Researcher:
Büyükdoğan, Kadir

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Doctor

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Kadir

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Büyükdoğan

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Büyükdoğan, Kadir

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2019 - 201912020 - 202214

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    Effect of tibial tunnel placement using the lateral meniscus as a landmark on clinical outcomes of anatomic single-bundle anterior cruciate ligament reconstruction
    (2021) Laidlaw, Michael S.; Fox, Michael A.; Kew, Michelle E.; Miller, Mark D.; N/A; Büyükdoğan, Kadir; Doctor; N/A; Koç University Hospital; N/A
    Background: It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau. Purpose: To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes. Study design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test. Results: A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer (r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups. Conclusion: Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.
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    Allograft bone dowels show better incorporation in femoral versus tibial tunnels in 2-stage revision anterior cruciate ligament reconstruction: a computed tomographyebased analysis
    (W B Saunders Co-Elsevier Inc, 2021) Laidlaw, Michael S.; Kew, Michelle E.; Miller, Mark D.; N/A; Büyükdoğan, Kadir; Doctor; N/A; Koç University Hospital; N/A
    Purpose: The purpose of this study was to quantitatively evaluate the radiographic outcomes of allograft dowels used in 2-stage revision anterior cruciate ligament reconstruction (ACLR) and to compare the incorporation rates of dowels placed in tibial and femoral tunnels. Methods: Prospective review of patients who underwent 2-stage revision ACLR with allograft bone dowels. Inclusion criteria were tibial/femoral tunnel diameter of >14 mm on preoperative computed tomography (CT) or overlapping of prior tunnels with planned tunnels. Second-stage timing was determined based on qualitative dowel integration on CT obtained at w3 months after the first stage. Quantitative analysis of incorporation rates was performed with the union ratio (UR) and occupying ratio (OR) on postoperative CT scans. Results: Twenty-one patients, with a mean (SD) age of 32.1 (11.4; range, 18-50) years, were included. Second-stage procedures were performed at a mean (SD) of 6.5 (2.1; range, 2.4-11.5) months after first-stage revision. All dowels showed no signs of degradation at the host bone/graft junction at the second-stage procedure. The mean (SD) diameter of the dowels placed in tibial tunnels was greater than those placed in femoral tunnels (16.1 [2.3] mm vs 12.4 [1.6] mm; P < .05). CT was obtained at a mean (SD) of 121 (28; range, 59-192) days after the first-stage surgery. There was no difference between the OR of femoral and tibial tunnels (mean [SD], 87.6% [4.8%] vs 85.7% [10.1%]; P = .484), but the UR was significantly higher in femoral tunnels (mean [SD], 83% [6.2%] vs 74% [10.5%], P = .005). The intraclass correlation coefficients of OR and UR measurements indicated good reliability. Conclusions: Allograft bone dowels are a viable graft choice to replenish bone stock in the setting of a staged revision ACL reconstruction. Allograft dowels placed in femoral tunnels had a higher healing union ratio than tibial tunnel allografts and no evidence of degradation at the bone/graft junction, with no difference seen in occupying ratio. Level of Evidence: Level IV, case series./ Öz: Amaç: Unikondiler diz artroplastisinde (UDA) aseptik gevşeme başarısızlığın en önemli nedenlerinden biridir. Bu çalışmanın amacı, tasarımcı olmayan bir grup kohortunda çimentosuz ve çimentolu UDA’lar arasındaki erken fizyolojik ve patolojik radyolusent hatları (RLH) karşılaştırmaktı. Yöntemler: Bu çalışmada 2012-2018 yılları arasında 38 çimentolu UDA ve 47 çimentosuz UDA uygulanan iki hasta grubu retrospektif olarak karşılaştırıldı. Hastaların klinik sonuçlarının değerlendirilmesinde Oxford Diz Skoru, EQ-5D-3L, EQ- VAS ve KOOS skorlamaları kullanıldı. RLH’lerin varlığının değerlendirilmesinde, tibial ve femoral bileşen ara yüzleri bölgelere bölündü ve RLH’ler için değerlendirildi. Bulgular: Klinik sonuçlar açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Hiçbir hastada femoral veya tibial bileşen ara yüzlerinde tam RLH gözlenmedi. Tibial bileşen ara yüzünde parsiyel radyolusent bölgeler çimentolu UDA’larda 32 (%11,3) ve çimentosuz UDA’larda 13 (%5,7) bölgede tespit edildi. Tibial bileşen arayüzünde kısmi RLH görülme sıklığı ve toplam radyolusent bölge sayısı çimentolu artroplastilerde daha yüksekti (p=0,040 ve p=0,025). Sonuç: Unikondiler diz artroplastisindegözlenen aşırı fizyolojik RLH’lerin hastaların klinik sonuçları üzerinde etkisi olmadığı tespit edildi. Fizyolojik RLH oranı çimentosuz UDA’da çimentolu UDA’ya göre önemli ölçüde daha düşüktü.
