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    COMPARISON OF FUNCTIONAL OUTCOMES AND KINESIOPHOBIA LEVELS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH HAMSTRING TENDON AUTOGRAFT VERSUS FRESH-FROZEN ALLOGRAFT: A CROSS-SECTIONAL STUDY
    (Kılıçhan BAYAR, 2024) Eldemir, Sefa; Öztemür, Zekeriya
    Objective: Determining the best graft in the selection of various graft types for anterior cruciate ligament reconstruction (ACLR) is still unclear. The study aimed to compare the functional outcomes and kinesiophobia among individuals who underwent ACLR with either hamstring tendon autograft or fresh-frozen allografts and healthy individuals. Method: A total of 44 individuals undergoing ACLR and 30 healthy individuals were assessed. Individuals who underwent ACLR with hamstring tendon autograft (Group 1) or fresh-frozen allograft (Group 2) and a control group with similar activity levels (Group 3) were included in this study. The surgical groups were evaluated 12-48 months after surgery. Evaluations included detailed history, knee muscle strength, single-leg hop test, and kinesiophobia. Results: There were 24 individuals (mean age 31.71±9.78 years) in Group 1, 20 individuals (mean age 32.35±5.58 years) in Group 2, and 30 healthy controls (mean age 33.77±7.09 years) in Group 3. There was no difference between the surgical groups in terms of single-leg hop test, kinesiophobia, and muscle strength (p>0.05). However, there were significant differences between the ACLR groups with the control group in terms of muscle strength of injured side (p<0.002), single-leg hop test (p<0.029), and kinesiophobia level (p=0.005). Conclusion: This study showed that no graft type was superior to another in terms of functional outcomes and kinesiophobia after ACLR. In addition, the need for long-term rehabilitation of individuals with ACLR should be taken into consideration to reach their pre-operative functional level.
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    Deneysel spinal kord yaralanma modelinde erken dekompresyonun etkinliği
    (Cumhuriyet Üniversitesi, 2005) Öztemür, Zekeriya; Tezeren, Gündüz
    IV ÖZET Bu çalışmamızda deneysel akut omurilik yaralanması hayvan modelinde, erken cerrahi dekompresyonun etkinliğim araştırmak için, motor sistemin yanı sıra mesane ve korpus kavernozum gibi düz kaslı dokuları da inceledik. Yirmi bir adet 9-12 aylık Yeni Zelanda tipi, erişkin erkek tavşan ile çalışmaya başlandı. Benekler kontrol grubu ( n=5), İarmnektomi grubu ( n=6), 15 saniye kompresyon grubu < n=5) ve 60 sn kompresyon grubu ( n=5) olmak üzere 4 gruba ayrıldı. Laminektomi grubuna sadece larateektomi işlemi yapıldı. Rompresyon gruplarına 60 g kapama gücü olan anevrizma klipsi ile 15 ve ?ö saniye kompresyon uygulandı. 1, 3, 5 ve 7. günler Modifiye Tarlov skora ile motor değerlendirme yapıldı. 7 gün sonunda bütün denekler sakrifiye edilerek spinal kordlanndan nistopatolojik çalışma ile beraber izole mesane ve korpus kavernozum dokularından in vitro organbanyosundakasüma ve gevşeme yanıtları incelendi. Moâifîye Tarlov skoruna bakıldığında gruplar arası fek anlama bulundu (p<0.Q5); Korpus kavernozum karbakol ile gevşeme yanıtlarına bakıldığında 15 ve 60 sn lik kompresyonlu grupta maksimum gevşeme yanıtlan istatistiksel olarak benzer idi ve bu gruplardaki maksimum gevşeme yanıtları gerek kontrol gerekse lammekîomfii gruba göre anlamlı oranda azâHniftt. ( p<0.05). Lammektonül ve kontrol grupla karşılaştırıldığında ksimum gevşeme yararları arasında anlamlı fek bulunmadı (p>0;05). Her 4 grupla da pD2 değerlei benzerdi {p>0.0 5)s İzole mesane detrussor kas preperatlannda karbakolun aftan konsantrasyonlarında kasılına yanıtlarına bakıldığında 15 ve 60 sn lik kompresyonlu grupta kasılma yanıtları istatistiksel olarak benzer idi. Bu gruplardaki maksimum kasama yanıtlan gerek kontrol gerekse laminektomili gruba göre anlamlı oranda artmıştı. (p<0.05). laminekomili ve kontrol grupları karşılaşıldığında maksimum kasima yanıtları arasında anlamlı fek bulunamadı 0.05% her 4 grupta dapD2 değerleri benzerdi (p>0.05). Sonuç olarak akut spinal kord yaralanması deney modelimizde erken cerrahinin etkinliği motor bulgular açısından olumlu bulunmuştur. Mesane ve korpus kavernozum gevşeme ve kasılma yanıtları açısından sonuçlar erken cerrahi lehinedir Ancak istatistiksel olarak fark bulunmamıştır.. İstatistiksel olarak fek olmamasına rağmen, erken dekompresyon cerrahisinin olumlu etkisini göstermek İçin değişik kapama gücü ve kompresyon süresi ile yeni deney modellerine ihtiyacımız olduğu düşüncesindeyiz Anahtar kelimeler erken dekompresyon, mesane, korpus kavernozum, spinal kord yaralanması, omurilik.
