Araştırmacılar(30)

• Altay, Ridvan
• Ari, Hamza
• Avcı, Berat
• Camurcu, Yalkin
• Can, Muhammet Ali
• Çamurcu, smet Yalkın
• Çelik, Mücahit
• Doğan, Ibrahim
• Gökgöz, Mehmet Burak
• Gönbe, Alper
• Gür, Volkan
• Issin, Ahmet
• Kandefer, Sami
• Karaköse, Reşit
• Koçkara, Nizamettin
• Kuru, Muhammed
• Ozcan, Seckin
• Öztürk, Akın
• Sahin, Vedat
• Saygili, Hakan
• Sezgin, Hicabi
• Sofu, Hakan
• Subasşi, Izzet Özay
• Subaşı, İzzet Özay
• Tanoğglu, Oğguzhan
• Tarduş, İsmail
• Taş, Metin
• Ucpunar, Hanifi
• Yanmaz, Oğuzhan
• Yapıcı, Furkan

• ArticleAçık Erişim2026/r/ebyu/19222
  Diagnostic Performance of the BioFire® Joint Infection Panel in Native Septic Arthritis and Periprosthetic Joint Infection: A Retrospective Diagnostic Accuracy Study

  Gür, Volkan; Akyüz, Sümeyye; Yapici, Furkan; Gülhan, Barış; Doğan, İbrahim; Gökgöz, Mehmet Burak; Ozturk, Akin; Topaluğurlu, Nedim Batuhan; Dündar, Harun

  Objective: Rapid identification of causative microorganisms is essential in suspected native septic arthritis and periprosthetic joint infection. This study evaluated the diagnostic performance of the BioFire® Joint Infection Panel and assessed its agreement with conventional culture and systemic inflammatory biomarkers. Methods: Hospital records from January 2025 to April 2026 were retrospectively reviewed. Of 115 screened patients with suspected joint infection, nine were excluded because BioFire® testing had not been performed and only culture results were available. The final analysis included 106 synovial fluid samples. All samples were tested using conventional culture and the BioFire® Joint Infection Panel during the same clinical episode. Demographic data, infection category, localization, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, and white blood cell count were recorded. Agreement was assessed using Cohen’s kappa, discordance using the McNemar test, and diagnostic performance using culture as the reference method. Results: Sixty-five samples (61.3%) were classified as suspected native septic arthritis and 41 (38.7%) as periprosthetic joint infection. BioFire® was positive in 22 samples (20.8%) and culture was positive in 32 (30.2%). Overall agreement was 86.8%, with substantial agreement according to Cohen’s kappa (0.656). Discordance was significant, predominantly due to culture-positive/BioFire®-negative samples (P = 0.013). BioFire® showed 62.5% sensitivity [95% confidence interval (CI): 43.7-78.9), 97.3% specificity (95% CI: 90.6-99.7), 90.9% positive predictive value, 85.7% negative predictive value, and 86.8% accuracy. C-reactive protein, procalcitonin, and white blood cell counts were significantly higher in patients with suspected native septic arthritis. Conclusion: The BioFire® Joint Infection Panel provides rapid and highly specific microbiological support in suspected joint infection. However, its moderate sensitivity and inability to detect off-panel organisms indicate that it should complement rather than replace conventional culture.

  RDL Kalıcı Kaydıİncele
• ArticleAçık Erişim2026/r/ebyu/19040
  Diagnostic Effectiveness of Ischiofemoral Space and Quadratus Femoris Distance Measurements in Ischiofemoral Impingement Syndrome

