Researcher: Kılıçoğlu, Önder
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Kılıçoğlu, Önder
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Publication Open Access Comparison of analgesic consumption of hemophilic and non-hemophilic patients in knee arthroplasty(Turkish Assoc Trauma Emergency Surgery, 2022) Canbolat, Nur; Dinc, Tugce; Koltka, Kemalettin; Zulfikar, Bulent; Koc, Basak; Buget, Mehmet I.; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; N/ABACKGROUND: Hemophilia is a rare hereditary bleeding disorder that develops as a result of factor VIII or IX deficiency. Long-term complications of hemophilia such as arthropathy, synovitis, and arthritis can lead to the development of recurrent chronic pain. Pain is therefore a critical aspect of hemophilia. The gold standard treatment for end-stage hemophilic knee arthropathy is total knee arthroplasty (TKA). The hypothesis of this study was that after knee replacement surgeries that cause severe post-operative pain, hemophilia patients with chronic analgesic consumption may experience higher levels of pain than non-hemophilic patients, and use more opioid and non-opioid drugs. METHODS: This retrospective study included 82 patients who were hemophilic and non-hemophilic TKA patients operated under general anesthesia. Seventy-three patients were evaluated and divided into two groups according to the diagnosis of hemophilia: 36 patients were investigated in the hemophilic group and 37 patients in the non-hemophilic group. RESULTS: Post-operative tramadol consumption (p=0.002) and pethidine consumption (p=0.003) were significantly higher in the group hemophilia. The length of stay in the hospital was also significantly longer in the hemophilic group (p=0.0001). CONCLUSION: In the light of these informations, we think that acute post-operative pain management of hemophilia patients should be planned as personalized, multimodal preventive, and pre-emptive analgesia.
Publication Metadata only Symptomatic osteonecrosis of the hip and knee in patients with systemic lupus erythematosus: prevalence, pattern, and comparison of natural course(Sage Publications Ltd, 2021) Ersin, Mehmet; Demirel, Mehmet; Ekinci, Mehmet; Mert, Lezgin; Çetin, Çiğdem; Artım Esen, Bahar; İnanç, Murat; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; N/AObjective Osteonecrosis (ON), also known as avascular necrosis, is characterized by the collapse of the architectural bone structure secondary to the death of the bone marrow and trabecular bone. Osteonecrosis may accompany many conditions, especially rheumatic diseases. Among rheumatic diseases, osteonecrosis is most commonly associated with systemic lupus erythematosus (SLE). We assessed prevalence and distribution pattern of symptomatic on in patients with SLE and compare the natural courses of hip and knee ON. Methods 912 SLE patients admitted between 1981 and 2012 were reviewed. SLE patients with symptomatic on were retrospectively identified both from the existing SLE/APS database. The prevalence of symptomatic on was calculated; with ON, the joint involvement pattern was determined by examining the distribution of the joints involved, and then the data about the hip and knee joints were entered in the Kaplan-Meier analysis. Kaplan-Meier methods were used to calculate 5- and 10-year rates of ON-related hip (the hip group) and knee survival (the knee group). Results Symptomatic on developed in various joints in 97 of 912 patients with SLE, and the overall prevalence of on was detected as 10.6%. The mean age at the time of SLE and on diagnoses were 27.9 +/- 9.9 (14-53) and 34.2 +/- 11.3 (16-62) years, respectively. The mean duration from diagnosis of SLE to the first development of on was 70.7 +/- 60.2 (range = 0-216) months. The most common site for symptomatic on was the hips (68%, n=66), followed by the knees (38%, n = 37). According to Kaplan-Meier analysis, hip and knee joint survival rates associated with 5-year on were 51% and 88%, and 10-year survival rates were 43% and 84%, respectively. Conclusion We observed that the prevalence of symptomatic on in patients with SLE was 10.6%. With the estimated 10-year survival rates of 40% versus 84% for the hip and knee joints, respectively, hip involvement may demonstrate a more aggressive course to end-stage osteoarthritis than the knee involvement.Publication Metadata only Time difference between onsets of lateral and medial hamstring muscles during gait in patients with patellofemoral pain: a preliminary study(Marmara University Press, 2022) Coskunsu, Dilber Karagozoglu; Can, Filiz; Kuchimovs, Shavkat; Akalan, Nazif Ekin; Öztürk, Necla; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; N/AObjective: Early activation of lateral hamstrings (LH) relative to medial hamstrings (MH) has been thought to be the cause of abnormal knee abduction and external rotation of the tibia, which affects the orientation of patellar tendon and increases lateral patellofemoral compression. Therefore, early activation of LH relative to MH is considered to have a role in the patellofemoral pain (PFP). The aim of this study was to investigate the time difference between MH and LH onsets in patients with PFP during gait. Methods: Thirteen patients with bilateral PFP (mean age 28.73 +/- 7.44 years) and 13 asymptomatic subjects (mean age 30.47 +/- 6.22 years) were recruited in the study. Gait analysis was performed using the ELITE system (BTS, Milano-Italy) with video cameras (TVC, BTS, Milano-Italy). Participants were requested to walk at a self-selected speed on a force platform, and EMG data were recorded from MH and LH muscles for 10 initial contacts by using TELEEMG (BTS, Milano-Italy). Time difference between the onsets of the MH and LH was calculated for each initial contact by using moving averaging method, then their mean was obtained for each participant. Results: The time difference between onsets of MH and LH was - 26.9 +/- 22.2 ms for PFP subjects