ISMAIL GOKHAN SAHIN
@saglik.gov.tr
Orthopaedics and Traumatology
Turkish Republic, Minister of Health
RESEARCH, TEACHING, or OTHER INTERESTS
Orthopedics and Sports Medicine, Surgery
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Yavuz Akalın, Özgür Avcı, Savaş İ. İnce, Nazan Çevik, İsmail G. Şahin, and Alpaslan Öztürk
Georg Thieme Verlag KG
AbstractThe aim of this study was to evaluate the success of the all-inside repair technique for medial bucket-handle meniscus tear (BHMT) and the factors affecting healing. A total of 36 patients with BHMT who were operated between 2012 and 2018 and completed final follow-up examinations were included in the study. Functional evaluation was made with the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score. Healing was evaluated on magnetic resonance imaging (MRI) slices. The patients were evaluated with respect to the effect on healing of factors such as demographic data, body mass index (BMI), smoking status, anterior cruciate ligament tear reconstruction (ACLTR) applied at the same time as BHMT repair, and the tear being chronic or acute. The mean age of the patients was 28.6 ± 8.6 years (range,18–46 years), the mean follow-up period was 25.8 ± 13.9 months (range, 13–59 months), and BMI was mean 25.6 ± 3.5 kg/m2 (range, 20.1–30.5 kg/m2). The meniscus tears were acute in 16 (44.4%) patients and chronic in 20 (55.6%). ACLTR was applied together with BHMT repair in 25 patients. The hybrid technique, as the outside-in technique in addition to the all-inside technique, was applied to 12 (33.3%) patients, where there was seen to be extension to the anterior horn. The failure rate was determined as 27.8% according to the postoperative MRI evaluation and the Barrett criteria. No positive or negative statistically significant effect on healing was determined of chronic BHMT or of simultaneous application of ACLTR (p = 1.00 and 0.457, respectively). Cigarette smoking and high BMI were determined to have a statistically significant negative effect on healing (p = 0.026 and 0.007, respectively). In conclusion, it can be seen that the success of the all-inside technique for BHMT remains controversial. Due to the features of the application, it can be used in meniscus tears of the posterior horn only. In the current study, with the success rate of 72.2% of the all-inside technique in meniscus body tears, it was seen that a high success rate could not be achieved.
Fatih İlker CAN, Emre GÜLTAÇ, Cem Yalın KILINÇ, İsmail Gökhan ŞAHIN, and Nevres Hurriyet AYDOGAN
Ondokuzmayis University, Faculty of Medicine
Biceps tendon disorders are substantial cause of intense shoulder pain, and thus they require a careful medical attention. We compared the clinical outcomes of chronic rupture, tenotomy and tenodesis of proximal biceps tendon of patients underwent arthroscopic shoulder surgery. We included 98 patients over 50 years-old who underwent arthroscopic surgery for rotator cuff tears and grouped as tenotomy, tenodesis and chronic rupture of biceps tendon. Preoperative and postoperative 24-months follow-up Visual Analog Scale (VAS) score and the University of California–Los Angeles (UCLA) Shoulder Scale scores were compared. Chronic biceps rupture was the most common pathology in massive rotator cuff rupture group (75.9%). As tenotomy, tenodesis and chronic rupture groups were compared in terms of VAS and UCLA score improvements (preoperative and postoperative change); tenotomy showed better outcomes and there was a statistically significant difference between tenotomy and tenodesis groups in terms of improvements in VAS and UCLA scores (p = 0.036, p = 0.010, respectively). No statistically significant difference between chronic rupture and tenodesis in terms of VAS and UCLA scores improvements were observed (p = 1.000, p = 0.250, respectively). Also, tenotomy showed superior VAS score improvement than chronic tendon rupture (p=0.024) however no statistically significant difference was observed in UCLA score improvement between tenotomy and chronic rupture (p = 0.527). According to our study, tenotomy seems to be a more appropriate surgical method than tenodesis in massive and full-thickness rotator cuff tears with severe biceps tendon degeneration, and also it is not necessary to perform tenodesis in cases with chronic biceps rupture.