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    Evaluation of urinary bladder function after acute spinal cord injury: An experimental study
    (Turkish Joint Diseases Foundation, 2010) Öztemür, Zekeriya; Tezeren, Gündüz; Ba?civan, Ihsan; Saraç, Bülent; Durmuş, Nedim; E?ilmez, Reyhan
    Objectives: The aim of this study was to evaluate the efficacy of early surgical decompression of acute spinal cord injury through the evaluation of urinary bladder function in rabbits. Materials and methods: The study was done with 21 New Zealand male rabbits which were 9 to 12 months in age, and weighed an average of 2438 grams (range 2150 to 3550 g). The animals were assigned into four groups as follows: a control group (n=5), a laminectomy group (n=6), a 15-second compression group (n=5) and a 60-second compression group (n=5). A 60 gram compression force was applied on both compression groups with aneurysm clips. All rabbits were sacrificed seven days postoperatively. Urinary bladder tissues were dissected and in vitro relaxation and contraction tests were performed in organ baths. Results: At the beginning of each experiment, 80 mM KCl was added to the isolated organ bath with no significant difference among all four groups (p>0.05). Carbachol was then added to the organ bath and contraction responses were obtained. Carbachol contraction responses were calculated as the percentage of the 80 mM KCl contraction responses, with compression groups showing significant difference from control and sham-operated groups (p<0.05). Electrical field stimulation responses were obtained for all group preparations at 4, 8, 16, 32 Hz frequencies, and showed significant difference in the 15 and 60-second compression groups (p<0.05). The contractility was assessed using E-max and pD2 values. All groups exhibited same pD2 values. Conclusion: The study demonstrated a slightly better outcome for bladder contractility with early decompression. However, there was no significant difference between early and delayed decompression groups.
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    Histological and scanning electron microscopy investigation of the effects of titanium surface modifications on osseointegration in rabbits
    (AVES, 2024) Aydın, Burak; Öztemür, Zekeriya; Yeldir, Neşe; Kılınç, Seyran; Aktı, Sefa; Bilgin, İsmail
    Objective: This study aimed to compare the novel Estaş Medical Anodization (EMA) surface treatment technique with the techniques commonly used in the literature and to examine their effects on osteointegration in the rabbit tibia. Methods: A total of 24 rabbits used in this study were divided into 3 groups, with 8 rabbits in each group. Using both tibias of all rabbits in the study, screws belonging to the control group were placed in the left tibia, and the right tibia belonging to the experimental group were placed. In the first 8 rabbits, a single experimental group in the right tibia were used; in the second 8 rabbits, 2 different experimental groups in the right tibia were used; and in the last 8 rabbits, 2 different experimental groups in the right tibia were used. Thus, 5 different experimental groups with 8 screws in each group and a separate control group were formed for each of them. EMA-treated surfaces were named 200-800 nm iris oxidation and 800-1200 nm gray oxidation according to the TiO2 layer thickness. Group 1 was implanted with mini-screws prepared with chemical etching + EMA iris oxidation, while group 2 was implanted with sandblasted, large-grit and acid-etched (SLA) mini screws treated with EMA gray oxidation. Group 3 was implanted with mini-screws treated with EMA gray oxidation, group 4 was implanted with mini-screws treated with chemical etching + micro-arc oxidation, and group 5 was implanted with mini-screws treated with chemical etching + EMA gray oxidation. The control group was