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Öğe Does femoral back wall failure affect the functional results of arthroscopic anterior cruciate ligament surgery?(EDIZIONI MINERVA MEDICA, 2013) Elmadağ, Mehmet; Erdil, Mehmet; Bilsel, Kerem; Acar, Mehmet Ali; Tuncay, I.; Yel, M.Aim. The aim of the study was to evaluate the effects of femoral back wall failure (FBWF) due to tunnel enlargement after anterior cruciate ligament (ACL) surgery on clinical outcomes. Methods. The functional results of 40 ACL reconstructions were evaluated prospectively. The study includes ACL reconstructions with transtibial single bundle technique with hamstring autografts whereas those with concomitant knee ligament injuries were excluded. Tunnel enlargements were measured with CT scan at the end of the 12th month after surgery Functional results were evaluated at the first year follow-up by an anterior drawer test, Lachman test, rollimeter, IKDC, and Lysholm Knee Scale. Results. Femoral and tibial tunnel enlargement was measured in all of our patients with 39% mean enlargement in femoral tunnels and 48% in tibial tunnels. No significant correlation between amount of tunnel enlargement and clinical outcomes was obtained. Additionally, no significant correlation between tibial fixation type and tibial tunnel enlargement was found (P>0.05). In nine patients (22.5%), FBWF was evaluated. These nine patients did not show any significant difference in clinical outcomes than the other 31 patients (P>0.05). Conclusion. Excessive femoral tunnel enlargements after ACL surgeries may lead FBWF. This pathology does not affect clinical outcomes. However, FBWF with bone defect may cause more complicated ACL revision surgery. This fact must be kept in mind by orthopedic surgeons.Öğe Ilizarov External Fixation for Severely Comminuted Supracondylar and Intercondylar Fractures of the Distal Femur(British Editorial Soc Bone Joint Surgery, 2001) Arazi, M.; Memik, R.; Ogün, T. C.; Yel, M.Our aim was to determine the clinical effectiveness and safety of Ilizarov external fixation for the acute treatment of severely comminuted extra-articular and intercondylar fractures of the distal femur. A total of 14 consecutive patients with complex fractures was treated. There were three type-A3, two type-C2 and nine type-C3 fractures according to the AO/ASIF system. The mean follow-up was 14 months. Most fractures (13) united primarily at a mean of 16 weeks. One patient with a type-IIIA open fracture had infection and nonunion. The mean range of flexion of the knee at the final follow-up was 105 degrees (35 to 130). We conclude that, in the treatment of comminuted fractures of the distal femur, the Ilizarov fixator is safe and effective in providing stability and allowing early rehabilitation.Öğe Results of Decompression and Rotator Cuff Repair in Patients 65 Years Old and Older: 6- to 14-year Follow-up.(2001) Yel, M.; Shankwiler, J. A.; Noonan , Jr. J. E.; Burkhead, Jr. W. Z.At an average of 9.2 years after surgery, 47 patients with 51 shoulders who had undergone rotator cuff repair and subacromial decompression through an open Rockwood 2-stage acromioplasty-type approach were reviewed. All patients were 65 years or older at the time of their initial index procedure. Results were rated by patient satisfaction, the Constant's score, American Shoulder and Elbow Surgeons (ASES) Evaluation, and Neer rating. Subjectively, the patients were highly satisfied, with a 94.1 overall satisfaction rate. Objectively, the average Constant's score was 82 when normalized to the opposite shoulder and age. According to the Neer rating scale, there were 20 (39%) excellent, 26 (51%) satisfactory, and 5 (10%) unsatisfactory results. When assessing the ASES Evaluation, the patients who had undergone an extensile deltotrapezial takedown had increased strength in their lateral deltoid as compared with a cohort of individuals who had undergone the VY exposure. There was no statistically significant difference in subjective or objective results. For the most part, open rotator cuff repair and subacromial decompression in older patients has a high level of success with respect to pain relief, independent living, and when desired, reasonable sports participation.Öğe The Utility of Dermatomal Somatosensory Evoked Potentials (Dseps) in Diagnosis and Prognosis of The Unilateral Lumbosacral Radiculopathy Due to Herniated Intervertebral Disc(1995) Özerbil, O. M.; Demir, O.; Oğuz, H.; Genç, B. O.; Yel, M.In this study, determination of the utility of DSEPs in patients with unilateral lumbosacral radiculopathy due to herniated intervertebral disc for diagnosing, planning the management and obtaining information about prognosis was purposed. Scalp-recorded somatosensory evoked potentials to electrical stimulation in L5 and S1 dermatomes in 31 patients and 26 normal subjects were examined. Abnormal DSEP recordings were obtained by comparing with normal values derived from studies of normal subjects. DSEP recordings were compared with the results of computed tomography and electromyographic studies of the same patients. All of the patients had conservative therapy, and physical examination and DSEP studies of 23 patients were reevaluated after three months and improvement of the clinical and DSEP findings were compared in each patient. DSEP sensitivity of 31 patients is 77.4 %. Absent responses were associated with acute lesions and with low back pain in extension. DSEP findings after three months perfectly reflected either clinical improvement or continuation of symptoms and clinical findings. It was concluded that, (1) there is no superiority of DSEP to the other studies in identifying unilateral lumbosacral radiculopathy due to herniated intervertebral disc, if technical and interpretational differences are removed, diagnostic utility of DSEPs will increase (2) DSEPs have a prognostic utility to follow the patients' courses.
