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Öğe Analgesic use may not decrease in the first postoperative year in patients underwent total knee arthroplasty due to advanced osteoarthritis(Elsevier B.V., 2024) Aslan, Ahmet; Maytalman, Erkan; Gulcu, AnilBackground: Total knee arthroplasty (TKA) is expected to relieve pain and reduce the use of analgesics in patients with advanced knee osteoarthritis. However, in some cases, there is no relief in the pain of the patients and the use of analgesics continues. The aim of this study was to compare analgesic consumption one year before and after TKA in the same patient group and to evaluate whether there is a decrease in analgesic consumption after TKA. Method: The cumulative amounts of analgesia used by the patients in the one-year periods before and after the operation were checked from the automated patient records system and the national systems showing drug prescriptions. The dosages of all the analgesics used in the one-year periods before and after the operation were calculated and converted to oral morphine equivalents (OME). The demographic data of the patients, cumulative OME and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used in the assessment. Results: It was observed that there was a statistically significant improvement in Womac scores after the treatment compared to the pre-treatment. Although the mean amount of analgesics decreased compared to pre-treatment, it was not statistically significant. Also, age and preoperative analgesic use were found to be the two most important factors in relation to total postoperative analgesic consumption. Conclusion: The results of this study indicate that there may not be a substantial reduction in the use of analgesic by patients within the first year after TKA. Furthermore, the age and preoperative analgesic use were identified as the two primary factors influencing postoperative analgesic consumption. Level of evidence: Retrospective Cohort Study. © 2024 Delhi Orthopedic AssociationÖğe Coracoid fracture caused by lifting a heavy object: a rare clinical presentation(Acta Medica Belgica, 2022) Gulcu, AnilThe purpose of this narrative review was to highlight the research on the influence of weather conditions on patients with osteoarthritis, the pathophysiological mechanisms and the therapeutic consequences. A search was conducted using the Pubmed, Medline and Web of Science databases. Barometric pressure, temperature and humidity are the weather conditions that are found to be correlated most to the worsening of pain complaints. But, due to the difficulty of measuring the impact of these variables and the great diversity in study protocols, an analysis of studies regarding this topic shows conflicting results. Central sensitization mechanisms and the function of a Transient Receptor Potential channel might explain the pain hypersensitivity to cold weather. Joint pain, caused by central sensitization mechanisms, cannot always be treated with joint arthroplasty. When pain remains present after joint arthroplasty, centrally mediated pain constitutes an important role.Öğe Does the Type of Surgical Technique and the Use of Prophylactic Antibiotics Affect the Clinical Results in Symptomatic Ingrown Toenail Patients?(Sage Publications Inc, 2024) Sargin, Serdar; Gulcu, Anil; Aslan, AhmetIngrown toenails are a common reason for referral to orthopedics and podiatry clinics. Recurrence and infection are common complications in ingrown toenail surgery. This study investigates the effect of an electrocautery matrixectomy on the recurrence and clinical outcomes in the Winograd technique applied in ingrown toenail surgery and whether prophylactic antibiotic use is necessary for these surgeries. One hundred forty-three patients who underwent surgery for ingrown toenails were analyzed retrospectively. Eighty-two patients underwent the Winograd procedure with electrocautery matrixectomy, whereas 61 patients underwent the Winograd procedure. While 78 patients were given prophylactic antibiotics, 65 patients were not. Patient satisfaction was evaluated with a surgical satisfaction questionnaire (SSQ). A visual analog score was used to evaluate the pain. Recurrence was observed in 3 toenails in the Winograd and electrocautery groups, while recurrence was observed in 9 toenails in the Winograd group (P = .018). In both groups, there was no statistically significant difference between the infection rates between patients who took antibiotics and those who did not (P > .05). There was no statistically significant difference between the groups in terms of SSQ scores (P > .05). It was observed that the surgery performed had a positive effect on pain, and this effect was statistically highly significant in both groups (P < .05). The outcomes of the present study suggest that the addition of an electrocautery matrixectomy to the Winograd technique in the surgical treatment of symptomatic Ingrown toenails may decrease recurrence rates. Additionally, this study showed that oral antibiotics, when used in addition to Ingrown toenail surgery, do not reduce postoperative morbidity.Öğe Investigation the Effect of Human Recombinant Epidermal Growth Factor on Rotator Cuff Healing: An Experimental Model(Georg Thieme Verlag Kg, 2023) Gulcu, Anil; Turhan, Egemen; Aslan, Ahmet; Cayli, Sevil; Alimogullari, Ebru; Akcan, GulbenObjective To investigate the effectiveness of human recombinant epidermal growth factor in the healing of rotator cuff tear in the rabbit shoulder. Methods Rotator cuff tears (RCTs) were experimentally created on both shoulders of 20 New Zealand rabbits. The rabbits were divided into the following groups: RCT (sham group; n = 5), RCT + EGF (EGF group; n = 5), RCT + transosseous repair (repair group; n = 5), and RCT + EGF + transosseous repair (combined repair + EGF group; n = 5). All rabbits were then observed for 3 weeks, and biopsies were taken from the right shoulders in the third week. After three more weeks of observation, all rabbits were sacrificed, and a biopsy removed from their left shoulders. All biopsy material was stained with haematoxylin & eosin (H&E) and vascularity, cellularity, the proportion of fibers and the number of fibrocartilage cells were evaluated under light microscope. Results The highest collagen amount and the most regular collagen sequence was detected in the combined repair + EGF group. The repair group and the EGF group showed higher fibroblastic activity and capillary formation when compared with the sham group, but the highest fibroblastic activity and capillary formation with highest vascularity was detected in the combined repair + EGF group ( p < 0.001). EGF seems to improve wound healing in the repair of RCT. The EGF application alone, even without repair surgery, seems to be beneficial to RCT healing. Conclusion In addition to rotator cuff tear repair, application of human recombinant epidermal growth factor has an effect on rotator cuff healing in rabbit shoulders.Öğe The effect of arthroscopic rotator cuff repair on sleep in degenerative full-thickness tears(Wolters Kluwer Medknow Publications, 2022) Gulcu, AnilAims and Background: Shoulder pathologies are frequently linked to sleep disturbances. The aim of this study is to investigate the effect on sleep disorders in patients with arthroscopic rotator cuff repair. Materials and Methods: Thirty-three patients who underwent arthroscopic rotator cuff repair due to a full-thickness rotator cuff tear were prospectively analyzed. The Pittsburgh Sleep Quality Index (PSQI), the American Shoulder and Elbow Surgeons Shoulder Score (ASES), visual analog scale (VAS), and Constant and Murley shoulder scores before surgery and at 6 months postoperatively. Preoperative clinical and radiological parameters of the patients were also evaluated. Results: The study analyzed 33 patients with a median age of 59.79 ± 9.0 years. There was a significant difference preoperatively versus postoperatively in terms of all PSQI global scores and subdivisions (P < 0.001). A statistically significant improvement was determined by the simple shoulder test, the Constant and Murley shoulder scores, and VAS (P < 0.001). Conclusion: Sleep disturbance is common in patients with symptomatic rotator cuff tear, and sleep disturbance can resolve after arthroscopic rotator cuff repair. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
