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Öğe An analysis of meniscal extrusion and associated knee joint lesions by magnetic resonance imaging(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2009) Kiresi, Demet; Ertekin, Ersen; Yel, Mustafa; Açıkgözoğlu, SaimObjectives: We investigated the frequency of meniscal extrusion and associated knee joint lesions by magnetic resonance imaging (MRI) in patients with meniscal tears. Methods: We retrospectively evaluated MRI findings of 100 patients (41 males, 59 females; mean age 54 +/- 10 years; range 27 to 76 years) with meniscal tears in 126 knee joints. Using coronal images, extrusion was defined as a distance of >= 3 mm between the peripheral border of the meniscus and the edge of the tibial plateau. All the knees were assessed with respect to the localization and type of meniscal tear and extrusion, accompanying joint effusion. cruciate ligament pathologies, and degenerative bone and cartilage changes. Results: Meniscal extrusion was detected in 31 knee joints (24.6%), with a mean extrusion of 3.72 mm. At I extrusions were found to be in the posterior horn of the medial meniscus and were associated with radial tears (n=18, 58.1%), radial-oblique tears (n=9, 29%), complex tears (n=2, 6.5%), and flap tears (n=2, 6.5%). Meniscal tears with extrusion differed significantly from those without extrusion with respect to the localization of all the tears being in the posterior horn of the medial meniscus (100% vs. 60%) and the higher frequency (58.1% vs. 20%) of radial tears (p<0.05). There were no significant differences in the types and frequencies of accompanying pathologies seen in meniscal tears with and without extrusion (p>0.05). Conclusion: Meniscal extrusion is a common finding particularly in osteoarthritis. It is mostly seen in the medial meniscus and accompanied by radial tears. Therefore, its presence should alert to the possibility of a radial tear extending to the meniscal root.Öğe Be Aware of Bone Marrow Edema Syndrome in Ankle Arthroscopy: A Case Successfully Treated with Iloprost(W B Saunders Co-elsevier Inc, 2006) Arazi, Mehmet; Yel, Mustafa; Uguz, Bilgehan; Emlik, DilekBone marrow edema syndrome (BMES) is a nontraumatic syndrome characterized by disabhng joint pain. The disease occurs especially in the hip joint, and the ankle joint has been reported in the English-language literature to be affected only rarely. We describe here the case of an adult with BMES in both ankle joints, She has been treated with nonsteroidal anti-inflammatory drugs and physical therapy, as well as ankle arthroscopy, all of which have been unsuccessful. BMES was diagnosed on the basis of clinical and magnetic resonance imaging (MRI) findings. The patient was treated with iloprost (Ilomedin. Schering AG, Berlin, Germany); the course of therapy consisted 6 of 5 infusions of 40 mu g of iloprost in 500 mL of sodium chloride solution, given over 6 hours on 5 consecutive days. MRI at the third monthly visit showed nearly complete resolution of bone marrow 7 edema. The patient was followed for 2 years and 6 months and was completely asymptomatic. This case report suggests the need for orthopaedic surgeons to know about BMES. Before all-arthroscopic interventions are performed, MRI views should be evaluated carefully. Iloprost infusion therapy seems to be effective and safe in the management of BMES.Öğe Di?z Artroskopi?si?nde Anti?bi?yoti?k Profi?laksi?si?ni?n Yeri? Varmıdır?