  Kızılgöz, Volkan; Sunar, Mukadder; Gökgöz, Mehmet Burak; Kolak, Merve

  Objective: To ascertain whether measurements of the quadratus femoris and ischiofemoral intervals obtained on pelvic magnetic resonance imaging (MRI) examinations are useful for diagnosing ischiofemoral impingement (IFI) syndrome. Methods: MRIs of 178 patients (104 females and 74 males) were reinterpreted bilaterally for signal changes on T2-weighted sequences in the ischiofemoral space (IFS) and quadratus femoris space (QFS), indicating IFI. Receiver operating characteristic (ROC) curves were plotted for each measurement parameter, and the corresponding area under the curve (AUC) values were reported. A P value of less than 0.05 was considered to indicate a significant difference, and the results were assessed at the 95% confidence level. Results: There was no significant difference in age between females and males (P = 0.064). Radiologically, 17.7% of all participants were diagnosed with IFI. Significant differences were observed between IFS and obturator femoris space values by gender, with both values being significantly lower in women. A higher percentage of patients testing positive for IFI was observed in women compared with men. In the ROC analysis conducted according to IFS, the AUC was 0.840. The highest value of sensitivity × specificity was 21.29 mm. The sensitivity at this value was 0.676. The specificity at this value was 0.857. In the ROC analysis using QFS, the AUC was 0.856. The highest value of (sensitivity × specificity) was 16.17 mm. The sensitivity at this value was 0.765. The specificity at this value was 0.794. Conclusion: The results of the current study indicated a significant relationship between the IFS and QFS measurements and IFI. These intervals showed a significant negative correlation with age. This study also identified important cut-off values for IFS and QFS intervals that indicate IFI, with relatively high sensitivity and specificity.

  RDL Kalıcı Kaydıİncele
• ArticleYalnız künye2026/r/ebyu/11331
  The effect of deltoid ligament repair on postoperative outcomes in supination-external rotation type bimalleolar equivalent ankle fractures; [Der Einfluss der Rekonstruktion des Ligamentum Deltoideum auf die Postoperativen Ergebnisse bei bimalleolären Äquivalenzfrakturen des Sprunggelenks vom Typ Supinations-Außenrotation]

  Tarduş, İsmail; Tanoğlu, Oğuzhan; Gökgöz, Mehmet Burak; Gür, Volkan; Subaşı, İzzet Özay

  Objective: This study aims to investigate the effect of deltoid ligament repair on postoperative ankle functional scores in patients treated for supination-external rotation type bimalleolar equivalent ankle fractures. Methods: A retrospective review was conducted on 43 patients (25 males, 18 females) diagnosed with supination-external rotation type fractures and deltoid ligament rupture between 2015 and 2022. All patients underwent open reduction and internal fixation of the lateral malleolus and syndesmotic fixation. The cohort was divided into two groups: Group 1 (n = 17) performed additional deltoid ligament repair, while Group 2 (n = 26) did not. Clinical and functional outcomes were assessed using the American Orthopedic Foot & Ankle Society score, Olerud-Molander Ankle Score, and Visual Analog Scale with a minimum follow-up of 12 months. Results: The study revealed no statistically significant differences between the two groups regarding American Orthopedic Foot & Ankle Society (p = 0,53), Olerud-Molander Ankle (p = 0,29), or Visual Analog Scale (p = 0,29) scores. Additionally, no significant differences were observed in terms of hospitalization time, duration of splinting, time to full weight-bearing, or total follow-up duration. Conclusion: Deltoid ligament repair does not provide a statistically significant benefit to functional recovery in bimalleolar equivalent fractures. However, deltoid ligament repair may be considered as an additional intervention for bimalleolar equivalent fractures in selected cases. 10.1016/j.fuspru.2026.08.001

  RDL Kalıcı Kaydıİncele
• Review ArticleYayıncıda açık erişim2026/r/ebyu/10903
  Who Is the Surgeon Now: Human Hands or Machine Minds? Artificial Intelligence in Orthopedics from Diagnosis to Follow-Up—A Structured Narrative Review