implanted with mini-screws prepared with pure titanium. At the end of 6 weeks, osseointegration percentages were calculated and compared using histological and scanning electron microscope (SEM) analyses. Results: The histological results confirmed the increase in osseointegration percentages in all experimental groups compared to those that received pure titanium implants (P values control group vs group 1 = .005, control group vs group 2, 3, 4, 5 = .001). The comparison between the groups revealed that the chemical etching + EMA gray oxidation modification technique (group 5) significantly increased osseointegration compared to the SLA + EMA gray oxidation technique (group 5 vs group 2 P = .016) and the chemical etching + EMA iris oxidation technique (group 5 vs group 1 Pp = .001). The EMA gray oxidation technique (group 3) significantly increased osseointegration compared to the chemical etching + EMA iris oxidation technique (group 1) (group 3 vs group 1 P = .043). The results of the SEM analysis showed that osseointegration was significantly increased in all experimental groups compared to that in the pure titanium (control) group (P values control group vs group 1, 2, 3 = .001, control group vs Group 4,5 = .006). The mean osseointegration percentage in the experimental groups was the highest in group 5, followed by group 4, group 3 and group 1 equally, and group 2. However, the differences among the experimental were not significant (group 1, group 2, group 3, group 4 vs group 5 P = .408). Conclusion: The EMA titanium surface modification techniques we developed significantly increased osseointegration compared to the pure titanium surface. The EMA gray oxidation technique seems to result in higher osseointegration rates than the EMA iris oxidation technique, and similar rates can be found with the SLA and chemical etching techniques. © 2024, AVES. All rights reserved.
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    YETİŞKİN HASTALARDA PROKSİMAL HUMERUS KIRIKLARI CERRAHİ TEDAVİ SONUÇLARIMIZ Surgical Treatment Results for Proximal Humerus Fracture in Adult Patients
    (2018) Pıçakçı, Ömer; Kılınç, Seyran; Pazarcı, Özhan; Öztürk, Hayati; Tezeren, Seyfi Gündüz; Öztemür, Zekeriya; Bulut, Okay
    Amaç: Humerus proksimal uç kırığı nedeni ile proksimal humerus kilitli plağı kullanılarak ameliyat edilen 38hastanın kırık tipi ve yaşa göre, klinik ve radyolojik sonuçlarını değerlendirmeyi amaçladık.Yöntem: Humerus proksimal kilitli plak cerrahisi uygulanan, yaş ortalaması 45,9 (aralık 16-74) olan 38 hasta(26 erkek , 12 bayan) çalışmaya alındı. Çalışmada 11 hasta 60 yaş üstü (aralık 60-74), 27 hasta 60 yaş altı(aralık 16-57) hastadan oluşmakta idi. Hastaların hastanede kalış süresi ortalama 10.1 gün (aralık 2-46 gün)idi. Hastaların ortalama takip süresi 9,5 ay (aralık 4-36 ay) idi. Değerlendirmeler Constant-Murley(CM) skor-lamasına göre yapıldı.Bulgular: Neer sınıflamasına göre 2 hasta tip1, 11 hasta tip2, 16 hasta tip 3 ve 9 hasta tip 4 kırık idi. Gruplaragöre ortalama CM skoru sırasıyla 93,60/78,27/79,00/62,66 olarak bulundu. 60 yaş üstü hasta grubu CMskoru 65,72, 60 yaş altı CM skoru 79,74 idi. Tüm hastalarda 3 ay sonunda tam kaynama görüldü. Cerrahiişlemler sonrası bir hastada avasküler nekroz, bir hastada implant yetmezliği, iki hastada antibiyotik teda-visi ve yıkama debritman ile tedavi edilen yüzeysel yumuşak doku enfeksiyonu ve iki hastada subakromiyalsıkışma görüldü.Sonuç: Hastaların kırık tipi ve fonksiyonel sonucun karşılaştırılmasın da kırık tipi arttıkça fonksiyonel sonuç-ların azaldığı, 60 yaş altı hastaların, 60 yaş üstü hastalara göre daha iyi fonksiyonel sonuçların olduğu izlendi.Kilitli plak uygulamasının tekniğine uygun şekilde yapıldığında, güçlü stabilizasyon ve erken rehabilitasyonaizin vermesi nedeniyle özellikle artan yaşlı nüfus populasyonun da iyi bir tercih olduğunu düşünmekteyiz.