Browsing by Author "Kaya, Sehmuz"

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Acetabular Fractures From Judet and Letournel To the Present: Research Trends and Global Outcomes With Bibliometric Analysis During 1980 To 2022
(Lippincott Williams & Wilkins, 2023) Dundar, Abdulrahim; Ipek, Deniz; Kaya, Sehmuz
Fractures of the acetabulum are one of the most challenging injuries treated by orthopedic surgeons. However, a bibliometric analysis has not been performed in the literature on acetabular fractures, which seriously affect the quality of life of patients. The aim of this study was to summarize the bibliometric and intellectual structure, and determine and map the most recent trends on the topic of acetabular fractures by analyzing the social and structural relationships between the different research components of articles published on the acetabular fractures. 1599 articles on acetabular fractures published between 1980 and 2022 were extracted from the Web of Science (WoS) database and analyzed. Bibliometric visualization maps were used to reveal trending topics, citation analyses, and international collaborations. Spearman correlation analysis was performed for correlation investigations. The trend in the expected number of articles to be published over the next few years was displayed using the exponential smoothing estimator. The top 3 contributing countries to the literature were United States of America (USA) (551, 34.4%), China (170, 10.6%), and Germany (160, 10%). The most active author was Berton R. Moed (n = 29) and the most active institution was the University of California System (n = 41). A high-level statistically significant correlation was found between the number of articles on the topic of acetabular fractures published by nations and the gross domestic product (GDP) and GDP per capita values of those countries (R = 0.719, P < .001; R = 0.701, P < .001, respectively). The trending topics researched in recent years were 3D printing, 3-dimensional printing, outcomes, Open Reduction and Internal Fixation (ORIF), mortality, Kocher-Langenbeck, Pararectus approach, tranexamic acid, transfusion, epidemiology, fracture mapping, modified Stoppa approach, post-traumatic osteoarthritis, pelvis fracture, pelvic trauma, fracture reduction, and pelvic ring injury. The leading countries in research on the subject of acetabular fractures were seen to be western countries with large economies (especially the USA, European countries, and Canada) and China, India and Turkey.
Comparison of Long-Term Clinical and Radiologic Outcomes of Aperfix and Fixed Loop Device Fixation in Anterior Cruciate Ligament Reconstruction: a Retrospective Study
(Lippincott Williams & Wilkins, 2025) Kaya, Sehmuz; Guven, Necip; Unal, Yunus Can; Ozkan, Sezai; Adanas, Cihan; Turkozu, Tulin; Gokalp, Mehmet Ata
Anterior cruciate ligament reconstruction aims to improve knee stability and range of motion. The AperFix system consists of polymer components, and fixed-loop fixation is an established endoscopic technique. Our aim in this study was to compare the long-term clinical and radiological results of AperFix and fixed-loop fixation and to prove that the long-term results of the AperFix fixation method are at least as good as those of the fixed loop device. This retrospective study included 109 patients who underwent primary anterior cruciate ligament reconstruction using single bundled hamstring tendon grafts. Patients under 16 years of age, patients with incomplete follow-up, bilateral or other ligament injuries, inflammatory arthropathy, previous knee surgery, or concurrent meniscal treatment were excluded. Participants were divided into 2 groups according to femoral fixation methods: AperFix fixation (group 1, n = 55) and fixed loop device fixation (group 2, n = 54). All operations were performed by senior surgeons under general or spinal anesthesia. Postoperative rehabilitation started on day 1 and allowed patients to resume normal activities at 6 months. Outcomes were evaluated during follow-up, including knee range of motion, clinical scores [Lysholm, Cincinnati, Tegner, and International Knee Documentation Committee] and radiographic measurements of femoral tunnel width and length. Measurements were performed by 2 orthopedic surgeons to ensure reliability. This study evaluated 109 patients (55 in group 1, 54 in group 2) and found no statistically significant differences in demographic variables such as age, sex, body mass index, follow-up duration, or side distribution. Clinical outcomes, including anterior drawer test, Lachman test results, knee flexion-extension degrees, and Lysholm, Cincinnati, Tegner, and International Knee Documentation Committee scores, were similar between the groups (P > .05). Complications occurred in 8 cases (rerupture, infection, and deep vein thrombosis), with no significant correlation to the fixation method used (P = .506). Radiographic analysis revealed no significant differences in femoral tunnel width or length between the groups (P > .05). In our current study, no meaningful disparity was found between the AperFix and fixed loop device methods in terms of long-term clinical outcomes. As there are no long-term studies on the results of AperFix fixation in the literature, more studies on this subject are needed.
