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Öğe Better short-term outcomes of mini-open rotator cuff repair compared to full arthroscopic repair(Korean Shoulder And Elbow Soc, 2024) Akdemir, Mehmet; Kılıç, Ali Ihsan; Kurt, Cengizhan; Çapkın, SercanBackground: Rotator cuff tears commonly cause shoulder pain and functional impairment, prompting surgical intervention such as mini-open and arthroscopic methods, each with distinct benefits. This study aimed to compare the clinical outcomes and complications of these two approaches. Methods: A retrospective analysis was conducted on 165 patients who underwent rotator cuff repair using either arthroscopic-assisted mini-open or full arthroscopic approaches. Patient demographics, tear characteristics, clinical outcomes, and complications were assessed, with statistical analyses conducted to discern differences between the groups. Results: Among the patients, 74 (53.2%) received the mini-open approach, while 65 (46.8%) underwent arthroscopic repair, with a mean follow-up of 19.91 months. The mini-open group exhibited significantly higher postoperative American Shoulder and Elbow Surgeons (ASES) scores compared to the arthroscopic group (P=0.002). Additionally, the mini-open group demonstrated a more significant improvement in ASES scores from preoperative to postoperative assessments (P=0.001). However, the arthroscopic method had a significantly longer operative time (P<0.001). Complications, including anchor placement issues, frozen shoulder, infection, and re-rupture, occurred in 17.3% of patients overall. Re-rupture rates were 13.5% for mini-open and 6.2% for full arthroscopic repair, with no significant difference between the two methods (P=0.317). Conclusions: Both the mini-open and arthroscopic methods yielded favorable clinical outcomes for rotator cuff tear treatment, but the mini-open group exhibited superior results. Surgeons should consider patient characteristics, tear attributes, and surgical expertise when selecting the appropriate technique.Öğe Clinical and radiological significance of posteromedial fragment in tibial plateau fractures(Elsevier, 2022) Akdemir, Mehmet; Turken, Mehmet Aykut; Turan, Ahmet Cemil; Bicen, Ahmet Cagdas; Kilic, Ali IhsanIntroduction: The effect of joint fragmentation, especially the posteromedial fragment, on treatment outcomes in tibial plateau fractures has been better understood in recent years. In this study, we wanted to examine whether the accompanying posteromedial fragment has an effect on clinical and radiological results. Patients and methods: Patients who underwent open reduction and internal fixation with plate and screw due to tibial plateau fracture were retrospectively screened. The patients were divided into two groups as with and without posteromedial fragment. Clinical, radiological and complications were compared statistically. Results: 38 out of 52 patients were included in the study. The mean age of the patients was 46.08, 26 (68.42%) were female and 12 (31.58%) were male. Mean follow-up was 18.55 months. Posteromedial fragment was present in 21 (55.6%) patients, but not in 17 (44.4%) patients. When the two groups were compared according to the Rasmussen clinical and radiological criteria, no statistically significant difference was found. There was no statistically significant difference between the two groups in the rates of infection, non-union, malunion, joint separation, early arthrosis and arthrofibrosis (p > 0.05). A statistically significant difference was found between the two groups in terms of reduction loss rates (p < 0.05). Conclusions: The accompanying tibial plateau fractures of the posteromedial fragment are characteristic fractures. Care should be taken to maintain the stability of the fracture fixation.Öğe Comparison of Conservative and Arthroplasty Treatment for 3 or 4 Part Proximal Humerus Fractures in the Elderly(2024) Akdemir, Mehmet; Biçen, Ahmet Çagdaş; Turan, Ahmet Cemil; Ekın, Ahmet; Kılıç, Ali Ihsan; Unal, MericAim: Proximal humerus fractures are common injuries in the elderly population. This study hypothesizes that arthroplasty is not superior to conservative treatment in the management of multi-part proximal humerus fractures in elderly patients. Material and Method: Patients aged 65 and above with 3–4-part proximal humerus fractures, treated either conservatively or with arthroplasty, were included in the study. The minimum follow-up period was set at 12 months. Functional evaluations of the patients were performed using the Quick Disabilities of Arm, Shoulder and Hand (Q-DASH) scoring system. Statistical analysis comparing the two groups was conducted using the SPSS software. The mean values of numerical data were analyzed using the Mann-Whitney U test, while categorical data were compared using the Chi-square test. A significant level of 0.05 was considered. Results: A total of 67 patients who received adequate clinical follow-up were included in the study (50 conservative 17 arthroplasty). The average age of the patients was 76.12 years, with 9 male and 58 female patients. The average follow-up period was 22.61 months (range: 12-82). There were no statistically significant differences in age, gender, side, follow-up period, and fracture type distribution between the two groups. However, a significant difference in Q-DASH scores was observed (p<0.05). Conclusion: In the treatment of proximal humerus fractures, even when they are multi-part fractures, conservative treatment should may be the first choice. We think that the early results of conservative treatment are better than arthroplasty.