(2001) Yel, Mustafa; Memik, Recep; Özdemir, Mustafa; Kapıcıoğlu, M. İ. SefaPurpose: A comparative and prospective study was carried out to find out the effects of the prophylactic antibiotic use on the knee arthroscopy. Materials and Methods: Between 1993 and 1996, 450 patients who underwent knee arthroscopy because of various knee pathologies, were evaluated by dividing them into two equal groups. Single dose of 1 gr cephalosporin (ceftriaxone) as prophylactic antibiotic was given to 225 patients who underwent knee arthroscopy in the first group one hour before arthroscopy. Prophylactic antibiotic was not given to 225 patients in the second group. Results: There was no significant statistical difference between the groups in terms of their sexes, average ages, mean duration of operations, diagnosis, and treatment. There were no clinical findings of infection in any of the patients in both groups after knee arthroscopy. Conclusion: These results suggest that the routine use of prophylactic antibiotics in such knee problems has no clinical value. Moreover, antibiotics may increase the cost of treatment and cause allergic reactions.Öğe Effects of Aprotinin on Pulmonary Functions in Experimental Fat Embolism: Changes in Arterial Blood Gas Levels and Scintigraphic Findings(2000) Yel, Mustafa; Dalgıç, Hülya; Taştekin, Güngör; Arazi, Mehmet; Kutlu, AbdurrahmanPurpose: To assess the effects of aprotinin on the formation and resolution of fat embolism of the lungs. Methods: The changes in arterial blood gas levels and perfusion scintigraphy were studied by forming experimental standardized fat embolism in rabbits with autogenous fat obtained from their femur medullas. Two groups, each consisting of 14 albino rabbits, were used in this study. Group 1, which received intravenous saline solution, was the control group. Group 2, which received aprotinin, was referred to as the aprotinin group. Autogenous femoral medullary content was used for embolization procedures. Arterial blood gas levels were recorded 72 hours before and 1, 24, 72 hours and 10 days following the embolization procedure. Pulmonary perfusion scintigraphies were performed 72 hours before the embolization procedure and on the first and 72nd hours, and the 10th day. Results: Fat embolism was achieved in all rabbits. Seven rabbits in the control group and one rabbit in the aprotinin group died within an hour after the embolization procedure. According to blood gas levels and perfusion scintigraphic findings, the aprotinin group significantly had less pulmonary fat embolism and recovered faster than the control group, especially during the first 24 hours. There was no significant difference in regression of pulmonary dysfunction between the two groups. Conclusion: The correlation between the blood gas levels and scintigraphic findings suggested that the administration of aprotinin for prophylactic purposes had favorable effects on the development of pulmonary gas exchange disturbance and perfusion defect in fat embolism.Öğe Femur Başı Epifiz Kaymasında Cerrahi Tedavi Sonuçlarımız(2000) Yel, Mustafa; Özdemir, H. Mustafa; Ertürk, Erol; Memik, RecepFemur başı epifiz kayması (FBEK) adolesan çağın en sık görülen kalça hastalıklarından biridir. Kliniğimizde 13 yıllık periyod içinde FBEK teşhisi alarak tedavi edilmiş 17 kalçanın tedavi sonuçları retrospektif olarak değerlendirildi. Ortalama yaşları 13.7 olan hastalarda ortalama semptom süresi 4.4 aydı. Kaymalar; 9 hastada kronik, 4 hastada akut ve 4 hastada kronik zemin üzerine akut kayma şeklindeydi. Bu hastaların radyolojik incelemelerinde 3 hastada hafif, 11 hastada orta ve 3 hastada ileri derecede