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    Changes in the loading of tibial articular cartilage following medial meniscectomy: a finite element analysis study
    (Springer, 2013) Atmaca, Halil; Kesemenli, Cevdet Cumhur; Memisoglu, Kaya; Ozkan, Arif; Celik, Yusuf
    Depending on the location and extent of the meniscectomy, loading on the tibial articular cartilage alters. The main purpose of the present study was to analyze the loading on the tibial articular cartilage following medial meniscectomy performed in various location and extent, as well as in the healthy knee, via finite element analyses on the solid models. Totally, 11 finite element solid models, including the reference model, were created to investigate the effect of location (anterior, posterior, longitudinal) and extent of meniscectomy (25, 50, 75, and 100 %) on loading of tibial articular cartilage. Maximum equivalent stress of the tibial cartilage was measured 0.86 Megapascal in the reference model and increased approximately by 78 % in 25 % meniscectomy group, 177.9 % in 50 %, 473.8 % in 75 % meniscectomy group, and 752.6 % in total meniscectomy. When only the amount of meniscal tissue removed was considered ignoring the location of meniscectomy, no significant difference was found in the amount of tissue excised between 25 % meniscectomy and 50 % meniscectomy, as well as between 75 % meniscectomy and total meniscectomy. In all meniscectomy models, the loadings on tibial articular cartilage increased. Except total meniscectomy, the highest impact was observed in longitudinal 75 % meniscectomy. During the surgical treatment, the contributions of menisci on load absorption by increasing the tibiofemoral contact area must be considered. In fact, the increase in the rate of loading on tibial articular cartilage depends on according to type and amount of meniscectomy.
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    Distraction osteogenesis is inhibited by cancer radiotherapy with Co 60
    (Canadian Soc Clinical Investigation, 2009) Kesemenli, Cumhur Cevdet; Kaya, Halil; Memisoglu, Kaya; Kaya, Beyza; Dirier, Ahmet; Tosun, Bilgehan; Kilinc, Nihal
    Aim: To investigate the effects of radiotherapy on distraction osteogenesis performed on the same bone in an area that has not received radiation. Radiotherapy (Co60) was carried out in a region where tumors may develop, and then, on the assumption that the tumoral region had been removed, distraction osteogenesis was carried out, and the effects were investigated. Method: Thirty New Zealand rabbits were randomized into two groups, a study group (15 rabbits) and a control group (15 rabbits). In the study group, Co60 was administered by teletherapy to the distal half of the left tibia. Rabbits in the control group were kept in the same environment for the same period, but were not subjected to radiotherapy. Four weeks after radiotherapy, osteotomy was performed on the proximal part of the left tibia of all subjects, and distraction was carried out until 10mm. After distraction was completed, the outcomes were evaluated radiologically, scintigraphically, and histopathologically, and the results were compared. Results: New bone formation achieved through distraction osteogenesis in the study group animals was inadequate, while new bone tissue achieved in the control group was superior (P<0.001). Conclusion: Radiotherapy has a negative effect on distraction osteogenesis, even if performed on a different part of the bone.
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    Treatment of intertrochanteric femur fractures with 95A° fixed-angle blade plate in elderly patients
    (Springer, 2010) Kesemenli, Cumhur Cevdet; Memisoglu, Kaya; Necmioglu, Serdar; Kayikci, Cuma
    In this study, we aimed to evaluate the results of treatment of intertrochanteric femur fractures fixation with a 95A degrees fixed-angle blade plate in elderly patients. Fifty-eight patients with intertrochanteric femoral fractures were treated with 95A(0) fixed-angle blade plate. There were 32 female and 26 male patients. The fractures resulted from a simple fall in 42 patients, a motor vehicle accident in 6, and a fall from a height in 10 patients. The mean clinical follow-up was 27 months. Clinical outcomes were evaluated according to the American Academy of Orthopeadic Surgeons' criteria. Shortening greater than 2 cm was noted in these patients at last follow-up as a result of varus malunion, plate bending developed only in 3 patients, and the loss of reduction developed in two patients, but reoperation was not needed. According to these criteria, results were poor in 2 patients, fair in 6, good in 16 and excellent in 31 patients. Consequently, 95A degrees fixed-angle blade plates could be thought as a proper alternative technique due to their easy applicability, low learning curve and complication rates.