Person: SARISÖZEN, MEHMET BARTU
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SARISÖZEN
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MEHMET BARTU
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Publication The effect of HIF stabilizer on distraction osteogenesis(Turkish Assoc Orthopaedics Traumatology, 2015-01-01) Özdel, Ahmet; Sarısozen, Bartu; Yalçınkaya, Ulviye; Demirağ, Burak; Özdel, Ahmet; SARISÖZEN, MEHMET BARTU; YALÇINKAYA, ÜLVİYE; Demirağ, Burak; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4071-8052; ABI-7283-2020; AAH-8924-2021; DLP-2668-2022; EVT-6166-2022Objective: The aim of this study was to investigate the effect of an orally applicable hypoxia-inducible factor (HIF) stabilizer on distraction osteogenesis (DO) in a rat model.Methods: The study included 24 Wistar albino rats undergoing osteotomy of the left tibia diaphysis. Rats were divided equally into experiment and control groups. Tibias were fixed using an external fixator. HIF stabilizer was administered to the experiment group. On the 5th postoperative day, distraction with increased rate (0.4 mm twice a day) was commenced and continued for 10 days. Histological and immunohistochemical evaluation was performed.Results: Vascular endothelial growth factor levels of the experiment group were higher than those of the control group (p<0.05). The experiment group had slightly better intramembranous ossification quality than the control group on both Day 16 and 30. Endochondral ossification rates were better in the experiment group on Day 16.Conclusion: Vascular endothelial growth factor levels increased and stimulated angiogenesis in the presence of HIF pathway activation by oral administration of HIF stabilizer during DO. The biomechanical features of the distraction and angiogenesis should be coupled to achieve adequate bone homeostasis.Publication Comparison of radiofrequency ablation and curettage in osteoid osteoma in children(Atha Comunicacao & Editora, 2019-03-01) Göksel, Ferdi; Aycan, Aye; Ermutlu, Cenk; ERMUTLU, CENK; Gölge, Umut Hatay; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; 0000-0002-9730-5454; 0000-0001-8259-3695; 0000-0003-4071-8052; ABI-7283-2020; AAB-2795-2021Objective: Osteoid osteoma, which is observed in the adolescent and young adult population as benign bone tumors, appears as a single nidus with a diameter < 2 cm and is treated with open surgery. However, technological advances in medicine have made it possible to apply less invasive procedures in surgery. Methods: Between 2006-2014, 24 patients < 18 years of age were treated for osteoid osteoma. Patient demographic data, surgical data, complications, and recurrences were noted. Results: Twenty-four patients (mean age, 11 [2-18] years) were treated and followed up for a mean 3.58 (range, 1-9) years. Mean patient age in the curettage group was 12.1 (range, 3-18) years. Mean operation length was 69.5 (range, 60-120) minutes. Mean hospital stay was 1.3 (range, 0-2) days. Mean patient age in the radiofrequency ablation (RFA) group was 10.7 (range, 2-17) years. Five patients were female and 8 were male. Mean operation length was 49.6 (range, 20-90) minutes. Mean hospital stay was 0.3 (range, 0-1) days. Mean follow-up time was 1.76 (range, 1-4) years. Mean operation length, hospital stay, and follow-up were significantly shorter in the RFA group. Conclusions: Considering reduced costs due to shorter hospitalization periods and the ability to reach anatomically difficult locations, percutaneous procedures are likely to replace the conventional open approach.Publication Forearm compartment pressure change in children operated for supracondylar humerus fracture(Lippincott Williams & Wilkins, 2022-10-01) Togaç, Soner; ERMUTLU, CENK; Ermutlu, Cenk; SARISÖZEN, MEHMET BARTU; Sarısözen, Bartu; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-4071-8052; ABE-9918-2021; AEQ-5464-2022; ABI-7283-2020Background: The aim of this study is to examine the preoperative and postoperative forearm compartment pressures in patients treated operatively for Gartland type III extension type supracondyler humerus fractures and understand the course of these values over postoperative period. Methods: Deep volar compartment pressure of 31 patients were measured in the proximal one third of the forearm preoperatively, and measurements were