Researcher:
Çalışkan, Emrah

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Emrah

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Çalışkan

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Çalışkan, Emrah

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2020 - 20227

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    Routine histopathological analysis of the synovium in patients with primary total knee arthroplasty
    (Georg Thieme Verlag Kg, 2021) Utkan, Ali; Gencer, Batuhan; Ozkurt, Bulent; N/A; Çalışkan, Emrah; Faculty Member; School of Medicine; 205925
    Although there are numerous studies about routine histopathological analysis during arthroplasty surgeries, most of them showed that new diagnoses have rarely been obtained as a result. The aim of this study was to evaluate the efficacy of routine pathological analyses of synovia resected during primary total knee arthroplasty in patients with osteoarthritis and its relevance in the treatment process. Of the 47 included patients who were followed up prospectively, 26 patients had clinical and histopathological concordant diagnoses and 21 patients had discrepant diagnoses. Oxford knee score and visual analogue score were performed for all the patients. Kallgren-Lawrence score was used for radiological analyses. The Mann-Whitney U test was used to examine the differences between the abnormally distributed variables. Mean age was 65.9 +/- 4.3 years (range, 50-89 years) and mean follow-up time was 19 +/- 7.8 months (range, 6-39 months). Grade IV gonarthrosis was found to be statistically lower in the discrepant group ( p =0.046). The mean preoperative Oxford knee score was 16.8 +/- 2.3 (range, 2-23) and the mean postoperative Oxford knee score was 44.6 +/- 1.8 (range, 27-48; p =0.016). Postoperative Oxford knee scores and VAS were significantly increased in both the concordant and discrepant groups ( p =0.026 and p =0.035, p =0.019 and p =0.039, respectively). Resection and histopathologic analyses of the hypertrophied and inflamed synovium encountered during primary arthroplasty procedure should be performed. This examination not only could provide crucial information that may influence the postoperative follow-up guidelines but also could help us to expand our knowledge and awareness of rare diseases that might yield osteoarthritis. The level of evidence for the study is level II.
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    Primary total knee replacement leads to an increase in physical activity but no changes in overall time of sedentary behaviour: a retrospective cohort study using an accelerometer
    (Springer, 2020) Igdir, Volkan; Dogan, Ozgur; Bicimoglu, Ali; N/A; Çalışkan, Emrah; Faculty Member; School of Medicine; Koç University Hospital; 205925
    Introduction There is no consensus between patient-reported subjective scores and objectively measured physical activity (PA) behaviour after total knee arthroplasty (TKA). The aim of this study was to understand the volume and pattern of physical activity and daily energy consumption after total knee arthroplasty for osteoarthritis. Method Physical activity patterns of 36 patients (31 female, 5 male) with an average age of 67.3 +/- 6.7 (50-81) years and end-stage gonarthrosis were investigated using an accelerometer (ActiCal) for seven consecutive days prior to and six months after total knee arthroplasty. Knee Society scores, Oxford knee scores, range of motion, and muscle strength around knee were also recorded. Results Sedentary behaviour did not change after total knee arthroplasty (p = 0.975). Increases in light physical activity time (p = 0.005) and moderate-vigorous physical activity time (p = 0.006) were found significant. In the post-operative period, light PA awake time increased 25% and moderate-vigorous PA awake time increased four times compared with the pre-operative value. In addition, a significant increase was observed in the amount of daily energy expenditure after TKA (p = 0.001). The subjective functional scores were increased in the post-operative period compared with baseline values (p < 0.001). While a significant increase in knee flexion angle was found after TKA (p = 0.01), there was no increase in muscle strength around the knee (p = 0.096). Conclusion Accumulation patterns of activity evaluated by using an accelerometer objectively can give a new insight to realize the behavioral changes after total knee arthroplasty. Daily life style changes can be encouraged by means of objective evaluations.
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    Ultrasonography and erythrocyte distribution width in patients with plantar fasciitis
    (Elsevier, 2021) Koparal, Salih Suha; Igdir, Volkan; Alp, Emre; Dogan, Ozgur; Çalışkan, Emrah; Faculty Member; School of Medicine; 205925