Öğe Comparison of the Complications of Knee Replacement Using Fixed or Mobile Inserts(Galenos Publ House, 2024) Akdemir, Mehmet; Kaya, Erol; Kilic, Ali Ihsan; Kurt, Cengizhan; Capkin, SercanBACKGROUND/AIMS: Knee replacement surgery or total knee arthroplasty is a widely performed procedure to alleviate pain and improve function in patients with severe knee joint degeneration or injury. The choice between fixed and mobile inserts for knee replacement implants remains critical. Fixed-bearing implants provide stability, whereas mobile-bearing implants offer increased conformity and potential for improved range of motion. This study aimed to compare the complications of knee replacement using fixed and mobile inserts. MATERIALS AND METHODS: A retrospective analysis was conducted on 412 knee replacement patients who underwent surgery between 2011 and 2021 using either the Smith & Nephew GENESIS-II fixed insert knee prosthesis or Zimmer-Mobile insert knee prosthesis. Data collection involved rigorous evaluation of patient files, radiographs, and postoperative outcomes. Data on age, gender, side of the knee prosthesis, preoperative and postoperative tibiofemoral angle, proximal tibia angle, osteolysis around the prosthesis, and complications, such as instability, infection, extensor mechanism problems, aseptic loosening, and radiological osteolysis, were recorded. Complications requiring surgical intervention were also noted. RESULTS: The mean age of patients was 65.18 years, and 88.5% were female. The mobile insert group included younger patients with a higher incidence of bilateral knee arthroplasties. Radiological evaluation revealed a higher incidence of patella changes and subsequent patella replacement in the mobile insert group. However, the overall complication rate was not significantly different between the two groups. Although postoperative joint alignment did not significantly differ between the groups, the postoperative proximal tibial angles were higher in the osteolysis, did not significantly differ between the two groups. CONCLUSION: The choice of fixed or mobile insert during knee replacement did not significantly affect the incidence of specific complications. Surgeons should consider individual patient factors, surgeon preference, and technical expertise when selecting the appropriate implant type for knee replacement surgery.Öğe Elbow arthroscopy: Where are We Today? A Bibliometric Analysis(Galenos Publ House, 2024) Capkin, Sercan; Kilic, Ali Ihsan; Şeker, Fatih; Akdemir, Mehmet; Aydin, Mahmud; Sahin, ErtugrulBACKGROUND/AIMS: Elbow arthroscopy is a critical procedure for the treatment of elbow disorders, largely due to advancements in arthroscopic technology. While the field has seen significant growth, no comprehensive bibliometric analysis has been conducted to map research trends, key contributions, and gaps in this area. This study aimed to fill this gap by conducting a bibliometric analysis of articles published on elbow arthroscopy between 1986 and 2023, with the goal of understanding the evolution of the field, identifying influential research, and guiding future studies. MATERIALS AND METHODS: Articles on elbow arthroscopy published between 1986 and 2023 from the Web of Science database were retrieved and subjected to bibliometric scrutiny. After an initial retrieval of 343 articles, we excluded irrelevant categories and focused on the 312 studies that were most relevant to the field. Using VOSviewer software, bibliometric network visualizations and specific result mappings were conducted. Citation analysis was employed to discern prominent journals and articles, while keyword clustering and trend analyses were performed to investigate the thematic landscape of the research. RESULTS: Our analysis of 312 articles on elbow arthroscopy published between 1986 and 2023 revealed a significant increase in the number of publications after 2006. The majority of these publications (82.5%) were original research articles. The average citation count per article was 13.14, with an H-index of 36. The most frequently used keywords were elbow and arthroscopy, with Complications of Elbow Arthroscopy being the most cited study. Prominent journals such as Arthroscopy: The Journal of Arthroscopic & Related Surgery and influential authors like Van Den Bekeron MPJ and O'Driscoll SW were identified. Additionally, the United States was found to be the leading contributor in this field. CONCLUSION: This study offers insights into the evolution and trends of elbow arthroscopy research. The findings serve as a valuable resource for guiding future investigations in this field, while the keyword analysis provides a roadmap for researchers in formulating new studies.