Comparison of the Popliteal Artery and the Capsule of the Posterior Knee (Ipack) Block and the Genicular Nerve Block in Primary Total Knee Arthroplasty a Prospective Randomized Trial
(Saudi Med J, 2024) Dundar, Abdulrahim; Ipek, Deniz; Yalvac, Mehmet; Kaya, Sehmuz
Objectives: To compare the efficacy of genicular block and interspace between the popliteal artery and the posterior capsule (IPACK) block in the reduction of postoperative pain, the need for rescue analgesics, and the effects on a range of motion (ROM) in patients with TKA. Methods: This prospective randomized controlled study was carried out between February and May 2023. Based on the block method, 60 participants were divided into three equal groups. These groups included the IPACK block group (n=20), the genicular block group (n=20), and control group (n=20). Western Ontario and McMaster Universities Arthritis Index (WOMAC), Knee Society score (KSS) and Oxford Knee score (OKS) were used for clinical evaluation in the postoperative period. Results: The KSS and OKS scores of the IPACK and GNB were significantly lower than the control group ( p <0.001, p <0.001). The timed up and go (TUG) values of the IPACK and GNB groups at 12th and 24th hour were significantly lower than the control group ( p <0.001, p <0.001). The Tramadol rescue values of the IPACK block and control groups were significantly higher than the GNB group ( p =0.028, p =0.001, respectively). The ROM values of the IPACK and GNB groups were significantly higher than the control group ( p <0.001, p <0.001). Conclusion: Both GNB and IPACK blocks had a significant positive impact on postoperative pain scores within the initial 24 hours following total knee arthroplasty (TKA). In comparison with IPACK, GNB had lower opioid consumption in the early postoperative period while also promoting better mobilization.
Diyabetik Hastalarda Tetik Parmakta Uygulanan Perkütan Gevşetme ve Açık Cerrahi Tekniklerinin Uzun Dönem Sonuçları
(2023) İpek, Deniz; Kaya, Sehmuz; Dündar, Abdulrahim
Giriş Tetik parmak diyabetik hastalarda daha sık görülür ve diyabetik olmayan hastalara göre ameliyat sonrası daha ciddi komplikasyonlara yol açabilir. Bu çalışmanın amacı, diyabetik hastalarda açık ve perkütan gevşetme tekniklerinin sonuçlarını karşılaştırmaktır. Gereç ve Yöntem Bu retrospektif çalışmaya dahil edilme kriterlerini karşılayan 62 hasta alındı. Bu hastalardan 32'sine açık gevşetme cerrahisi, 30'una ise 18 ölçer iğne ile perkütan gevşetme uygulandı. Hastalar veriler açısından ameliyat öncesi ilk başvuru anında, postoperatif 3. hafta, 6. ay ve 1. yıl olmak üzere retrospektif olarak değerlendirildi. Demografik veriler, ameliyat öncesi ve ameliyat sonrası 6. ve 12. aylarda Visuel Analog Skala (VAS) skorları, 6. ay ve 1. yıl sonunda nüks oranları, 1 yıl sonunda Quinnell derecelendirme ölçeği ve yara yeri enfeksiyonu, tendon hasarı ve nörovasküler komplikasyonlar retrospektif olarak incelendi. Klinik değerlendirmede VAS skorları ve Quinnell derecelendirme ölçeği kullanıldı. Bulgular Çalışmada 32'si (%51.6) açık grupta ve 30'u (%48.4) perkütan grupta olmak üzere toplam 62 hastanın verileri istatistiksel olarak analiz edildi. Hastaların yaş ortalaması 58.97±7.51 (min-max: 45-72) yıl idi. Tetik parmak ve Quinnell derecelendirme sistemi puanlarının dağılımları gruplar arasında istatistiksel olarak benzerdi (sırasıyla P=0.974, P=0.279). Perkütan grupta 6. ve 12. aylarda tekrarlayan tetikleme oranı anlamlı olarak daha yüksekti (sırasıyla P=0.049, P=0.049). Perkütan grupta (1.70±0.75) ortalama işe dönüş süresi açık gruptakilerden (3.88±1.21) anlamlı olarak daha kısaydı (P<0.001). Pre-op, Post-op 6. ve 12. ay VAS skorları gruplar arasında anlamlı farklılık göstermedi (sırasıyla P=0.466, P=0.356, P=0.175). Sonuç Bu çalışmada diyabetli hastalarda hem perkütan hem de açık gevşetme teknikleri ile tatmin edici sonuçlar elde edilmesine rağmen, perkütan salınım tekniğinin ayaktan tedavi ortamında kolaylıkla uygulanabilen ve daha az komplikasyonu olan bir yöntem olduğu görülmüştür.