and - 11.2 +/- 14.2 ms for control subjects, and LH mainly became activated earlier compared to MH in most of the subjects in both groups. There was a statistically significant difference between the time differences of the groups (p=0.041). Conclusion: Our findings suggest that LH displayed an earlier activation in subjects with PFP compared to control subjects during gait.Publication Metadata only Anatomical bone structure differences in patients with hemophilic arthropathy of the knee(Scientific Scholar Llc, 2022) Ekinci, Mehmet; Akgül, Turgut; Arzu, Ufuk; Bayram, Serkan; Yağcı, Taha Furkan; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; Koç University Hospital; N/AObjectives: The anatomical differences of the bony structure of the knee joint in patients with hemophilia were evaluated, and the results were compared with the knees of patients with primary gonarthrosis and no arthrosis. Material and Methods: This study reviewed 41 knees in 21 patients (with an Arnold-Hilgartner classification of Stages 4 and 5 hemophilic arthropathy) who underwent total knee arthroplasty in single center. Two control groups including 21 asymptomatic patients (42 knees) and 21 primary knee osteoarthritis patients (42 knees) were formed to compare the measurements with hemophiliacs. Femoral mediolateral width, femoral anteroposterior width, femur and tibia diaphysis width, adductor tubercle-joint line distance, tibial plateau width, and medial and lateral tibia plateau width were measured separately. Results: Femoral mediolateral width was significantly narrow comparing with healthy individuals and primary knee osteoarthritis group. Tibial plateau was similar to asymptomatic group but significantly narrow compared with primary knee osteoarthritis group. With the correlation, the tibial plateau measurements and medial and lateral plateau were significantly narrow at hemophilic arthropathy group (P < 0.05). The slope was less in hemophilic patients as compared with asymptomatic individuals (P: 0.001). Hemophilic patients had larger femoral aspect ratios than asymptomatic group but there were no observable differences with the primary osteoarthritis group. For the tibial aspect ratios, hemophilic had a smaller ratio than the primary osteoarthritis group but there were no significant differences with the asymptomatic group. Conclusion: Hemophilic knee has a mismatch between femoral and tibial side while comparing with the other groups.Publication Metadata only Reasons for resident resignations from orthopedic residency programs in Turkey: a cross-sectional survey from residents' perspectives(Turkish Association of Orthopaedics and Traumatology, 2022) Mert, Lezgin; Demirel, Mehmet; Kendirci, Alper Şükrü; Akgul, Turgut; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; N/AObjective: The aim of this study was to analyse the factors that led to resignations from Orthopaedics and Traumatology Residency programmes in Turkey, and to determine the overall rate of resignation among residents from Orthopaedics and Traumatology programmes. Methods: In this cross-sectional survey,120 residents who either resigned or transferred to other OT clinics between autumn of 2013 and spring of 2020 were included. They were asked to complete a questionnare which was sent via Whatssapp application or e-mail. The questionnare was comprised of 2 sections; Section A, which adressed resignation, consisted of 15 questions and Section B, which adressed transfer to another OT programme, consisted of 12 questions. Both sections had open ended and multiple choice questions. Results: of 120 residents, 96 (6.6%) resigned and then transferred to another specialty, and 24 (1.6%) transferred to another orthopedics and traumatology clinic based on our review. The overall resignation rate as per the total quotas for orthopedics and traumatology residency from 2013 to 2020 was 8.2%. of the 120 orthopedics and traumatology residents who were eligible for the survey, 83 (70%) completed the questionnaire. Sixty-one (60 males, 1 female; median age = 26 years; age range = 25-35) of 96 residents who resigned from the orthopedics and traumatology residency completed section A (the response rate was 63.5%); 22 (22 males; median age = 27.6 years; age range =25-34) out of 24 residents who transferred to another orthopedics and traumatology clinic completed section B (the response rate was 91.6%). In section A, 40 out of 61 individuals (65.5%) preferred orthopedics and traumatology specialty as the first choice in TUS, and 34 residents (55.7%) reported not to have had enough information regarding the residency program before starting their clinics. In section B, out of the 22 residents, 13 (59%) stated that orthopedics and traumatology residency was not their first choice in TUS, and 18 (81.8%) reported not to have had sufficient knowledge about the preferred clinic. The most common reason for resignation or transfer to another specialty was heavy workload (n = 46, 74.19%), followed by excessive hours of work (n =45, 72.58%). The most common reason for transfer to another orthopedics and traumatology clinic was drudgery (n= 10, 45.5%), followed by problems with the hierarchy in orthopedics and traumatology residency (n = 9, 40.9%). Conclusion: The results of this survey have shown us, with an overall resignation rate of 8.2% as per the total quotas for OT residency from 2013 to 2020, that resignation from OT residency represents an important problem in Turkey. Workload and excessive hours of work were the most common reasons for resignation from orthopaedic residency programmes. Furthermore, extra work that diverted residents from their actual job responsibilities, as well as academic and educational concerns, were the main factors leading to transfer to another OT residency programme.Publication Open Access An algorithmic approach for the surgical treatment of bone metastases(Kare Yayıncılık, 2021) Kılıçoğlu, Önder; Faculty Member