    Background: The measurement of plantar fascia thickness with ultrasonography can be used for both for diagnosis and as a response-to-treatment parameter in plantar fasciitis. Furthermore, with the recent studies, red cell distribution width may be used as an inflammatory marker. Aim of this study is to investigate the association of red cell distribution width and ultrasonography on diagnosis and monitoring of treatment in patients with plantar fasciitis. Methods: Clinically diagnosed 102 patients with plantar fasciitis between the dates January 2016 to July 2018 were analysed. Hemogram, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and plantar fascial ultrasonography were obtained on initial evaluation and in 1 month, 2 months and 3 months of the standard nonoperative treatment; American Orthopaedic Foot & Ankle Hindfoot Score (AOFAS) and Visual Analog Scale (VAS) scores were recorded. Posthoc and multivariate logistic regression analysis were used for statistical analysis on SPSS 21.0. Results: Red cell distribution width was correlated with plantar fascia thickness by the end of the 1 month (r = 0.26, P = .013). Female sex, BMI over 30 kg/m2, higher red cell distribution width and higher plantar fascia thickness were associated with plantar fasciitis on initial evaluation. Higher red cell distribution width together with higher plantar fascia thickness were also found to be a risk factor for both on initial evaluation and 1 month after treatment in plantar fasciitis. Conclusion: This study shows that association of red cell distribution width and plantar fascia thickness can be not only a diagnostic predictor but also an indicator of treatment response in plantar fasciitis. Level of clinical evidence: Level IV (c) 2020 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.
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    Long-term follow-up of eosinophilic granulomas of the axial and appendicular skeleton managed with biopsy alone
    (Lippincott Williams & Wilkins, 2020) Erol, Bülent; Sofulu, Ömer; Çalışkan, Emrah; Faculty Member; N/A; Koç University Hospital; 205925
    Background: This study aimed to evaluate the long-term clinical and radiologic follow-up results of eosinophilic granulomas (EGs) of the axial and appendicular skeleton managed with biopsy alone. Methods: Fifty-five patients with unifocal osseous EGs of the axial and appendicular skeleton were followed after biopsy. Patients were divided into 2 groups on the basis of localization of the lesions. In group 1, there were 32 (58.2%) children with extremity long bone involvement: femur, tibia, humerus, ulna, and radius. Group 2 included 23 (41.8%) patients with lesions located in other appendicular and axial skeleton bones: pelvis, scapula, clavicle, lumbar, and thoracic vertebrae. After confirming the diagnosis by a closed biopsy, no further surgical intervention was performed. Clinical recovery included regression of the localized symptoms, mainly pain resolution. Functional improvement was assessed by Musculoskeletal Tumor Society (MSTS) scoring. Radiologic healing was defined as ossification of the entire lesion with cortical thickening in long and flat bones, and restoration of vertebral body height in the spine. Complications, including local recurrence, were determined. Results: The patients comprised 28 boys and 27 girls with an average age of 9.2 years (range, 3 to 16 y). The average follow-up was 76 months (range, 28 to 132 mo). The median time from biopsy to clinical recovery was 17 days [95% confidence interval (CI), 13.3-20.6] and 36 days (95% Cl, 32.8-39.1) in group 1 and group 2, respectively. MSTS scores increased progressively till the end of 12 months in both groups. The median time from biopsy to radiologic healing was 16 months (95% CI, 11.5-20.4) and 42 months (95% Cl, 39.3-44.6) in group 1 and group 2, respectively. Both clinical recovery (P=0.021) and radiologic healing (P=0.009) were significantly faster in group 1 compared with group 2. No major complication was seen after biopsy. All lesions regressed without a local recurrence. Conclusions: Unifocal osseous EGs have spontaneous healing potential and confirming the diagnosis by biopsy is enough to obtain good clinical and radiologic results without any additional surgical intervention. Type of Study: This was a therapeutic study.
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    Searching for a new parameter in the healing of Tibia Pilon fractures: fracture area measurement
    (NLM (Medline), 2022) Gencer, Batuhan; Doğan, Özgür; Igdir, Volkan; Çulcu, Ahmet; Biçimoğlu, Ali; Çalışkan, Emrah; Faculty Member; School of Medicine; 205925
    Background: Tibia pilon fractures are associated with high complication rates, decreased quality of life, and low patient satisfaction. Although many factors such as reduction quality and soft-tissue coverage have been identified, researchers continue to investigate the factors that affect healing in tibia pilon fractures. Our objective was to investigate the effect of initial fracture crack width and displacement degree on clinical functional results in tibia pilon fractures. Methods: In this retrospective cohort study, 40 patients with Arbeitsgemeinschaft für Osteosynthesefragen and Orthopaedic Trauma Association type 43B and 43C tibia pilon fractures and operated on through the extensile anteromedial approach were analyzed. The demographic data of the patients, injury mechanisms, fracture type, reduction quality, clinical results, and postoperative complications were recorded. To evaluate the objective quantity of initial fracture crack width and displacement, a new parameter was defined: "fracture area." All measurements were conducted using