Eklem İçi Kalkaneus Kırıklarında Sinus Tarsi ve Ekstensil Lateral Yaklaşımın Karşılaştırılması
(2022) Güzel, Fatih; Türközü, Tülin; Özkan, Sezai; Güven, Necip; Kaya, Sehmuz; Tokyay, Abbas
Amaç: Bu çalışmada kalkaneus kırığı cerrahisinde ekstansil lateral (EL) yaklaşım ile sinüs tarsi (ST) yaklaşımının klinik ve radyolojik sonuçlarını karşılaştırmayı amaçladık. Gereç ve yöntem: Bu retrospektif çalışmaya, EL grupta 22 hasta ve sinüs tarsi grubunda 18 hasta olmak üzere Sanders II-III kalkaneus kırığı olan toplam 40 hasta dahil edildi. Radyolojik değerlendirmede, preoperative ve postoperative dönemde Bohler ve Gissane açısı, kalkaneusun uzunluğu, genişliği ve yüksekliğindeki değişiklikler ölçüldü. Klinik olarak ise Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) ve görsel analog skalası (VAS) değerlendirildi. Ayrıca postoperative komplikasyonlar da değerlendirildi. Bulgular: Demografik veriler açısından her iki grubun sonuçları benzerdi. ST grubundaki hastaların lateral ekstensil grubuna göre ameliyata alınma ve hastane kalış süresi açısından istatistiksel olarak anlamlı bir şekilde daha kısaydı ( p=0.019, p=0.02, sırasıyla). Gruplar arasında radyolojik, klinik AOFAS ve VAS skorları açısından anlamlı fark bulunmadı. Ekstensile lateral grubunda %13,6 yüzeyel enfeksiyon görüldü ve sinüs tarsi grubunda herhangi bir yara sorununa rastlanmadı (p=0,102). Sural sinir yaralanması extensil lateral grupta 36.4% oranında, sinüs tarsi grubunda ise 5.6% oranında görüldü (p=0.003). Sonuç: Her iki yaklaşımın klinik ve radyolojik sonuçları benzerdi. Ancak hastanede kısa yatış süresi, yara yeri enfeksiyon problemlerinin ve sural sinir yaralanmasının az olması ST yaklaşımının avantajıydı.
Evaluation of the Relationship of Posterior Tibial Slope With Gender and Age in Turkish Population With 3 Different Methods
(Bmc, 2024) Kavak, Seyhmus; Kaya, Sehmuz
Background This study aimed to reveal the posterior tibial slope (PTS) angle with 3 different methods in a large case group in the Turkish population. In addition, the reproducibility of the measurement methods used was questioned while determining the age groups, gender and side relationship of this angle. Materials and methods In our retrospective study, radiographs of both knees were evaluated in all 610 patients (344 women, 56.4%) aged 25-65 years. PTS angles were measured by a radiologist and an orthopedist using anterior tibial cortex (ATC), posterior tibial cortex (PTC) and proximal tibial anatomical axis (PTAA) methods. The relationship of these angles with age group and gender, and the intra-class and inter-class correlations of all three methods were evaluated. Results The mean and standard deviation (SD) of PTS angle was 11.03 +/- 2.33(degrees) with ATC method, 6.25 +/- 2.22(degrees) with PTC and 8.68 +/- 2.16(degrees) with PTAA, and the difference was significant (p < .001). In the evaluation according to age groups, the highest mean PTS angles were detected in cases aged 25-35 (9.63 +/- 1.97(degrees) [mean +/- SD] by PTAA method), and there was a significant difference in comparison with other age groups (p < .05). In comparison with age groups, higher mean PTS angles were found in women and on the right side, but the difference was not statistically significant (p > .05). The intraclass and interclass correlation coefficient (ICC) of all three methods was excellent (ICC > 0.91). Conclusion This study emphasizes that the mean PTS angle in Turkish population is higher than the angle values recommended by prosthesis manufacturers, and factors such as patient age and gender should be calculated in order to ensure more effective prostheses to be applied to patients.
