Browsing by Author "Turken, Mehmet Aykut"

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Citation - WoS: 14
Citation - Scopus: 12
Analysis of Risk Factors Affecting Mortality in Elderly Patients Operated on for Hip Fractures: a Retrospective Comparative Study
(Turkish Assoc Orthopaedics Traumatology, 2021) Biçen, Ahmet Çağdaş; Akdemir, Mehmet; Turken, Mehmet Aykut; Cekok, Kubra; Ekin, Ahmet; Turan, Ahmet Cemil
Objective: The aims of this study were (1) to investigate the effects of different demographic and perioperative modalities on mortality rates and (2) to compare mortality rates between different implants in elderly patients operated on for hip fractures. Methods: In this retrospective study, a total of 314 patients who were operated on for hip fractures were included study. Patients were then divided into four groups based in their implant types: long-stem cementless bipolar hemiarthroplasty (n = 124; 102 female, 22 male; mean age = 84.2 +/- 6.4 years), standard-stem cementless bipolar hemiarthroplasty (n = 74; 48 female, 26 male; mean age = 83.5 +/- 6.9 years), antegrade intertrochanteric nail (n = 61; 35 female, 26 male; mean age = 78.5 +/- 6.8 years), and total hip arthroplasty (n = 55; 34 female, 21 male; mean age = 72.5 +/- 4.3 years). Data including gender, age, duration from injury to surgery, American Society of Anesthesiologists (ASA) score, comorbidities, use of antiplatelet agents, Barthel Index of Activities of Daily Living, type of anesthesia, operation time, preoperative hemoglobin values, blood transfusions given, duration of hospital stay, complications, and type of fracture were recorded. Results: Overall, the mean follow-up was 36.5 (range = 0 - 107) months. The overall mortality rate was 53.2%. The median survival duration was 44.2 +/- 5 months (range = 34.3 - 54). Survival rates were found significantly different among the groups (P = 0.001). In the first three years postoperatively, the mortality rate was higher in the standard-stem bipolar hemiarthroplasty group, but in the long-term follow-up, the long-stem bipolar hemiarthroplasty group exhibited the higher mortality rates. It was observed that some parameters had statistically significant effects on the mortality rates. Male gender, higher age, lower hemoglobin values, increased number of blood transfusions, ASA scores >= 3, the existence of >= 3 comorbidities were found as main predictors of increased mortality rates. Conclusion: The results of this study have shown that age, gender, preoperative hemoglobin levels, ASA scores, and comorbidities are significant factors affecting mortality in elderly patients operated on for hip fractures. Long-stem cementless bipolar hemiarthroplasty appears to show similar rates of mortality with standard-stem cementless bipolar hemiarthroplasty.
Effects of Coronavirus Disease-2019 Pandemic and New Normal on the Orthopedic Outpatient Clinic Practice
(Galenos Yayincilik, 2021) Biçen, Ahmet Çağdaş; Turken, Mehmet Aykut
Objective: This study aimed to evaluate the effects of the coronavirus disease-2019 pandemic on the orthopedic outpatient clinic, including an investigation of the number, changes in complaints, and demographics of patients. Materials and Methods: Data of patients who visited the orthopedic outpatient clinic at our hospital within four periods were evaluated. Period 1 was between March and May 2019, period 2 was between June and August 2019, period 3 was between March and May 2020, and period 4 was between June and August 2020. Data of patients were recorded for each period including age, gender, number, and International Classification of Diseases 10th Revision codes for comparative analysis. Results: This study included 7,120 patients who were admitted to the orthopedic outpatient clinic within the four periods. The lowest number of patients (1,119) who visited the outpatient clinic was observed in the three months following the pandemic declaration (period 3), in March 2020, whereas the highest number (2,149) was observed in the three months following the lifting of restrictions, in June 2020 (period 4). No significant difference was observed in the age between the four periods (p=0.945). However, a difference was found between the periods for patients aged >= 65 years. Reasons for admission were also different between the periods. In period 3, admissions due to traumatic reasons were statistically higher compared with the other three periods (p<0.001, p=0.003, p<0.001). Conclusion: It was observed that the number of patients visiting the orthopedic outpatient clinic increased after the restrictions were lifted. Outpatient clinic management must be organized in a way that prevents contamination and preserves efficient outpatient support.
Long-Stem Prosthesis for Intertrochanteric and Femoral Neck Fractures in the Elderly: Retrospective Comparison of Short-Term Clinical Outcomes
(Galenos Yayincilik, 2021) Biçen, Ahmet Çağdaş; Akdemir, Mehmet; Turken, Mehmet Aykut; Cekok, Kubra
Objective: Hip fracture treatment in elderly patients remains challenging. This study aimed to evaluate short-term clinical results of long-stem cementless arthroplasty in elderly patients with femoral neck and intertrochanteric fractures. Materials and Methods: We collected data of patients we treated with long-stem cementless arthroplasty between January 2011 and December 2019 due to hip fractures. This study included 48 patients (>= 65 years of age) with femoral neck and intertrochanteric fractures. The patients underwent either bipolar or total hip arthroplasty. A 2-year follow-up was conducted in all the patients. Outcomes were evaluated with the Harris hip score (HHS), Koval categories, complications and hip and mid-thigh pain. We compared clinical results of patients with femoral neck fractures and those with intertrochanteric fractures. Results: The mean follow-up period was 57 (34-92) months. Sixteen patients had femoral neck fractures and 32 had intertrochanteric fractures. No difference in demographic characteristics and comorbidities was noted between groups. The mean preoperative Barthel index of activities of daily living score was 79. At the last follow-up, the mean HHS of the control group was 77 and the mean Koval categories score was 3. Revision surgeries were conducted in two patients due to dislocation. Infection was observed in one patient and was treated by debridement and anti-biotherapy. Implant loosening and periprosthetic fractures were not noted. Conclusion: With fair outcomes, long-stem cementless arthroplasty is a potential treatment for hip fractures in elderly patients. A longer follow-up to evaluate the efficacy of these prostheses is warranted.