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Öğe 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis(SPRINGER HEIDELBERG, 2018) Tuncer, Tiraje; Cay, Fatih Hasan; Altan, Lale; Gurer, Gulcan; Kacar, Cahit; Ozcakir, Suheda; Atik, Sahap; Ayhan, Figen; Durmaz, Berrin; Eskiyurt, Nurten; Genc, Hakan; GokceKutsal, Yesim; Gunaydin, Rezzan; Hepguler, Simin; Hizmetli, Sami; Kaya, Taciser; Kurtais, Yesim; Saridogan, Merih; Sindel, Dilsad; Sutbeyaz, Serap; Sendur, Omer Faruk; Ugurlu, Hatice; Unlu, ZelihaIn a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.Öğe Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis(Turkish League Against Rheumatism, 2023) Altan, Lale; Okmen, Burcu Metin; Tuncer, Tiraje; Sindel, Dilsad; Cay, Hasan Fatih; Hepguler, Simin; Sarikaya, SeldaObjectives: The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients.Patients and methods: This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6 +/- 10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings.Results: Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion: The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain.Öğe Evidence-Based Recommendations for the Management of Knee Osteoarthritis: A Consensus Report of the Turkish League Against Rheumatism(TURKISH LEAGUE AGAINST RHEUMATISM, 2012) Tuncer, Tiraje; Cay, Hasan Fatih; Kacar, Cahit; Altan, Lale; Atik, Osman Sahap; Aydin, Ahmet Turan; Ayhan, F. Figen; Yanik, Burcu Corekci; Durmaz, Berrin; Eskiyurt, Nurten; Genc, Hakan; Kutsal, Yesim Gokce; Gunaydin, Rezzan; Hepguler, Simin; Hizmetli, Sami; Kaya, Taciser; Kurtais, Yesim; Olmez, Nese; Saridogan, Merih; Sindel, Dilsad; Tur, Birkan Sonel; Sutbeyaz, Serap; Sendur, Omer Faruk; Ugurlu, Hatice; Unlu, ZelihaObjectives: Knee osteoarthritis (OA) is a common disease which causes pain, disability and great socioeconomic burden as a result. Turkish League Against Rheumatism (TLAR) initiated a project to prepare national, "evidence-based recommendations for the management of knee osteoarthritis" supported by expert-opinion in order to assist the physicians who are interested in knee OA in their daily clinical practice. Materials and methods: The expert committee was composed of 25 academicians, 23 of whom were physical medicine and rehabilitation (PM&R) specialists (three also had rheumatology subspeciality) and two were orthopedic surgeons. At the first meeting, the previous guidelines were discussed, and 2008 Osteoarthritis Research Society International (OARSI) recommendations were decided to be taken as the fundamental template for national recommendations. Databases of the Pubmed, Embase, Cochrane, and Turkish Medical Index were used to search the literature, and this was carried out for the period between 2009-2010 for international publications since studies up to 2009 were present in the 2010 OARSI update. No limit was applied for searching of national publications. The selected relevant publications were graded according to evidence level and quality, and were sent to the members who were then asked to suggest propositions according to their experiences, knowledge, and review of the literature. After amalgamation and editing of new proposals, Delphi rounds were started. After five Delphi rounds, the propositions on which the members were in consensus, were discussed with regard to evidence and the "strength of recommendation" was determined by measuring on visual analog scale (VAS) for each proposal at the final meeting. Results: Nineteen propositions (one for general principles, nine for non-pharmacologic treatments, seven for pharmacologic treatments, and two for surgical treatments) were accepted as the "TLAR Evidence-Based Recommendations for the Management of Knee OA" in consensus as a result of Delphi rounds. Conclusion: Evidence-based recommendations for the management of knee OA were developed by TLAR for the first time in our country. The recommendations should be updated regularly according to new evidence and insights. It is expected that physicians who are interested in knee OA will benefit greatly from this report in their daily clinical practice.Öğe Neuropathic Pain in Patients with Knee Osteoarthritis and Related Factors: A Multicenter Longitudinal Study-Preliminary Report(WILEY, 2017) Kaptanoglu, Ece; Sahin, Ozlem; Tuncer, Tiraje; Hizmetli, Sami; Altan, Lale; Ayhan, Figen; Bal, Ajda; Bilgilisoy, Meral; Bozbas, Gulnur; Cerrahoglu, Lale; Cevik, Remzi; Duruoz, Tuncay; Dulgeroglu, Deniz; Gurer, Gulcan; Gursoy, Savas; Hepguler, Simin; Kacar, Cahit; Kaya, Taciser; Melikoglu, Meltem; Nas, Kemal; Ozcakir, Suheda; Ozdolap, Senay; Saridogan, Merih; Sarikaya, Selda; Sindel, Dilsad; Sendur, Omer F.; Tikiz, Canan; Ugurlu, Hatice…
