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Öğe A comparison of the effects on postoperative bleeding of the intra-articular application of tranexamic acid and adrenalin in total knee arthroplasty(PAKISTAN MEDICAL ASSOC, 2019) Durgut, Fatih; Erkocak, Omer Faruk; Aydin, Bahattin Kerem; Ozdemir, Ali; Gulec, Ali; Tugrul, Ali IhsanObjective: To compare the efficacies of intra-articular applications of tranexamic acid and adrenaline on postoperative bleeding after total knee arthroplasty. Methods: The single-center, retrospective, controlled study was conducted at Selcuk University, department of orthopedics surgery and comprised data of patients who underwent primary, unilateral, cemented total knee arthroplasty between July 2012 and December 2014. Group 1 had received tranexamic acid 1g after closure of articular capsule. Group 2 had received adrenalin. Group 3, the control group, received no medication intra-articularly after total knee arthroplasty. The amount of blood collected in the drain and postoperative alterations in haemoglobin and haematocrit values were compared. Results: Of the total 90 subjects, there were 30(33.33%) in each of the three groups. The decrease of haemoglobin and haematocrit values in Group 1 was statistically significant compared to both Group 2 and Group 3 (p<0.05). The amount of blood collected in the drains was remarkably lower in Groups I and 2 compared to Group III (p<0.05). No deep venous thrombosis or pulmonary emboli were encountered across the sample. Conclusion: Intra-articular administration of tranexamic acid was found to be beneficial and safe for the achievement of effective haemostasis after total knee arthroplasty.Öğe Lower limb injuries secondary to hoeing machine cccidents(2019) Güleç, Ali; Durgut, Fatih; Ozdemir, Ali; Yıldırım, Ahmet; Aydın, Bahattin KeremAgricultural accidents are important for Turkey as more than 20 million people are involved in agriculture. The aim of this study was to evaluate orthopaedic lower limp injuries related to hoeing machine from a trauma centre localized in Middle Anatolia Region. 15 patients who hospitalized for hoeing machine were included to study due to lower limp injuries between April 2012 and May 2017. All the medical records were scanned retrospectively to evaluate “the demographic, epidemiologic characteristics of patients, cause of accidents, type of injury, duration of hospital stay and also hospital costs were evaluated retrospectively “. According to database, fifteen patients were hospitalised for lower limp injuries (14 were male, 1 female). The mean age was 45.2 (19-64) years old. The most frequent injury was tibia fracture (64 %). The mean hospital stay time was 14 days (between 1and 53). The mean cost was 11.140,16 (500 and 27.115,08) Turkish Liras. The rate of knee dislocation was 26 %. Most prevalent injury was tibia fracture. Simple precautions can be effective for preventing this kind of injuries. Meticulous examination is important as the rate of knee dislocation is high in these types of traumas.Öğe Other benefits of intra-articular injection of tranexamic acid in primary total knee arthroplasty apart from reducing blood transfusion rates(TURKISH JOINT DISEASES FOUNDATION, 2017) Aydin, Bahattin Kerem; Durgut, Fatih; Erkocak, Omer Faruk; Acar, Mehmet AliObjectives: This study aims to evaluate the effect of intraarticular tranexamic acid (TA) administration on the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and the total cost in total knee arthroplasty (TKA) patients. Patients and methods: The study included a total of 118 patients (24 males, 94 females; mean age 67.0 years, range 52 to 81 years) who underwent primary unilateral TKA surgery. Patients were divided into two groups as 58 patients who were performed intra-articular injection of 2 g TA after closure of articular capsule (TA group; 10 males, 48 females, mean age 65.6 years; range 55 to 80 years) and 60 patients who were not performed any intra-articular injection (non-TA group; 14 males, 46 females; mean age 68.3 years; range 52 to 81 years). The maximum difference between pre-and postoperative hemoglobin levels, the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and cost of each patient were recorded. Results: The mean difference between pre-and postoperative hemoglobin levels were higher in the non-TA group (1.7 g/dL vs 2.6 g/dL, p<0.05). The mean amounts of blood in drains (327.5 mL vs 800.0 mL, p<0.05), the amounts of blood transfusions (0 units vs 10 units, p<0.05), the mean lengths of hospital stay (4.03 days vs 4.53 days, p<0.05), and the hospital costs (1,935.26 United States dollars vs 1,959.64 United States dollars, p<0.05) were lower in TA group. Conclusion: Administration of intra-articular TA during primary TKA may reduce blood loss and the need for blood transfusion while significantly shortening the postoperative length of hospital stay and reducing the total hospital costs. rthroplasty;Öğe Percutaneous double-button fixation method for treatment of acute type III acromioclavicular