  Yapıcı, Furkan

  Background: Artificial intelligence (AI) is transitioning from proof-of-concept prototypes to clinically utilized tools in orthopedics. The key translational question is whether AI will replace surgeons or, more realistically, augment human expertise. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Web of Science, and Google Scholar (completed 31 January 2026). Peer-reviewed English-language studies that utilized AI for orthopedic clinical problems were eligible. To synthesize the 73 included papers without forced quantitative pooling, evidence was qualitatively charted and organized using a four-axis framework: clinical task, data modality, validation maturity, and intended user/setting. Results: The evidence base was dominated by retrospective, imaging-centered AI studies (predominantly LOE III). Radiograph-based fracture detection and automated measurements were frequently reported to achieve high discrimination, though performance degraded in complex or “edge” cases. Predictive models for arthroplasty and spine outcomes demonstrated variable actionability and inconsistent reporting of calibration. Common translational barriers across subspecialties included limited external validation, dataset shift, and a scarcity of prospective impact studies. Conclusions: Current evidence supports an augmentation paradigm rather than a replacement paradigm. AI acts as a “co-surgeon,” improving triage and standardizing quantification. However, safe clinical translation requires representative external validation, rigorous failure analysis, and human-in-the-loop workflows where surgeons retain ultimate accountability.

  RDL Kalıcı Kaydıİncele
• ArticleYayıncıda açık erişim2026/r/ebyu/10877
  MRI-Derived Scapular Superomedial Angle and Acromial Morphology: A Retrospective Cross-Sectional Reliability and Morphometric Association Study

  Kandefer, Sami; Gür, Volkan; Gökgöz, Mehmet Burak; Can, Muhammet Ali; Taş, Metin; Memiş, Kemal Buğra; Kantarcı, Mecit; Koçkara, Nizamettin; Yapıcı, Furkan

  Background/Objectives: The magnetic resonance imaging (MRI)-derived scapular superomedial angle (SMA) may serve as a continuous descriptor of scapular geometry. We evaluated whether SMA is associated with acromial morphology, examined SMA and subacromial space (SAS) across acromial categories, and quantified measurement reliability. Methods: In this retrospective cross-sectional study, 306 shoulders from 279 patients (27 bilateral) were analyzed after screening 353 examinations. SMA and SAS were measured independently by two orthopedic observers, and acromial morphology was classified independently by two radiologists, all in blinded sessions. Reliability, group comparisons, receiver operating characteristic (ROC) analyses, and patient-level clustered generalized estimating equations were performed. Results: Interobserver reliability was excellent for SMA (intraclass correlation coefficient [ICC], 0.960) and SAS (ICC, 0.926), and intraobserver reliability was excellent for SMA and good for SAS (ICC, 0.944 and 0.848); acromial classification agreement was almost perfect (linear-weighted kappa, 0.980). SMA increased stepwise across Type I to III acromia (128.7°, 133.9°, 137.2°; p < 0.001), whereas SAS decreased (7.5, 6.8, 6.3 mm; p < 0.001). Each 1° SMA increase was independently associated with Type III morphology (adjusted odds ratio, 1.18; p < 0.001). SMA was not independently associated with rotator-cuff severity (p = 0.842). Because adjacent Type II–III differences approached the minimum detectable change, individual-level discrimination was limited. Conclusions: MRI-derived SMA is a reproducible descriptor associated with acromial morphology at the group level, but adjacent-category differences approached measurement error. SMA should not substitute for direct acromial classification, and external validation is required before clinical thresholds are considered.

  RDL Kalıcı Kaydıİncele
• ArticleAçık Erişim2026/r/ebyu/10845
  Internal-locking intramedullary nails (talons, claws, wings, wedge-locks, endopins): a mechanics-guided scoping review of designs, failure signatures, and technique imperatives