Öğe Enhanced stability of the distal radioulnar joint with double suture button construct: a cadaveric study(BMC, 2024) Çapkın, Sercan; Kilic, Ali Ihsan; Huesemoglu, Resit Bugra; Akdemir, Mehmet; Zeybek, Gulsah; Kiray, AmacBackground Distal radioulnar joint (DRUJ) instability is a common post-traumatic complication, often leading to chronic pain and dysfunction. Current reconstructive techniques, such as the single suture button construct, offer suboptimal stabilization in certain motions. This study aimed to evaluate whether a double suture button construct provides greater stability than the single construct in a cadaver model of DRUJ instability. We hypothesized that the double suture button construct would more effectively minimize dorsal translation of the radius relative to the ulna. Methods We used nine freshly frozen human cadaver upper extremities, destabilized the DRUJ, and then reconstructed the joint using three different suture button constructs: single transverse, double (transverse + oblique), and single oblique. The specimens were secured in a custom-designed testing apparatus to measure dorsal translation of the radius. The study proceeded in five stages: stable DRUJ, unstable DRUJ, and reconstruction using a single transverse, double (transverse + oblique), and single oblique suture button construct. Dorsal translation was measured at neutral, 45 degrees pronation, and 45 degrees supination. Statistical comparisons of mean values were conducted for each stage. Results Reconstruction with the transverse, transverse plus oblique, and oblique suture button constructs resulted in statistically significant reductions in dorsal translation compared to the unstable DRUJ (p < 0.001 for all). The double-suture button construct significantly minimized dorsal translation in all positions, restoring stability comparable to a stable DRUJ: neutral (p = 1.000), pronation (p = 0.963), and supination (p = 1.000). In contrast, single constructs failed to fully restore stability in pronation and supination. Conclusion The double suture button construct provides significantly greater stabilization of the DRUJ compared to the single construct. These findings suggest that the double construct could be a more effective option for treating DRUJ instability, particularly in restoring normal joint function during various motions. Further research is warranted to confirm these results in clinical settings.Öğe Evolution of Thoracic Outlet Syndrome Research: A Detailed Bibliometric Study(Tıbbi Kayıtlar Derneği, 2025) Çapkın, Sercan; Kılıç, Ali İhsan; Şeker, Fatih; Akdemir, Mehmet; Aydın, Mahmud; Şahin, ErtuğrulAim: Thoracic outlet syndrome (TOS) is a complex clinical condition caused by the compression of neurovascular structures in the thoracic outlet. Over the past few decades, research on TOS has expanded significantly. This study aims to analyze the literature on TOS using bibliometric methods to identify critical trends, influential authors, prominent themes, and emerging topics in the field. Material and Method: A comprehensive literature search was conducted using the Web of Science (WoS) database for articles on TOS published between 1980 and 2023, employing the keyword 'thoracic outlet syndrome.' The collected data were analyzed using bibliometric methods. VOSviewer software was utilized to visualize bibliometric networks and map critical findings. Citation analysis was performed to identify influential journals and significant articles in the field. Additionally, keyword clustering and trend analyses were conducted to explore the thematic landscape of TOS research. Results: In a literature search on TOS, 2248 publications were found, with 1509 journal articles (67.13%) included in the bibliometric summary. The most common research area was surgery (633 articles, 41.94%), and the United States had the highest publication productivity (684 articles, 45.32%). The University of California System had the highest number of publications among institutions (62 articles, 4.1%). These 1509 articles received 7831 citations (6596 excluding self-citations), averaging 13.1 citations per article and with an h-index of 57. 