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    Comparisons of the radiolucent lines between cemented and cementless Oxford unicondylar knee arthroplasty: a non-designer group report
    (Bezmialem Vakif Univ, 2022) Aslan, Hakan; Atilla, Halis Atil; Akdogan, Mutlu; Cevik, Huseyin Bilgehan; N/A; Büyükdoğan, Kadir; Doctor; N/A; Koç University Hospital; N/A
    Objective: Aseptic loosening is one of the most important reasons for failure in unicondylar knee arthroplasty (UKA). The aim of this study was to compare early physiological and pathological radiolucent lines (RLL) between cementless and cemented UKA within a non-designer group cohort. Methods: Two groups of patients who underwent 38 cemented UKA and 47 cementless UKA between 2012 and 2018 were compared retrospectively. In evaluating the clinical results of the patients, the Oxford Knee Score, EQ-5D-3L, EQ-VAS, and KOOS scoring were used. In the evaluation of the presence of RLLs, the tibial and femoral component interfaces were divided into regions and evaluated for RLLs. Results: There was no statistically significant difference, between the groups in terms of clinical results (p>0.05). No complete RLLs were observed in either the femoral or tibial component interfaces in any patient. Partial radiolucent regions at the tibial component interface were detected in 32 (11.3%) regions in cemented UKAs and 13 (5.7%) in cementless UKAs. The incidence of partial RLLs in the tibial component interface and the total number of radiolucent zones were higher in the cemented arthroplasties (p=0.040 and p= 0 .025). Conclusion: It was determined that the excessive physiological RLLs observed in UKA had no effect on the clinical outcomes of the patients. The rate of physiological RLLs was gnificantly lower in cementless UKA than in cemented UKA.
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    Bizarre parosteal osteochondromatous proliferation (Nora’s lesion) in the medial sesamoid of the first toe
    (American Podiatric Medical Association, 2020) Chodza, Mehmet; Kılıçoğlu, Önder; Aslan, Lercan; Tetik, Onur; Büyükdoğan, Kadir; Faculty Member; Doctor; Doctor; School of Medicine; N/A; N/A; N/A; Koç University Hospital; Koç University Hospital; 145301; N/A; N/A
    Bizarre parosteal osteochondromatous proliferation, or Nora’s lesion, is a unique bony lesion that generally originates from the small bones of the hands and feet in young adults. We report a case of a bizarre parosteal osteochondromatous proliferation originating from the medial sesamoid of the first toe that was managed surgically by en bloc excision. At 5-year follow-up, there was no evidence of recurrence.
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    Bizarre parosteal osteochondromatous proliferation (Nora's lesion) in the medial sesamoid of the first toe
    (Amer Podiatric Med Assoc, 2020) Chodza, Mehmet; Kılıçoğlu, Önder; N/A; N/A; N/A; Tetik, Onur; Aslan, Lercan; Büyükdoğan, Kadir; Doctor; Faculty Member; Doctor; School of Medicine; School of Medicine; N/A; Koç University Hospital; N/A; 145301; N/A
    Bizarre parosteal osteochondromatous proliferation, or Nora's lesion, is a unique bony lesion that generally originates from the small bones of the hands and feet in young adults. We report a case of a bizarre parosteal osteochondromatous proliferation originating from the medial sesamoid of the first toe that was managed surgically by en bloc excision. At 5-year follow-up, there was no evidence of recurrence.