Fatih İlker Can, Rabia Mihriban Kılınç, Emre Gültaç, Cem Yalın Kılınç, and İsmail Gökhan Şahin
Joint Diseases and Related Surgery
Objectives This study aims to evaluate the two-year clinical results of bilateral acetabular fractures operated via a single incision with the modified Stoppa approach. Patients and methods Between January 2013 and January 2020, a total of 22 acetabular fractures of 11 patients (7 males, 4 females; mean age: was 42.9±13.7 years; range, 19 to 62 years) who were operated via the modified Stoppa approach were retrospectively analyzed. The medical records were analyzed in terms of time to surgery, fracture patterns, Injury Severity Score (ISS), operation duration, blood loss, reduction quality, perioperative complications and concomitant injuries. Reduction quality was assessed according to Matta’s criteria. The Harris Hip Score (HHS) and modified Merle d’Aubigne score (MDS) were utilized for functional assessment. Results The mean follow-up was 49±15 (range, 30 to 79) months. The mean ISS was 28.2±7.2. The mean modified MDS was 15.90±1.57. The mean HHS was 84.27±8.85. For both sides, reduction was anatomical-anatomical (63.6%) in seven patients, anatomical-imperfect in three (27.3%) patients, and imperfectpoor in one (9.1%) patient. According to the Kellgren-Lawrence radiological evaluation at 24 months of follow-up bilaterally, Grade 0-1 osteoarthritis was observed in six (54.5%) patients, Grade 1-1 in four (36.4%) patients, and Grade 1-2 osteoarthritis in one (9.1%) patient. Conclusion The modified Stoppa approach in bilateral acetabular fractures seems to be more preferable than other approaches, as it can be performed with a single incision and provides less bleeding, shorter operation duration, and satisfactory results.
EMRE GÜLTAÇ, CEM YALIN KILINÇ, FATİH İLKER CAN, İSMAİL GÖKHAN ŞAHİN, AHMET EMRAH AÇAN, ÇAĞATAY GEMCİ, and NEVRES HÜRRİYET AYDOĞAN
The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL COMMONS JOURNALS
Background/aim Within this study, we aimed to investigate the radiological and functional outcomes of acetabular fractures involving quadrilateral surface using 105° drill attachment in the anterior intrapelvic approach. Materials and methods The 35 patients who underwent surgical treatment from January 2016 and January 2020 for acetabular fractures involving quadrilateral surface with anterior intrapelvic approach using 105° drill attachment and a minimum of 12 months of postoperative follow-up were included. Perioperative complications, operation duration, and the quality of reduction were evaluated. Reduction quality was classified as poor, imperfect, and anatomic. Functional evaluation was performed according to the Harris Hip Score (HHS) and Merle d’Aubigne Score. Results Among 35 patients (median age 36 (21–80)), radiological results of the acetabular fixations were anatomic, imperfect, and poor in 28 (80%), 5 (14.3%), and 2 (5.7%) patients, respectively. Postoperative 1-year functional outcomes with Merle d’Aubigne scores and HHS were median 18 (10–18) and 90 (60–96), respectively. The clinical outcomes of the patients showed concordance with reduction quality. The median operation duration was 180 minutes (range 125–270). Iatrogenic neurovascular damage was not noted in any patients. Conclusion Reduction and fixation of deep intrapelvic fractures are risky and difficult due to the narrow anatomy and adjacent crucial neurovascular structures. As the 105-degree drill application is safe and easy to intervene in, short surgery duration and satisfactory results with minimum complications can be obtained with a 105 angulated drill in the deep pelvic region.