  Yapici, Furkan

  BACKGROUND: "Internal-locking" concepts-deployable talons/claws and tanged anchors, winged/wedge-wing head elements, blade-expandable and wedge-locked distal modules, inside-to-out internal distal locking pins (endopins), and shape-memory (nitinol) wings-aim to streamline intramedullary (IM) fixation by reducing reliance on freehand distal interlocking screws while maintaining stability. METHODS: A scoping, mechanics-informed review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (January 1980-October 2025; last search October 25, 2025). Studies evaluating intramedullary systems with internal-locking mechanisms for the humeral shaft/diaphysis, hip (intertrochanteric, basicervical, or subtrochanteric), femoral shaft/distal femur, tibia, fibula, clavicle, and selected pelvic/foot indications were eligible. Bench/FEA, cadaveric, clinical (comparative and single-arm), technique, and health-economic reports were included. For human clinical studies, English-language full texts were eligible; during revision, non-English full texts with an English abstract and extractable outcome data were re-evaluated. Screening was performed by a single reviewer, and data were charted by anatomic pattern, key technique covariates (reduction quality, central-inferior head position, tip-apex distance [TAD]), outcomes, and complications. Sixty-three sources of evidence met eligibility criteria and were charted; details are compiled in Supplementary Table S1 (Master Evidence Table). The remaining 10 references are background/methodological or definitional citations-for example, foundational work informing technique covariates such as tip-apex distance (TAD) and calcar-referenced metrics (e.g., Calcar-TAD)-and therefore are not listed or appraised in the supplementary evidence tables. RESULTS: For the humeral shaft, internal distal-locking strategies reduce the distal-targeting burden of antegrade nailing and may shorten surgery while avoiding an additional distal incision, but outcomes remain strongly technique-dependent. Historical Seidel data and more recent humeral internal-locking series suggest that the main risks are rotational instability, technical locking failure, proximal hardware-related symptoms, and shoulder morbidity rather than the distal mechanism alone. Bench and cadaveric studies indicate that inferior subchondral deployment of talons increases torsional resistance (~ 2-3×) and interfragmentary compression (~ 2×) versus retracted configurations, providing a plausible basis for reduced lag-element sliding when TAD is 15-25 mm and the head element is central-inferior. Finite-element models suggest that wedge-locked constructs can approximate screw-locked axial/torsional stiffness when deployment torque and friction are adequate, albeit with stress concentrations near the locking windows. Clinically, in geriatric intertrochanteric fractures, union and functional outcomes are generally similar among talon-equipped, helical-blade, and dual-screw cephalomedullary nails when reduction/TAD are optimized; internal-locking designs are often associated with shorter operative and fluoroscopy times, and distal talon locking has been reported to be associated with lower cutout in unstable patterns. In femoral/tibial shafts, internal distal locking shortens procedures and radiation without consistent union penalties, although simple diaphyseal patterns distal to the isthmus show a greater risk of axial shortening/malrotation without adjuncts. In the fibula and clavicle, modern intramedullary systems achieve high union rates (~ 98-100%) with low wound morbidity; in benchtop/synthetic models, talon screws have reproduced plating-like axial stiffness while remaining torsionally inferior. Early health-economic signals suggest the potential cost-effectiveness of talon-locking constructs. CONCLUSIONS: Across indications, operative technique remains the dominant determinant of outcome; thoughtfully selected internal locking mechanisms can deliver efficiency and soft tissue advantages without compromising stability when fundamentals (reduction quality, central-inferior head position, TAD 15-25 mm) are respected. A practical taxonomy and decision framework are proposed, along with priorities for pattern-stratified comparative trials and engineering refinements.

  RDL Kalıcı Kaydıİncele
• ArticleYayıncıda açık erişim2026/r/ebyu/10766
  Preoperative Geriatric Nutritional Risk Index (GNRI) and Comorbidity Burden as Mortality Risk Markers After Proximal Femoral Nailing in Older Patients with Pertrochanteric Hip Fractures

  Gökgöz, Mehmet Burak; Kahraman, Hamit Çağlayan; Gür, Volkan; Öztürk, Akın; Doğan, İbrahim; Gönbe, Alper; Avcı, Berat; Koçkara, Nizamettin; Sofu, Hakan; Yapıcı, Furkan