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    Achilles tendon-splitting approach and double-row suture anchor repair for Haglund syndrome
    (Elsevier, 2021) Guler, Yasin; Birinci, Murat; Hakyemez, Omer Serdar; Cacan, Mehmet Akif; Arslanoglu, Fatih; Mermerkaya, Musa Ugur; N/A; Büyükdoğan, Kadir; Doctor; N/A; Koç University Hospital; N/A
    Background: Haglund syndrom is characterized as a painful posterosuperior deformity of the heel with possible causes as tight Achilles tendon, high-arched foot and tendency to walk on the outside of the heel. Surgical treatment may be recommended in cases where of insufficient response to nonoperative treatment. This study aims to evaluate the clinical and radiographic results of central Achilles tendon splitting and double-row suture anchor technique in the surgical treatment of patients with Haglund syndrome. Methods: 27 patients with Haglund syndrome who underwent central Achilles tendon splitting and double-row suture anchor were retrospectively evaluated. The results were evaluated by the pre- and post-operative American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and visual analogue scale (VAS). All patients were evaluated radiographically to assess lateral talus-first metatarsal angle (TMTA), Calcaneal pitch angle (CPA), and the Fowler-Philip angle (FPA) preoperatively and postoperatively. Results: The mean preoperative AOFAS score was 47 +/- 7 points; at the end of the follow-up period, it increased to 92 +/- 4 points (p < 0.001). The mean preoperative VAS score was 9 +/- 0.9 points; at the end of the follow-up period, it was 2 +/- 0.6 points (p < 0.001). The lateral TMTA (preoperative: 5 degrees +/- 2 degrees; follow-up: 4 degrees +/- 2 degrees; p < 0.001), CPA (preoperative: 21 degrees +/- 5 degrees; follow-up: 20 degrees +/- 5 degrees; p = 0.005) and FPA (preoperative: 55 degrees +/- 6 degrees; follow-up: 32 degrees +/- 3 degrees; p < 0.001) values decreased at the end of the follow-up period. Conclusion: In the absence of an improvement to nonoperative treatment methods, central Achilles tendon-splitting approach appears to be an effective and safe treatment option. Level of evidence: Level IV, retrospective case series. (C) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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    Long-term outcomes after arthroscopic transosseous-equivalent repair: clinical and magnetic resonance imaging results of rotator cuff tears at a minimum follow-up of 10 years
    (Mosby-Elsevier, 2021) Koyuncu, Özgür; Fox, Michael A.; N/A; N/A; N/A; N/A; N/A; Büyükdoğan, Kadir; Aslan, Lercan; Eren, İlker; Birsel, Olgar; Demirhan, Mehmet; Doctor; Faculty Member; Faculty Member; Doctor; Faculty Member; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 145301; 168021; 202021; 9882
    Purpose: The objective of this study was to evaluate the long-term functional outcomes and structural integrity of medium to massive rotator cuff tears at 10-12 years of follow-up after arthroscopic transosseous-equivalent (TOE) repair. Methods: This was a retrospective study of a consecutive series of patients who underwent primary arthroscopic TOE repair of medium- to massive-sized degenerative rotator cuff tears performed by a single surgeon between January 2007 and August 2009. Patients were examined at a minimum follow-up of 10 years, and magnetic resonance imaging (MRI) was performed to assess tendon integrity. The Constant score (CS), American Shoulder and Elbow Surgeons score, and pain level documented using a visual analog scale were compared between intact repairs and recurrent defects. Univariate analysis was performed to identify factors related to recurrent defects. Results: A total of 102 patients met the inclusion criteria, and 79 shoulders in 76 patients (74.5% of eligible patients) with a mean age at surgery of 55 +/- 8 years (range, 40-72 years) were available for clinical evaluation at a mean follow-up time of 10.9 years (range. 