continued every 4 hours for the first 24 hours after the operation with a catheter. Type of the reduction technique (open reduction vs. closed reduction), duration of surgery, the time from the injury to surgery were all evaluated. Results: In the measurements made immediately after the operation (0 h), a sudden increase in the compartment pressure was detected in all patients (15.0 +/- 5.9 to 27.9 +/- 7.5 mm Hg) independent of the reduction technique and gradually decreased over time. The mean compartment pressure at the 12th hour postoperatively was higher in the open reduction group than in the CR group (24.5 +/- 3.4, 20.7 +/- 6.7 mm Hg, respectively) (P=0.044). The mean preoperative compartment pressure was 17.7 +/- 5.8 mm Hg in patients with a time from injury to surgery longer than 12 hours, and 12.4 +/- 4.8 mm Hg in patients with 12 hours or less (P=0.006). The postoperative 0-, 12-, and 20-hour pressure values were higher in the >1 hour operation time group than in the <= 1 hour group and the differences were statistically significant (P=0.046, 0.016, and 0.032, respectively). Conclusions: In pediatric supracondylar humeral fractures, those who underwent open reduction had higher preoperative and postoperative compartment pressures. The reduction attempt was found to be a factor that increased the compartment pressure and after the operation, the compartment pressure values decrease gradually. Prolonged operative time (>1 h) and increased time from injury to operative fixation (>12 h) were associated with higher compartment pressures.Publication The effect of local anaesthetic on post-operative pain with wound instillation via a catheter for paediatric orthopaedic extremity surgery(British Editorial Soc Bone Joint Surgery, 2011-06-01) Bulut, T.; Yılmazlar, Aysun; Yavaşçaoğlu, Belgin; YAVAŞCAOĞLU, BELGİN; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-4820-2288; 0000-0003-4071-8052; AAG-9356-2021; AAI-7914-2021; ABI-7283-2020Purpose We aimed to investigate the effects on postoperative pain of local anaesthetic administration via a catheter placed into the operation site in patients who were undergoing upper and lower extremity paediatric orthopaedic surgery.Methods In this randomised, double-blind and placebo study, 40 ASA I-II patients aged between 1 and 12 years were randomly allocated into two groups: study group (Group S: 0.2 ml/kg, 0.5% bupivacaine, n = 20) and control group (Group C: 0.2 ml/kg, serum physiologic, n = 20). Before the fascia was closed by the surgical team, the solution previously prepared by the chief nurse was injected into the subfascial soft tissue with the syringe as the "injected dose'' of serum physiologic or bupivacaine. After the closure, 0.2 ml/kg (1 mg/kg) bupivacaine or saline was instillated as the "first instillated dose'' into the surgical area via the catheter. Pain scores were recorded at 0, 1, 2, 4, 8, 12, 24 and 48 h post-operatively. Patients were administered 0.75 mg/kg meperidine intramuscularly post-operatively to equalise the pain scores.Results No statistically significant difference was found between Group S and Group C in terms of demographic and other data and pain scores in the post-anaesthesia care unit, while a statistically significant decrease was found at 2, 4, 8, 12, 24 and 48 h in Group S and at 1, 2 and 4 h in Group C based on pain scores in the post-anaesthesia care unit (P < 0.05). A statistically significant decreasing pain score was found at 4, 8, 12, 24 and 48 h in Group S (P < 0.05).Conclusion The local anaesthetic administered via a catheter implanted in the surgical field may provide long-term and efficient post-operative analgesia.Publication Effect of bone morphogenic protein-2 and desferoxamine on distraction osteogenesis(Elsevier Sci Ltd, 2022-05-25) Kalay, Emre; ERMUTLU, CENK; YENİGÜL, ALİ ERKAN; Yenigül, Ali Erkan; Yalçınkaya, Ulviye; YALÇINKAYA, ÜLVİYE; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-4071-8052; ACP-2755-2022; AFH-1678-2022; ABI-7283-2020; AEQ-5464-2022Background: Angiogenesis is crucial for formation of a stable regenerate during distraction osteogenesis (DO). This experimental study evaluates if bone morphogenic protein-2 (BMP-2) and desferrioxamine (DFO), two agents which are known to induce neoangiogenesis in vivo , would increase angiogenesis and osteogenesis, and improve