kayma mevcuttu. Cerrahi tedavi olarak; 9 kalçaya subtrokanterik biplanar osteotomi, 3 kalçaya küneiform osteotomi, 3 kalçaya kapalı redüksiyon ve 2 kalçaya ise in situ çivileme yapıldı. Ortalama 33 ay takip edilen hastalar, klinik ve radyolojik (Heyman-Herdon) olarak değerlendirildiğinde; hastalardan 10'u çok iyi ve iyi, 4'ü orta, 2'si kötü olarak bulundu. Komplikasyon olarak; 2 kalçada avasküler nekroz (AVN), 3 kalçada kondroliz, 1 kalçada eklem sertliği, 1 kalçada infeksiyon ve 1 kalçada çivi migrasyonu gelişti. FBEK olan hastalarda kayma derecesi ve süresi ile cerrahi korreksiyon ve osteotomi seviyesi sonuçları etkilemektedir. Bu çalışmada mükemmel cerrahi korreksiyon sağlanmasa da endikasyonları içinde subtrokanterik osteotomi daha başarılı bulunmuştur.Öğe Giant Osteochondral Loose Body of the Knee Joint(2000) Yel, Mustafa; Avunduk, Mustafa Cihat; Memik, Recep; Kutlu, AbdurrahmanA rare giant loose body in the knee joint and the treatment carried out were reported. Two loose bodies sized 5.5 and 1.5 cm were extracted from the knee of a patient who suffered from pain and knee motion restricted chronically. The histopathological evaluation revealed normal bone, hyaline cartilaginous tissue, and partly fibrocartilaginous tissue. These loose bodies suggested that they were separated in small pieces from the femoral condyles and were nourished by the synovial fluid. Over time, they adhered to each other in the knee joint.Öğe Glenohumeral Instabilitelerde Pnömoartro-Bilgisayarlı Tomografi(2001) Yel, Mustafa; Karabacakoğlu, Aydın; Karaköse, Serdar; Arazi, Mehmet; Akçalı, ÖmerAmaç: Travmatik, tek yönlü glenohumeral (GH) instabilitelerdeki kemik ve yumuşak doku değişikliklerini radyografi, bilgisayarlı tomografi (BT) ve pnömoartro-BT (PA-BT) ile incelemek ve artroskopi veya artrotomi bulgularıyla karşılaştırarak doğruluk oranlarını belirlemek. Çalışma planı: Glenohumeral instabilite saptanan ve cerrahi olarak tedavi edilen 20 hastanın (19 erkek, 1 kadın; ort. yaş 23.4; dağılım 17-41) omuz radyografileri, BT ve PA-BT incelemeleri değerlendirildi. Radyografi, BT ve PA-BT ile belirlenen kemik lezyonları ve yumuşak doku değişiklikleri, omuz artroskopi veya artrotomi bulgularıyla karşılaştırıldı; bu yöntemlerin tanıdaki etkinlikleri ve doğruluk oranları belirlendi. Sonuçlar: Kemik lezyonlarında artroskopi bulguları ile radyografi, BT, PA-BT bulguları karşılaştırıldığında, doğruluk oranları glenoid köşe kırığında radyografide %11.1 1/9), BT'de %100 (9/9), PA-BT'de %100 (9/9); Hill-Sachs lezyonunda sırasıyla %42.9 (3/7), %71.4 (5/7) ve %71.4 5/7) bulundu. Yumuşak doku lezyonlarında artroskopi bulguları ile PA-BT bulguları karşılaştırıldığında PA-BT' nin doğruluk oranı Bankart lezyonunda %81.8 (9/11), anterior kapsüler bollaşmada %95 (19/20) olarak belirlendi. Çıkarımlar: invaziv bir yöntem olmasına rağmen, PABT incelemesinin GH instabilitelerdeki kemik ve yumuşak doku değişikliklerini belirlemede başarılı ve ucuz bir görüntüleme yöntemi olduğu sonucuna varıldı.Öğe Menisküs taşması ve beraberinde görülen diz eklemi lezyonlarının manyetik rezonans görüntüleme ile değerlendirilmesi(2009) Kıreşi, Demet; Ertekin, Ersen; Yel, Mustafa; Açıkgözoğlu, SaimAmaç: Menisküs yırtığı olan olgularda menisküs taşması (extrusion) sıklığı ve eşlik eden diz eklemi patolojileri manyetik rezonans görüntüleme (MRG) ile araştırıldı. Çalışma planı: Diz eklemine yönelik MRG incelemesi ile menisküs yırtığı saptanan 100 hastanın (41 erkek, 59 kadın; ort. yaş 5410; dağılım 27-76) 126 diz eklemi geriye dönük olarak değerlendirildi. Koronal görüntüde, tibia