10-12 years). The mean anteroposterior tear size was 3.1 +/- 1.1 cm, and there were 41 medium (52%), 26 large (33%), and 12 massive (15%) tears. MRI was performed in 72 shoulders in 69 patients (91% of available shoulders) and revealed that 13 shoulders had recurrent defects (Sugaya stages 4 and 5). During the follow-up period, 3 patients underwent revision surgery, and the overall recurrent defect rate was 21.3%. A clinically meaningful improvement was observed in all outcome measures at the final follow-up regardless of tendon integrity. Patients with intact repairs showed superior outcomes compared with those with recurrent defects; however, only the overall CS met the threshold for clinical relevance. A significant linear correlation was observed between the Sugaya classification and all outcome scores except the CS pain subscale; however, the strength of correlation was weak. The presence of diabetes (odds ratio [OR], 8.6; 95% confidence interval [CI], 2.25-33.2; P = .002), tear size (OR, 2.08; 95% CI, 1.16-3.46; P= .012), and tear refraction (OR. 4.07: 95% CI, 1.11-14.83; P = .033) were associated with recurrent defects in the univariate analysis. Conclusion: Arthroscopic TOE repair of rotator cuff tears provided improved clinical outcomes with a recurrent defect rate of 21.3% at 10-12 years after surgery. Future research focusing on tendon healing is needed as repair integrity on MRI correlates with clinical outcomes. (C) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
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    Lateral collateral ligament and biceps femoris tendon fixation with a suture anchor to the tibial metaphysis after proximal fibula en bloc resections preserve lateral knee stability
    (Georg Thieme Verlag Kg) Isik, Samet; Ayik, Gokhan; Tokgozoglu, Mazhar; Ayvaz, Mehmet; N/A; Büyükdoğan, Kadir; Doctor; N/A; Koç University Hospital; N/A
    This study aims to analyze the functional outcomes and lateral knee stability of patients who underwent lateral collateral ligament (LCL) and biceps femoris tendon reconstruction with suture anchors after proximal fibula en bloc resection for bone tumors. Patients who underwent proximal fibular en bloc resection between 2007 and 2018 were retrospectively viewed. Patients were invited to visit the clinic, and their functional scores were evaluated using the Musculoskeletal Tumor Society Scoring (MSTS) system. Lateral knee stability was evaluated by varus stress radiographs obtained at 20 degrees of flexion, and the range of motion (ROM) of the bilateral knee was assessed. Side-to-side differences were graded according to the International Knee Documentation Committee (IKDC) criteria and compared between types I and II resections. A total of 17 patients (4 males and 13 females) with a mean age of 31.1 +/- 17.1 (range: 13-65) years at the time of surgery were available for radiological and clinical examination at a mean follow-up of 68.6 +/- 36.4 (range: 22-124) months after surgery. In terms of ROM measurements, IKDC grades and side-to-side differences in both flexion and extension were not significantly different between the groups. On varus stress radiographs, lateral knee gapping was measured to be 0.93 +/- 0.91 mm in type-I resections and 1.83 +/- 0.45 mm in type-II resections, and statistically significant differences were detected among the groups ( p = 0.039). When the values were graded according to IKDC criteria, none of the knees were classified as abnormal, and no difference was observed between the groups. Mean MSTS score of patients with type-I resections was significantly higher than those of patients with type-II resections (92.7 vs. 84.4%, p = 0.021). In the subscale analysis, a significant difference was observed in the support scores (type I = 94.5%, type II = 70%; p = 0.001). The reattachment of LCL and biceps femoris tendon to the tibial metaphysis with a suture anchor is a simple and effective method to prevent lateral knee instability after proximal fibula resections.
