Browsing by Author "Dündar, A."

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Comparison of Ultra-Congruent Anterior-Stabilized Vs. a Posterior Cruciate Substituting Total Knee Arthroplasty for Osteoarthritis With Severe Varus Knee Deformity: Comparable 2 Year Outcomes With Two Design
(Verduci Editore s.r.l, 2023) Dündar, A.; İPek, D.; Kaya, Ş.
OBJECTIVE: In this retrospective study, we compared the functionality and clinical outcomes of patients with severe varus knees who underwent total knee arthroplasty (TKA) that used prostheses with either a posterior stabilized (PS) design or an ultra-congruent (UC) design. PATIENTS AND METHODS: Primary TKA was performed in 161 patients; the UC device was used in 82 (51%) cases and the PS device in 79 (49%). Preoperatively and at the final follow-up examination, all patients were evaluated by orthoroentgenography. The mechanical axis angle and radiolucent lines were evaluated according to the Knee Society Roentgenographic Evaluation System on preoperative and 5-year follow-up radiographs. Total Knee Society Score (KSS) (knee score/function score) and Visual Analog Scale scores were obtained at the final follow-up examination. Demographic and surgical data and revision rates were evaluated for all patients. RESULTS: Postoperative angle values were significantly decreased in both the UC and PS groups (p<0.001 and p<0.001, respectively). Postoperative flexion range of motion values were significantly increased in both the UC and PS groups (p<0.001 and p<0.001, respectively). The postoperative KSS function scores were not significantly different between the groups (p=0.194). The mean surgical time of the PS group (54.99±4.18 minutes) was significantly higher than that of the UC group (46.02±4.48 minutes) (p<0.001). CONCLUSIONS: No notable differences were found between the UC and PS groups with respect to the clinical and functional parameters examined. Based on these results, UC TKA can be considered a safe alternative to PS TKA in severe varus knees. © 2023 Verduci Editore s.r.l. All rights reserved.
Is a Single Dose of Antibiotic Prophylaxis Sufficient To Prevent Infections in Total Joint Arthroplasty
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Kaya, S.; Güven, N.; Ünal, Y.C.; Dündar, A.
Introduction: Prosthetic infection is a serious complication that can develop after knee and hip arthroplasty and remains a common reason for revision surgery. Guidelines recommend various measures to prevent infection, howewer some professional associat ions argue that there is insufficient evidence for single-dose antibiotic prophylaxis. Our study compares the outcomes of patients receiving short-and long-term antibiotic prophylaxis in arthroplasty surgery. Materials and Methods: In this retrospective study of 424 patients undergoing knee or hip arthroplasty, two prophylaxis protocols were compared. Group 1 (190 patients, 44.8%) received cefazolin pre-and postoperatively on day 1, while group 2 (234 patients, 55.2%) received extended cefazolin (5 days postoperatively) and oral amoxicillin clavulanic acid (5 days). Early postoperative infection rates wer e evaluated. Results: In this study, 83.4% of 424 patients who underwent total knee and hip arthroplasty were female. Knee and hip operations were performed in 86.8% and 13.2% of the patients, respectively. The mean age did not show a statistically significant difference. There was no significant difference between the groups in terms of periprosthetic infection rates (p=0.828). Posto perative wound complications were seen in 34 (18%) patients in group 1 and 44 (19%) patients in group 2, but this difference was not statistically significant (p=0.704). No significant difference in wound complications and prosthesis infection rates was fo und between group 1 and group 2 patients with risk factors (p>0.05). Conclusion: In primary joint arthroplasty, extended oral antibiotic prophylaxis did not provide additional protection against single-day antibiotic prophylaxis. The results were similar in both risk and non-risk groups. Considering antibiotic resistance, side effects and costs, it is concluded that extended prophylaxis is unnecessary. However, further large-scale studies on this subject are required. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Is the Use of Low Molecular Weight Heparin Sufficient in Patients Undergoing Total Knee Arthroplasty for 15 Days
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Kaya, Ş.; Dündar, A.; Turgut, M.H.; Ünal, Y.C.
Venous thromboembolic events, which can occur, if necessary, precautions are not taken after total joint arthroplasty, are a significant cause of mortality. One of the medical treatments used for prevention is low molecular weight heparin. Duration of low molecular weight heparin (LMWH) is used for prophylaxis can vary among physicians.In this study, we c ompared the effect of the duration of LMWH use on thromboembolic complications within patients, who had total knee arthroplasty. The study is retrospective and data is obtained from total of 224 adult patients over the age of 18. Age, gender, and thromboembolic complications were evaluated. The patients were separated into two groups as those who used LMWH for 15 days and those who used LMWH for 30 days and the development of thromboembolic complications between the two groups was compared statistically. Of the 224 patients thrown in the study, %81.7 were women. Group 1 (those who used LMWH for 15 days) consisted of 116 patients, and group 2 (those who used LMWH for 30 days) consisted of 108 patients. The distinction between the two groups regarding deep vein thrombosis (DVT) did not display any statistically significant difference (p=0.943). In DVT prophylaxis in patients undergoing total knee arthroplasty, LMWH for 15 days is as effective as LMWH for 30 days Therefore, it is sufficient to give LMWH for a short period of time as it is an invasive procedure. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.