platosu kenarı ile menisküsün dış sınırı arasındaki mesafenin 3 mm olması menisküs taşması olarak kabul edildi. Tüm diz eklemlerinde, menisküs yırtığının ve taşmanın yeri, yırtığın tipi, eşlik eden eklem sıvısındaki artış, çapraz bağ patolojisi, kemik ve kıkırdak patolojileri araştırıldı. Sonuçlar: Otuz bir diz ekleminde (%24.6) ortalama 3.72 mm ölçülen menisküs taşması görüldü. Taşma tüm menisküslerde medial menisküsün arka boynuzundaydı. Taşma görülen 31 menisküsün 18’inde (%58.1) radial, dokuzunda (%29) radial-oblik, ikisinde (%6.5) kompleks, ikisinde (%6.5) flep yırtık bulundu. Taşma olmayan menisküslerle karşılaştırıldığında, taşma görülen menisküslerde tüm yırtıkların medial menisküs arka boynuzunda olması (%100 ve %60) ve bu grupta radial yırtıkların daha sık (%58.1 ve %20) görülmesi anlamlı bulundu (p0.05). Çıkarımlar: Menisküs taşması özellikle osteoartritli hastalarda sık görülen bir bulgudur ve genellikle medial menisküste ve en sık radial yırtık tipiyle birlikte görülmektedir. Bu nedenle, menisküs taşması özellikle menisküs köküne uzanan radial yırtık varlığı açısından uyarıcı olabilir.Öğe Modüler Unipolar Kalça Protezi Kırılması ve Revizyonu (Stem Çıkarmada Yeni Bir Teknik) (Olgu Sunumu)(2000) Yel, Mustafa; Arazi, Mehmet; Öğün, Tunç Cevat; Kutlu, AbdurrahmanSelçuk Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalında femur boyun kırığına bağlı modüler unipolar kalça protezi uygulanan hastada 30 ay sonra femoral stem kırılması tespit edildi. Hastanın protezi ve kırık stem parçası bu ameliyat için geliştirilen aletlerle çıkarılarak total kalça protezi uygulandı. Çelik delici matkap ucu, buna uygun yapılan yiv açıcı ve yivli çıkarıcı ile uyguladığımız bu teknik bir çok avantajlar sağladı. Bunlar ameliyat süresinden tasarruf, daha küçük cilt insizyonu, ilave kesi ve osteotomilere ihtiyaç göstermemesi, ameliyat sonrası erken rehabilitasyon ve erken fonksiyon kazandırma olarak sayılabilir.Öğe Osteoid Osteoma of the Carpal Bones(SPRINGER, 2001) Arazi, Mehmet; Memik, Recep; Yel, Mustafa; Öğün, Tunç C.Osteoid osteoma is a benign bone tumor that rarely localizes in the hand or the carpal bones. We report two cases of osteoid osteoma localized in two different carpal banes. Unremitting wrist pain was a major clinical symptom. Surgical treatment including excision of the nidus was dramatically curative. In young patients, osteoid osteoma should be considered in the differential diagnosis of chronic wrist pain.Öğe Osteomuskülokütanöz Flep ile Klavikula Rekonstrüksiyonu: Olgu Sunumu(2007) Yel, Mustafa; Karalezli, M. Nazım; Tosun, Zekeriya; Sezgin, Serhan; Savacı, NedimTümör tedavisinde kullanılan radyoterapi yumuşak doku nekrozu, kemik nekrozu ve patolojik kırıklara neden olabilmektedir. On yıl önce meme kanseri nedeniyle geçirdiği radikal mastektomi sonrasında radyoterapi gören 47 yaşındaki kadın hasta sol klavikulada meydana gelen patolojik kırık nedeniyle başvurdu. Hastaya kaburga ve latissimus dorsi ile beraber altıncı kaburganın 4 cm’lik parçasını içeren osteomuskülokütan flep ile tedavi uygulandı. Kaynama ameliyat sonrası üçüncü ayda sağlandı. Verici saha morbiditesi kozmetik açıdan kabul edilebilir derecedeydi ve omuz fonksiyonlarında ilerleme sağlandı. Hastanın 38 aylık izlemi sonrasında Constant omuz skoru 36’dan 88’e yükseldi.