a feature from the picture archiving and communication system on anteroposterior and lateral radiographs taken separately in standard fashion. Results: With an average follow-up period of 29.2 months (range, 24-40 months), 34 patients (85%) had excellent or good results, whereas only two patients (5%) had poor clinical results. Age, injury mechanism, and reduction quality have a significant relationship with Maryland Foot Score (P < .001, P < .037, and P < .001, respectively). Preoperative fracture area, measured on both the anteroposterior and the lateral views, are significantly related to both Ovadia-Beals Score and Maryland Foot Score (P < .001 for each). Conclusions: Preoperative fracture area measurement has a major effect on healing of tibia pilon fractures. Increased initial fracture area is correlated with poor clinical functional results. High-energy injuries, older age, and poor reduction quality are also related to worse clinical outcomes.
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    Intraosseous calcific tendinitis of the rotator cuff yields similar outcomes to those of intratendinous lesions despite worse preoperative scores
    (Springer, 2022) Koyuncu, Özgür; N/A; N/A; N/A; N/A; N/A; Çalışkan, Emrah; Eren, İlker; Aslan, Lercan; Seyahi, Aksel; Demirhan, Mehmet; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 205925; 168021; 145301; 52082; 9882
    Purpose To evaluate the surgical outcomes of arthroscopic removal of intraosseous deposits in patients with intraosseous calcific tendinitis of the rotator cuff. Methods This study involved a retrospective review of 96 patients operated on from 2004 to 2019. Patients were divided into two groups according to the location of calcific deposits. Group I had pure tendinous involvement (n = 71), and Group II had tendinous and intraosseous involvement (n = 25). The mean follow-up time was 6.4 +/- 3.9 years. There were 71 patients (46 women, 25 men) in Group I, and the mean age was 49.3 +/- 8.2 years (range 30-65 years). In group II, there were 25 patients (18 women, 7 men); the mean age was 47.3 +/- 11.2 years (range 28-70 years). Results The mean preoperative VAS pain score was 8.8 +/- 1.4 in Group I compared to 9.5 +/- 0.5 in group II (p = 0.017). The median preoperative Constant and Oxford scores were 42 (20-65) and 22 (8-34) in Group I and 25.5 (22-46) and 10 (8-16) in group II, respectively (p < 0.001). There was no difference in postoperative pain scores (Group I: 0.7 +/- 1.6 and group II: 0.5 +/- 0.6, p = 0.926), Constant scores [Group I: 100 (80-100) and group II: 100 (90-100), (n.s).] and Oxford scores [Group I: 48 (28-48) and group II: 46.5 (4-48), (n.s.)] between the two groups. The number of preoperative injections was higher in Group II (p = 0.05). There was no correlation between the size of the soft tissue calcific deposit and the preoperative pain, Constant, and Oxford scores (n.s.). Conclusion Arthroscopic debridement of calcific tendinitis with intraosseous involvement is a safe and effective treatment method similar to that of pure tendinous involvement.
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    Single versus double plating for bicondylar tibia plateau fractures: comparison of range of motion, muscle strength, clinical outcomes and accelerometer-measured physical activity
    (Elsevier, 2022) Gencer, Batuhan; Doğan, Özgür; Iğdır, Volkan; Biçimoğlu, Ali; Çalışkan, Emrah; Faculty Member; School of Medicine; 205925
    Background: Optimal treatment of bicondylar plateau fractures is still a matter of debate. Accelerometer-measured physical activity levels may help us to obtain objective information regarding the quality of life of patients. The aim of this study was to compare the physical activity levels, objective and subjective functional results and stabilities of fixations of patients with treated bicondylar plateau fractures. Methods: In this cross-sectional study of 23 patients, accelerometer-measured physical activity levels, daily energy consumption and measurements of knee joint range of motion (ROM) and muscle strength were measured. While Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as a patient-reported outcome measurement, Rasmussen Radiological Score was used for radiological evaluation. Results: There was no significant difference between the groups in terms of physical activity levels and daily energy consumption (P = 0.667). While Total KOOS, Symptom and Stiffness and Sports Activities scores were higher in patients with a single plate (P = 0.034, P = 0.003 and P = 0.014, respectively), knee flexion and extension ROM and flexor and extensor muscle strength were similar between groups (P = 0.405, P = 0.095, P = 0.982 and P = 0.988, respectively). Conclusions: While patient-reported outcome measurements were better with single plating, there was no difference between the groups in terms of physical activity levels, ROM, muscle strength and radiological results. Although it should be kept in mind that the choice of the primary surgeon, the condition of the soft tissue and the fracture geometry are also effective in the decision-making process, single plating seems to be a valid surgical option in the treatment of bicondylar plateau fractures. (C) 2021 Published by Elsevier B.V.