mechanical properties of bone regenerate in DO model. Methods: Twenty-four tibias of 24 New Zealand rabbits were osteotomized and fixed with semi-circular fixators. Three groups of 8 animals were formed. BMP-2 soaked scaffolds were used in the first group, whereas daily local DFO injections were made in the second group. Subjects in the control group did not receive any agents during the surgery or in the distraction period. The rabbits in all three groups underwent distraction at a rate of 0.6 mm/day for 15 days following the 7-day latent period. Animals were sacrificed on day 38, and the tibia were harvested for histological and mechanical examination of the regenerate. Results: All 24 rabbits survived the surgical procedure, and there were no side effects against the BMP-2 and local DFO. Three-point bending tests revealed a higher force (361 +/- 267 N.) required for fracture in Group 1 ( p : 0.018). Similarly, the bending moment in Group 1 (5.4 +/- 4.0 Nmm) was significantly higher than the other groups ( p : 0.021). There was no significant difference between the groups in terms of deflection and stiffness ( p > 0.05). Histologically, there was no statistical difference between the groups in terms of endochondral, periosteal, and intramembranous ossification and VEGF activity ( p > 0.05). Conclusion: BMP-2 and DFO stimulate angiogenesis by increasing VEGF activity. Angiogenesis is one of the most important mechanisms for the initiation and maintenance of new bone formation. Stimulation of angiogenesis in unfavorable biomechanical conditions may not be sufficient for ideal bone formation.Publication Evaluation of children with arthritis: 9 years retrospectif study(Galenos Yayınevi, 2020-08-01) Yeşil, Edanur; Çelebi, Solmaz; Özcan, Nur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Ermutlu, Cenk; Sarısözen, Bartu; Hacımustafaoğlu, Mustafa; YEŞİL, EDANUR; ÇELEBİ, SOLMAZ; Özcan, Nur; Özer, Arife; TURAN, CANSU; BÜLBÜL, BEYHAN; ERMUTLU, CENK; SARISÖZEN, MEHMET BARTU; HACIMUSTAFAOĞLU, MUSTAFA KEMAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Enfeksiyon Bilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0002-8926-9959; 0000-0003-3146-6391; 0000-0002-5720-1212; 0000-0003-4071-8052; 0000-0003-4646-660X; GSO-3630-2022; AEQ-5464-2022; JCD-9679-2023; ENK-4130-2022; JRU-9977-2023; DLB-3888-2022; IVB-4013-2023; GAX-3172-2022; ABI-7283-2020; CTG-5805-2022INTRODUCTION: The aim of this study was to evaluate the clinical and laboratory findings and treatment responses of patients with arthritis.MATERIALS and METHODS: The medical records of 111 children (0-18 years) were evaluated who were hospitalized with the diagnosis of arthritis between January 2010 and January 2019 retrospectively. The aim of this study was to evaluate the clinical and laboratory findings and to investigate the treatment and prognostic features of the patients.RESULTS: : A total of 111 patients, 66% were male and the mean age was 91+56 (median 83,1-215) months. The most of the patients (n=62,56%) were between 3-10 years of age. Septic arthritis was diagnosed in 60% (n=67) of the patients. This diagnosis was followed by reactive arthritis (10%), juvenile idiopathic arthritis (10%), toxic/transient synovitis (5%) and other arthritis. On admission, there were pain in 96%, joint swelling in 63%, redness in 21%, increased temperature of the joint in 41%, decreased range of motion in 64%, and inability to walk in 38% of the patients. The most frequently involved joints were knee (51%) and hip (35%). The possibility of septic arthritis was significantly higher in patients with high fever (p=0,0001). The response to ibuprofen was higher in non-septic arthritis (p=0,0001). Arthrocentesis was performed in 55% (n=61) of the cases and 34% (n=38) of the patients had underwent intra-articular debridement surgery. Staphylococcus aureus and Streptococcus pyogenes were the most common microorganisms growth in joint fluid culture. When septic arthritis and other arthritis cases were compared, the effusion amount, the amount of fluid taken by puncture were significantly higher and the level of CRP and leukocytes were higher in septic arthritis group (p=0,001;p=0,025;p=0,018;p=0,032,respectively). Osteomyelitis was observed in 19%(n=21) of the cases.CONCLUSIONS: In this study, the probability of septic arthritis was found to be statistically