  Background: Mortality after geriatric hip-fracture surgery remains substantial. This study evaluated whether preoperative GNRI, comorbidity burden, and CBC-derived inflammatory indices were associated with one-year and long-term mortality after PFN for pertrochanteric/intertrochanteric fractures. Methods: In this single-centre retrospective cohort study of prognostic risk markers, 248 PFN records were screened. After excluding six incomplete records and 25 patients aged <65 years, 217 older fracture/surgical episodes formed the time-to-event cohort; 194 were evaluable for binary one-year mortality. Living patients/episodes with <365 days of follow-up were censored in survival analyses. Logistic and Cox models were supported by Firth penalized logistic regression, calibration assessment, and internal validation. Results: Median age was 82 years, 65.0% were female, and 68.7% were ASA III–IV. Overall, 96/217 (44.2%) died during median follow-up of 570 days. Thirty-day, 90-day, and one-year evaluable mortality were 7.4%, 15.2%, and 27.3%. GNRI < 82 identified a small high-risk subgroup: 10/13 evaluable patients/episodes (76.9%) died within one year versus 43/181 (23.8%) with GNRI ≥ 82. GNRI < 82 remained associated with one-year mortality in adjusted logistic regression, although with a wide confidence interval due to sparse subgroup size (OR 6.43, 95% CI 1.50–27.55; p = 0.012), and in Firth penalized sensitivity analysis (OR 5.51, 95% CI 1.34–22.61; p = 0.018). In Cox analysis, age, ASA III–IV, available Charlson-domain comorbidity burden, and lower continuous GNRI were associated with long-term mortality, whereas adding GNRI < 82 and NLR did not materially improve cross-validated discrimination. Conclusions: GNRI < 82 identified a small subgroup with high observed mortality after PFN. Because the subgroup was sparse and biomarker addition did not materially improve internally validated discrimination, GNRI should be treated as an alerting clinical flag rather than a stand-alone basis for patient-level risk prediction. External validation is required.

  RDL Kalıcı Kaydıİncele
• ArticleAçık Erişim2026/r/ebyu/10758
  Is bone mineral density a risk factor for femoral stem subsidence in primary cementless total hip arthroplasty: a prospective study

  Kalyenci, Ahmet Sinan; Dogan, Ibrahim; Tekin, Saltuk Bugra; Ozmen, Zana; Senel, Ahmet; Ozturkmen, Yusuf

  Background: The success of primary total hip arthroplasty (THA) in patiens with primary osteoarthritis (OA) of the hip is significantly influenced by stem osseointegration, migration and implantation. Additionally, the bone mineral density (BMD) of the proximal femur, the femoral morphology and stem design play important roles in these outcomes. This study aimed to evaluate the effect of BMD on subsidence who underwent primary cementless THA with a fit-and-fill stem design for primary OA of the hip, assuming that subsidence is not influenced by BMD. Methods: This prospective study included 72 hips from 67 patients who underwent primary cementless THA for OA between May 2019 and March 2022. Two patients were excluded due to intraoperative complications, and the final analysis was conducted on 70 hips. Patients were grouped according to preoperative BMD and proximal femur anatomy based on Dorr classification. Harris Hip Score (HHS), radiological subsidence and Engh score values ​​were used for postoperative clinical evaluation. Results: The mean age was 65.99 ± 8.10 years (range 52 to 83 years). The mean follow-up was 24.6 ± 5.8 months (range, 12 to 34 months). Amongst 70 OA of the hip cases, 22 (31.43%) were Dorr type A, 44 (62.86%) type B, and 4 (5.71%) type C. Forty-three patients (61.43%) had normal BMD, while 27 patients (38.57%) were osteopenic or osteoporotic. The mean axial migration at the latest follow-up was 1.04 ± 0.69 mm (range 0 to 3.1 mm). Total Engh score was 22.89 ± 3.28 (range 14 to 27), and in terms of stabilization bone ingrowth was seen in all of the femoral stems. There was no statistically significant effect of femoral T-score levels (p = 0.853) or femoral morphologies (p = 0.763) on femoral stem subsidence. Conclusions: No statistically significant differences were observed in clinical or radiological outcomes between patients with normal and low BMD. These findings suggest that early stem migration and osseointegration are more closely related to initial mechanical stability than to BMD. Cementless femoral stems can therefore be considered reliable across different bone qualities, offering an innovative perspective that challenges the conventional emphasis on bone density in implant selection.