Öğe The pain associated with intraarticular hyaluronic acid injections for trapeziometacarpal osteoarthritis(SPRINGER, 2007) Karalezli, Nazim; Ogun, Tunc Cevat; Kartal, Senay; Saracgil, Sacide Nur; Yel, Mustafa; Tuncay, IbrahimTrapeziometacarpal osteoarthritis predominantly affects middle-aged women. Most cases with rhizarthrosis can be managed successfully by conservative means. The purpose of this prospective study was to evaluate pain and tolerability of viscosupplementation therapy with hyaluronic acid (HA) for trapeziometacarpal osteoarthritis. Groups A and B consisted of eight patients each with Eaton stage 3 or 4 rhizarthrosis, who underwent one cycle of three injections of (one per week) 0.3 cm(3) sodium hyaluronate. The injections for group A were under fluoroscopy control, but fluoroscopy was not used in group B. Pain and tolerability of both groups A and B were measured and compared. The patients of the groups were also asked to evaluate the tolerability of the treatment. The results suggested that HA injection in the carpometacarpal joint is a tolerable procedure but the patients complained of pain and discomfort during the injections. The pain in group A was much greater than in group B. Viscosupplementation for the treatment of trapeziometacarpal osteoarthritis is a viable treatment option for stages 3 and 4 patients when they do not want to be operated on. It is a tolerable but not a painless procedure especially when it is done without fluoroscopy control. We recommend giving injections under fluoroscopy control.Öğe The Pelvic External Fixation: The Mid-Term Results of 41 Patients Treated With a Newly Designed Fixator(Springer-Verlag, 2000) Arazi, Mehmet; Kutlu, A.; Mutlu, M.; Yel, Mustafa; Kapıcıoğlu, Mehmet İsmail SafaThe purpose of this study was to evaluate the clinical and radiological results of unstable pelvic fractures:treated with a new external fixation device. Between May 1992:and May 1998, 43 patients with unstable pelvic fractures were treated with a new anterior pelvic external fixator. Two died, and therefore 41 patients' results were evaluated. There were 29 men and 12 women, and their average age was 34 years (range 12-70 years). Traffic accidents accounted for 34 injuries. Three patients fell from a height, 3 were injured in industrial accidents, and 1 was hit by a train. According to the Tile classification, there Were 24 type B pelvic injuries and 17 type C. Associated injuries Were observed in 21 patients. A considerable reduction of the pelvic pain was noted after application of the fixator in all patients. Excessive blood transfusion was not required in any patient, The average follow-up was 24 months (range 12-50 months). Clinical results at final evaluation were good according to the criteria of Matta and Saucedo in 34 patients and poor in 7, In conclusion,:the new pelvic external fixator is effective, safe, and easy to apply in the treatment of unstable pelvic fractures. The fixator can be used alone in patients with type B pelvic injuries such as open book and lateral compression. However, it does not provide sufficient stability for severely displaced type C injuries when applied alone. Nevertheless, it may be helpful for fixing type C injuries like a posterior iliac fracture without dislocation of the sacroiliac joint.Öğe Rotator Manflet Yırtıklarının Sınıflandırılması(2003) Yel, Mustafa; Arazi, MehmetRotator manflet y›rt›klar›n›n s›n›flamas› tan›, tedavi ve prognozun ve tedavi sonuçlar›n›n bilimsel de¤erlendirme - sine yard›mc› olur. Y›rt›¤›n flekli, yeri, etiyolojisi, büyüklü¤ü, topografisi, patolojisi ve öyküsü, tendonlar›n y›rt›k oluflumana katk›s› ile birlikte uzman yorumcular için çok da¤erli bilgi sa¤layabilir. Bu makalede, rotator manflet y›rt›klar›n›n bu yönünün, flekillendirme ile birlikte okura sunulmas› amaçland›.Öğe