Experimental Evaluation of Timing and Preference of Surgical Intervention for Crush Syndrome in Disaster Scenarios: Fasciotomy or Amputation? a Rat Model Study
(BMC, 2025) Kaya, Sehmuz; Unal, Yunus Can; Guven, Necip; Dundar, Abdulrahim; Keles, Omer Faruk; Basbugan, Yildiray
Background Crush syndrome is a severe condition caused by the systemic effects of rhabdomyolysis due to prolonged muscle compression. Common in disasters like earthquakes, it poses life-threatening risks, including acute renal failure, hyperkalemia, and metabolic acidosis. Although surgical interventions such as fasciotomy and amputation are critical in its management, the optimal timing and criteria remain unclear. This study investigates the impact of surgical intervention timing on crush syndrome outcomes, providing guidance through the first experimental rat model evaluating fasciotomy and amputation post-injury. Methods Forty-eight Wistar albino rats were divided into six groups. Rhabdomyolysis was induced experimentally, followed by amputation or fasciotomy at 0, 12, or 24 h. The control group underwent rhabdomyolysis induction without surgery. Weekly urine samples were collected during the study, and blood, muscle, and kidney tissues were examined biochemically and histopathologically at the experiment's end. Data analysis focused on the systemic and tissue-specific effects of intervention timing. Results Early intervention groups (0 h) demonstrated minimal muscle inflammation and necrosis, preserved muscle fiber arrangement, and more pronounced regeneration. Late interventions (12 and 24 h) were associated with intense inflammation, necrosis, edema, and hemorrhage in muscle tissue. Immediate amputation (0 h) limited toxic metabolite effects, reducing kidney inflammation and damage. Late interventions showed increased interstitial nephritis and inflammatory cell infiltration in kidney tissue. Biochemical analyses revealed that urinary myoglobin levels decreased and renal function was preserved in the early intervention groups. Conclusions The timing of surgical intervention is critical in managing crush syndrome. Early amputation and fasciotomy minimized necrosis and inflammation in muscle tissue, supported tissue regeneration, and reduced systemic complications by preventing toxic metabolite accumulation in the kidneys. Early amputation particularly showed superior renal protection and lower systemic complication risks compared to late interventions. These findings highlight the importance of timely surgical action and provide valuable insights for developing effective treatment strategies in disaster settings. However, the descriptive nature of the study and the fact that the data obtained from the experimental model cannot be directly applied to clinical practice should be taken into account. Therefore, the findings should be supported by future clinical trials.
Femur Cisim Kırıkları İçin Talon Distalfix Femoral İntramedüller Çivi ile Tedavi Edilen Hastaların Klinik ve Radyolojik Sonuçları
(2023) Dündar, Abdulrahim; İpek, Deniz; Kaya, Sehmuz; Zehir, Sinan
Amaç: Talon distalfix intramedüller çiviler, distal kilitleme vidalarının yerleştirilmesi sırasında yaşanan teknik zorluklara çözüm olarak geliştirilmiştir. Femur şaft kırıklarının tedavisinde geri çekilebilir Talon distalfix çivisinin radyolojik ve klinik sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2017-Ocak 2022 tarihleri arasında femur şaft AO tip 32-A, B kırığı olan 28 hasta Talon distalfix çivileri ile tedavi edildi. AO Tip 32-A, B kırıkları çalışmaya dahil edildi. Demografik özellikler, takip süreleri, ASA sınıflaması ve kırık tipleri kaydedildi. Ameliyat süresi, intraoperatif kan kaybı, floroskopi süresi (dakika cinsinden) ve kemik kaynamasına kadar geçen süre kaydedildi. Genel ve teknik (kaynamama, yanlış kaynama, malrotasyon ve kısalık) komplikasyonlar değerlendirildi. Klinik fonksiyonel sonuçlar Diz Yaralanması ve Osteoartrit Sonuç Skoru Fiziksel Fonksiyon Kısa Skoru (KOOS-PS), Kalça Yaralanması ve Osteoartrit Sonuç Puanı Fiziksel Fonksiyon Kısa Skoru (HOOS-PS) ve Thoresen kriterleri kullanılarak değerlendirildi. Bulgular: Çalışmaya toplam 28 hasta (11 kadın, 17 erkek) dahil edildi. Ortalama yaş 46,8 yıl, ortalama takip süresi 23,7 ay idi. Ortalama kemik kaynama süresi 22,6 hafta idi. Hiçbir hastada kaynamama gözlenmedi. Ortalama hastanede kalış süresi 3,4 gün, ortalama Body Mass Index 24,2 idi. Ortalama ameliyat süresi 40,3±3,4 dakika, ortalama skopi süresi ise 26,9 saniye idi. Ortalama KOOS-PS skoru ve HOOS-PS skoru sırasıyla 83,4 ve 85,6 idi. Sonuç: Talon distalfix çiviler femur orta şaft AO tip A-B kırıklarında güvenle kullanılabilir. Talon distal fiks çivi uygulaması daha kısa ameliyat süreleri, daha az radyasyona maruz kalma, daha az cerrahi kesi ve daha az kan kaybı gibi avantajlar sağlar. Bununla birlikte kaynama süresinin geleneksel çivilere göre daha uzun olduğu akılda tutulmalıdır.