joint dislocation(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2015) Acar, Mehmet Ali; Gulec, Ali; Erkocak, Omer Faruk; Yilmaz, Guney; Durgut, Fatih; Elmadag, MehmetObjective: The aim of this study was to evaluate the functional and radiological results of patients treated with the percutaneous double-button technique for acute acromioclavicular (AC) joint dislocation. Methods: A retrospective evaluation was performed of 13 patients surgically treated for acute Type III AC joint dislocation with the percutaneous double-button fixation method. The coracoclavicular (CC) distance of the affected side was compared with that of the healthy side on anterior-posterior radiographs obtained at the final follow-up. In the functional evaluation, Disabilities of the Arm, Shoulder and Hand (DASH), Constant, and visual analog scale (VAS) scores were used. Results: The 13 patients in the study included 12 males and 1 female with a mean age of 43.4 years (range: 22-60 years). The mean follow-up period was 13.61 months (range: 9-24 months). The mean CC distance on the operated side was 9.23 mm (range: 8-15 mm), and when compared with the healthy side, no statistically significant difference was observed. Preoperative Constant scores of a mean of 30.3 (range: 18-42) increased to 84.4 (range: 70-90) at the final follow-up. Preoperative DASH scores had a mean of 14.1 (range: 11-28) and decreased to 0.4 (range: 0-3) at the final follow-up (p<0.001). Mean preoperative VAS score was 6.0 (range: 5-8), which decreased to 0.6 (range: 0-3) at the final follow-up (p<0.001). Conclusion: The percutaneous double-button fixation technique is a safe, practical, and effective fixation method that can be used as an alternative to arthroscopic and open methods for acute Type III AC joint dislocations.Öğe Short-term results of early (before 6 months) open reduction of dislocated hips in arthrogryposis multiplex congenita(LIPPINCOTT WILLIAMS & WILKINS, 2016) Aydin, Bahattin K.; Yilmaz, Guney; Senaran, Hakan; Durgut, FatihThe aim of this study was to report the results of early open reduction of hip dislocations in infants with arthrogryposis multiplex congenita. Seven patients who were under 6 months of age at the time of hip reduction, with a mean follow-up period of 47.5 +/- 11.3 months after surgery, were included in this study. Four of seven patients (six of 13 hips) required additional hip surgeries during their follow-up. The short-term results of early open reduction of hips were not promising as most of the patients required additional hip surgeries. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.Öğe Total diz protezi cerrahisinde intraartiküler uygulanan traneksamik asit ve adrenalin in postoperatif kanama üzerine etkinliklerinin karşılaştırılması(Selçuk Üniversitesi Tıp Fakültesi, 2015) Durgut, Fatih; Erkoçak, Ömer FarukGiriş: Total diz protezi uygulaması sonrası kanama miktarını azaltmak için ameliyat sonunda diz eklemi içerisine uygulanan traneksamik asit ve adrenalinin kanama üzerine etkileri değerlendirildi. Gereç ve Yöntem: Temmuz 2012 - Aralık 2014 tarihleri arasında primer TDP uygulanan hastalar arasında kriterlere uyan 90 hasta retrospektif olarak incelendi. Kanama bozukluğu olan, antitrombotik veya antiagregan ilaç kullanan, daha önce diz çevresinden cerrahi geçirmiş, TEA ve adrenalin alerjisi olan, patellar komponenti değişmiş olan veya romatolojik nedenlerle TDP yapılmış hastalar çalışma dışı bırakıldı. Hastalar diz içerisine TEA uygulanan, adrenalin uygulanan ve kontrol grubu olmak üzere 3 gruba ayrıldı.Her 3 grupta ameliyat sonunda eklem içerisine dren yerleştilip kapsül kapatıldı. TEA ve adrenalin grubunda ajanlar eklem içine uygulandı. Dren 30 dakika sonra açıldı ve 24 saat sonunda çekildi. Gruplar drenden gelen kan miktarı, preoperatif ve postoperatif 24. saat Hb –Htc farkı açısından karşılaştırıldı. Bulgular: Her 3 grupta yaş, cinsiyet, VKI, ek hastalık, preoperatif Hb-Htc değerleri açısıdan homojen dağılım mevcuttu. Ameliyat öncesi ve ameliyat sonrası 24. saatteki Hb değerleri farkı TEA grubunda 1,68 , adrenalin grubunda 2,30 , kontrol grubunda 2,67 idi. Htc farkı ise TEA grubunda 5,68 , adrenalin grubunda 7,44 , kontrol grubunda 8,37 idi. Hb ve Htc düşüşü istatiksel olarak incelendiğinde diğer iki gruba göre TEA grubunda daha azdı.(p=0,00) Drenden gelen kan miktarı TEA grubunda 321 ml, adrenalin grubunda 615 ml, kontrol grubunda 800 ml olarak ölçüldü. Buna göre drenden gelen kan miktarı açısından TEA ve adrenalin grubu kontrol grubuna göre, TEA grubuda adrenalin grubuna göre anlamlı olarak az kanamıştır. (p=0.00) Hiçbir hastada klinik olarak DVT ve pulmoner emboli tespit edilmedi. Sonuç: TEA nın TDP cerrahisi sonrası lokal olarak eklem içine uygulanması ve ardından drenin belirli süre kapalı bırakılmasının kontrol grubuna göre oldukça etkili olduğu, hatta vazokonstrüktör bir ajan olan adrenalinden daha iyi kanama kontrolü sağladığı tespit edilmiştir. Bu verilere göre eklem içi TEA uygulamasının TDP cerrahisindeki kanama kontrolünde faydalı olacağı kanaatindeyiz