significant in patients with fever, leukocyte>12100/mm(3), CRP>3 mg/dl, and effusion measured 8.5 mm or more by ultrasonography. Also, ibuprofen response was higher in non-septic arthritis group.Publication A comparison of percutaneous and mini-open techniques of Achilles tenotomy: An experimental study in rats(British Editorial Soc Bone Joint Surgery, 2009-12-01) Doğan, Ahmet; Uzumcugil, Onat; Sarısözen, Bartu; Özdemir, Bülent; Akman, Y. Emre; Bozdağ, Ergün; Sunbuloğlu, Emin; Bozkurt, Erol; SARISÖZEN, MEHMET BARTU; ÖZDEMİR, BÜLENT; Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Kliniği; 0000-0003-4071-8052; FVC-9695-2022; ABI-7283-2020Purpose To investigate the effect of Achilles tenotomy performed percutaneously and by mini-open methods on tendon healing and final strength.Materials and methods In two groups, each consisting of 14 rats, percutaneous and mini-open techniques in Achilles tenotomy were compared in terms of biomechanical, histological and gross properties.Results In the gross evaluation, it was observed that an obvious thickening and adhesion to the subcutaneous tissue of the healing tendon were observed in nearly all rats in which the mini-open technique was performed. In the biomechanical analysis, there was no significant difference between percutaneous and mini-open groups and between operated and intact Achilles tendons in both groups, in terms of tendon strength (P > 0.05). In the histological evaluation, irregularity in the parallel pattern of the collagen fibres, emergence of a non-specific collagenous tissue formation and infiltration of mild mononuclear inflammatory cells were reported. These changes were more marked in the rats in which the percutaneous technique was performed.Conclusion Mini-open technique for Achilles tenotomy may be considered as an alternative method of treatment to apply the tenotomy technique in a secure way. Clinical relevance There are two basic advantages of Achilles tenotomy performed by the mini-incision open technique: (1) a complete tenotomy is guaranteed, as it has to be in the original Ponseti technique, (2) iatrogenic neuro-vascular injury risk is nearly completely avoided due to the subparatenon exploration of the tendon and direct visual observation during the transection. The mini-open technique may only be used in cases in which a vascular compromise is clinically suspected or confirmed by Doppler ultrasonography and/or arteriography. On the other hand, the technique may be performed in all cases routinely by the choice of the surgeon.Publication Entrapment of the brachial artery in the cancellous bone in pulseless supracondylar humerus fractures with well-perfused hands: Report of three cases(Turkish Joint Diseases Foundation, 2022-01-01) Ermutlu, Cenk; ERMUTLU, CENK; Sarısözen, Bartu; ATICI, TEOMAN; SARISÖZEN, MEHMET BARTU; Atıcı, Teoman; Durak, Kemal; DURAK, KEMAL; ÇAKAR, ADNAN; Çakar, Adnan; 0000-0001-8259-3695; 0000-0003-4071-8052; ABI-7283-2020Management of pediatric pulseless supracondylar humerus fractures is a point of continuous debate. In this article, we present three cases admitted to the emergency department with pulseless, but well-perfused hands. The fractures were reduced and fixed using the antecubital approach. Prior to reduction, the brachial arteries of all three patients were entrapped in the cancellous bone of the proximal fragment segment. The arteries could only be released after freeing the adventitia by carefully scraping the adjacent bone with the tip of a hemostat. One case required thrombectomy through an arteriotomy using No. 3 Fogarty catheter. In two cases, the pulse returned after a brief period of waiting with no need for vascular intervention. Proceeding with closed reduction, as proposed by the recent guidelines, would result in further damage to the entrapped vasculature, which may go unnoticed due to collateral circulation.Publication Less malunion and shorter bone union time with titanium elastic nail treatment for isolated femoral shaft fractures in three- to six-year-old children(Springernature, 2022-02-18) Eken, Gökay; EKEN, GÖKAY; Ermutlu, Cenk; ERMUTLU, CENK; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Atıcı, Teoman; ATICI, TEOMAN; Çakar, Adnan; DURAK, KEMAL; ÇAKAR, ADNAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.; 0000-0003-4071-8052; 