'Annals of Vascular Surgery' published the most articles (71, 4.7%), while 'Journal of Vascular Surgery' had the highest number of cited articles (65, 4.3%), accumulating Aim: Thoracic outlet syndrome (TOS) is a complex clinical condition caused by the compression of neurovascular structures in the thoracic outlet. Over the past few decades, research on TOS has expanded significantly. This study aims to analyze the literature on TOS using bibliometric methods to identify critical trends, influential authors, prominent themes, and emerging topics in the field. Material and Method: A comprehensive literature search was conducted using the Web of Science (WoS) database for articles on TOS published between 1980 and 2023, employing the keyword 'thoracic outlet syndrome.' The collected data were analyzed using bibliometric methods. VOSviewer software was utilized to visualize bibliometric networks and map critical findings. Citation analysis was performed to identify influential journals and significant articles in the field. Additionally, keyword clustering and trend analyses were conducted to explore the thematic landscape of TOS research. Results: In a literature search on TOS, 2248 publications were found, with 1509 journal articles (67.13%) included in the bibliometric summary. The most common research area was surgery (633 articles, 41.94%), and the United States had the highest publication productivity (684 articles, 45.32%). The University of California System had the highest number of publications among institutions (62 articles, 4.1%). These 1509 articles received 7831 citations (6596 excluding self-citations), averaging 13.1 citations per article and with an h-index of 57. 'Annals of Vascular Surgery' published the most articles (71, 4.7%), while 'Journal of Vascular Surgery' had the highest number of cited articles (65, 4.3%), accumulating 2563 citations. Conclusion: This bibliometric analysis provides valuable insights into the evolution and trends of research on TOS. The keyword analysis offers a roadmap for researchers to design new studies. Additionally, the study highlights the influence of economic size and development levels on academic productivity in TOS, underscoring the importance of promoting multidisciplinary studies, especially in less developed countries.63 citations. Conclusion: This bibliometric analysis provides valuable insights into the evolution and trends of research on TOS. The keyword analysis offers a roadmap for researchers to design new studies. Additionally, the study highlights the influence of economic size and development levels on academic productivity in TOS, underscoring the importance of promoting multidisciplinary studies, especially in less developed countries.Öğe Open reduction and plate fixation, external fixator, and conservative treatment for intra- articular distal radius fractures(Springernature, 2024) Akdemir, Mehmet; Kılıç, Ali Ihsan; Kurt, Cengizhan; Çapkın, SercanBackground Distal radius fractures are common fractures. Treatment of intra-articular fractures is controversial, with treatment modalities including closed reduction and casting, open reduction and plating, and closed reduction and fixation with an external fixator. In this study, we compared the clinical and radiological outcomes of our patients treated with three different methods for intra-articular distal radius fractures. We hypothesize that open reduction and plate application are superior. Methodology Adult patients with intra-articular (AO type B and C) fractures of the distal radius and treated with closed reduction-casting, volar locking plate, and external fixator were identified. Radiologically, joint stepping at the end of treatment, radial inclination, radial height, volar tilt, and distal ulna fracture were examined. For clinical scoring, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) scores were computed. Obtained data were compared statistically between groups. Results A total of 164 patients were included in the study. Overall, the treatment modality was conservative in 61, volar with plating in 78, and external fixation in 25. The mean age of the patients was 53.7 years (range = 20-82 years). Overall, 39.6% of the patients were male and 60.4% were female. The mean follow-up period of the patients was 16.7 months (range = 12-28 months). No statistically significant difference was found between Q-DASH scores in the statistical evaluation (p > 0.05). There was a statistically significant difference between the groups in the radiological evaluation. When conservative treatment and the volar plate group were compared, the volar plate was superior in all radiological parameters (p < 0.05). Compared with conservative treatment and external fixation, only volar tilt and radial inclination angle were different. External fixation was better (p < 0.05). Radial length, volar compared to plate and external fixation tilt, and ulnar variance were better in the plate group (p < 0.05). Regarding joint stepping and radial, there was no difference in inclination between the two groups (p > 0.05). Reflex sympathetic dystrophy was seen in a total of 10 (6.1%) patients. Pin-site infection was seen in three (12%) patients in the external fixator group. Implant removal was performed in seven (9.0%) patients who developed plaque due to irritation and tenosynovitis. Early arthrosis was seen in three (4.3%) patients. Conclusions The treatment of distal radius intra-articular fractures should be evaluated and decided individually for each patient. No single method is directly superior to other methods. However, in some cases, the best results radiologically in the treatment of comminuted intra-articular fractures have been obtained in patients with volar plates.