.5%); average age 67 (59-80 age)] were included in the study. During surgery, PCA+3 degrees ER line and cTEA line were drawn on the distal femoral cutting surface by electrocautery pencil following distal femoral cut. The both lines on distal femur were recorded by digital camera and relationship between lines was ascertained in reference to PCA+3 degrees ER line [parallel, internal rotation (IR), ER]. Statistical analysis was performed by the McNamara chi square test and Kappa (kappa) value. Results: Assessment of the images revealed that cTEA line in comparison to PCA+3 degrees ER line was parallel in 22 knees (61.2%), but not parallel in 14 knees (38.8%) [IR in 10 knees (71.5%), ER in 4 knees (28.5%)]. There was a significant difference (McNamara chi square=12.7 +/- 1; p<0.001) and poor consistency (kappa=0.00055) between both lines and techniques, respectively. Conclusion: For determination of femoral component rotation in surgery setting, different results between cTEA and PCA+3 degrees ER techniques possibly may due to disadvantages of techniques and anatomic variation of distal femur. Thus, using both techniques to check each other's results seems unsafe.Item Hand injury with a nail gun: a case report with literature review(2015) Boya, Hakan; Uzun, Belkan; 26200416The nail gun was introduced in the late 1950s to increase the ease of driving nails, studs, bolts, or staples into various hard surfaces. The nail gun is a potentially dangerous device that is still commonly used in the construction industry. Since its introduction, an increasing number of studies have reported injuries associated with nail guns. Nail gun-related injuries-such as to the head, neck, and chest-can be devastating, and in some cases, even fatal. Extremity injuries, notably in the hand, can cause loss of function, missed work, and long-term health effects. This case report describes a nail-gun injury of the hand along with a discussion of the unique features of and treatment strategies for nail gun injuries.Item Clinical utilization of arterial occlusion pressure estimation method in lower limb surgery: effectiveness of tourniquet pressures(2016) Tuncali, Bahattin; Boya, Hakan; Kayhan, Zeynep; Arac, Sukru; Camurdan, Mehmet Ali Koray; 26969952Objective: The effectiveness of the arterial occlusion pressure (AOP) estimation method to set tourniquet inflation pressures was assessed in patients undergoing lower limb surgery. Methods: One hundred ninety-eight operations were performed in 224 lower extremities of 193 patients. Tourniquet inflation pressures were set using the AOP estimation formula and adding 20 mmHg of safety margin to AOP value. Primary outcome measures were the amount of tourniquet pressure and its effectiveness. The quality of the surgical field and complications were assessed by the surgical team in a blinded fashion. Secondary measures included the time required to set the tourniquet pressure and complications. Results: The initial and maximal tourniquet pressures used were 168.4 +/- 14.5 and 173.3 +/- 15.6 mmHg, respectively. The performance of the tourniquets was assessed as "excellent" and "good" in all stages of the procedure in 97.76% of cases. The time required to measure AOP and set the tourniquet cuff pressure was 19.0 +/- 2.6 sec. No complications occurred during or after surgery until discharge. Conclusion: Clinical utilization of the AOP estimation formula is a practical and effective way of setting tourniquet pressures for lower limb surgery. Its usage allows achievement of a bloodless field with inflation pressures lower than those previously recommended in the literature for lower limb tourniquets.Item Practice of tourniquet use in Turkey: a pilot study(2016) Boya, Hakan; Tuncali, Bahattin; Ozcan, Ozal; Arac, Sukru; Tuncay, Cengiz; 26969951Objective: The aim of the present pilot study was to evaluate patterns in the current practice of tourniquet use in Turkey. The results of this study can provide detailed information regarding tourniquet use and evaluate the need for guidelines on tourniquet use in Turkey. Methods: The questionnaire was sent to orthopedic residents and surgeons by either giving printed questionnaires directly or by establishing preliminary communication with surgeons and then sending questionnaires by e-mail. Participating staff consisted of 3 groups: Group 1: orthopedic surgeons; Group 2: orthopedic residents; and Group 3: orthopedic academic staff. Statistical differences in tourniquet use were analyzed among the groups. Results: Use of mechanical tourniquet was significantly higher in Group 1. Plain cuffs were used in orthopedic surgical practice more frequently. Assistant and orthopedic theatre personnel were commonly reported by participants as the tourniquet applicant. Periodic educational practice was not routine. The number of reported complications was higher in Group 3. Cuff padding was generally routine practice. Scientifically valid options at lowest inflation pressure were not observed among the results at the expected rates. Conclusion: The results of this pilot study indicate that there is wide variation in some aspects of tourniquet practice in Turkey. The differences are not acceptable because of the potential for significant complications with some practices. There is a need to provide and ensure adequate education to provide the best patient care. Furthermore, protocols should be developed for acceptable standards of tourniquet use.Item A rare complication of total knee arthroplasty: Type l complex regional pain syndrome of the foot and ankl(2016) Soylev, Gozde Ozcan; Boya, Hakan; 0000-0001-6110-4004; 0000-0001-8742-5543; 27726920; W-7391-2019; AAJ-4917-2021Complex regional pain syndrome (CRPS) is a painful and disabling disorder that usually affects the extremities. This complication may affect the knee joint after total knee arthroplasty (TKA). We report a unique case of CRPS of the foot and ankle, which was an unusual involvement site for CRPS after TKA. (C) 2016 Publishing services by Elsevier B.V. on behalf of Turkish Association of Orthopaedics and Traumatology.Item Does severe osteoarthritis in knees with varus deformity alter the adductor ratio?(2017) Boya, Hakan; Arac, Suleyma Sukru; 0000-0001-6110-4004; 29029868; W-7391-2019Objective: In our retrospective study, we aimed to investigate the differences between the adductor ratio (AR) in knees with and without osteoarthritis, and its validity in determining the articular level. Methods: Data from 80 knees of 80 patients were retrospectively evaluated. Anteroposterior weight bearing knee radiographs of the patients with and without osteoarthritis (40 knees in each group) were obtained. The adductor ratio was determined using the following formula: ATJL/FW (adductor tubercle-joint line distance/femoral width). All radiographs were evaluated at the baseline and at one-month intervals afterwards. Intraobserver reliability of the two measurements was assessed using interclass correlations (ICC). Pearson's correlation test was used to evaluate the correlation between the ATJL and the FW. The differences between the adductor ratios of the two groups were evaluated by the independent samples two-tailed t-test. Results: Most of the ICC values were well above 0.95, indicating a very high intraobserver reliability. The adductor ratio was significantly greater in Group 2 in comparison to Group 1 (Mean AR in Group 2: 0.522 +/- 0.031 and Mean AR in Group 1: 0.502 +/- 0.032; p = 0.005). There was a significant correlation between the ATJL and FW in the groups when assessed both separately and combined. Conclusion: In conclusion, we can assert that if the AR is used to determine the articular level in revision arthroplasty cases, it may be sensible to measure the FW intraoperatively rather than measuring it on primary or contralateral radiographs of arthritic patients. (c) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.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.