Impact of Buried Versus Exposed Flexible Intramedullary Nails Osteosynthesis on Pediatric Forearm Fractures
(Soc Chilena Pediatria, 2024) Dundar, Abdulrahim; Kaya, Sehmuz
In elastic stable intramedullary nailing (ESIN), there are different opinions among surgeons on whether to leave the nail buried in the same arm or to leave it exposed. Objective: To determine the risk of re -fracture in patients with a nail buried directly into the amr or left exposed as a treatment for forearm fractures, and to investigate postoperative complications. Patients and Method: The study included 113 pediatric patients with a forearm fracture of both diaphyses. Two groups were formed according to whether the nail was buried (Group B, n: 53) in the same arm or left exposed (Group E, n: 60). Data on the number of open reductions, the time to nail removal, the anesthesia type used for its removal, the number of re -fractures, skin infection, and nail entry site irritation were analyzed. Results: The mean union times between the groups were not significantly different ( P = 0.371). The mean time of nail removal in group B (16.02 +/- 1.29 weeks) was significantly longer than that of group E (6.65 +/- 0.95 weeks) ( P < 0.001). Open reduction rates were similar between groups ( P = 0.401). The general anesthesia rate for nail removal in group B (77.4%) was significantly higher than group E (11.7%) ( P < 0.001). The re -fracture rate was higher in patients who underwent open reduction in both groups ( P < 0.001). Conclusion: The results of this study demonstrated that, despite the increased infection rate, leaving the nail exposed did not increase the re -fracture rate, which was associated with open reduction.
The Impact of Early Weight-Bearing on Results Following Anterior Cruciate Ligament Reconstruction
(Bmc, 2024) Kaya, Sehmuz; Unal, Yunus Can; Guven, Necip; Ozcan, Can; Dundar, Abdulrahim; Turkozu, Tulin; Gokalp, Mehmet Ata
Introduction Anterior cruciate ligament (ACL) ruptures are common injuries that typically affect young, physically active individuals and may require surgical reconstruction. Studies have shown that the long time success of ACL reconstruction depends on the surgical technique and the postoperative rehabilitation strategy. However, there is still no consensus on the content of rehabilitation programs. Hence, additional research is required to elucidate the significance of early weight-bearing in the rehabilitation process following ACL reconstruction. The aim of this article is to examine the impact of weight-bearing on the clinical results of ACL reconstruction.Materials and methods We retrospectively reviewed patient records who had undergone arthroscopic reconstruction using a semitendinosus-gracilis tendon graft for anterior cruciate ligament rupture between January 2018 and December 2020. The study included the data of 110 patients. The patients were split into two groups: Group 1 underwent early weight-bearing, while Group 2 followed a non-weight-bearing regimen for three weeks. We assessed the patients using the anterior drawer test, Lachman test, range of motion, Lysholm knee scale, Cincinnati scale, Tegner scale, International Knee Documentation Committee (IKDC) form and clinical records. Analytical tests were conducted to compare the results.Results The complication rates did not show a significant difference between the groups. Group 1 had higher frequencies of positive anterior drawer and Lachman tests. The Lysholm and Cincinnati knee scores of patients in Group 1 were notably lower than those of patients in Group 2. Additionally, the Tegner activity scores and IKDC scores of patients in Group 1 were also meaningfully lower than those of patients in Group 2. In Group 1 patients, there was no notable relationship observed between body mass index (BMI) and the results of the anterior drawer test (ADT) or Lachman test. However, patients with a BMI of 25 or higher in Group 1 showed a decrease in postoperative IKDC scores. In Group 2 patients, no significant relationship was identified between BMI and either the ADT or the Lachman test outcome.Conclusion Based on current literature and current rehabilitation guidelines following ACL reconstruction, the decision to initiate early weight-bearing is based on a limited number of studies with low levels of evidence. In our study, we found that patients who followed a non-weight-bearing regimen for 3 weeks after surgery had better mid-term results than those who were allowed to bear weight early. It appears that further prospective studies on this topic are needed to update rehabilitation guidelines in the next.