Fatih İlker Can, Emre Gültaç, İsmail Gökhan Şahin, Cem Yalın Kılınç, and Nevres Hürriyet Aydoğan
Joint Diseases and Related Surgery
Objectives This study aims to investigate the relationship between proximal biceps tendon disorders and the degree of subacromial impingement in patients who underwent arthroscopic subacromial debridement. Patients and methods Between January 2015 and June 2021, a total of 110 patients (44 males, 66 females; mean age: 52.5±11.43 years; range, 15 to 78 years) who underwent arthroscopic subacromial decompression were retrospectively analyzed. The degree of the subacromial impingement observed during arthroscopy was classified into four stages according to the Neer classification. We classified proximal biceps tendon disorders as five grades according to the Nirschl classification. The proportional relationship between subacromial impingement and biceps tendinopathy severity was analyzed. Results While biceps tendon degeneration was found to be significantly lower in patients with mild or no subacromial impingement, high rates of severe biceps tendon degeneration were observed in patients with high degree of subacromial impingement. A total of 75% of the patients who had no subacromial impingement had no biceps tendon disorder. Approximately 50% of the patients with Stage 1 subacromial impingement did not have biceps disorder, 31.3% had inflammation, and 12.5% had minor degeneration. In Stage 2 subacromial impingement group, the ratio of inflammation (42.9%) and minor degeneration (42.9%) of biceps tendon greatly increased, and the highest rate of biceps tendon degeneration was observed in the most advanced stage (Stage 3) subacromial impingement group (39.3%) (p=0.001). Conclusion The stage of subacromial impingement is correlated with the degree of biceps degeneration. Therefore, one should keep in mind that the presence of advanced subacromial impingement may indicate advanced biceps tendon pathologies.
Mustafa Çınar Akça, Yavuz Akalın, Nazan Çevik, İsmail Gökhan Şahin, Özgür Avcı, and Alpaslan Öztürk
Springer Science and Business Media LLC
Abstract Background In this study, the traditional “Anatomical Landmark-Distance Method (AL-DM)” in the formation of joint line (JL) was compared with “Adductor Tubercle-Ratios method” (AT-RM), and the effect of reestablishment of JL on clinical and functional outcomes were evaluated. Materials and methods 16 revision total knee arthroplasties (rTKAs) were performed by using “AT-RM” (group 1) and 16 rTKA by using “AL-DM” (group 2) in our clinic between 2015 and 2018. The data were prospectively collected and a total of 32 knees of 31 patients were analyzed. At the final follow-up, knee functions were evaluated by using Knee Society Score (KSS) knee and function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, Short Form-36 (SF-36) questionnaires and physical examinations. Results Postoperative flexion arc was higher in Group 1. KSS knee and function scores were better in group 1. In group1, JL was reestablished successfully in all revision rTKAs in terms of ATJL and the tibial tubercle TT-JL ratios. The improvement in KSS knee and function scores and WOMAC scores were also better in group 1. Measurements showed that the improvement in KSS scores increased as AT-JL and TT-JL distances approached the calculated values. Conclusion “AT-RM” was shown to be superior to the traditional distance method in terms of JL reestablishment. Functional results and patient satisfaction increased when JL was reestablished.
Yavuz Akalın, İsmail Gökhan Şahin, Nazan Çevik, Burak Olcay Güler, Özgür Avci, and Alpaslan Öztürk
Springer Science and Business Media LLC
Mehmet Taner Palabıyık, Yavuz Akalın, Ömer Yalçın, İsmail Gökhan Şahin, Nazan Çevik, and Alpaslan Öztürk
Index Copernicus
Background. To investigate the effects of hyperbaric oxygen (HBO) and pentoxifylline (PTX) treatment on osteotendinous junction healing of Achilles tendon in an animal model. Materials and methods. Thirty-six adult female Wistar-albino rats were randomly divided into three groups as control, PTX and HBO groups with a total of 12 rats per group. Under general anesthesia, the Achilles tendons were cut at the level of the osteotendinous junction and repaired. After the surgery, no treatment was given to the control group. Fifty mg/kg intraperitoneal PTX was administered to the PTX group daily for 1 week. The HBO group was exposed to 2,5 atmospheric pressure, 100% oxygen for 2 hours daily for 1 week. All animals were sacrificed at the end of sixth week. Biomechanical tests and histological examinations were performed. Results. Energy absorption was significantly higher in the PTX group than that in the control group after biomechanical tests (p=0.010). Histopathological evaluation results revealed no difference between the groups: however, hyalinization level was relatively better in the HBO group than that in the control group (p=0.026). Conclusions. 1. We concluded that PTX has a positive effect on the treatment of osteotendinous junction injuries based on our results. 2. Although HBO therapy did not provide statistically significant differences, it might have some positive effects on these injuries. 3. Further experimental studies and clinical trials should be conducted.