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    Effect of surgical closing in total knee arthroplasty at flexion or extension: a prospective, randomized study
    (Springer, 2014) Komurcu, Erkam; Yuksel, Halil Yalcin; Ersoz, Murat; Aktekin, Cem Nuri; Hapa, Onur; Celebi, Levent; Akbal, Ayla
    The aim of this study was to evaluate the effect of knee position during wound closure (flexed vs. extended) in total knee arthroplasty on knee strength and function, as determined by knee society scores and isokinetic testing of extensor and flexor muscle groups. In a prospective, randomized, double-blind trial, 29 patients were divided in two groups: for Group 1 patients, surgical closing was performed with the knee extended, and for Group 2 patients, the knee flexed at 90A degrees. All the patients were treated with the same anaesthesia method, surgical team, surgical technique, prosthesis type, and rehabilitation process. American Knee Society Score values and knee flexion degrees were recorded. Isokinetic muscle strength measurements of both knees in flexion and extension were taken using 60A degrees and 180A degrees/s angular velocity. The peak torque and total work values, isokinetic muscle strength differences, and total work difference values were calculated for surgically repaired and healthy knees. No significant difference in the mean American Knee Society Score values and knee flexion degrees was observed between the two groups. However, using isokinetic evaluation, a significant difference was found in the isokinetic muscle strength differences and total work difference of the flexor muscle between the two groups when patients were tested at 180A degrees/s. Less loss of strength was detected in the isokinetic muscle strength differences of the flexor muscle in Group 2 (-4.2 %) than in Group 1 (-23.1 %). For patients undergoing total knee arthroplasty, post-operative flexor muscle strength is improved if the knee is flexed during wound closure. II.
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    Öğe
    Investigation of the effect of ghrelin on bone fracture healing in rats
    (Wiley, 2021) Erener, Tamer; Ceritoglu, Kubilay Uğurcan; Aktekin, Cem Nuri; Dalgıç, Ali Deniz; Keskin, Dilek; Geneci, Ferhat; Ocak, Mert; Bilecenoglu, Burak; Hücümenoğlu, Sema; Çaydere, Muzaffer; Senes, Mehmet; Sezgin, Özge
    Ghrelin is known to have effects on proliferation and differentiation of osteoblasts and improvement of bone mineral density in rats. However, no experimental research on ghrelin's effects on fracture healing has been reported. In this context, the effect of ghrelin on the union of femoral shaft fractures was examined in this study by evaluating whether ghrelin will directly contribute to fracture healing. Forty male Wistar-Albino rats were divided into two groups as control and experimental (ghrelin treated) and standard closed shaft fractures were created in the left femurs of all rats. Daily ghrelin injections were applied to the experimental groups and equal numbers of rats were killed after 14 and 28 days following fracture formation. Tissue samples were examined with radiological, biomechanical, biochemical and histological analyses. Densitometry study showed that bone mineral density was improved after 28 days of ghrelin treatment compared to control. On histological examination, at the end of the 14 and 28 days of recovery, significant union was observed in the ghrelin-treated group. The ghrelin-treated group had higher breaking strength and stiffness at the end of 28 days of recovery. Biochemically, ALP levels were found to be higher in the ghrelin-treated group at the end of 28 days of recovery. Results showed that ghrelin directly contributes to fracture healing and it is promising to consider the effect of ghrelin on fracture healing in human studies with pharmacological applications.