Measuring the Knowledge and Attitudes of Physicians Towards Patients With Hiv/Aids: Study of Anatolian Group
(Emerald Group Publishing Ltd, 2024) Kaya, Safak; Arac, Esref; Akgul, Fethiye; Comoglu, Senol; Kaya, Sehmuz; Arac, Songul; Aksoz, Selcuk
Purpose This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked. Design/methodology/approach The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title. Findings A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively. Originality/value In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.
Rhabdomyolysis in Patients With Covid-19: a Cause or Consequence of Acute Kidney Injury or Mortality
(Lippincott Williams & Wilkins, 2025) Mertsoy, Yilmaz; Kavak, Seyhmus; Yildirim, Mehmet Serdar; Kacar, Emrah; Kaya, Sehmuz; Gunay, Emrah
Rhabdomyolysis can occur due to many traumatic and nontraumatic causes. Rhabdomyolysis has been reported in new type of coronavirus disease (COVID-19) cases. The aim of our study was to examine the effects of rhabdomyolysis on mortality and renal outcomes in patients hospitalized in our hospital's COVID-19 wards. In our single-center and retrospective study, we included patients who were admitted with a diagnosis of COVID-19 by a thorax-computed tomography finding who were older than 18 years of age and with a measured creatinine kinase (CK) > 1000 U/L on any day of hospitalization. The same number of patients hospitalized in COVID-19 services with CK < 1000 U/L and with similar gender and age were determined as the control group. We analyzed the data of 2065 patients, and compared 154 patients in the rhabdomyolysis group (group 1) and 154 patients in the control group (group 2). Acute kidney injury (AKI) (44.2% vs 21.4%; P < .001), intensive care unit (ICU) admissions (53.2% vs 13.6%; P < .001), intubation (75.6% vs 23.8%; P < .001), mortality (36.4% vs 3.2%; P < .001) and the need for dialysis (3.9% vs 0.6%; P = .005) were seen more in the rhabdomyolysis group. When that group was divided into the early rhabdomyolysis group (group 1a), where the CK value reached its highest value in <= 3 days, and the late rhabdomyolysis group (group 1b), where it was >= 4 days, AKI (29.7% vs 65.1%; P < .001), ICU (35.2% vs 79.4%; P < .001), intubation (56.2% vs 88%; P = .001), mortality (18% vs 61.9%; P < .001), and dialysis (1.1% vs 7.9%; P = .031), the results were higher in the group 1b. The available data suggest that rhabdomyolysis seen in COVID-19 patients is not a direct predictor of mortality and poor renal outcomes, but is a secondary outcome to multiple-organ failure caused by worsening clinical status.
Virtual Reality Headset Versus Traditional Training in Orthopedic Surgery: a Comparative Study on Real Surgical Performance in Total Knee Arthroplasty
(Lippincott Williams & Wilkins, 2024) Unal, Yunus Can; Adanas, Cihan; Kaya, Sehmuz; Ozkan, Sezai; Ismailov, Ulan
Is it possible for a low-volume surgeon to enhance their surgical skills without performing actual surgeries by utilizing virtual reality headsets and emerging technologies? It has been observed that the time spent by surgical assistants in the operating room decreased after the post-shift leave regulation. In the literature, the use of virtual reality simulations as a support tool in surgical training is recommended. Although the efficacy of virtual reality surgical simulations in surgeries such as arthroscopy and laparoscopy has been proven, there are limited studies on their effect in open surgeries. In this study, 20 orthopedic and traumatology residents with no experience in primary total knee arthroplasty were divided into 2 groups. One group was prepared for surgery using surgical simulation with virtual reality headsets, while the other group was prepared for surgery with traditional methods. The actual surgical performance of the participants was evaluated with the Objective Structured Scale of Technical Skills (OSATS) surgical skills scale. It was observed that the virtual reality group was more successful in the "Time and Motion" and "Surgical Functioning and Fluency" criteria. Virtual reality surgical simulations are useful tool in surgical training and can contribute to the development of surgeons' skills. However, more research is needed on how to integrate these simulations into training programs and in which areas they are most effective.