  RDL Kalıcı Kaydıİncele
• Review ArticleYayıncıda açık erişim2026/r/ebyu/10746
  High Tibial Osteotomy (HTO) Versus Unicompartmental Knee Arthroplasty (UKA) in Medial-Compartment Knee Osteoarthritis (KOA): A Critical Narrative Review of Comparative Costs and Cost-Effectiveness

  Yapıcı, Furkan

  Background: Medial-compartment knee osteoarthritis (KOA) carries substantial disability and long-term cost. High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are key joint-preserving or joint-replacing options for selected patients, but their comparative economic ranking remains uncertain. Methods: This critical narrative review synthesized comparative economic evidence on HTO versus UKA for isolated medial-compartment KOA. PubMed and Web of Science were searched as primary sources for English-language studies published from 1 January 2000 to 15 January 2026, while Google Scholar and citation tracking were used supplementarily to identify potentially missed records. Eligible studies were direct economic evaluations or comparative cost/resource studies with clear decision relevance to the HTO–UKA choice. Burden and cost-of-illness studies were used for contextual framing only and were not included in the core comparative synthesis. Results: The direct evidence base was small and methodologically heterogeneous and was dominated by decision-analytic models that differed in perspective, time horizon, utility metric, and assumptions regarding reoperation, revision, and conversion to total knee arthroplasty (TKA). These structural differences largely explain why a U.S. lifetime societal model favored HTO, a UK age-stratified 10-year model produced age-dependent findings, and a recent Canadian public-payer model favored UKA. Observational studies suggest that UKA episode costs can fall substantially in outpatient or ambulatory pathways, whereas HTO costs may rise when reoperations and technique-specific resource use are explicitly captured. Conclusions: Current evidence does not support a context-free economic ranking of HTO and UKA. Because the available studies are heterogeneous and incremental utility differences are often small, the findings should be interpreted cautiously and as scenario-dependent rather than definitive. Future comparative analyses should use contemporary pathway data, transparent and standardized costing, and explicit downstream event definitions for both procedures.

  RDL Kalıcı Kaydıİncele
• ArticleYayıncıda açık erişim2026/r/ebyu/10690
  Lower Trochlear Facet Asymmetry Ratio Is Associated with Objective Patellar Instability in a Retrospective MRI Case-Control Study with Patella Alta-Positive Controls

  Kuru, Muhammed; Koçkara, Nizamettin; Gökgöz, Mehmet Burak; Gür, Volkan; Yapıcı, Furkan

  Background/Objectives: Because patella alta frequently accompanies objective patellar instability, separating trochlear morphology from patellar height is difficult. We evaluated whether the trochlear facet asymmetry ratio was associated with instability among knees with patella alta. Methods: This retrospective case-control MRI study included 123 knees: 43 with objective patellar instability, 43 normal-height controls, and 37 patella alta-positive controls without instability identified by re-screening the eligible control pool. Nine morphologic parameters were measured. The primary analysis compared the instability group with patella alta-positive controls; a supportive analysis used the full cohort. Results: The facet asymmetry ratio showed a graded pattern across groups (instability, 42.7 ± 12.4%; patella alta-positive controls, 59.2 ± 10.7%; normal-height controls, 70.3 ± 11.4%; p < 0.001). In the primary comparison, it had the highest observed apparent area under the curve (0.855), although its confidence interval overlapped with those of quantitative trochlear depth and tibial tubercle-trochlear groove (TT-TG) distance; the Insall–Salvati ratio showed weaker discrimination (0.679). After adjustment for the Insall–Salvati ratio and age, a lower facet asymmetry ratio remained associated with instability (odds ratio per 1-percentage-point increase, 0.903; 95% confidence interval, 0.854–0.956; p < 0.001). This association was attenuated after additional adjustment for quantitative trochlear depth or for tibial tubercle-trochlear groove distance together with Wiberg type. Interobserver reliability was excellent (intraclass correlation coefficient, 0.994). Conclusions: In this selected cohort, a lower trochlear facet asymmetry ratio was associated with objective patellar instability after adjustment for patellar height and age. The internally derived 49% threshold is exploratory and requires external validation before clinical use.

  RDL Kalıcı Kaydıİncele