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    Patients without re-dislocation in the short term after arthroscopic knotless Bankart repair for anterior shoulder instability may show residual apprehension and recurrence in the long term after 5 years
    (Elsevier, 2022) N/A; N/A; N/A; N/A; N/A; N/A; Eren, İlker; Büyükdoğan, Kadir; Yürük, Batuhan; Aslan, Lercan; Birsel, Olgar; Demirhan, Mehmet; Faculty Member; Doctor; Researcher; Faculty Member; Faculty Member; Faculty Member; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 168021; N/A; 327613; 145301; 202021; 9882
    Hypothesis: The aim of this study was to report the long-term results, residual instability, and recurrence rate of arthroscopic Bankart repair surgery without a re-dislocation event in the first 5 years. Methods: We performed a retrospective analysis of Bankart repairs performed in a single center, by a single surgeon, with a minimum of 5 years' follow-up. Patients without a re-dislocation in the first 5 years of surgery were included. Patients who underwent open repair, those who underwent revision surgery, and those with critical glenoid bone loss were excluded. A total of 68 shoulders in 66 patients (51 male and 15 female patients) were included. Patients were analyzed in 2 domains: (1) failures defined as re-dislocation and (2) failures defined as apprehension and re-dislocation combined (residual instability). Clinical outcomes were assessed using shoulder range of motion, the American Shoulder and Elbow Surgeons score, and the Western Ontario Shoulder Instability Index (WOSI) score. Pain, residual apprehension, re-dislocations, and additional surgical procedures were recorded. Results: The mean age of patients was 31.16 (range, 16-60 years), and the mean follow-up duration was 8.42 +/- 2.1 years. The median number of dislocations was 3 (range, 1-20), and the median time from first dislocation to surgery was 16 months (interquartile range, 3-100.5 months). Five patients reported re-dislocations (7.4%) with a mean period of 6.54 +/- 2.5 years (range, 5-10.8 years). Seven patients without re-dislocations and 2 patients with re-dislocations reported residual apprehension. Mean shoulder elevation and mean external rotation were 161.3 degrees +/- 12.4 degrees and 39.2 degrees +/- 11 degrees, respectively. The mean visual analog scale, American Shoulder and Elbow Surgeons, and WOSI scores were 0.5 +/- 1.4, 91 +/- 11.9, and 88 +/- 12.1, respectively. Age was similar in patients with stable shoulders and those with shoulders with re-dislocation or residual instability. The WOSI score was lower in patients with re-dislocation and residual instability (P = .030 and P = .049, respectively). Conclusions: Arthroscopic Bankart repair is a successful surgical option for anterior shoulder instability. The 7.4% re-dislocation rate after 5 years indicates there may be a deterioration of capsulolabral repair in certain patients. The long-term failure pattern may be underestimated in short- to mid-term projections. (C) 2021 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
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    Translation, cross-cultural adaptation, reliability, and validity of Turkish version of the University of California Los Angeles (ucla) shoulder scale into Turkish
    (Taylor & Francis Ltd, 2022) Koyuncu, Özgür; Aslan, Lercan; Çelik, Derya; Demirhan, Mehmet; N/A; Büyükdoğan, Kadir; Aslan, Lercan; Demirhan, Mehmet; Doctor; Faculty Member; Faculty Member; N/A; School of Medicine; School of Medicine; Koç University Hospital; N/A; 145301; 9882
    Purpose To translate and culturally adapt the University of California Los Angeles (UCLA) shoulder scale into Turkish (T-UCLA) and determine its psychometric properties. Material and methods The UCLA scale was translated into Turkish using Beaton guidelines. Ninety-one patients (46 male; mean age: 46.0 +/- 13.7 years) with shoulder disorders completed T-UCLA and American Shoulder and Elbow Score (ASES), Simple Shoulder Test (SST) and 36-Item Short Form (SF-36). Test-retest reliability was tested in 50 patients at a mean of 5.2 +/- 2.2 days after initial assessment. Validity was evaluated in 91 patients, and correlations between ASES, SST and SF-36 were analyzed. Responsiveness was assessed in 33 patients who underwent arthroscopic rotator cuff repair with a mean follow-up of 12.8 +/- 0.5 months. Results Test-retest reliability of overall T-UCLA, pain and function subscales were 0.96, 0.94 and 0.86, respectively. The correlation coefficients between T-UCLA and SST and ASES were r = 0.752 and r = 0.783, respectively (p < 0.001). The highest correlations between T-UCLA and SF-36 were observed in physical functioning (r = 0.64) and bodily pain subscales (r = 0.66). No ceiling or floor effect observed. Overall and subscales of T-UCLA were highly responsive (ES = 3.22-4.31). Conclusion T-UCLA has sufficient reliability and validity similar to original and translated versions. T-UCLA is responsive in patients who underwent rotator cuff repair.