Person:
EROL, BÜLENT

Profile Picture

Email Address

Birth Date

Research Projects

Organizational Units

OrgUnit Logo
Organizational Unit

Job Title

Last Name

EROL

First Name

BÜLENT

Name

Filters

2016 - 201912020 - 20211
Reset filters

Settings

Author: TOPKAR, OSMAN MERT × Subject: MANAGEMENT ×

Search Results

Now showing 1 - 2 of 2
  • Thumbnail Image
    PublicationOpen Access
    Clinical outcomes and complications of surgical interventions for multiple myeloma lesions in the extremities and pelvis: A retrospective clinical study
    (TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2021-04-07) EROL, BÜLENT; Topkar, Osman Mert; Erol, Bulent
    Objective: This study aimed to assess the pain and functional status of patients who underwent various surgical interventions for the stabilization of selected multiple myeloma (MM) lesions in the extremities and pelvis and to investigate the rate of complications requiring reintervention. Methods: Patients with MM who underwent various surgical interventions for the extremity or pelvic lesions were retrospectively reviewed. Change in the pain intensity was assessed using visual analogous scale (VAS) preoperatively, at the time of discharge, and at the final follow-up. Functional status was assessed using the musculoskeletal tumor society (MSTS) scoring system for both upper and lower extremities preoperatively and at the final follow-up. Postoperative complications requiring reintervention, including dislocation, loss of fixation/aseptic loosening of prosthesis, mechanical insufficiency, periprosthetic fracture, infection, or progression of the local disease, were recorded. Results: A total of 49 (20 men and 29 women) previously (23) or newly (26) diagnosed patients with a mean age of 60.8 +/- 18.2 years were included in this study. Of these, 6 patients underwent multiple surgeries for different skeletal sites; in total, 57 procedures were performed. The mean follow-up was 47.7 +/- 21.63 months. The lesions were localized to the humerus (19), radius (1), pelvis (4), femur (30), and tibia (3). The surgical indications included therapy-refractory pain for 17 patients and pathological fractures due to progression of pre-existing lesions for 12 patients or newly diagnosed lesions with extensive bone destruction at initial presentation for 28 patients. Surgical procedures included prosthetic reconstruction in 32 patients, cement-augmented osteosynthesis in 9, and closed intramedullary nailing in 16. The mean VAS score decreased from 8.75 +/- 1.2 preoperatively to 3.21 +/- 1.56 at the time of discharge and 1.2 +/- 0.42 at the final follow-up. Although a significant decrease was detected between the preoperative and postoperative VAS scores at the time of discharge (p=0.0001), the decrease between the time of discharge and the final follow-up was statistically insignificant (p=0.086). The mean MSTS score significantly improved from 9.1%+/- 6.4% (range: 0%-40%) preoperatively to 76%+/- 14.9% (range: 40%-93.3%) at the final follow-up (p=0.0001). Significantly higher MSTS scores were obtained in the upper extremity than lower extremity/pelvis (p=0.04) and in isolated diaphyseal involvement than metaphyseal or articular involvement (p=0.032). A total of 11 complications requiring reintervention (19.2%) were observed, which included dislocation (3.5%), loss of fixation (5.2%), mechanical insufficiency (3.5%), infection (5.2%), and local tumor progression (1.7%). The rate of complications requiring reintervention was lower but statistically insignificant in the upper extremity (5%; 1/20) than lower extremity/pelvis (27%; 10/37) (p=0.076) and in isolated diaphyseal involvement (6.2%; 1/16) than metaphyseal or articular involvement (24.3%; 10/41) (p=0.079). Conclusion: Although different types of surgeries can achieve pain relief and good function in different anatomical localizations, better functional results with lower complication rates may be obtained following surgical management of MM lesions in the upper extremities and in diaphyseal localizations.
  • No Thumbnail Available
    PublicationMetadata only
    Biomechanical determination of the relationship between femoral neck lesion size and the risk of pathological fracture
    (SAGE PUBLICATIONS LTD, 2016) EROL, BÜLENT; Caypinar, Baris; Erol, Bulent; Topkar, Mert; Basci, Onur
    Purpose: Half of the pathological fractures of the proximal femur occur in the neck region. We evaluate the relationship between the defect size within the femoral neck and the risk of pathological fracture. Methods: After creating metastasis-like lesions in the neck regions of 21 human cadaver femurs, compression was applied to simulate single-limp stance type loading. First, a loading of 600 Newtons (N) was applied to the 35%-defected femoral necks. If the bone fracture did not occur, the defect size was increased to 45% and the 600 N force was applied again. If no fracture was observed then the defect size was increased to 55% and the bones were loaded again. The 55%-defected bones with no fractures were loaded until a fracture was detected. Results: There were no fractures with the 35%- and 45%-defected femurs until 600 N was applied. However, when the defect size was increased to 55%, 3 bones were fractured before reaching 600 N. The fractures occurred at an average of 455 N in the 3 bones. At a compression of 600 N, 18 bones (84%) were intact, and the loading was continued. 18 femurs with 55%-defected neck regions had an average endurance of 1270 N compression (range 750-2800 N). Conclusions: This study showed that even very osteoporotic bones with large metastases can withstand high forces of compressive loading.