Öğe Quality Assessment of YouTube Videos on Avascular Necrosis of the Femoral Head: An Analysis of Content, Reliability, and Educational Value(2024) Kılıc, Ali Ihsan; Sayer, Gokhan; Akdemir, MehmetAim: Videos related to avascular necrosis of the femoral head are no exception, and so the aim of this study is to evaluate the educational quality of YouTube videos on this topic. Material and Method: A standardized video search was performed on YouTube using the terms “avascular necrosis of the hip”, “osteonecrosis of the hip” and “avascular necrosis of the femoral head”. The top 50 videos were then analyzed, and the characteristics and content of the videos were recorded. The Journal of American Medical Association criteria, The DISCERN score, The Global Quality Score and the new YouTube ‘Avascular Necrosis of the Femoral Head Score” were all used to assess the reliability and accuracy of the videos. Results: The median video duration of the 50 videos was 10.85±19.17 minutes. The median number of views was 10,866 (range 221 to 278,174). According to the video content, 60% of the videos contained information about the disease, 10% were about patient experience, and the remaining 30% related to surgical technique or approach. Physicians were the primary uploader on YouTube for this topic. The rate of low-quality videos was determined as following according to the different evaluative systems: 68% according to the newly defined YouTube Avascular Necrosis of the Femoral Head Score, 60% according to the DISCERN score, and 56% according to The Global Quality Score. The Journal of the American Medical Association, The Global Quality Score, and DISCERN score were significantly correlated with video duration, while the New YouTube Avascular Necrosis of the Femoral Head Score was significantly correlated with video duration, time since upload, number of views, and like rate. Conclusion: Most of the popular YouTube videos about avascular necrosis are of a low quality.Öğe Retrospective comparison of open and percutaneous repair methods in acute achilles- tendon repair(2022) Kılıç, Ali İhsan; Akdemir, Mehmet; Turan, Ahmet CemilPurpose: In recent years Achilles’ tendon tears are becoming more common. Open and percutaneous repair methods have been described in the surgical treatment of tendon tears. The aim of this study is to determine whether there is a difference between open repair and percutaneous repair. Methods: Patients who underwent surgical repair due to acute Achilles’ tendon full-thickness rupture in our clinic, were included in the study. Open repair was performed for one group of patients and percutaneous repair was performed for the other. At the end of follow-up, clinical scores and complication rates were compared statistically. Results: Thirty-six patients with a mean age of 46.3 years were included in the study. Nineteen patients were treated with the open method and seventeen patients with the percutaneous method. The mean follow-up period was 27.3 months for both groups. Mean Leppilahti scores were 94.71 in the percutaneous repair group and 90.79 in the open repair group (p>0.05). Re-rupture, deep infection and DVT rates were similar (p>0.05). Skin necrosis was more common in the open repair group (p<0.05). While sural nerve neuropraxia was more common in percutaneous repair (p<0.05). Conclusion: In the surgical treatment of acute Achilles’ tendon tears, the percutaneous method should be the first choice with its low complication rate and good clinical results. It is necessary to pay attention to the sural nerve during surgery.Öğe RETROSPECTIVE COMPARISON OF TWO DIFFERENT FIXATION METHODS FOR FIRST METATARSOPHALANGEAL JOINT ARTHRODESIS(Dokuz Eylul Univ Inst Health Sciences, 2023) Akdemir, Mehmet; Turan, Ahmet Cemil; Kilic, Ali IhsanPurpose: Arthrosis of the first MTP joint is a common condition. Among the available arthrodesis methods, plate/screw and screw methods are the current treatment methods of choice. In this study, we investigated whether there is a difference between these two methods. Material and Methods: Thirty-four toes of 32 patients with advanced arthrosis were included in the study. Eighteen arthrodesis were fixed with locking plates/screws and 16 with cross-screws. In the radiological evaluations, malunion and nonunion were examined. Clinical evaluation was made according to AOFASResults: The mean age of the patients was 57.74 +/- 10.079 years and the mean follow-up period was 22.21 +/- 9.108 months. There was no statistically significant difference in clinical scores or union times between the two groups. As complications, superficial skin problems developed in 2 (5.9%) cases, deep infection in 3 (8.8%) cases, and nonunion in 3 (8.8%) cases. There was no statistically significant Conclusion: Plate/screw and cross-screw techniques give similar clinical and radiological results in cases of arthrodesis of the first MTP joint. The cross-screw technique, which can be performed more easily and