0000-0002-3396-3407; AEQ-5464-2022; ABE-9918-2021Purpose Titanium elastic nail (TEN) is a good option for femoral shaft fractures in school-age children, whereas a spica cast is favored for younger patients. We aimed to compare these treatment modalities in a group of children aged three to six years. Methods 34 patients aged 3-6 years with an isolated closed femoral shaft fracture treated with TEN or one-leg spica cast immobilization were retrospectively assessed. Age, gender, weight, mechanism of injury, hospital stay time, bone union time, radiographic shortening, malunion, and complications were compared between the treatment groups. Results 16 (47.1%) patients who were treated with TEN (Group T) and 18 (52.9%) patients with spica casting (Group S) were included with a mean of 51 (24-94) months follow-up. The mean age was 4.98 years and statistically similar between both groups (mean, 5.2 vs. 4.8 years; p = 0.234). The patients in Group T were heavier (mean, 19.3 vs. 17.2 kg; p < 0.001) and were more likely to have a higher-energy mechanism of injury (p = 0.006). The mean late femoral shortening of Group S patient's was 6.5 +/- 3.5 mm and significantly higher than Group T, which was 2.0 +/- 2.9 (p = 0.050). However, effective late femoral shortening rates were not statistically different between groups (p = 0.347). Malunion was seen in six (33.3%) patients in Group S, whereas none of the patients in Group T had malunion at the last follow-up examination and were statistically different (p = 0.011). Conclusion Our study identified radiographic evidence favoring TEN over spica cast immobilization in treating preschool-age children with an isolated femoral shaft fracture in terms of malunion.Publication Effect of platelet-rich plasma on bone regenerate consolidation in distraction osteogenesis: An experimental study in rabbits(Turkish Assoc Orthopaedics Traumatology, 2022-01-01) Karakayalı, Mehmet; Alpay, Yakup; Sarısözen, Bartu; SARISÖZEN, MEHMET BARTU; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi Anabilim Dalı.; 0000-0003-4071-8052; ABI-7283-2020Objective: The aim of this study was to determine the effect of platelet-rich plasma (PRP) on bone regenerate consolidation in a rabbit model of distraction osteogenesis.Methods: In this study, 12 male New Zealand rabbits weighing 1600 to 2000 g were used. All the rabbits were randomly divided into two groups (n = 6 per group): PRP group and control group. A two-ring, circular external fixator was applied to the right tibia of each rabbit in both groups. After corticotomy, all the tibiae were distracted at a rate of 0.5 mm/day for 20 days. PRP was injected to the osteotomy sites on the 7th, 14th, and 21st days postoperatively. Mineral density of the new bone tissue formed in the distraction zone was measured using quantitative computed tomography in the 3rd, 4th, and 5th weeks. At the end of the 6th week, the animals were sacrificed, and the specimens were evaluated biomechanically and histologically.Results: Microcomputed tomography assessment showed significant bone mineral density increase from the 3rd to the 6th week (62.3% and 43.7% for the PRP and control groups, respectively). In the PRP group, the measurements on the 3rd, 4th, and 5th weeks were 416 +/- 29, 487 +/- 9.9, and 675 +/- 37.8HU (Hounsfield units), respectively, whereas in the control group were 313, 374, and 450 HU, respectively. In the comparison of weekly measurements of the two groups, the increase in bone density in the PRP group was higher than that in the control group (P < 0.001). During the mechanical tests, in the PRP group, the mean torsion was 46.50 degrees and the mean torque 0.53 Nm, while in the control group, the mean torsion was 19.33 degrees and the mean torque 0.65 Nm. The mechanical analysis of the groups revealed significant differences in the mean maximum torsion angles (P = 0.024). The histological examination showed that both groups had external and internal periosteal calli. Callus tissue in four rabbits in the PRP group and two rabbits in the control group was remodeled; normal bone formation occurred and distracted bone ends were completely healed.Conclusion: The results of the present study have indicated that PRP injection can enhance bone regenerate consolidation and increase bone mineral density during the healing process of distraction osteogenesis.